Thursday, October 18, 2007

The benefits of depression - on a social scale

Individual depression may have a benefit to the herd. If so, it may be hard-wired into our genes nd our social structures that reflect our genes as a preserved trait, and that changes how to treat it.

All organisms and organizations need immune systems to detect invaders or parts of themselves that have gone astray, so they can be marked for removal and eliminated.

In the body, one troublesome situation is that some cells or pathogens may get off into a corner, or inside a bone, or up against a steel plate, where they are hard to be evaluated and attacked, so they multiply. Another may be that they no longer recognize the authority of the body, and go off on their own doing something else. But, evolution has come up with one clever solution to this problem - namely, apoptosis or "cell suicide."

If a cell is removed from active, productive, working connection with the body, it is programmed to kill itself. It doesn't need to be found by the body's police force - it finds itself. No castle or moat or steel wall or bone can protect it, because the destruct system is already built in.

It may be than that evolution has similarly built in an "auto-braking" system into human physiology, so that, when a human becomes disconnected from productive interaction with the social body, the human slows to a stop and then shuts himself down.

This results in resources flowing primarily to social members still able to act energetically and confidently. Over time, those who care about interactions with the social body end up dominating the scene. (sources of "altruism"?).

But, what's that model say about treatment of depression?

First, it says that depression is a symptom, not a cause - and so treating depression with drugs to "cure it", while immediately helpful personally, from the social body's perspective is a bad idea -- in that it means that socially discordant individuals will continue to act badly and absorb energy and resources, and, if left unchecked in large scale, eventually the social body will die from a loss of cohesion and trying to carry the burden of all this non-productive tissue.

Second, it would mean that "depression" is not, in fact, a pathology - it is a very healthy normal response of a subsystem of the social body to a disconnection event. From a social point of view, it's good. In fact, the whole terrorist "problem" and the corruption "problem" could be viewed as precisely a breakdown in such a system: people who have turned against the social body should, many people would assert, self-destruct so we don't have to go to the very hard work of trying to destroy them ourselves. That would be very efficient if they'd just get really really depressed, then suicidal. It would be way more efficient than trying to locate them in caves somewhere on earth.

But, it brings to focus a different problem. If we use that model, then why is it that we now are looking at 20 or 30% of the US population that is depressed? And, have all these people broken the connection with the social body, or did the social body break the connection with them, or both in some sort of vicious circle? It may be that the cost of health care is rising because the body of the public is, in fact, becoming unwell. And, again, this may be a symptom not a cause, and masking it with drugs would be "quackery" - treating symptoms while the disease grows worse.

Well, the work of Robert Putnam ("Bowling Alone") and the Duke study (mentioned in myprior post on depression) would seem to indicate that connections are, in fact, deteriorating and rather rapidly. That begs the question of why this is happening, or how.

One possible hypothesis would be that the culture of materialism and self-centeredness, sustained and amplified by television, is causing people one by one to abandon their concern for society and become increasingly self-oriented, which is triggering the hard-wired fatigue and depression responses. The trend towards "Me first" or "Only me, forget you, Jack" is evident and widely discussed in the media.

Another possible hypothesis is that, collectively, whole groups of people, such as the rich or middle class, have turned their backs on and abandoned the poor, the 45 million without health coverage, the jobless, etc. This could cut both ways, both by making the ones cut-off from social life become increasingly depressed or anxious, and by making those who are doing the cutting-off also depressed, because they are losing the other end of the social connection.

In other words, class-ism and racism ultimately do as much harm to the holder of the destructive bigotry as to the group on the receiving end -- it just takes longer. That would predict that even some of the very rich - say Britney Spears or Paris Hilton, would end up extraordinarily unhappy. That's not proof, but it illustrates the point. Britney lost custody of her children to get what? Another drink?

There is a long literature on the harmful effects on the rich and powerful of exploiting, or neglecting the poor and the [apparently] powerless. By this herd model, the powerless actually have their own protection built into the DNA of the powerful, where it can and will be triggered as the powerful cut ties to the powerless.

This is certainly a core lesson of many religions of the world. "Do unto others as you would have them do unto you." The model seems to say that no "enforcement by an angry God" is necessary in fact - that the downstream result of the action of discrimination and superiority culture, both individually and overall, follows automatically from the action, and returns the favor, with interest.

So, if we boost the world, it will echo with amplification, and we will be boosted, and that becomes a self-climbing loop or spiral. If we cut off the links to the world, the world cuts off its links to us, which, surprisingly, we needed to continue to exist. If we actively exploit the outside world (think sub-prime mortgages) it will come back tremendously amplified and damage those who thought they could "get away with it."

This would imply that the same feedback mechanism and pattern might be true for cells, for individuals, for companies, and for entire nations or cultures.

For a company-sized organism, though, I've discussed the need for the "horizontal loop", the living feedback that Toyota calls "pull" that connects the company to the customers. Breaking this loop, as Comcast is described to be doing by many customers in today's Washington Post, may appear in the short run to be "working" and making more money than caring what customers think, but this model says that the resentment and social response is just building up steam and ultimately will come back with amplification.

It's a fairly simple model, but it seems to explain a lot of what we see going on around us. These "scale-invariant" patterns seem important to investigate to see if they hold up under more rigorous investigation. If so, we have some public policy and public health decisions we may want to rethink.

Religion and commerce (the Toyota Way) suggest the model, and system dynamics simulations show that some feedback with delay and amplification like this may be very hard to detect coming until it is too late. As with the Georges Bank model we ran in class, as the sustainable limit is passed and use turns into abuse, the fishing just seems to get better and better and the catch keeps rising as the fishermen build more boats until one day it is exhausted and it's simply over. We've depleted it entirely. The rising exponential plummets to zero.

There are almost no blatant clues this is happening. You have to understand what is going on to "see" it and realize it.

But it's up to Science now to take that suggested model and design careful experiments to test whether this is just an interesting analogy or the handle to some basic principle like gravity that we need to pay attention to. If the NIH or Business Roundtable won't fund it, maybe the John Templeton foundation will. Maybe a business "depression" bears more than a passing resemblance to a larger version of an individual "depresison."

Actually, MIT's John Sterman in his 1000 page textbook "Business Dynamics" lays out exactly how trying to push a company to grow too fast results in an apparent speed-up of profits, followed by a drop or crash, depending on exactly how it went. That implies that the villains of the corporate growth story are the stockholders themselves, from venture capitalists who demand 37% growth per year, to e-traders who chase the smallest fraction of a percent of a rate, punishing any CEO who pauses for breath or needed consolidation.

It also is a lesson for China, one that it is increasingly realizing, that growing too fast can be as much of a problem as not growing fast enough. Living things have natural growth rates, and we don't gain by trying to push them to do unnatural acts.

There's nothing wrong with wealth and prosperity, but vastly unequal and unjust accumulation of wealth by taking it instead of earning it does seem to lead to a "correction" that undoes all of the apparent progress and then some. Short-term greed is a very expensive pleasure, for it quickly becomes the long-run, and the bills come due. Without a deep keel, a culture and a social ethic that can hold off that temptation to maximize short-term gains, we can easily be led astray.

It's time to fund that research and let the data speak for itself. A reasonable search for counter-examples and contrary evidence is required. All models are wrong but some models are useful - so maybe this has merit regardless.

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