Dr. Stuart Jeanne Bramhall Says Depression is a Community Problem, Not a Disease

The mainstream medical and psychological communities claim depression is a genetic disease, but Dr. Stuart Jeanne Bramhall disputes this. She argues that human beings are hard-wired for communal living. As financial necessity and cultural shifts isolate us from our community, she believes this is the true cause of clinical depression.

It’s a controversial claim, but Stuart is no stranger to controversy. She is a child and adolescent psychologist, but she is also a social activist. In The Most Revolutionary Act: Memoir of an American Refugee, she details how she was “bullied” (to say the least) by US intelligence agencies.

Stuart’s political leanings are obvious, but they do nothing to derail her desire to back up claims with empirical evidence. Her argument for the true origins of clinical depression is hard to disagree with.

The Interview

I’m excited to speak with you, Stuart. Thanks for the opportunity.

Okay, let’s get started. Much of modern psychology focuses on improving self-esteem. Supposedly, we’re supposed to be able to solve our own psychological problems just by improving our own self-image, or by treating the problem with drugs. We should be capable of achieving “self-actualization” in complete isolation. But you’re arguing something else.

Yes. At present the conventional wisdom is that clinical depression is a genetic disorder resulting in a deficiency of serotonin and other neurotransmitters that are needed to maintain mood stability. I dispute this theory, mainly because there is no evidence whatsoever of biochemically caused depression in any other mammals.

I feel there is much stronger evidence that the extremely high incidence of depression in the US stems partly from the appalling American diet, which is deficient in essential nutrients (with Omega 3 and Vitamin D being the most common), and partly from the total breakdown of traditional community life. In my clinical experience, this decline in civic engagement is a far bigger factor than diet.

This argument reminds me of an evolutionary psychologist named Robin Dunbar, who argues that the human brain may have evolved precisely so that humans could band together into larger groups, which gave them a survival advantage. He puts the limit on this number at 150 people. Beyond that you start requiring hierarchical organization. I’d like to hear more about this.

Actually evolutionary selection for group living started much farther back than our first human ancestors. Most higher primates – for example chimpanzees, gorillas and orangutans – live in social groups. And research shows clearly that, with the exception of the speech area and the frontal lobe (which is responsible for higher intellectual functions), the human brain is remarkably similar to that of great apes.

I absolutely agree with the 150 number Dunbar came up with, which is larger than the social groups of great apes. With chimpanzees, the maximum size of a social group is 50. However I don’t think we have enough research data to determine whether the increased group size with human beings is due to evolutionary change – or if they were simply able to accommodate a larger group size owing to their greater intelligence.

Yes, individual evolutionary theories are notoriously difficult to test. In any case, it’s clear that we are wired to live in relatively large social groups. It’s interesting to me how little we hear about this aspect of life. Whether speaking with a psychotherapist, reading a self-help book, or watching a movie, this aspect of fulfillment receives almost no lip service. It seems to me like we’re expected to achieve fulfillment only through romantic love, financial success, and introspective self-love. Why do you think this is?

The problem, in my view, is that citizens of western democracies are constantly bombarded with messages via the mainstream media (movies, TV, magazines, even newspapers) that they can only achieve fulfillment through romantic love, financial success, and what you call introspective self-love. I see it more as an extreme self-centeredness, and a sense of entitlement. In fact, it’s the motto of a major cosmetics manufacturer: “You’re worth it.”

Australian psychologist Alex Carey was the first to study the history of the American public relations industry, and to look at the profound effect of this constant psychological messaging on American thinking and social behavior. Sigmund Freud’s nephew Edward Bernays is considered the father of public relations. He got his start in 1914 when Woodrow Wilson hired him to produce propaganda to convince Americans that the US needed to enter World War I. Carey’s work was published posthumously in a 1997 book called Taking the Risk Out of Democracy: Corporate Propaganda versus Freedom and Liberty.

I suppose our economic system requires this in order to prevent us from spending too much time doing “unproductive” work like raising families and building communities.

Okay. Let’s talk a little about what’s happening from a biochemical standpoint. How is social engagement tied to neurochemical activity?

We have the most information about various hormones that reward social interaction by creating a “feel good” sensation. Oxytocin is the one that is most studied – possibly because a liquid containing oxytocin is being marketed as a nasal spray, called Liquid Trust. It’s a potential treatment for children with autism and Asperger’s Disorder.

Oxytocin has been dubbed the “bonding” hormone, as a result of animal experiments in which males become super attentive to their young following treatment with oxytocin. High oxytocin levels in human beings seem to stimulate bonding and group loyalty. The reverse is also true. Various group activities elevate peoples’ mood by increasing their oxytocin levels.

Endorphins, which are also “feel good” opiate-like substances produced within the brain, are also increased by social and group activity.

There are also “feel good” neurotransmitters – specifically dopamine, norepinephrine and serotonin, that are increased by social activity. Antidepressants are also designed to increase these biochemicals. However, their link to social behavior hasn’t received very much study.

I’d be interested to see what the results would be if such a study were conducted. You’ve mentioned that lab animals are sometimes put into a state of depression by placing them in isolation. This is done to test the effectiveness of antidepressants. You’ve also noted that when prisoners are placed into isolation, it is reported to be even more devastating than beatings.

I am also very keen to see more research into the effect of social interaction on hormones and neurotransmitters. However, I think it’s very unlikely to happen so long as most of our medical research is dominated by drug companies. Obviously they have no incentive to fund non-drug treatments for depression.

Social activity is also strongly affected by mirror neurons. These are special nerves that are activated when one animal observes another performing a specific action. In lower animals they are essential for learning new skills. In human beings, it’s thought they make it possible to make inferences about another person’s mental state. This is how we develop empathy.

That’s a subject I found very intriguing when I first heard about it. Undoubtedly it has something to do with our ability to understand how other people are thinking and feeling, which is vital for effective community living. I’ve heard that there are even some people who suffer from a special kind of synesthesia that effects the mirror neurons, causing them to literally feel the pain that others are going through.

I included mirror neurons as an example of how human beings are hard wired to be a social species. With hormones and neurotransmitters, clear “feel good” reward mechanisms have been identified. Based on my clinical experience, I think people who are socially isolated miss out on the little hits of oxytocin, endorphins, and dopamine that most people need to maintain a stable mood. Mirror neurons have only recently been discovered, and we don’t really know whether they are connected to these biochemical reward systems.

I would be interested to see if they were. Either way, it’s clear evidence that the human brain is built to understand the motives and emotions of the people around them.

Okay. The basis of this argument is that the increase in depression is tied to a decrease in community activity. Why do you think we are seeing this trend away from a sense of community?

Both Ralph Nader and Harvard political science professor Robert Putnam have written extensively about the decline of what they call “civic engagement.” They both relate this mainly to the decline of social and community organizations – churches, unions, community and service organizations, granges, etc – that traditionally have been an essential part of American society.

They both blame it mainly on increasing work demands in the US. In most families, both parents work now, and Americans work more hours per week and more weeks per year than any other nationality. They’re too exhausted at night to do anything but flop in front of the TV.

Nader is also concerned – and I share his concerns – about Americans being constantly bombarded by corporate media messages that drive home the idea that they are primarily individuals and consumers, rather than citizens and interdependent members of a community. Nader calls it growing up “corporate,” rather than growing up “civic” like our parents and grandparents.

Unfortunately, I think he’s right. Most of the people I work with believe their problems stem from individual shortcomings, and that it’s on them as individuals to solve them. It no longer occurs to people that some of their unhappiness might stem from social problems that the community as a whole needs to address.

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