Reproductive Postponement and Human Depression

Discussion

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From the preceding analysis, it follows that human depression should be treated clinically as a manifestation of a reproductive postponement state.

The reader may ask, "Why not simply cure depression by blocking activity of the adrenal cortex and stimulating production of gonadal hormones?" However, such therapy in isolation might not be advisable.

We know from the study of other dramatic hormonal shifts in the human life history that social factors are more important in humans than are the internal hormonal factors. For example, the profound hormonal shift of menopause is very debilitating in some cultures, but is relatively unimportant in other cultures where there is social support for the menopausal woman (32). Similarly, the profound hormonal shifts following parturition in women may lead to depression if there is no social support, or may be of little consequence if the social situation, both past and present, gives support and assistance (33).

There would be little value in simple hormone therapy if the depressed patient, temporarily "cured" by hormones, were then returned to the same social situation where social stress produced the reproductive postponement state in the first place. In fact, if the patient were a woman and she became pregnant under such stressful conditions, it is possible that the baby could not be cared for properly. Reproductive postponement, in such situations, is adaptive in humans just as it is in other animals.

Furthermore, there are other effects of depression that both cause and are caused by the decreased social motivation of the patient and that are not directly affected by hormones. A depressed person, with decreased motivation, is likely to have lost a job, a marriage, and friendships, and may have turned to alcohol, anti-social, or suicidal behavior, and these problems, as well as the hormonal state, would need to be treated in order to "cure" the patient.

Isolation of the depressed patient is contra-indicated by the theory of reproductive postponement. We know, from animal studies, that the triggering stimuli for the courtship reproductive state, which is the state of recovery following a reproductive postponement state, consist of stimuli from interactions with other reproductively active individuals. To isolate the depressed patient, as if they had a contagious disease, can only serve to prolong the problem.

By recognizing depression as; the human homologue of an adaptive mammalian behavioral system, the reproductive postponement state, it should be possible to devise more effective therapies in the future. Such therapies should include alteration of the hormonal balance, provision of appropriate positive social stimuli, and correction of the causal conditions of social stress. They should recognize that the reproductive postponement state has adaptive, as well as "pathological" aspects under various conditions.