Depression: epidemic or pseudo-epidemic?

Abstract

D Summerfield (March 2006 JRSM1) reports that the epidemiology of depression is difficult as emotion is understood differently in Eastern and Western cultures. Emotion is a word that presents difficulty for us all. The Concise Oxford Dictionary records the word emotion as originating in the 16th century replacing the older word passion and that it is from the French emouvoir, to excite. The taxonomy of emotions presents many difficulties; in 1872 Darwin2 wrote only of emotional expression in man and animals. Shand in 18693 noted that sentiments were groups of emotions dependant on the environment. If one loved a person and something good happened to them, one was happy; if something adverse occurred, sadness resulted. A further refinement was suggested by McDougall,4 who in 1905 stated that moods were a tendency to primary emotion, e.g. rage or fear. Much was written in the 20th century about the lmbic system and emotion. Attempts were also made to divide emotions into primary, blended and derived—the latter are not shared with animals as they are constructed by cognitive functions. A current view has been expressed by Carpenter,5 who suggests that there are two basic emotions in man and animal—arousal and withdrawal. Arousal is associated with'fight or flight' and the sympathetic system: withdrawal is associated with a range of depressive states. It seems that human behaviour, as with other sciences, needs its own specific—a subject discussed by C P Snow (The Two Cultures. Cambridge University Press).