Letters to the Editor |

Clinical Depression Is a Disease State, Not an Adaptation

Robert Feder, MD
Arch Gen Psychiatry. 2001;58(11):1084. doi:.
Text Size: A A A
Published online


In his recent ARCHIVES article, Nesse1 discusses depression as a possible evolutionary adaptation. Dr Nesse presents some interesting arguments that in certain stressful situations, the symptoms of depression can help increase the likelihood of an individual's survival. One cardinal symptom of depression that Dr Nesse fails to discuss, however, is suicidal behavior.

In Darwinian analyses, natural selection will tend to favor behavioral traits that will maximize an individual's reproductive capacity.2 It is hard to imagine a behavior that is less likely to maximize an individual's contribution to his or her gene pool than suicide. There is no way that suicidal thoughts or behaviors can lead to a person's surviving any situation. Even if suicidal behavior in an individual somehow conveyed an advantage to the species as a whole, genetically determined suicidal behavior would rapidly be selected against as individuals who displayed it killed themselves before being able to increase the frequency of these "suicidal" genes in the population by reproducing.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.