Rethinking Depression
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What is the main topic discussed in this episode?
This is Hidden Brain. I'm Shankar Vedanta. For centuries, physicians regarded fever as a dangerous disease, an enemy to be crushed.
What are the historical views on depression and its treatment?
In ancient and medieval medicine, fever was thought to represent an excess of heat or humor in the blood, a sign that the body's internal balance had gone dangerously askew. Treatments aimed to drive out the heat. Patients were bled, purged, or doused with cold water. Some were packed in ice, or fed diets designed to cool the blood. Well into the 19th century, fever was still widely feared as a destructive force that could consume a person from within. Doctors prescribed mercury-based compounds, quinine, or alcohol in large quantities. Patients were subjected to fever cures in which they were submerged in prolonged cold baths or were wrapped in vinegar-soaked sheets, all in the hope of forcing the body's temperature back down.
It wasn't until the late 19th and early 20th centuries that scientists began to recognize fever not as a disease, but as a natural response of the body's immune system. Research showed that infections, not fever, were the real enemy. Studies showed that moderate fever actually helped the body fight infection by slowing the growth of bacteria and enhancing immune function. This shift marked a profound change in medical thinking. Instead of reflexively suppressing fever, physicians began to see it as evidence of the body's vitality and capacity for self-defense. Today, while very high fevers are still considered dangerous and treated, mild to moderate fevers are often allowed to run their course, a quiet acknowledgement that what was once seen as a deadly illness
is, in fact, a sign of the body's strength. Today on the show, we investigate the possibility that what is true of our physical health may also be true of our mental health. That even a scourge like depression may have its roots in our powerful drive to survive and flourish. The origins of depression, this week on Hidden Brains.
A note that this story includes a discussion of suicide. If you or someone you love is struggling with thoughts of suicide, there are people who can help. Call or text the Suicide and Crisis Lifeline at 988. If you're outside the U.S., we've included a link in our episode notes where you can find mental health support in your country. We live in a culture that prizes strength and confidence and that celebrates happiness and high mood. So when those things slip away, when our energy disappears, when joy goes missing, we naturally assume that something must have gone very wrong. We look for a problem to fix, a disease to cure. At Cornell University, psychologist Jonathan Rottenberg has long asked if this is the right way to think about depression.
John Rottenberg, welcome to Hidden Brain.
Thank you. It's wonderful to be here with you.
Thirty years ago, John, you were a confident, self-assured college graduate preparing to get married and to start a career. What was your life like at the time, and what were your plans for the future?
I was studying. I was in a PhD program in history, living in Baltimore at Johns Hopkins University. I studied American history, and I thought I was the smartest guy in the room. And I was then struck by a series of very bizarre experiences that I had no framework for understanding.
Tell me what happened. In many ways, you had all of your life before you. You had graduated from an Ivy League school. You were about to get married. You were doing this PhD and you thought you were the smartest person in the room. It felt like everything was going your way.
Yes. And so when I started to feel unwell, I didn't have really much of a framework to go on. I first noticed physical symptoms that didn't make a whole lot of sense. I had pain on the left side of my body. I thought there might be something wrong with my heart. I felt physically weak, like I thought I might have a fever or some kind of flu-like illness. I felt incredibly run down. And I thought that it would just go away on its own. And then other problems started.
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Chapters
4 chapters
1
What is the main topic discussed in this episode?
0:00–0:12
2
What are the historical views on depression and its treatment?
0:12–13:28
3
What is the prevailing model of depression according to Jonathan Rottenberg?
13:28–14:50
4
How does Jonathan Rottenberg describe his experience with depression?
14:50–52:55