Abstract
In this paper, I offer an argument for cultivating cheerfulness as a remedy to sadness and other emotions, which, in turn, can provide some relief to certain cases of depression. My thesis has two tasks: first, to establish the link between cheerfulness and sadness, and second, to establish the link between sadness and depression. In the course of accomplishing the first task, I show that a remedy of cultivating cheerfulness to counter sadness is supported by philosophers as diverse as Thomas Aquinas, Baruch Spinoza, and David Hume in their writings on the passions. I also show that my argument can generalize to promote the cultivation of other emotions. In the course of accomplishing the second task, I consider different models of depression and how the emotions are related to depression. The purpose of this paper is to offer conceptual, philosophical support that is consistent with the most current empirical data on depression.
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Notes
Others might think the claim trivially true, if my thesis is sufficiently weak.
There are certain cases of depression, such as those that present with catatonia (186, DSM-V) or psychomotor retardation (163, DSM-V), for which even willing in the second order is much too difficult, perhaps impossible. Admittedly, I am restricting my account to exclude these types of cases, as I indicate in §2.
Some might prefer the word “treatment” to “remedy”, but, although the former is more widely employed, I find its usage too imprecise and unhelpful. Hence the introduction of this otherwise unused term.
As Pittenger and Duman (2008) argue, neuroplasticity is “a fundamental mechanism of neuronal adaptation,” utilizable by those with mood disorders, but which can be disrupted by factors such as chronic stress. Antidepressants, however, can produce opposing effects and can enhance neuroplasticity. Cf. Schwartz and Begley (2003) for more on how neuroplasticity has been used to treat obsessive-compulsive disorder: by having patients focus their attention from negative thoughts and behaviors to positive ones.
While my main target is depression, one can begin to think how this proposed remedy might also be applied to mood disorders in general.
I need to say more about what this essential feature of depression amounts to: (a) whether it is essential in characterizing a group of disorders for the purpose of taxonomizing them, in which case their shared feature may be merely accidental and this so-called “essence” is really nominal, or (b) whether it is in some way essential to the nature of the disorder. I take up this issue again, albeit tangentially, in §4.
I understand “emotion” in the broad sense as a passion, affection, or feeling (these terms I use interchangeably). I draw largely, though not exclusively, upon the following two sources: Thomas Aquinas in understanding passions as movements in the affective part of the soul (of which there are the concupiscible and irascible powers); and Robert C. Roberts (2003) in understanding emotions as concern-based construals.
For Aquinas, see ST I-II.25.2. For Aristotle, see NE 7.13.
These descriptions may or may not be interchangeable synonyms of one another, depending on how the subject uses them and whether she can pick out any meaningful distinctions between them.
Not all things may be equal. One could have the emotions that characteristically manifest in depression as a result of a spiritual “dark night of the soul” or a season of grief. The diagnosis of and prescription for such mixed cases is crucially important, since certain emotions may be negative in one way yet healthy or positive in another.
cf. Miner (2009), p. 64, 67.
Srinivasan et al. (2003), Lebowitz et al. (2013). In addition, there are biopsychosocial models (Engel 1977, 1980); cognitive models (Beck 1974, 2008, Beck et al. 2012, Beck & Bredemeier 2016); attribution models, including the learned helplessness paradigm (Klein et al. 1976, Seligman et al. 1979, Shirayama et al. 2002); mere psycho-social models, which are more a reflection of patients’ beliefs about depression than an actual model (Ogden 1999, Read et al. 2014); self-control models (Rehm 1977); and maladaptive anxiety models (Wolpe 1958).
Of course, if one has a more holistic approach to medicine, all of these latter components fall under medicine, and what I have referred to as strictly pharmaceutical one might call the biochemical component. As far as my argument goes, it makes no difference how we categorize them. I need only to show that different components exist and that the emotions are not insignificant.
As the DSM-V puts it, “the common feature of all [depressive] disorders is the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. What differs among them are issues of duration, timing, or presumed etiology” (155).
The psychiatric literature is split on what composes depression. As I pointed out in fn. 13, there are several models of depression on offer, with the most widely accepted model being the biochemical-disease model. I offer CP as a non-exclusive starting principle in the attempt to be exhaustive before narrowing my focus to the emotional component.
One may consider this an inductive argument. However, to be more precise, this argument—along with the next two arguments in this section—might better be understood as toy models that inform how one might, under the right circumstances (i.e., proper application, having the kind of depression amenable to this kind of remedy, etc.) successfully remedy depression or a depressive episode.
Hence my earlier caveats warning against using this remedy in isolation.
To be clearer, I do not think that sadness (for example) is a part, strictly speaking, of depression or of one’s emotional life. To speak of these in terms of a part-whole relation is a bit awkward. Thanks to Alex Pruss for helpful discussion on this and related matters.
This may seem strange, because premise 3 might seem plausible on its own. However, recall the various different senses in which premise 3 can be understood (which depends on how one understands the relation between the emotional component and depression). Here I am interested only in the concomitant relation, which features in premise 2.
This points to a larger potential project, a virtue model of depression.
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McAllister, D. Depression and the Emotions: An Argument for Cultivating Cheerfulness. Philosophia 46, 771–784 (2018). https://doi.org/10.1007/s11406-018-9970-0
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DOI: https://doi.org/10.1007/s11406-018-9970-0