Is Postpartum Depression a Disease of Modern Civilization?

Abstract

Access to calorie-dense foods, medicine, and other comforts has made modern humans healthier than our prehistoric ancestors in many respects. However, the epidemics of obesity, diabetes, and cardiovascular disease suggest that there are also drawbacks to modern living. Here, we address the question of whether the dramatic cultural changes that have occurred over the past century have inflated rates of postpartum depression, adding postpartum depression to the list of “diseases of modern civilization.” We review evidence from cross-cultural, epidemiological, and experimental studies documenting associations between postpartum depression and modern patterns of early weaning, diets deficient in essential fatty acids, low levels of physical activity, low levels of sun exposure, and isolation from kin support networks, all of which mark significant divergences from lifestyles believed to have been typical throughout human evolutionary history. This “mismatch hypothesis” of postpartum depression integrates research across diverse research areas and generates novel predictions.

Biological and Psychosocial Predictors of Postpartum Depression: Systematic Review and Call for Integration

“…In line with this view, the present review points to poor infant and maternal health and lack of social support (father abandonment, poor family support) as predictors of PPD. More recently, Hahn-Holbrook & Haselton (2014) proposed that current high rates of PPD are a byproduct of major changes in motherhood over the last century, leading to the conclusion that PPD may be a “disease of civilization.” For example, early weaning, low omega-3 fatty acid consumption, vitamin D deficiency, sedentary lifestyles, and isolation from family are more prevalent today than in the past. Each has been associated with increased risk of PPD and with elevated inflammation.…”

Postnatal depression and reproductive success in modern, low-fertility contexts

“…That PND significantly reduces the chances of progression from parity 2 in women who had high levels of paternal support or positive emotional experiences of birth also raises the question as to why women of such good circumstances become depressed in the first place, and how PND can occur in such women and reduce fitness. Our results do not preclude ‘mismatch hypotheses’ [ 25 ] or maintenance based adaptive explanations of PND such as the Pathogen Host Defence hypothesis [ 88 ] and the related psychobiological model of depression and social rejection [ 71 ]. It has been proposed that PND is a product of particular sociocultural environments [ 16 , 17 , 89 ].…”

“…The occurrence of PND in women in seemingly affluent circumstances is problematic for explanations of PND which frame it as an adaptive aid to maternal investment decisions when circumstances are poor and thus, constrain fitness. Hahn-Holbrook and Haselton [ 25 ] have recently put forward an evolutionary based ‘mismatch hypothesis’ for PND aetiology, proposing that it results from a modern parenting environment characterized by low kin support, dietary alterations, early weaning and lack of physical activity. If PND is a disease of modern civilization then its impact on reproductive success would be expected to be detrimental, or at least neutral.…”

Cultural Genomics: Promises and Challenges

“…Classic examples of evolutionary mismatch include human physical problems such as back problems, obesity, diabetes, and so forth. Researchers have speculated about evolutionary mismatch in mental illnesses such as attention-deficit/hyperactivity disorder (ADHD; Jensen et al, 1997) and postpartum depression (Gluckman & Hanson, 2006; Hahn-Holdbrook & Haselton, 2014; Nesse & Williams, 1996). Finally, evolutionary psychologists have discussed mismatches in social cognition and various cognitive biases (Barkow, Cosmides, & Tooby, 1995; Buss, 2005).…”