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I went along last night to hear a presentation from Lord Layard – the economics professor from the LSE who recently published a book on happiness. Professor Layard defines happiness in very hedonic terms – ie he see is primarily as pleasure (as opposed to eudaimonia which is more about meaning and purpose). As he thinks it important for everyone to have pleasure in their lives he thinks that the biggest barrier to happiness for many people is anxiety and depression. He argues that about 16% of the population in the UK suffer, at any one time, from these two conditions. Many of them suffer privately and don’t even go to their GPs. If they do see their doctor they are most likely to be offered drugs. Very few will be given some kind of talk therapy.

Professor Layard is now intent on persuading the Government to spend around £400 million a year on cognitive behavioural therapy. He is pushing this type of therapy as it appears to have a much better track record in helping people to recover than other therapies. Professor Layard argued strongly last night that since depression and anxiety often lead people to claim incapacity benefit or undermines their performance at work, this would be money well spent. The beneficiaries would not simply be the individuals themselves but also employers and ultimately the treasury – and this means all of us.

I have some sympathy with this argument. CBT does have a good track record in helping people to recover and there’s little doubt that this type of mental illness can be a blight on people’s lives. However, I have an important reservation as well. During the course of his talk Professor Layard said almost nothing about the causes of depression. At the end he said something general about the need to move towards a more compassionate society but that was really it. The overwhelming thrust of his argument was that here were frail, vulnerable individuals who needed the support of therapy.

In the question and answer session and later in the evening I had a chance to ask Richard Layard if he thinks there has been a rise in depression in modern society. He said he did not think so. He believes that throughout the ages many people (16%?) have been depressed or anxious but that it has gone unrecognised and untreated. Now we can diagnose these conditions and treat them effectively and so these people shouldn’t be left to suffer any more.

I just don’t agree with this viewpoint. I agree with Martin Seligman on this one. He argues that at the turn of the 20th century depression was almost unheard of and that it has increased, particularly from the 50s on as a result of individualism.
He cites various studies in support of his claim and also research into the Amish in the USA. This is a Christian sect who live a very traditional style of life very similar to previous eras. Their rate of bipolar depression (manic depression) is exactly the same as it is in our society but their rate of depression is a fraction of ours – more in line with early 20th century levels.

In some of the workshops I have been running recently I have been asking people why they think there has been a rise in depression in modern society. Hardly have I asked the question and the room is buzzing. All the groups say similar things: "cause you’re never good enough, never got enough, never get there …." is the general response with lots of other things added in about commuting and work life balance.

By all means let us try to help people whose lives are blighted by depression and anxiety but we must also be aware that they are the tip of the iceberg. It isn’t their brain chemistry, or wiring, which is primarily the problem but major fault lines in our culture.