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“Depression may seem completely useless. Even apart from the risk of suicide, sitting all day morosely staring at the wall can't get you very far. A person with severe depression typically loses interest in everything -work, friends, food, even sex. It is as if the capacities for pleasure and initiative have been turned off. Some people cry spontaneously, but others are beyond tears. Some wake every morning at 4 A.M. and can't get back to sleep; others sleep for twelve or fourteen hours per day. Some have delusions that they are impoverished, stupid, ugly, or dying of cancer. Almost all have low self-esteem. It seems preposterous even to consider that there should be anything adaptive associated with such symptoms. And yet depression is so frequent, and so closely related to ordinary sadness, that we must begin by asking if depression arises from a basic abnormality or if it is a dysregulation of a normal capacity.”