EVOLUTIONARY PSYCHIATRY WITH DR.NESSE

·46 min·4 clips

Dr. Randolph Nesse asks why natural selection has left us vulnerable to depression and anxiety, not just why certain people suffer.

The episode begins with Dr. Carlos introducing Dr. Randolph Nesse, author of 'Good Reasons for Bad Feelings' and a pioneer in evolutionary medicine. Nesse describes his frustration with traditional psychiatry and how conversations with biologists led him to evolutionary approaches. He explains that evolutionary psychiatry asks why natural selection shaped vulnerabilities, not just how disorders work. Nesse introduces the smoke detector principle, using the amygdala analogy to show why anxiety systems have false alarms. He discusses how explaining panic as a useful false alarm can cure patients, contrasting with iatrogenic effects from misdiagnosis. The conversation covers low mood and depression, with Nesse cautioning against over-pathologizing normal emotions. He details his prospective bereavement study, finding that people with the best relationships had more depression after loss, challenging psychoanalytic theories. Nesse addresses PTSD, referencing Chris Cantor's work on evolutionary perspectives. He explores schizophrenia, explaining the genetic paradox and the cliff edge effect, with recent genetic evidence supporting evolutionary theories. The discussion touches on modern life's impact on mental health, with Nesse citing studies showing no significant increase in disorders during COVID. He concludes by discussing aging, referencing George Williams' 1957 paper on evolutionary explanations, and emphasizes avoiding the mistake of viewing disorders as adaptations.

As heard by us

A clear introduction to why emotions may fit recurring survival situations.

Dr. Carlos speaks with Dr. Randolph Nessie about Good Reasons for Bad Feelings and the logic of evolutionary psychiatry, asking not why some people suffer but why natural selection has left emotions that can come at a cost.

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Why you'd press play

You get a clear, slightly uncomfortable tour of why bad feelings might have a job.

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