Las emociones negativas tienen una explicación evolucionista. Transcript: Randy Nesse Why do people have so much social anxiety? Because being very sensitive is generally a good thing for your genes, if not necessarily for you. And why do people have so much guilt and worry so much that they might have accidentally offended somebody? Because having that moral sense really is very important. People who don’t have that moral sense don’t have very many friends. Or at least their friends are just friends who want to get something and trade favors, instead of friends who will actually care for them when they really need help. But I think a big reason why evolutionary psychology hasn’t caught on more is because a lot of people have a simplistic version of selfish gene theory, and they think it implies cynicism, And it implies everybody’s just out to have as much sex as they can. But taking a step back and looking at how natural selection shapes our capacities for morality and loving relationships, I think is the antidote that can make all of this grow in a healthy Rob Wiblin Way. (Time 0:00:00)
causas emociones evolución salud_mental
causas emociones evolución salud_mental
La psiquiatría típicamente no ha explicado la existencia del trastorno mental. Transcript: Randy Nesse Is a medical, a really medical approach to psychiatry carefully separates symptoms from diseases. And right now, there’s all kinds of arguments about how much depression is abnormal. And there’s a vague idea that some might be normal, but without thinking about how the capacity for depression evolved and how it can be helpful, all those questions are just arguments Instead of actually science. (Time 0:07:11)
La psiquiatría típicamente no ha explicado la existencia del trastorno mental.
causas psicopatología cita función evolución
Los trastornos psiquiátricos no se construyen de la misma manera que otras enfermedades. Transcript: Rob Wiblin You say that someone has depression if they have a set of symptoms that correspond with this kind of cluster that you call depression. But that’s not how we think about respiratory illnesses. We don’t say someone comes in with cough and you’re like, okay, yes, you have cough. Yes, you have fever. And then we say, okay, you have respiratory disease syndrome. And then leave it at that. But because we don’t have a deep understanding of the mechanisms that are generating the symptoms, everything is just a syndrome. Or it seems like basically, we just approach everything as just a cluster of symptoms, and then we imagine that that is a disease. But that’s not really, that’s not what we do in the rest of medicine, I don’t think. That’s right. (Time 0:09:20)
definición enfermedad medicina psiquiatría
definición enfermedad medicina psiquiatría
Si la psicopatología es tan pervasiva, debe tener función adaptativa. Transcript: Randy Nesse If you ask about pain, I think where I really started getting going on this, Rob, is in neurology studying pain. And we saw a patient who had no capacity for pain. And he was a wreck. I mean, he was a smoker, and his fingers were burned right down to the bone. Wow. Because he didn’t know, you know. And that reminded me of a kid that I had known in junior high school. And he, too, had the same syndrome. It’s extremely rare, one out of several hundred thousand people. And why is it rare? Because most people with that syndrome are dead by the time they age are 30 or 40. Pain itself is useful. When you’re experiencing pain, it means something’s wrong. You better change things. But this made me start thinking differently about all these responses that natural selection has shaped for us. And it made me think, gosh, if physical pain is so useful, what about mental pain? And that’s really the foundation for a lot of evolutionary psychiatry. Rob Wiblin Okay, (Time 0:12:27)
evolución psicopatología
Complexity and Evolution of Emotions Emotions are complex and multifaceted, with no clear consensus on their nature and purpose, as highlighted by a psychiatrist’s frustration in studying them. William James compared understanding emotions to cataloging rocks on a farm, indicating the lack of order and categories. Evolutionary approaches suggest that emotions are suites of coordinated responses developed over time to cope with recurring situations, affecting physiological, cognitive, and behavioral aspects. Transcript: Speaker 1 Why do they exist at all? And I went reading in my psychiatry textbook, and the entire chapter on emotions was one and a half pages. That’s interesting. I mean, if you study heart disease and you look up in a medical textbook about heart disease, and there’s a hundred pages about how the heart works and how the different parts are for. So then I went looking at emotions research, and it’s been a full year, just reading about emotions. And I pretty much gave up at the end of that. And I thought, you know, everybody’s arguing about how many emotions there are and what each emotion is for, and there’s no agreement. And I really was very frustrated. And then I went back and found what William James had to say about it. You know, William James is a great psychologist. He essentially said, I’d rather read the literature on emotions again as catalog rocks on a New Hampshire farm. There was no order. There’s no categories. There’s no way of making sense of it. And I thought, well, if you can be frustrated, I can be frustrated too. So I looked at evolutionary approaches, and most of them were saying, what’s the function of anger? What’s the function of anxiety? What’s the function of depression? And I asked myself, well, how do these emotions come to be? And the answer is that they’re, they’re suites of coordinated responses that change lots of things physiologically, and cognitively, and behaviorally, to cope with a particular Kind of situation that’s recurred over evolutionary time. (Time 0:15:18)
Optimizing Anxiety Thresholds through Signal Detection Theory Natural selection shapes the anxiety threshold in the brain based on the costs and benefits of sensitivity. This process can be explained using signal detection theory, similar to electrical engineers distinguishing between signals and noise. Just like in radar setups where the threshold is set high to distinguish between missiles and geese, the brain sets its anxiety threshold to ensure accurate responses with high stakes at risk. Transcript: Speaker 1 Again, if you just think about this in terms of rain mechanisms, you can talk about the locus ceruleus, a little blue spot in the brain, brain that influences how much your anxiety goes Off. But when you think about how natural selection shaped those mechanisms in that little blue spot in the brain, you have to ask, you know, what are the costs and benefits of the anxiety Threshold, the sensitivity of that system being cranked up so it goes off for anything or cranked down so hardly ever goes off. And that took me to thinking about what’s called signal detection theory. Signal detection theory is the same thing that electrical engineers use when they try to decide whether a click coming across a wire is an actual signal or just noise. Getting us to the signal noise ratio that we talked about a minute ago is we were figuring out the microphone setups. Likewise, if you’re running a radar setup and looking to see if those blips on your radar are Soviet missiles coming across the North Pole or a flock of geese, you would better be really Really sure that it’s a flock of missiles not geese. So you set the threshold for that to be a really really really high threshold for saying it’s rockets because making the wrong decision could end the entire world as we know it. (Time 0:24:30)
Questioning the Smoke Alarm Principle and Normal Levels of Anxiety The insight highlights a critique of the smoke alarm principle in explaining anxiety and fear by discussing a humorous book review that argued against a philosopher’s complex justification of disgust. The speaker questions why not everyone experiences extreme anxiety all the time if the principle holds, suggesting that anxiety has both costs and benefits, leading to variation in individuals’ levels of anxiety. Transcript: Speaker 2 Yeah, I’m not sure whether you go down the rabbit hole, but there was this beautiful case of one of the funniest book reviews I’ve ever seen of a philosopher who tried to explain disgust, Who tried to explain why it is that human beings have a disgust reaction. And they went through this extraordinary philosophical thing that it’s about ambiguity between death and life without any reference to evolution or without any reference to what Function disgust might serve. And this person wrote this absolutely scathing, hilarious book review where they said, obviously it’s to prevent disease, obviously it’s to prevent you from dying. Likewise, I could imagine a philosopher saying like, why is it that we fear death? They’re like, if you’re a biologist, this is a very, very straightforward question. Anyway, you’re bringing it back to anxiety. So this argument seems extremely powerful. It’s almost, I think, too powerful. I’m always worried that this would suggest that all of us should have an extreme level of anxiety, right? And personally, I feel like the smoke alarm principle doesn’t really describe my relationship with fear. I feel like I’m more like, I’ve never really had a panic attack. Sometimes in I’m in situations that are a little bit dangerous and I usually don’t feel that concerned. Shouldn’t be some bizarre aberration that’s highly dysfunctional, but it seems like there’s at least a meaningful number of people who are like me. So how is it that we can explain normal levels of anxiety given the smoke alarm principle? Speaker 1 It’s a good question, Rob. I mean, how come everybody doesn’t have bad anxiety all the time? And I think it’s because anxiety has costs as well as benefits, you know? I mean, I’ve talked with people who do podcasts who are so nervous that they might make a mistake on their podcast that they can’t do it. Speaker 3 Yeah. (Time 0:30:39)
Regulation of Anxiety Thresholds Natural selection has shaped mechanisms that regulate the threshold of anxiety based on experience. This regulation can vary in outcomes, as seen in a case where a woman’s anxiety escalated to the point where being in a grocery store felt life-threatening due to traumatic experiences. Conversely, treating individuals with agarophobia involves facing their fears head-on by staying in the triggering environment until the panic attack naturally subsides, typically within half an hour. Transcript: Speaker 1 Stopping you from doing things that are useful and interesting. Yep, absolutely. Yeah. But did this things, this brings up another thing, though, that natural selection has also shaped mechanisms that regulate the threshold, how easily anxiety goes off as a function Of experience. And this can be good and it can be bad. I had one woman who, she was working in a grocery store in downtown Detroit. And she’d been on her job for about two weeks. And somebody came in and pointed to gun in her face and said, give me all the money in a cash register, I’ll blow you away. And she fell apart, gave him the money, and decided she’s never going back to work there. But no, that’s what she knew how to do. And so she got a job in a suburb where she thought she’d be safer. Three weeks later, she’s sitting near her cash register on the night shift because she got to start the night shift or if you’re a new employee. And somebody comes in and points a gun at her and says, give me your money or you’re dead. And that was it for her. I mean, we were supposed to treat her in the anxiety clinic and relieve her of her fear of working as a grocery store cashier. But her anxiety system had adjusted to the point where, you know, even being in a grocery store felt dangerous to her because in her experience, it was life threatening. Conversely, the way we work with people who are, you know, just go into the grocery store to the right of our groceries and having fear, which is the classic symptom of agarifobia, by The way. How do we help those people? Well, you have them go to the grocery store and stay there while they have their panic attack and wait for the panic attack to go away because it always will in half an hour at the most usually. (Time 0:33:33)
Balancing False Positives in Response to Threats The brain strives to maintain an appropriate level of false positives in response to threats. The frequency of panic or anxious responses depends on the likelihood of an actual threat. If a threat is improbable, there is no need for frequent panic or anxiety. Conversely, if a threat is common, a heightened state of alertness is warranted. Panic disorder can be created by amplifying a single panic attack through medical reassurance that might increase false positives, leading to persistent anxiety and panic. Transcript: Speaker 2 So in the book, you talk about this capacity that humans have for kind of sensitization with the moods or with the feelings that they have. And I think the way to understand that is to think, so your brain is trying to balance or it’s trying to get an appropriate level of false positives. And the appropriate level of false positives varies depending on how likely a threat is to actually be there. If a threat is extremely unlikely, then you don’t need to panic as frequently or you don’t need to have a very anxious response as frequently. By contrast, if you know someone coming into the grocery store and putting a gun at you is actually very common, then there’s far more reason to be to be skittish and to allow a lot of a lot Of false positives, basically. Well, here’s here’s a way of creating panic disorder or taking one panic attack and creating it into panic disorder. Speaker 1 All you have to do is take your panic attack into an emergency room at a busy hospital. And the doctor says to you, gosh, you’re breathing fast and your heart is pounding like mad. There doesn’t seem to be any sign of a heart attack or a stroke or a seizure or anything like that. But you should be very careful and watch for these symptoms. If they happen again, come back. Whoa, be very worried. (Time 0:35:43)
Vicious Cycles in Mental Disorders Vicious cycles in mental disorders are control systems that escalate out of control, leading to a snowball effect of symptoms like anxiety, increased heart rate, shortness of breath, muscle tightness, and sweating. In the example of a panic attack, a well-meaning doctor’s warning about possible serious conditions can inadvertently heighten anxiety, triggering a cycle of escalating symptoms. Simply informing patients about the cycle does not provide a quick solution. Transcript: Speaker 1 All you have to do is take your panic attack into an emergency room at a busy hospital. And the doctor says to you, gosh, you’re breathing fast and your heart is pounding like mad. There doesn’t seem to be any sign of a heart attack or a stroke or a seizure or anything like that. But you should be very careful and watch for these symptoms. If they happen again, come back. Whoa, be very worried. All of a sudden that well-meaning doctor has transformed an ordinary, you know, fear, fight, flight response into a signal to the person that it could be, a heart attack or a stroke or A seizure. And they should start watching for such symptoms. And then they go mow the lawn and their heart starts pounding and think, oh my god, maybe it’s happening again. And guess what that does? That causes anxiety. And what is the anxiety to do? The anxiety causes higher heart rate and more shortness or breath and more muscle tightness and more sweating and more anxiety. And this is called a vicious cycle. And so many mental disorders are products of vicious cycles. That is control systems that run out of control and escalate, just like a snowball running downhill or a truck without breaks. And telling patients that that’s what’s going on doesn’t solve it quickly. (Time 0:36:24)
Anxiety and the Vicious Cycle of Fear Anxiety can lead to a vicious cycle where past anxiety triggers more anxiety attacks, causing a heightened perception of threat in the environment. This perpetuates a cycle where fear of anxiety itself becomes a significant source of anxiety. The speaker questions the lack of a built-in stabilization mechanism in the brain to prevent individuals from spiraling into a state where they avoid situations due to heightened anxiety. They suggest that in ancestral times, the necessity to leave the safety of hiding due to hunger would naturally reallocate effort and adjust anxiety levels based on the environment. Transcript: Speaker 2 Yeah. Yes. You talk about how this sensitization process, which is evolutionarily adaptive, we think, because the brain is kind of learning how threat filled the environment is based on how Frequently you’ve had anxiety in the past. But then that can create this runaway spiral where past anxiety causes more anxiety attacks, which then causes you to learn that the environment is more for the threats and on and on Speaker 1 And on. But a lot of anxiety is caused by anxiety, right? And people who have a public speaking fear sometimes get so frightened in the midst of their public speaking that they lose their train of thought or something like that, making them Again fear the anxiety itself. So a lot of the worst anxiety is a vicious cycle caused by fear of anxiety. Speaker 2 But that made me wonder, given that these systems are, at least with that design, very unstable and at risk of spiraling off in a very bad direction, shouldn’t you also need to evolve Some stabilization mechanism, basically, to short circuit that from ever happening, because otherwise you do end up with someone who’s just a person who’s just hiding in their cave Unable to go out because they’ve ended up on the wrong end of one of these sensitization spirals. Speaker 1 And in ancestral times, if you’re hiding in that cave, you’ll eventually get hungry. And therefore you’ll have to go out. There’s no alternative. And then the normal systems will reallocate your effort and your anxiety threshold appropriately for your environment. (Time 0:38:09)
Understanding the Complexity of Mood Regulation Mood regulation is a complex process that can fail in various ways including having baseline levels that are too low or too high, having inappropriate responses to stimuli, having responses that are either too weak or too intense, having responses that are triggered in the absence of cues, and having responses that last for either too long or too short a time. These failures in control systems are crucial to address in individuals struggling with anxiety, depression, or other mood disorders, to understand and treat the root cause of the issue effectively. Transcript: Speaker 1 But it’s not that easy. I mean, you can tell people, Oh, just go expose yourself. Speaker 2 Just something incredibly scary. Speaker 1 Yeah, I mean, it’s very, most people need help and guidance in doing that. Speaker 2 Yeah, in the book, you make this great point that mood regulation is a more tricky business than it might first appear. Because for any axis like anxiety or or anger or fear or sadness, it can fail in any one of at least these are the ways that that you mentioned. So you can have the baseline level being too low, baseline level being too high. The response to a stimulus being insufficient. The response to a stimulus being too much. The response being generated to things that are inappropriate, you know, like, like being very anxious around puppy dogs or something like that. The response could go up and down just independently of any particular cues, or the response could be appropriate, but then last for an excessive amount of time, or the response could Be appropriate, but fade too quickly. Speaker 1 So I mean, I mean, I pause just for a second. Those categories you just listed are appropriate for almost every response. Those are the ways in which a control system can go wrong. And what you just said is more sophisticated than any psychiatry textbook, because what we should be doing for every patient who has, you know, control systems out of control, whether It’s anxiety or depression or something else, we should be asking in what way is this control system failing using what we know about control systems. (Time 0:41:03)
The Importance of Design Trade-offs in Evolution Evolution shapes species by balancing design trade-offs, finding the middle ground between competing considerations. Examples include the balance between curiosity and caution, brain size and energy consumption, and immune system activity and self-attack risk. Recognizing symptoms as diseases and diseases as adaptations are crucial in evolutionary medicine to avoid misconceptions. Transcript: Speaker 2 Yeah, this is actually a good moment to highlight the central importance of design trade-offs in understanding why evolution shaped us to be the way we are. I can and again, you find that evolution, just like a human engineer, is stuck trying to find the right middle ground, that the sweet spot between competing considerations. You know, on the one hand, if you’re not curious, then you might not learn something that’s really important. But if you’re too curious, then you might try eating something new and that new food might turn out to be poisonous and kill you. If you have a big brain, you’re smarter and you might be able to solve more problems that come up. But on the other hand, your brain consumes an enormous amount of energy, something like 20% of all of the energy that humans use up. So if you have a bigger brain that’s consuming more energy, or perhaps more likely to starve to not be able to sustain it, or you’ll at least not have free energy that you can put towards Other really important bodily systems that might do even more to keep you alive. If you have a very active immune system, then you’re more likely to find off an infection before it gets going. But on the other hand, you’re more likely to have a false alarm that causes your immune system to start attacking and destroying your own healthy tissue. And on and on, these tricky trade-offs are the bread and butter of design, whether that design and engineering regards cars or people. Anyway, in the book, you warn that in doing evolutionary medicine, there’s two big mistakes that people need to keep in mind in order to steer clear of them. And those are viewing symptoms as diseases and viewing diseases as adaptations. First off, what’s an example of viewing symptoms as diseases? Speaker 1 Gosh, viewing anxiety, viewing your ordinary flight response as if it’s an abnormal response. It’s not an abnormal response. It’s a normal useful response in the right situation. (Time 0:43:09)
Ambivalent Relationships and Grief: Unexpected Findings Research on individuals who experienced loss of a spouse revealed that contrary to psychiatric teachings, people with ambivalent relationships before the loss had less grief afterward. This contradicted the belief that getting in touch with ambivalence was necessary for overcoming long-term grief. Additionally, the theory that delayed or absent grief required intervention to connect with suppressed anger based on Freudian concepts was disproven by the research, as there was no indication that lack of immediate grief led to more grief later on. Transcript: Speaker 1 And I spent three years of my life delving into a very detailed database where we looked at people who would experience loss of a spouse. And they were asked six months, 18 months and 48 months later about all of the details. And we had a lot of information about them before they ever had the loss. And one of the questions was, gosh, dude, is it true what we were all taught in psychiatry that people who have ambivalent relationships need to get in touch with that ambivalence to Get over their long term grief. And one of the profound findings from our research was that people who have ambivalent relationships before the loss don’t have as much grief as other people. It’s exactly the opposite of what we were all taught. Whoa. Plus, the theory in psychiatry was always that delayed, absent grief, people who don’t grieve really have a problem. And you need to get them in touch with their grief more specifically based on Freudian theory. I spent many hours upon the direction of my well-meaning supervisors trying to help people who are having bad long-term grief get in touch with their anger towards the bereaved because Freud’s idea was that suppressed anger was causing depression. And everybody has anger towards everybody at some time, you know, so you can always find something like that. But in our data, we found no hint that people who didn’t grieve immediately had more grief later. (Time 0:51:46)
Balancing Enthusiasm and Sadness It’s not always beneficial to be positive and optimistic all the time as excessive enthusiasm can lead to wasting time on unproductive activities. Sadness is often undervalued in terms of its utility as it plays a role in avoiding unnecessary anxiety. Understanding the balance between being happy for personal enjoyment and being sad for evolutionary reproduction is crucial. Transcript: Speaker 1 In general, it’s everybody imagines it’s good to be positive all the time and enthusiastic all the time and optimistic all the time. That’s pretty obviously false, at least in our system environment. Speaker 2 Even in the modern world, which has many more opportunities, there is a malady that happens to people who are too cheerful and too happy. I mean, by and I think for them, their lives are better, their wellbeing is improved. But from from the jeans point of view, they do end up wasting time a little bit on things that are not so useful because they have excessive enthusiasm for things that may not may not lead Anywhere. How confident are we that those explanations for why sadness exists are correct? How do we figure out like what what the balance is between the different possible functions that we can imagine? Speaker 1 That’s a wonderful question. It’s such an understudied problem. I mean, I wrote a chapter in this book on bereavement about the origins of sadness, but its utility is just vastly underappreciated. And again, my anxiety, it’s usually excessive. Usually, we just feel more bad than we need to and it doesn’t do us any good. Speaker 2 Yeah. One thing that maybe we should have elaborated on earlier is the distinction between something being good for a person in terms of enjoying their life and something being good for someone’s Jeans in terms of reproducing themselves. Do you want to highlight the difference between those two things? Speaker 1 Yeah, I found this a shocking thing, Robin, and a disturbing idea. (Time 0:55:15)
Uncovering the Mystery of Severe Depression Severe depression is a common phenomenon that remains a mystery in mood research. The concept of kindling, derived from epilepsy research, suggests that inducing seizures in animals can make them more prone to future seizures with less stimulation. Similarly, in depression, unresolved ordinary low moods may lead to dysregulation, making individuals unaware of opportunities or trapped in repeated negative experiences. Transcript: Speaker 2 So those are some reasons why you might have low mood, normal mood and sadness. How is it then that severe depression can be really common? This helps explain why there’s a direction to move in. But why do so many people get stuck so far off in one direction where they can’t even see obviously great opportunities that are in front of them? Or they just keep trying to learn from the same bad experience for years at a time? Speaker 1 Yeah. So this is, I think, the most important unanswered question in mood research. We need to try to understand severe depression in terms of how ordinary low mood is dysregulated. There is something called kindling at the foundation of a lot of depression research. Kindling means it comes from epilepsy research, really. If you induce seizures in an animal by putting electrical probes in the brain, it makes it more easy for them to have seizures in the future with lower stimulus of a drug or electrodes. And there’s an analogy here with depression. (Time 1:01:11)
Navigating Unreachable Goals and Depression When facing unreachable goals, it is essential to experiment with different strategies, take breaks, and eventually consider changing the goal entirely. Research indicates that persisting with unattainable goals can lead to worsening depression. Studies on women approaching menopause trying to conceive showed that giving up on unachievable goals positively impacted their depression. This research has shifted the perspective of the speaker, prompting them to reconsider how they approach patients struggling with unreachable goals. Transcript: Speaker 1 And it’s quite profound work. He points out that the first thing you do is wait for a while. And the next thing you do is try a different strategy. And the next thing you do is give up completely for a while. The next thing you do is try another strategy. And the next thing you do is completely change your goal and recognize that you’re never going to reach that goal. There’s also other good research on this, Yoda Heckhausen. And again, I’m going to really simplify subtle social science research. A Carson Roche is another research who has worked on this, showing that people who keep pursuing unreachable goals spiral into worse and worse depression. She was studying people, women, who were approaching menopause who wanted to have a child. That’s a bad situation, because you’re doing more kinds of IVF and other kinds of things to try to have a child that’s not working. And this is spending a lot of effort and time and worry trying to make something happen that it might not work. And then when many of these women reach menopause and give up on that, their depression goes away. And this whole line of research has made me change how I see patients. And it used to be that I would always encourage patients, keep trying, never give up. Your difficulty trying to do this is because of your depression. (Time 1:03:49)
Understanding the Importance of Letting Go The insight highlights a shift in perspective from encouraging persistence at all costs to empathetically considering reasons behind persistent behaviors, such as continued attempts at having a child or pursuing unrequited love. The speaker emphasizes the significance of understanding the underlying motivations and questioning the effectiveness of ongoing efforts, rather than dismissing concerns or pushing unrealistic optimism. This approach aims to foster open conversations and reflection on the value and impact of one’s pursuits, ultimately guiding individuals towards making informed choices and finding emotional relief. Transcript: Speaker 1 She was studying people, women, who were approaching menopause who wanted to have a child. That’s a bad situation, because you’re doing more kinds of IVF and other kinds of things to try to have a child that’s not working. And this is spending a lot of effort and time and worry trying to make something happen that it might not work. And then when many of these women reach menopause and give up on that, their depression goes away. And this whole line of research has made me change how I see patients. And it used to be that I would always encourage patients, keep trying, never give up. Your difficulty trying to do this is because of your depression. Don’t let the depression get the better of you. And as I got older and I saw that not everybody can succeed in everything they’re doing in life, I started just listening more and being more sympathetic and saying, gosh, can we talk More about why you feel you really have to apply to medical school for a fifth time? Or to somebody else, can we talk more about why this is the only woman for you in the world and you feel like you shouldn’t go on living unless this person will love you? I mean, so often people are pursuing something that’s very, very important and you sympathize with them. And I think the key to good therapy in these situations is not just to tell them, no, don’t pay attention to your depression. And it’s not to just tell them, oh, you’re never going to succeed at that give up. The thing is to talk with them about, gosh, do you think that’s working? (Time 1:04:29)
Understanding the Complex Nature of Depression and the Role of Reevaluation in Overcoming Unreachable Goals Depression is a complex condition with multiple underlying causes, indicating that individuals can end up extremely unhappy due to various reasons. One significant aspect discussed is the role of extended low mood in prompting individuals to reassess fundamental life goals. This process involves a deep rumination, leading to the realization that certain goals may not be achievable. However, individuals can get stuck in a state of depression when faced with unattainable goals that are crucial and cannot be abandoned, such as the need to care for a child with a life-threatening illness. In such cases, individuals may remain in a perpetual state of depression, caught between the unacceptable and the impossible. A book by Emily Goot explores the concept of productive and unproductive depression, examining how individuals, including public figures, navigate unreachable goals and the impact of depression in such situations. Transcript: Speaker 2 Yeah. So I think that answer demonstrates how complex a question this is. And it suggests that depression as a cluster of symptoms is probably multiple different underlying maladies or there’s multiple different independent ways that someone can end Up stuck extremely unhappy. One that you elaborate on in the book, I guess, because maybe we have a better understanding of it and it might also be really underrated, is this issue of one reason that we need to get Sad and one reason that it’s maybe beneficial for our genes if we become like, if we have extended low mood is when we need to reassess a fundamental goal that we have in life, something That we’ve been working towards that’s important to us that we’ve been at for years, maybe, that’s part of our identity. It’s not easy to get rid of those to give up those goals. And it shouldn’t be because sometimes they’re really important and you shouldn’t be abandoning them. Absolutely. So you go through this kind of extended rumination thinking reevaluation process where at the end, if you ultimately decide that the thing that you’re trying to pursue just ultimately Isn’t going to happen, it’s not likely enough, then you can give up on that and replace it with something else and reconstruct your goals and your identity and so on. But it’s possible to get stuck in that basically to be stuck in that status. If you if the thing that you describe is some is people who are they’re stuck between the unacceptable and the impossible where they have the goal that they’re striving for is something That they can’t give up like, I need to take care of my child or I need to save my child’s life because they have cancer. They can’t abandon that goal and yet they also maybe cannot succeed at it because there may just be no treatment that’s that that’s available and in that situation we tend to just get Stuck in this intermediate state of depression forever. Is there anything you want to offer for a long time? Is there anything you want to add to that? Speaker 1 A lot to add to that. There’s a wonderful book by a woman named Emily Goot, a Swedish psychoanalyst called productive and unproductive depression where she goes through cases of public figures who basically Are pursuing unreachable goals and and when depression is productive and when it’s unproductive. (Time 1:06:24)