Why evolution left us so vulnerable to depression and anxiety | Randy Nesse

Originally released February 2024. Mental health problems like depression and anxiety affect enormous numbers of people and severely interfere with their lives. By contrast, we don’t see similar levels of physical ill health in young people. At any point in time, something like 20% of young people are working through anxiety or depression that’s seriously interfering with their lives - but nowhere near 20% of people in their 20s have severe heart disease or cancer or a similar failure in a key organ of the body other than the brain.
Why is it that these evolutionary selective pressures seemingly fixed our bodies so that they work pretty smoothly for young people most of the time, but it feels like evolution fell asleep on the job when it comes to the brain? Why did evolution never get around to patching the most basic problems, like social anxiety, panic attacks, debilitating pessimism, or inappropriate mood swings? For that matter, why did evolution go out of its way to give us the capacity for low mood or chronic anxiety or extreme mood swings at all?
Today’s guest, Randy Nesse - a leader in the field of evolutionary psychiatry - wrote the book _Good Reasons for Bad Feelings_, in which he sets out to try to resolve this paradox.
In this episode:
• Rob's intro [00:00:00]
• The history of evolutionary medicine [00:01:51]
• The evolutionary origin of anxiety [00:10:32]
• Design tradeoffs, diseases, and adaptations [00:39:17]
• The tricker case of depression and the purpose of low mood [00:46:53]
• Big mood swings vs barely any mood swings [01:20:36]
• Is mental health actually getting worse? [01:31:38]
• A general explanation for bodies breaking [01:35:22]
• Freudianism and the origins of morality and love [01:46:48]
• Evolutionary medicine in general [02:00:36]
• Objections to evolutionary psychology [02:14:23]
• How do you test evolutionary hypotheses to rule out the bad explanations? [02:21:15]
• Striving and meaning in careers [02:23:06]
• Why do people age and die? [02:43:15]
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The 80,000 Hours Podcast features unusually in-depth conversations about the world’s most pressing problems and what you can do to solve them.
Learn more, read the summary and find the full transcript on the 80,000 Hours website:
80000hours.org/podcast/episod...

[@Shantewa]

Randy, finding this video and hearing your insight was SUCH a blessing today. No one I speak to seems to understand all of these complex "eclectic" components and how they all are very real and impactful. You really get it, and I'm super hopeful to connect with more of your insights and continue to gain clarity.

[@margaretpulley5194]

Thank you, Dr. Nesse, for your optimism and many contributions to Medicine and human decency.

[@adrianfeeger]

WOW Rob processes and responds at about 1.5x the normal human rate. Awesome and interesting episode, well worth the watch.