Dr. Randy Nesse - Depression & the Art of Giving Up

Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy

Understanding the evolutionary significance of depression can quite helpful in its conceptualization and treatment. Founder in the field of evolutionary medicine, Dr. Randy Nesse, joins us for an encore discussion in which we consider how striving, motivation and desire for control can play into the evolution of depressive symptoms. In this conversation we cover:

• why failure to give up an unachievable goal may be a central cause of some forms of depression and why low mood might be advantageous in these situations
• how understanding dynamics around food-foraging can give us insight into how our nervous system cues us to disengage from various activities at the best cost-benefit ratio
• the types of stressors that might be particularly likely to evoke a response of “ceaseless striving” that can potentially cause depression
• some of the other causes of depression that exist outside of this model
• how this model can inform our assessment and treatment of depression
• mania through the lens of an evolutionary model
• the compassionate consideration of grief (and complicated grief) from an evolutionary lens
• differentiating between the “necessary” pain of to alert oneself to a life circumstance that needs remediation vs. the opposite – where perhaps the mood problem is causing the life circumstance (i.e., the normal emotion regulation mechanisms have broken down)
• the role of medication in treating depression given some of the caveats around the evolutionary origins of depression

Randolph M. Nesse, MD, is a founder of the field of evolutionary medicine and co-author with George C. Williams of Why We Get Sick. He served for many years as Professor of Psychiatry, Professor of Psychology and Research Professor at the University of Michigan. He was the Founding Director of the Center for Evolution & Medicine at Arizona State University and Foundation Professor in the School of Life Sciences from 2014 to 2019, where he is now a Research Professor. He is a Fellow of the Association for Psychological Science, a distinguished Life Fellow of the American Psychiatric Association, and an elected Fellow of the AAAS.