
Anxiety, depression, and PTSD may be adaptive responses to adversity: study - firstbase
https://www.psychologytoday.com/us/blog/shouldstorm/202008/what-if-certain-mental-disorders-are-not-disorders-all
======
slfnflctd
At first I viewed the depression I started fighting in my teens as a scourge,
a defect, something broken to be fixed.

I have since come to see it as an important signal. When I am managing my life
and mental states well, it often fades into the background. When it starts to
flare up, like with some kind of physical pain, that's telling me I need to
pay attention and change things up a bit.

Furthermore - and perhaps most importantly - it is a preferred failure mode to
freaking out or engaging in suicidal ideation. When I'm overwhelmed by that
gloom, I remind myself that I could have a stroke, aneurysm or heart attack at
any moment, and I think about what the consequences would be if I did. As long
as I'm in a safe situation, I can simply take my first opportunity to Just.
Stop. Taking time to shut down, and to cease forcing yourself to engage with a
world that would go on without you if you suddenly died, is a good idea now &
then.

Yeah, at times I feel some twinges of guilt for doing this. It seems selfish
on the surface. But when you compare it to the alternatives, well-- it's
better than being dead, isn't it? I feel like my ability to manage my life
(and depression) has improved considerably with this insight. If you need to
stop, stop. Rest. Let whatever is pushing you to the brink simmer in a corner
for a while, provided it is physically safe to do so. You will be better
equipped to deal with it when you've had a chance to breathe, and to remind
yourself that a temporary shutdown is indeed better than being dead.

~~~
hexxiiiz
This may make sense for you in particular, but it a lot of people the signal
provided by depression is distinct in its persistent alarm about something
that isn't really in the present. Listening to the signal and stopping to take
stock of it and make changes is often what makes depression so paralyzing,
since it is characteristic of it that this doesnt help. Depression for most
people is that "stop, stop, rest" happening indefinitely. This is not to say
that what works for you doesn't work for you. But, in general, treating
depression like an important signal of something really wrong in one's life
that one needs to stop and address before moving forward is pretty much
depression itself.

~~~
golergka
> about something that isn't really in the present

Or is it? Therapy, especially gestalt or existential, often makes people
realise that something really is off with their outlook on life, relationships
with other people or other things like this — something that they had paid no
attention to and perceived as "normal", that really wasn't. And in the end,
what started as their fight against depression ended up as work to fix the
core reason for which that depression was only a symptom.

I know this to be the case with myself and some close friends of mine. I'm not
a health professional, and this is anecdotal evidence, but from talking to
other people and therapists, I hear about this quite often.

~~~
jiggybling
Can you give an example, personal or otherwise?

~~~
golergka
This is not an anonymous nickname, so I wouldn't be able to give you an honest
and full answer.

~~~
jiggybling
fair enough

------
tomhoward
Out of necessity (after existing conventional treatments offered little help)
I've been conducting a 10+ year self-experiment related to this topic.

Like others have described, when I started experiencing symptoms of conditions
resembling anxiety, depression, ADHD, mild bipolar, paranoia and CFS/ME, I
initially sought mainstream medical psychiatric treatment and undertook talk
therapy and was prescribed anti-anxiety (benzos) and antidepressant (SSRI)
medications. There was some relief but there were also unpleasant side-
effects, and I just had a strong feeling these treatments were not really
addressing the core problems, and indeed I even felt like the symptoms were
fairly normal reactions to the life experiences I'd endured.

Later I tried to heal myself with nutritional and exercise-based approaches,
and relatively conventional emotional approaches like meditation. Again, some
mild/temporary improvements were noticeable, but they were inadequate, and it
still felt like there was something deeper I needed to connect with.

About 8 years ago, I found an approach that involves identifying and releasing
traumas, attitudes, behavioural patterns, self-perceptions and defense
mechanisms that are held in the subconscious mind, particularly ones that have
been attained in early life and have snowballed through repetition compulsion
[1] (a concept that Freud first articulated).

I've been undertaking these approaches continually since I discovered them,
and bit by bit all the symptoms have resolved.

My experience has confirmed, at least to me, that these conditions are
"adaptive responses to adversity" (or something else related to that concept),
and that in order to heal the symptoms, I needed to understand their basis at
a very deep level; as Jung said, "making the unconscious conscious" [2].

Once that had been done, adopting new, healthy attitudes and behaviours and
living free of those symptoms has been fairly easy; i.e., healthier behaviours
just emerged naturally once the causes of the unhealthy behaviours were
identified and understood.

If any researchers or laypeople are interested to know more about the
techniques I've used and the results I've experienced, I'm happy to be
contacted (email address in profile). None of the approaches I've used or
their underlying hypotheses are novel; it's been written/spoken about
extensively by veteran experts on mind+body health including Maté and Bruce
Lipton. But there doesn't seem to be much in the way formal studies into these
concepts, so I'd be happy to connect with anyone working in the field or
anyone else interested to explore further.

[1]
[https://en.wikipedia.org/wiki/Repetition_compulsion](https://en.wikipedia.org/wiki/Repetition_compulsion)

[2] [https://www.goodreads.com/quotes/44379-until-you-make-the-
un...](https://www.goodreads.com/quotes/44379-until-you-make-the-unconscious-
conscious-it-will-direct-your)

~~~
astrocat
_The Trauma of the Gifted Child_ by Alice Miller is probably a good read to
throw in here if this is the direction you're looking to explore - especially
if you can get an early edition that hasn't been watered down. Some of her
perspectives into experiences as a child that are commonly accepted as
"normal" but are often experienced by the child as trauma and grow into
dysfunction as adults were interesting.

~~~
Ancapistani
Is it "Trauma" or "Drama"? The version I'm seeing on Amazon is "The Drama of
the Gifted Child".

ETA: I found this interesting, too - the author's own child wrote a book about
his negative childhood experiences:
[https://www.haaretz.com/life/books/.premium-mother-
dearest-1...](https://www.haaretz.com/life/books/.premium-mother-
dearest-1.5255078)

~~~
thebean11
It's "Drama"

~~~
Ancapistani
Thanks :)

------
framecowbird
I'm most surprised to learn that this _isn't_ the current prevailing view in
the medical profession. I am not a doctor, but it's always seemed more natural
to me to view depression and anxiety as adaptive behaviours - albeit perhaps
ones that can end up being triggered too far.

I read an article once (wish I could find it) that one advantage of mild
depression was as sort a "call for help and support" from other embers of a
close-knit social group, although I'm not sure how well-founded the claim was.

~~~
frereubu
One thing that I learned during my psychology degrees that always stuck with
me was that mildly depressed people are measurably better at judging
probabilities of things happening. (Unfortunately I can't remember off the top
of my head the structure of the study, or how much better they were). I wonder
if that might fit into this, in that if you're mildly depressed presumably bad
things are happening to you, so perhaps it's adaptive to be more realistic
about your situation. Pretty hand-wavy stuff, but interesting to think about.

~~~
b0rsuk
I remember reading an article like that. Also, it's a bit of a meme that if
depression was 100% harmful then it would already be eliminated by evolution.
I mean why shouldn't people prone to depression die off?

Don't make a mistake, I'm still working on improving my life and uncovering
the root causes. It is a silent thief of life.

~~~
gowld
The appendix is 100% harmful but not eliminated. As is nearsightedness.

Evolution is only affected by genotypes that prevent reproduction.

~~~
podgaj
Uhm, no.

[https://academic.oup.com/mbe/article/35/12/2957/5112969](https://academic.oup.com/mbe/article/35/12/2957/5112969)

"the strongest signals of recent human adaptation in Europe did not coincide
with the Neolithic transition but with more recent changes in environment,
diet, or efficiency of selection due to increases in effective population
size."

------
vanderZwan
> _If ADHD is not a disorder, but a mismatch with a human environment, then
> suddenly it’s not a medical issue. It’s an issue for educational reform. And
> that is a compelling thought, given the evidence that kids’ focus and
> cognition are improved by physical activity. Still, we need to take this
> study with a grain of salt. There is a large body of research showing other
> biological factors when it comes to ADHD. For instance, there is evidence
> that premature birth increases rates of ADHD later._

So speaking as someone with adult ADHD who is getting by without medication
with the right lifestyle choices, this sounds a bit like arguing that
cardiovascular diseases are not medical issues, they're lifestyle problems.

I mean, yeah, in both cases the problems very much _are_ largely caused by our
lifestyles. But these lifestyles still affects me differently than how it
affects most other people. Don't get me wrong, I'd be very happy if we get rid
of the _disorder_ label, not to mention societal stigmas surrounding mental
illnesses and/or being neuro-atypical in general, but I don't see why we'd
have to choose between (in this example) educational reform and psychiatric
therapy when both seem valid options that complement each other.

EDIT: also, if you _really_ want a good example of dystopian victim blaming in
psychology, I'd suggest checking out "opppositional defiant disorder" and
imagining how _that_ label can be abused

[https://en.wikipedia.org/wiki/Oppositional_defiant_disorder](https://en.wikipedia.org/wiki/Oppositional_defiant_disorder)

~~~
Pelic4n
>So speaking as someone with adult ADHD who is getting by without medication
with the right lifestyle choices

How do you do it exactly? Without ADHD medication I can't function on a basic
level, and even then it's pretty hard. (Yes that's just ADHD, I tried every
antidepressant and mood stabilizer under the sun for years before getting
diagnosed with ADHD)

~~~
vanderZwan
Well, I have the inattentive subtype, without hyperactivity or much of the
associated impulsivity. So I guess I'm already in a starting point that is
easier to compensate for.

I pay a _lot_ of attention to my sleep - I'm a chronic insomniac. And keep in
mind that it's not just about sleep time, it's also about sleep _quality_. So
sleep hygiene is really crucial. No caffeine after lunch, and no alcohol in
general (unless you know you can afford to be less well-rested the next day)
because that might make you drowsy but it prevents entering the deep sleep
cycle. Low-dosage melatonin seems to help me, not so much with falling asleep
as it does with ensuring that once I _do_ manage to sleep, I hit that "deep
sleep" cycle that is absolutely necessary to recover.

I'm very sensitive to disturbances at night, noises can drive me _nuts_. So I
spent a _lot_ of time finding comfortable ear-plugs. They are essential for
uninterrupted sleep for me, which again is crucial for hitting the deep sleep
cycle.

Then there is the question of _falling_ asleep. If I have trouble with that
(which is almost every night), I get out of bed and go read in the living
room, so that my brain keeps associating the bedroom with rest. Sometimes I
start having ideas just before falling asleep, I then try to write those down
on paper, and maybe work them out a bit - I realized that part of why late
night thinking keeps me awake is that I'm afraid to forget all the ideas, so
writing it down gives me peace, and doing so by hand also calms forces me to
slow down. Meditation is also good for slowing down racing thoughts, but it
really depends on what the thoughts in question are.

Then there's diet. I don't know if I can generalize what works for me
specifically, but lots of leafy greens in general. There is evidence that
berries and other sources of polyphenols help a lot with children with ADHD,
and in general those are supposedly really healthy, so I figure they won't
hurt me either. Avoid things that give sugar rushes/crashes. Finally I take
supplements for common deficiencies that apparently disproportionately affect
people with ADHD (B, zinc, magnesium).

Exercise helps because the cerebellum is involved with regulating attention.
So I try to start the day with some mild exercise (like a short run) to really
activate it. I've noticed that this helps with my attention regulation
throughout the day. Sitting all day programming reduces activity again, so
sometimes I take short "activation breaks" where I just do ten squats or
burpees or whatever, not to exercise but to wake up the cerebellum.

Therapy is important. The overlap between ADHD symptoms and co-morbid/complex
PTSD symptoms is large, leading me to believe that maybe people with ADHD are
just more likely to end up in traumatizing situations (in my case: other kids
_loved_ to provoke temper tantrums in me) and part of their symptoms are
really just a consequence of the resulting PTSD. As difficult as it was to
process my past, therapy helped me a lot. It seems to have reduced some of my
ADHD symptoms a bit, but even if it didn't: someone with ADHD is likely to
have a lot of pain to process as a result of their condition. Doing so means
having one burden less to carry, making it easier to cope with the remaining
issues.

One very important thing I learned: ADHD means that _inevitably_ I will slip
up at some point and forget an important appointment or something. The screw-
up itself is punishment enough, so if I hate myself for always screwing up too
I'm just punishing myself twice. So learn to be kind to yourself and forgive
yourself when that happens, that makes it easier to pick yourself up, fix the
problem, and move on when this happens.

Therapy also helped me with being better at being brutally honest about my
limitations. No, I cannot plan five things in a day when I know that I can't
complete more than two. If I know I'll likely forget _something_ at home when
I go somewhere, even with checklists, leave early so I can go back to pick it
up when I inevitably remember I forgot it five minutes after leaving the
house. Try to develop good habits. More importantly, _only try to develop one
habit at a time, and give it enough time to really become a habit._ And so on.

And finally: use that ADHD hyperfocus to your advantage, and do deep dives
into learning as much as you can about how to ADHD works and what you can do
about it.

~~~
Pelic4n
Thanks a lot, this is very good resources. I read the whole thing several
times despite having a pretty bad brainfog day.

------
leto_ii
Here's a personal anecdote of the moment when I realized that perhaps mental
disorders are not disorders at all:

A few years ago I had a job that made me deeply unhappy. The unhappiness came
about gradually, but in my last year there it was overwhelming. In my last
year on the job I spent a good chunk of my working hours holding back feelings
of deep frustration and anger over how things were progressing and over how I
was being treated by my boss and by a few coworkers. At times I considered
going to see a therapist, but in the end I opted for a more direct solution -
I spontaneously quit the job.

Even though my financial situation became a lot less secure, my state of mind
improved greatly. I started sleeping better, some stress related physical
symptoms went away, I started working on personal projects that I had been
neglecting etc.

I'm pretty sure that, had I gone to the therapist, I would have been diagnosed
with some sort of depressive disorder and probably would have been prescribed
some sort of medication. I probably would have still been in the job I
actually hated and I wouldn't have made as much progress in understanding what
I actually wanted from my life.

~~~
podgaj
This is like saying people with heart disease do not have a disease because
they stopped eating poorly and the heart disease went away.

You did have a metal disorder. You were just lucky to find the cause. The
cause was job stress.

I have a mental disorder that was harder to find the cause. But I did as well.

~~~
leto_ii
> You did have a metal disorder. You were just lucky to find the cause. The
> cause was job stress.

You could phrase it that way, but the fact remains that for me, I feel, there
was an objective external cause to my unhappiness. It wasn't a spontaneous and
inexplicable 'chemical imbalance in the brain'. It was a reasonable reaction
to a shitty life experience.

> I have a mental disorder that was harder to find the cause. But I did as
> well.

Indeed I may have stated my conclusion too broadly. I'm sure there are
problems out there that can't be fixed by changing your lifestyle/job etc. and
that may require serious effort, therapy, medication.

~~~
podgaj
But you see, I was hospitalized several times for my mood disorder. I have
come to find out that there was an objective external cause of that as well.

The problem is not with the psychiatric "cures", the problem is the
psychiatrists. It took a test to LOOK at my brain chemistry form them to see
what was going on with me. It took 25 years of convincing them to give me the
test. THAt is the disorder.

Shitty life experiences, and almost every environmental input, will affect
chemicals in our brain and body. I mean, how do you think saddness happens? It
just appears out of no where? NOPE.

[https://www.sciencedirect.com/science/article/abs/pii/S01650...](https://www.sciencedirect.com/science/article/abs/pii/S0165032719325388)

~~~
proverbialbunny
>Shitty life experiences, and almost every environmental input, will affect
chemicals in our brain and body.

I think that is a key point many people fail to see. Our present moment
(including our thoughts and beliefs in the present moment) determine what
chemicals get released in the brain.

Calling something a chemical disorder is overlooking correlation is not
causation. (That does not imply pills can not be helpful and should not be
considered.)

Did you end up finding a cure on your end? What was it?

~~~
podgaj
I was recently diagnosed with a genetic condition, GCH1 deficiency, which
lowers the amount of serotonin and dopamine I make and increases the amount of
trace amines. (Trace amines are similar to methamphetamines.)

------
kbos87
This feels so obvious. 30 years from now, we might very well look back at
these labels we applied to people, implying something is wrong with them for
responding to their negative circumstances, and feel like we were living in
the dark ages.

When we see historic rises in mental disorders following an external event
like the coronavirus pandemic, is it not something we should reasonably
expect? I can accept that some sliver of the population has an unreasonable
reaction to something like this, but for most people, it isn’t a problem in
their head as modern psychology tends to imply.

[https://www.google.com/amp/s/www.washingtonpost.com/health/2...](https://www.google.com/amp/s/www.washingtonpost.com/health/2020/05/04/mental-
health-coronavirus/%3foutputType=amp)

~~~
Cthulhu_
I hope so, and that what we now call depression will be considered as silly a
moniker as hysteria or "troubled humours" back when.

~~~
proverbialbunny
Exactly. When it comes to depression the chemical imbalance theory comes from
Zoloft. It is a drug that accidentally had the side effect of reducing
depression in some patients. Curious scientists wanted to figure out why, so
they examined it. Turns out Zoloft boosts serotonin in the brain. This created
the chemical imbalance theory, but since then study after study for decades
has disproved this, yet for some sort of reason the theory stays in the
mainstream.

Ibuprofen can cause an ulcer. Imagine some primitive ape sees this blood loss
and assumes the blood loss is what reduces inflammation. The Zoloft serotonin
study follows the same faulty logic.

~~~
dorchadas
You might be interested in Johann Hari's _Lost Connections: Uncovering the
Real Causes of Depression - and the Unexpected Solutions_ , who really looks
into this and how depression is diagnosed and treated, as well as why it may
actually be the 'adaptive response' suggested above.

------
carabiner
The money quote:

> Study author Kristen Syme, a recent WSU Ph.D. graduate, compares treating
> anxiety, depression, or PTSD with antidepressants to medicating someone for
> a broken bone without setting the bone itself. She believes that these
> problems “look more like sociocultural phenomena, so the solution is not
> necessarily fixing a dysfunction in the person's brain but fixing
> dysfunctions in the _social world_."

This is EXACTLY what Kaczynski said:

> The concept of 'mental health' in our society is defined largely by the
> extent to which an individual behaves in accord with the needs of the system
> and does so without showing signs of stress ... Instead of removing the
> conditions that make people depressed, modern society gives them
> antidepressant drugs. In effect, antidepressants are a means of modifying an
> individual’s internal state in such a way as to enable him to tolerate
> social conditions that he would otherwise find intolerable.

~~~
vorpalhex
Kaczynski ends up positing a kind of return to the natural state as the
ultimate solution (which he basis his actions on). The issue being that
historically, these problems existed in earlier times even if not discussed in
detail. Kaczynski blames "the state of the world" without ever listing some
state where the problem didn't exist.

> “Research on depression, anxiety, and PTSD, should put greater emphasis on
> mitigating conflict and adversity and less on manipulating brain chemistry.”

Whereas Kaczynski blames society, the world at large, the paper sets these up
as smaller addressable issues. You can identify "kid B needs extra recess"
more readily than abolish schools as Kaczynski calls for.

------
heisenbit
Insights from psychology today from an article originally in Forbes.

About the Author: A pediatrician and writer, Dr. Escalante is on a mission...

~~~
usgroup
+1 but let’s see where your comment ends up ranked in the thread at days’ end.

~~~
podgaj
+2

"Dr. Escalante understands because she is a recovering worried mother herself.
"

I am tired of people prescribing their cure to everyone else in the world.
Great, it worked for her. And I get it, the whole world is neurotic, but to
say it is not a disorder is idiotic.

If I make a mess of my room, it is just disordered. It is just that simple.

------
bmitc
I would recommend people watch this lecture by Stanford professor Robert
Sapolsky, who studies these things in depth and is an actual expert.

[https://www.youtube.com/watch?v=NOAgplgTxfc](https://www.youtube.com/watch?v=NOAgplgTxfc)

There is a lot of arm-chair thoughts on this matter in this thread, and I feel
this lecture sets a lot of things straight.

A helpful quote from the talk: "...the single point I want to hammer in here
over, and over, and over, is something that people with depression constantly
battle with. Back to semantics, we all get depressed. Bad stuff happens to us.
We all get depressed. We feel lousy. We feel withdrawn. We feel a sense of
grief. And we're not taking much pleasure. And we withdraw. And then we get
better. We cope. We heal. We deal with things in life. What's the deal with
you that you can't do that? And there's this lurking sense given that all of
us have periods of being depressed and come out the other end. When you look
at people who instead go down and stay down there to this crippling extent,
there's always this little voice between the lines there of, come on, pull
yourself together. We all deal with this sort of thing. I will make the
argument throughout here that depression is as real of a biological disorder
as is juvenile diabetes."

------
HeckFeck
Honestly, this squares with personal experience. I've had long periods of
anxiety, which I'd describe as perceiving outside things as greater threats
than they are, excessive worry and overthinking and withdrawal from outside
world. I've also endured depression, that is overmuch despair and lack of
willpower to complete even simple tasks.

It plagued me for years, badly affecting much of my personal life. I had some
therapy (for 3 months), and interestingly a doctor actually voiced the same
view put forward in this article. I never took medication.

Latterly, after gaining more life experience and connecting some dots, I
realised much of this was fed by my environment when I was growing up. I
realised this comparing outcomes with others who had stabler, supportive
homes. Bad circumstances leading to social ostracisation, which meant I never
developed social skills well, which meant I always dreaded social contact.
This fed an endless anxiety cycle.

After ten painful years, wrangling and working through it, I've eventually
managed to make better friendships. As a result, my anxiety has dropped and my
overall social ability improved. Nowadays, social contact has been reduced and
I've been forced to stay in my childhood home thanks to "lockdown". Curiously,
I've once again had more of the depression-like symptoms.

I wonder how much of these afflictions are brought on by poor family
environments, and even when they are stronger the parents providing little
personal input into children's lives. Lack of community generally and
increased personal isolation. I'd put it forward that medicalisation isn't the
answer to all of life's woes, or the problems we face individually or
collectively.

------
insickness
Trying to decide if mental disorders are disorders or adaptations is a false
dichotomy. They can be both. For example, the 'dark triad', narcissism,
Machiavellianism, and psychopathy, can help an individual succeed. Studies
have shown that women are attracted to these personality traits in men.

On a group level, anxiety in individuals may be evolutionarily advantageous to
the group while being disadvantageous to the individual. If a person is hyper
alert, it may help the group to become aware of danger but cause tremendous
stress to the individual.

~~~
proverbialbunny
The key criteria for something to be called a psychological disorder is it has
to hurt the patient in some way, causing them a disadvantage in life.

To flesh this out:

>Studies have shown that women are attracted to these personality traits in
men.

Woman are attracted to men who are as successful or are more successful as
them. NPDs and ASPDs (though more rare than NPDs) can fake being successful
and others fall for it. This relationship is often short lived once they
realize they were tricked.

The most common form of employment for someone who is ASPD (what you're
calling psychopathy) is being a homeless alcoholic. The second most common is
being in prison. The leading theory is ASPD is an adult who did not grow out
of their terrible twos. This does not help an individual succeed in any shape
or form. ASPDs do not and can not maintain relationships for a long period of
time, and the few high functioning ones not in prison or homeless roam around
like nomads from town to town leaving once they are no longer welcome.

Machiavellianism is a philosophy or a set of beliefs. It is not a
psychological disorder. It does not harm the belief holder. Machiavellianism
is a sort of game theory on a macro nationwide scale.

I can continue with NPD (narcissistic personality disorder), but I can assure
you in the long run it does not benefit them. They believe manipulating people
is better for them and will jump through mental hoops to justify their
behavior to themselves. When someone is thought of as a con artist or a gold
digger, that is most likely someone who is NPD.

>On a group level, anxiety in individuals may be evolutionarily advantageous

Anxiety is assuming (usually unconsciously) a negative outcome will happen.
It's a danger feeling. When anxiety moves from a rare feeling to a disorder,
it's because they're overly assuming/believing faulty futures. This can come
from faulty logic, or being told incorrect beliefs during childhood, or many
other situations. Anxiety as a disorder has no advantage to the user.

------
podgaj
As someone on disability with a mood disorder I can say without reservation
that that article was mostly horrible.

I will agree with them that there is a mismatch, but the mismatch is between
each individuals genetics and environment. so they are still disorders, it is
just that they have not found the right treatment.

And as someone who has been hospitalized several times it is amazing to me how
little testing they do for people with serious mental illnesses. It was not
until after I had to learn genetics and neurobiology that I forced them to
give me a simple serum amino acid test that showed something atypical was
going on. Turned out I have a BH4 (tetrahydrobiopterin) deficiency that limits
the amount of serotonin and dopamine I make. BH4 deficiency has already been
show to be a cause for anxiety and depression.

So Mood Disorders are all environmental illnesses. I am off of all my
medications and I control my mental health by diet and environmental changes.
But some neurological damage has been done that I might have to live with. So
you youngins heed my advice, if something feels bad, don't do it.

------
molticrystal
We could rationalize an opposite hypothesis as well, perhaps they are adaptive
responses to lack of adversity. It would be interesting if a good experiment
can be formulated to figure it out.

One rationale is that life for billions of years and humans for millions have
faced harsh conditions never letting us rest and relax for long.

So if we are sitting still, relaxing, often it meant something must be
wrong(physically or mentally) and in less sympathetic times mental illness
would encourage culling, either by the tribe or yourself to ensure the limited
resources were spent on people who are contributing more physical action.

Roles that didn't have to deal with as much adversity obviously formed
eventually, but they took a long time to stabilize, likely being poorly
tolerated in most ages, and if the hypothesis was true, were plagued more with
the OP's issues.

~~~
nicoffeine
I have had similar thoughts. I think that's why exercise is so much more
effective than medicine - it's making your lower physiological self think that
you are doing something important and exciting. It also explains why people
get so invested in the drama of others. In economically developed countries,
we have far fewer life and death situations that help us appreciate it when
things are going well.

The other difficulty is that our higher order functions know that exercise is,
in the short term, a waste of energy and time. It's not getting us any more
resources. I include myself in the subset of people with impulse and
procrastination issues, which makes it very difficult to invest in things that
pay off over the long term. Depression for me is being stuck in that hole,
knowing there may be a way to feel better, but believing the world would be
better if I was dead. Maybe my evolutionary contribution would have been as a
martyr if I lived in a different circumstance.

More generally, healthcare suffers from the idea that there is "a" population.
Our brains and bodies are unique, and until they can identify types of brain
patterns and perform studies against those, it's really throwing pills at
someone and hoping for the best. Some parts of science have entered into a
dangerous dogmatic phase of "this is how we've always done it" which is the
opposite of the point.

I would really like to see the mental health community rally behind getting
people into recovery-style support groups where people encourage each other to
socialize, eat healthier, and get more exercise. That would put all three of
the most effective ways to fight depression and anxiety into practice. Of
course then the problem is that prescribing virtually free services isn't in
the economic interest of for-profit systems.

------
MaxBarraclough
This strikes me as a pretty clumsy article.

> What if mental disorders like anxiety, depression, or post-traumatic stress
> disorder aren’t mental disorders at all?

Of course they're disorders. That's why they deserve treatment. This bears no
connection to the question of whether they're adaptive. Our capacity for
physical pain is adaptive, but doctors still treat pain.

> With a thorough review of the evidence, they show good reasons to think of
> depression or PTSD as responses to adversity rather than chemical
> imbalances.

Besides clueless commentators on the Internet, who is suggesting depression is
simply a matter of 'chemical imbalance'? If that were the case, it wouldn't be
brought on by loneliness, and it wouldn't be treated with CBT and talking
therapy.

~~~
npwr
> Besides clueless commentators on the Internet, who is suggesting depression
> is simply a matter of 'chemical imbalance'? If that were the case, it
> wouldn't be brought on by loneliness, and it wouldn't be treated with CBT
> and talking therapy.

Most of (all?) chemical depression treatments are based on the serotoninergic
depression hypothesis that has never been verified. In the recent years more
and more arguments come directly against this hypothesis. Yet SSRIs are still
the first line of treatment for depressive patients.

[https://en.wikipedia.org/wiki/Major_depressive_disorder#Path...](https://en.wikipedia.org/wiki/Major_depressive_disorder#Pathophysiology)

------
lazyeye
So much of what we think is knowledge is actually just a construct to allow
someone to make some money. You cant make billions of dollars selling pills
through educational reform. Carbs have a longer shelf-life, high profit margin
and are hunger inducing so fat was demonised. Recycling doesnt work because
its not cost effective but the plastics industry pushes it to shift
responsibility away allowing them to fill our world with garbage. You cant
make money with treatments out of patent so meds like chloroquine are
demonised with cherry-picked research. We are swimming in an ocean of garbage
presented to us as fact.

------
mlang23
PTSD is quite obviously a response to adversity, that is already implied by
the name! What am I missing here? Why is this news?

~~~
MaxBarraclough
The point is whether it's _adaptive_ , i.e. whether it has evolved because it
is beneficial (such as our pain aversion), rather than arising as an
unfortunate bug in the system (such as cystic fibrosis, a genetic disorder
which seems pretty clearly not to be adaptive).

~~~
mamon
Of course PTSD is beneficial: it gets you discharged from military, for
example, so the chances of you being in the situation where someone is
shooting bazooka at you drop to zero.

In general PTSD helps you avoid traumatic experience in future.

~~~
blame_lewis
In many interpersonal relationships, a trauma response causes you to become
_more_ liable to ending up in the same situation, not less. Do not
underestimate how many people end up reliving their trauma over and over
because they can't overcome that response.

------
throwaway0a5e
So why didn't anxiety, depression and PTSD abound in historical societies that
were always at risk of some bad thing (usually famine but also sometimes
invasion)?

Bad stuff has always happened and always will happen. Something about modern
society makes us bad at dealing with it in a healthy way.

I don't doubt that there might be some mismatch between the environment our
biology is optimized for and the one we live in now but it seems like these
conditions weren't common, or if they were they weren't a problem, among our
ancestors who lived under different circumstances.

------
raducu
Besides raving on and on about ADHD, the article offers little actionable
stuff, dubious reasoning and outright falsehoods at places (like the fact that
antidepressants are no better than placebo).

~~~
disgruntledphd2
I wouldn't say that that is a false statement, there's been a bunch of
research in the area, mostly started by this paper:
[https://www3.nd.edu/~ghaeffel/Kirsch2002%20Prevention%20&%20...](https://www3.nd.edu/~ghaeffel/Kirsch2002%20Prevention%20&%20Treatment%20copy.pdf)

Note that the above is an analysis of the data used to approve the medications
from the FDA, so likely to be optimistic.

The headline finding is that compared to an active placebo (i.e. one with
similar side effects), the benefits of SSRIs are very small.

However, if you have a diagnosis of MDD, there is more evidence for an effect
(although it's still pretty small).

It's a difficult subject to study correctly, because of the strong commercial
pressures (like most drug studies, to be fair), but depression does seem
relatively placebo responsive, which would suggest either a connection to
inflammation or the body's opioid system.

This does not mean that people should stop taking anti-depressants, I'm not a
medical doctor etc, but there is some research to support the assertion around
SSRIs and placebo in the article.

------
solinent
I used to get severely depressed, and it was often stress-related; adversity,
work, even sickness would make things worse. I completely changed my lifestyle
and started working out almost 3 hours a day (walking counts)in addition to
removing carbohydrates from my diet almost entirely. After this change, I only
get depressed for a second, then I realize I can take action, and then I take
action, and it leads to happiness.

YMMV.

my personal theory is that it's related to bacteria in your gut--working out
helps promote a good gut microbiome (this is well studied) and removing
carbohydrates removes all those bacteria such as lactobactilla which will
literally cause psychological changes, these bacteria are part of the
metabolic process converting carbohydrates to blood glucose, and they are
literally interacting with the nerves in your gut making you feel depressed.
It's a biological thing. Psychology never helped me, instead it actively
harmed me. The lectures of Robert Sapolsky and the concepts of cognitive
behavioral therapy helped the most from the psychological perspective,
however. This combination of advice is purely anecdotal of course, but all the
steps I took have been widely studied. It's hard to create an industry around
the removal of a product, I guess.

------
SzamarCsacsi
_" When it comes to what labels we use, a change is welcome. Mental health
recovery in part depends on whether patients believe they can get better.
Telling our patients that their symptoms may be tied to a healthy response to
adversity could be very encouraging."_

I find it the exact opposite. For me it seems easier to fix a mental disorder
in my brain than to bring the necessary sociocultural changes in the world to
mitigate my problems.

------
bernardlunn
This will help a lot of people avoid unnecessary anxiety and shame/guilt.

------
johnnujler
It took humans thousands of years to adapt to the side-effects of the
agricultural(Neolithic) revolution ([https://www.discovermagazine.com/planet-
earth/the-worst-mist...](https://www.discovermagazine.com/planet-earth/the-
worst-mistake-in-the-history-of-the-human-race)). I think we are in a similar
situation—psychological revolution?—where the side-effects due to social
media, globalization, and other related phenomenons are starting to change the
landscape. My guess is we will soon see that the plateau we have attained in
the form of psychological disorders will slowly fade away in couple more
generations as people start adapting to this kind of stress. Maybe our
generation is evolution's transition point? At least I hope that it is, I've
never seen this at this level of intensity with my grandparents'/parents'
generation and I do not want to see this with the next generation.

------
dathinab
Anxiety & depression might be useful if handled well but if not...

The problem is often on the line of you get depression & anxiety as a symtom
of some other problems if you fix the problems fine. If you don't it can get
out control and then you _can become conditioned to do "bad" responses to all
kind of things making the symptom a illness itself_. And making it really hard
to get out of it.

Or at least this is how it _often did look like to me_ when I looked at people
with depression & anxiety.

Just to be clear with "bad" responses I mainly mean thinks like avoiding
problems instead of fixing (or sidestepping) them making it with every time
you do so harder to "fix" that underlying problem in the future.

------
anonzzz
“there is little in our evolutionary history that accounts for children
sitting at desks quietly while watching a teacher do math equations at a
board.”

In the section that discusses labels, I am particularly struck by this quote.
So many things in our evolutionary history seem contrary to the way we live,
learn, and interact. Perhaps this is the catalyst that ignites the
evolutionary flames. I often think that we are just hitting our heads against
a wall and expecting different results other than a bloody head.

------
softwaredoug
The ACE (adverse childhood experiences) study might be one of the most
important health findings since Germ theory. In the sense that it finds a true
root cause for a lot of health maladies, as well as physical mechanisms that
cause these health issues in traumatized kid (all animals respond
maladaptively to stress hormones introduced too early in development)

I’d recommend people read “The Deepest Well” - a great book on this topic.

------
raindeer3
"Anxiety may be due to chronic activation of the fight or flight system. PTSD
may occur when trauma triggers the freeze response which helps animals
disconnect from pain before they die, and depression may be a chronic
activation of that same freeze response." Isn't this a quite good definition
of disorders? If a system is chronically activated when it should not, it
seems like a disorder.

------
mlthoughts2018
This is an interesting read on a similar take on major depression,

[https://grasshoppermouse.github.io/2018/12/16/seven-
reasons-...](https://grasshoppermouse.github.io/2018/12/16/seven-reasons-why-
major-depression-is-probably-not-a-brain-disorder/)

------
anm89
I'm not a psychologist but this feels pretty intuitively self evident to me.
Did anyone ever think otherwise?

------
billman
Another thing to think about is that these responses may cross generations.
i.e the anxiety someone experiences today may be due to trauma suffered by
thier grandparents. The mind is a wonderful thing, but there is so much that
we don't understand about it/ourselves.

~~~
podgaj
This happens through epigentic changes, not through the mind or the brain.

[https://www.sciencemag.org/news/2019/07/parents-emotional-
tr...](https://www.sciencemag.org/news/2019/07/parents-emotional-trauma-may-
change-their-children-s-biology-studies-mice-show-how)

------
sudofail
Couldn't a person have a biological makeup that predisposes them to experience
greater or lesser adversity? If mental disorders are adaptive responses, that
doesn't seem to rule out that some people may be more prone to interpreting
situations as adversarial.

~~~
tapland
Yes of course one could have more or less of a response. Situations and
circumstamces (we’re talking about entire lives worth of experiences) vary so
much though that it would be impossible for an outsider to state _you are
weaker_ based on the limited knowledge you can have about another person.

------
bjornsing
Well we surely did not evolve to be happy and content, that’s for sure. Sounds
to me like a good bet that most mental disorders are adaptations to adversity
in evolutionary time, that are often maladaptive in modern society.

------
tabtab
Younger boys who get a lot of exercise consistently perform better in school
on average. The "problem" is that girls don't need as much exercise.
Coordinating the difference confounds US schools.

------
throwaway4747l
Ah yes, yet another occurence of adaptationists trying to shoehorn literally
every single trait into their framework. It's basically intelligent design
that doesn't say its name.

------
fnord77
when these conditions persist after the adversity has passed, that's
maladaptive.

~~~
dredmorbius
Is a leg that remains fractured after a physical shock has passed also
maladaptive?

~~~
fnord77
if it doesn't heal in some reasonable amount of time after the trauma and
remains fractured indefinitely, then yes.

~~~
dredmorbius
How do fractures heal without proper medical care?

The "just walk it off" method fares poorly.

Magaret Mead uses this for her exemplar of civilisation foe a reason.

~~~
fnord77
for many fractures, yes.

fractured usually ribs heal by themselves.

I once had a broken, displaced rib. Nothing was done except to let it heal by
itself

------
whearyou
No way! /s

------
holidayacct
Anxiety is a disorder of the nervous system that is a by-product of
civilization. We are one of the only mammals that gets anxiety, if you get
anxiety in the wild you won't be alive much longer.

Depression and PTSD are not responses to adversity. If you face adversity and
suffer depression or PTSD you were raised psychologically weak in a way that
is dangerous to you.

There are people who have survived civil wars, drought and mass starvation all
over the world that don't have these problems get out of your bubble.

~~~
tsimionescu
> There are people who have survived civil wars, drought and mass starvation
> all over the world that don't have these problems get out of your bubble.

And similarly, there are people who have been traumatized by the same events.

In fact, there are war heroes who have taken bullets for their comrades, saved
platoons, jumped at the enemy, and have been stricken with PTSD - if you think
these people are "weak", then you probably also consider people who get cancer
to be of inferior stock, right?

~~~
podgaj
It is so shocking to me that people do not think genetic diversity exists
without the human species.

