Monday, November 05, 2012

Culture Lab - Is There an Upside to Anxiety?

This is a brief review of a new book by Jeffrey P. Kahn, Angst: Origins of Anxiety and Depression, that suggests social anxiety and depression may have evolutionary benefits. As someone who has lived with SA for my whole life, I find this questionable, so I will likely have to read the book.

Here is the publisher's description of the book:

Some twenty percent of us are afflicted with common anxiety and depressive disorders--not just brief bouts of nervousness or sorrow, but painful dysfunctions without obvious benefit. Why do so many people suffer from angst?

In this path-breaking volume, engagingly written for the general public, psychiatrist Jeffrey Kahn reveals that angst ultimately results from our transformation, over tens of thousands of years, from biologically shaped, almost herd-like prehistoric tribes, to rational and independent individuals in modern civilization. Kahn looks at five basic types of modern-day angst--Panic Anxiety, Social Anxiety, OCD, Atypical Depression, and Melancholic Depression--and shows how each derives from primeval social instincts that once helped our ancestors survive. For instance, the "panic disorder" which prevents some people from flying may have originally evolved to keep our tribal ancestors from traveling dangerously far from home. Likewise, the increased emotional sensitivity to social rejection that now triggers episodes of "atypical depression" may have helped maintain polite behavior and social harmony in our ancestors. Our distinctly human civilization and rational consciousness lets us defy these social instincts. But those over-ridden instincts can resurface as stressful emotional disorders. Kahn notes that some of us painfully tackle this distress head-on, in ways that can advance intellectual creativity, social performance and productivity. He also describes the interplay of instinct with the advance of civilization, and on how evolutionary perspective explains why modern treatments work.

Ranging from Darwin and Freud to the most cutting-edge medical and scientific findings--drawing from ancient writings, modern humor and popular lyrics, and with many amusing cartoons--Angst offers us an exciting new slant on some of the most pervasive mental health issues of our time.
The review suggests that the book is a little too filled with jargon and psychiatric lingo for the average reader, but those of us in the field can deal with that.

angst.jpg Samantha Murphy, contributor

Social anxiety and depression are miserable, but they may have evolutionary benefits

DEPRESSION and anxiety are easily two of the most commonly diagnosed psychiatric ailments. But if they are so prevalent across so many cultures and societies, where did they come from? Are we experiencing an epidemic? Or is it simply a case of mislabelling a common, though unpleasant, life experience as a disorder in order to medically whisk away the tough bits of what it means to be human?

In psychiatrist Jeffrey Kahn's new book, Angst, he examines the origins of depression and anxiety and, using current research in psychology and evolutionary biology, carefully applies a unique anthropological perspective for why these conditions exist.

He reasons, for example, that social anxiety - the fear of interactions with strangers - may have evolved to enable a natural social ranking system in which some people feel most comfortable towards the bottom of the totem pole. This natural shuffling would have made for a less aggressive, more survivable living situation and reduced fighting for leadership.

Alcohol, Kahn goes on to argue, may well be the "first widely used psychopharmacological medication" - given its ability to "lubricate" a socially anxious person. It is no secret that alcohol can allow us to disregard our varying degrees of social anxiety and pursue endeavours that we may otherwise avoid. Kahn suggests this, too, has an evolutionary purpose: for a person who is normally withdrawn, "beer muscles" can provide a chance to get socially involved, or contribute to their community in a way they might not otherwise.

Viewing depression and anxiety as a form of survival strategy is novel, and as yet the practical application of these theories remains elusive. One possible conclusion is that people with such conditions should not be medicated because, in spite of the personal struggles they may endure, there are hidden evolutionary benefits.

But Kahn is not endorsing the idea that we stop treating people with medication, and the book falls short on applications in a real-world context. As a result, the usefulness of these new perspectives feels limited.

The book is written for a wide audience, but Kahn's valiant attempt to break down the points with colourful examples, quotes and case studies, is mired by psychiatric lingo and jargon. Consequently, the book reads like a well-researched bar chat between off-duty psychiatrists bantering about how maybe, just maybe, angst isn't such a bad thing after all.
Book information
Angst: Origins of anxiety and depression by Jeffrey P. Kahn
Oxford University Press

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