This is a novel and counter-intuitive evolutionary theory, as presented at UCLA: Anxiety and Depressive Subtypes Evolved from Primal Altruistic Instincts. (From the book: "Angst: Origins of Anxiety and Depression" Oxford University Press. Feel free to comment or share! Overview: A synthesis of common psychiatric problems as overarchingly derived from ancient (and cross-species) evolved social instincts. Where applicable, the book (in non-technical language, with cartoons, blues lyrics, and bad puns) incorporates prior theory, and is well supported by more than 600 scientific references. Summary: Did Common Anxiety and Depressive Subtypes Evolve from Primeval Altruistic Instincts? Anxiety and depression are here for a reason - they evolved from the ancient herd social instincts (of many species) for social harmony and group evolutionary success - but they can be painful and maladaptive for us conscious human individuals! Rather than blindly follow our biological instincts, we use our consciousness and culture to choose our place in society and our social behavior. As a result, some of us suffer the distressing emotional prompts of instincts as we over-ride them. There are implications for self-understanding, reductionist psychiatric diagnosis, genetic research; and understanding why existing treatments are effective, how beer became popular and where all this Angst comes from! Thanks!

1. The Origin of Angst:
How Anxiety and Depression Evolved From
Ancient Herd Instincts –
And Became Painful to So Many of Us
Jeffrey P. Kahn, M.D.
Weill-Cornell Medical College
New York, NY
UCLA Psychiatry Grand Rounds
February 2015
VIDEO LINK:
psychiatrygrandrounds.com/GR15/JKahn.html

2. Jeffrey P. Kahn, M.D.
Disclosures:
Author:
“Angst: Origins of Anxiety and Depression”
Oxford University Press
No other disclosures

3. Why Is There Angst?
 Anxiety/Depression Must Have a Reason
 A Theory on The Origin of Angst
Five specific syndromes reflect five
corresponding social instincts - that try to
coax us back to more herd-like behaviors
Our Anxiety and Depressive Disorders Are
Modern Expressions of Ancient Herd Instincts
Simplistic nutshell: five core anxiety and
depressive subtypes emerge when our
rational and civilized behavior arouses our
sociobiological instincts

4. Humans Wonder - and Wander

5. Humans Think Like This, Not Cows

6. Sheep Can Recognize Humans

7. And When We Wander From the Herd…
…Social Instincts Coax Us Back

8. Lions and Tigers and Bears are Not Why:
Angst is the Modern Echo of
Evolved Social Instincts
 Primeval Lions Evoked Fear - Not Angst
 Most Important to People is: Other People
 Even Thoreau
 The Central Social Core of Human Existence:
 Tribal/Herd Behavior Instincts
 Social Emotion
 A Social Focus for Evolution

9. Evolutionary Selection
 Survival of the Fit Individual
 The Fittest Individuals Pass On Their Own DNA
 Survival of the Socially Fit Herd
 The Fittest Social Behaviors Pass On Group DNA
Sterile Worker Bees Protect Species DNA
A Brave and Childless Mouse Protects Family DNA
 Altruism!
 Natural Selection: 2 Complementary Processes

10. Evolutionary Psychiatry
Is Not A Brand New Idea
 Darwin
Expression of Emotions in Man and Animals
 Freud
A Phylogenetic Fantasy
Hyperaggressive “Ice Age Man”
Das Unbehagen in der Kultur
Civilization and Its Discontents
“The Discomfort in Culture”
 Jung
Collective Unconscious
 Many Others

11. Evolutionary Psychiatry:
A Newer View of Psychopathology
 DSM
Validated and Specific Psychiatric Diagnoses
 But Some Diagnoses May Be Overly Broad
Major Depressive Disorder
Generalized Anxiety Disorder
Bipolar II Disorder

12. Five Specific Syndrome Subtypes
Panic Anxiety
Social Anxiety
OCD
Atypical Depression
Melancholic Depression

13. Evolutionary Psychiatry:
A Novel Sociobiological Synthesis
 These Five Core Syndrome Subtypes Are Our Angst
Each One Matches a Specific Social Instinct
Instinct Matches Syndromal Core Cognitions
Corresponding Behaviors Even in Us Civilized Types
Ethology and Animal Behavior
Specific Angsts from Specific Aroused Instincts
Each Syndrome Includes Related Syndromes
 Humans Have Further Evolved These Instincts
Intensification
Counter-Instinctive Adaptation

14. For Each Syndromal Instinct:
Real Scientific Support
Science (More Than 600 References)
Genetics and Epigenetics
Social Psychology
Animal Ethology
Psychopharmacology
Neurosciences
Clinical, Biological, Workplace Psychiatry

15. #1: Panic Anxiety: Stay Near Home
 Social Purpose:
 Kept us close enough to home and group that we could
safely find our way back.
 An alarm to warn of geographic or emotional distance
 Counterinstinctive Behavior
Example: Challenging Fear of Flying
 Motto:
 “Catastrophes await if you can’t find your way home.”
 Animals:
 Infant Separation Anxiety

16. Don’t Stray Far From Family, Home or Safety:
Panic Anxiety

17. #2: Social Anxiety: Social Hierarchy
 Social Purpose:
 Kept us in line in tribal social hierarchies to
keep the peace at home.
 Shy embarrassment from gratifying attention
 Counter-Instinctive Coping
Example: Performers Challenging Their Fears
 Motto:
 “Shame and embarrassment come from not
knowing your primeval rank.”
 Animals:
 Dominance Hierarchy – Alpha Dogs & Baboons

18. Follow the Leader of the Pack:
Social Anxiety
“Too Many Cooks Spoil
the Broth”
– Old English Proverb

19. #3: OCD – Nesting Behavior
 Social Purpose:
 Impels the work needed for groups to live together safely.
 Motto:
 “Clean, arrange, save and behave for a sure and tidy nest.”
 The Four OCD Factors by Factor Analyses
 Para-Instinctive Coping
Example: Numbers and Technical Work
Animals:
 Nesting (and Grooming)
 Clean, Arrange, Save, Behave

20. #4: Atypical Depression: Social Harmony
 Social Purpose:
 Kept us well-enough behaved for a cooperative society.
 Rejection Sensitivity Leads To More Polite Behavior
 Counter-Instinctive Coping
 Example: Detached Workaholism to Succeed and Remain
 Motto:
 “Behave yourself to avoid rejection, remorse and exile.”
 Animals:
 Canine Apologies
 Winter Hibernation
 Earlier Evolutionary Instinct, With Similar Symptoms

21. Go Along to Get Along:
Atypical Depression
“Nature, when she formed man for society, endowed him
with an original desire to please, and an original aversion
to offend his brethren.” - Adam Smith

22. #5: Melancholic Depression:
Preserving Herd Resources
 Social Purpose:
 Death kept us from using scarce resources when we no
longer felt useful to the herd.
 Eskimo Ice Floe Myth
 Counter-Instinctive Coping
 Example: Counter Fatalism with Reason
 Motto:
 “Take one for the team if you are too old or too ill.”
 Animals:
 “Illness Behavior”
 Salmon, Mice - and the Human DST
 Apes and Dogs

23. Feeling So Useless You Could Die:
Melancholic Depression
“How do we, humans
know when it is time to
move on? As with the
migrant birds, so
surely with us, there is
a voice within if only
we would listen to it,
that tells us certainly
when to go forth into
the unknown.”
- Elisabeth Kubler-Ross

24. #6: Consciousness: Social Awareness
 Social Purpose:
 Keep Us Responsive To Our Companions And Environment.
 Allows Counter-instinctive And Repurposed Behavior
 Moderates Ancient Instinctive Fears
 Except When Diminished by “Hypofrontality”
 Motto:
 “Thoughtful Understanding Leads To Better Solutions.”
 Animals:
 Dolphins, Apes, Crows And Dogs Have Some
 But Human Consciousness They Have Not!
 Positive Psychotic Symptoms Not Clearly Known In Animals

25. Consciousness Lost & Instinct Run Amok:
Schizophrenia and Psychosis
“The very essence
of instinct is that it
is followed
independently of
reason.”
- Charles Darwin

26. Psychosis/Schizophrenia: Syndromes
 Five Syndromes: Five Psychotic Subtypes
Aroused Instincts Override Reason
Hypofrontality
The Missing Think
Decreased Conscious Mediation
Dopamine
The Provocative Power of Appetite
Increased Instinctive Arousal

27. Five Human Syndromes:
Instinct Becomes Psychotic Perception
 Panic Anxiety
 Classical Paranoid Schizophrenia: Alone against predators
 Social Anxiety
 Paranoid Delusional Disorder: Authorities will punish you
 OCD
 Schizo-Obsessive: Catastrophe from ignoring the nest
 Atypical Depression
 Mania: From social harmony to saving the world
 Melancholic Depression
 Psychotic Depression: The purposeless must die, rot away

28. Happy in the Herd:
Instinctive Herds & Primeval Ignorance
“The security of Society
lies in custom and
unconscious instinct, and
the basis of the stability of
Society, as a healthy
organism, is the complete
absence of any
intelligence amongst its
members.”
- Oscar Wilde

29. Assembling the Herd
 From Bacteria to Herd to Homo sapiens
 The Same Six Instincts Everywhere
 (Maybe not Melancholia)
 Boids: Computer simulation of bird flocks
 The Big Five Personality Traits (OCEAN)
 All I Really Need to Know I Learned in
Kindergarten
 Varieties of Moral Experience: Political Herds
 Instincts & Specialized Social Group Roles

30. Climbing To Civilization:
The Rise of Reason & the Ascent of Angst
“It is impossible to overlook the extent to which civilization
is built upon a renunciation of instinct.” - Sigmund Freud

31. Cogito Ergo Vincere Instinctu:
Quelling Angst & Rethinking Herds
 Beer and Civilization
 Consciousness and Everyman
 The Origin of Psychopharmacology and Beer
 Alcohol Free Societies Today
 The Deliberate Herd
 A Higher Authority
 Government
 Civilization and Societal Advance
 Counter-Instinctive Coping
 Consciousness, Teams and Technology

32. Illness and Instinct:
Consciousness Has Consequences
“Man is the only
creature that refuses
to be what he is.”
- Albert Camus

33. Mere Civilized Consciousness
Does Not Blissfulness Buy
 Triggered Psychiatric Syndromes
 Coax us Back to the Herd
 Stigma
 Suicide
 Alcohol and Substance Abuse
 Crime
 Heart Diseases
 “Stress” of Counter-instinctive Behavior

34. Free to Choose:
How to Balance Your Reason & Instinct
“Nothing in biology makes
sense, except in the light
of evolution”
- Theodosius Dobzhansky
“The final mystery is
oneself.”
- Oscar Wilde

35. Who Are You?
 Consciousness or Biology?
 Endure Suffering or Seek Succorance?
 You’ve Gotta Ask Yourself One Question:
Do You Feel Yucky? Do Ya?
 Unexpected Risks of Treatment
 The Helmet Effect
 Shiny Happy People?
 The Vital Importance of Psychotherapy
 Where Are We Headed Now?

36. Are We Still In the Same Place?
 “The past is never dead. It’s not even past.”
- William Faulkner
 To a greater extent than we have imagined,
we may still live today in an emotional world
designed on that ancient African savannah.

37. Angst: Origins of Anxiety and
Depression
Oxford University Press
For Book Reviews:
Facebook.com/Evolutionary.Psychopathology
Jeffrey P. Kahn, M.D.
Weill-Cornell Medical College