Good reasons for bad feelings.

Why we are all so unhappy - and does evolution have a good answer to this profound question?

The reason I picked up this book, was because it marries my current curiosities around mental health with the eternal fascination I have with the craftiness of biological evolution.

The author Randolph M. Nesse has been a professor of psychiatry and psychology and is considered the founder of evolutionary medicine. So, he is the perfect person to help us understand, the insights that evolutionary biology can provide for mental disorders.

He sets out to ask the question, that I, and I am sure you must have pondered over as well:

Why do mental disorders exist at all? Why are there so many? Why are they so common? Natural selection could have eliminated anxiety, depression, addiction, anorexia, and the genes that cause autism, schizophrenia, and manic-depressive illness. But it didn’t. Why not?

Part I: Why are Mental Disorders so confusing?

The entire field of psychiatry looks pretty confusing from outside, with experts from various domains offering all sorts of explanations and treatments. The explanations of these disorders range from chemical imbalances, childhood trauma, the impact of urban-life to repressed Freudian thoughts, while the prescriptions range from pills to wide-ranging therapies and lifestyle changes. These explanations and purported remedies are not wrong, but insufficient as they look at the mental disorders from what the author refers to as "proximate - slice in time" perspective.

There is another perspective, which helps us in a deeper understanding of many biological processes, that is their adaptive significance and their evolutionary history. Quick e.g. Fever is caused by pathogens such as a virus which is a proximate cause, but the reason that fever even exists is that high body fever helps to reduce the replication rate of pathogens and fight infection.

In this way, evolution can, not only explain, few symptoms or diseases but even much more complex aspects of human sufferings. A great example of this is evolutionary understanding that we have developed for the decline of health with age. Here is a quote from the book which summarizes this concept well

.......... a gene causing aging could become universal if it gives benefits early in life, when selection is stronger because more individuals are alive then. For instance, a genetic variation that causes coronary artery calcification that kills many people by age ninety could nonetheless become universal if it also makes broken bones heal faster in childhood. If aging has an evolutionary explanation, what about schizophrenia, depression, and eating disorders?

So, just like for ageing, the author is trying to similarly explore possible explanations for our propensities for mental disorders.

But, we need to be careful. It is very easy to misunderstand this idea, especially in the context of mental health. So, the way we may start asking the question, just like in the 'fever' example above - 'what is the adaptive utility of anxiety, low mood and plethora of mental disorders?'. This line of questioning is erroneous and this common misreading even has a name - VDAA (Viewing Diseases as Adaptations).

A good analogy that I found to absorb this idea, is to think about our modern propensity for "obesity". It is more intuitive to understand, that it is not correct, to ask what is the adaptive utility of obesity, but the right perspective is to understand that in our evolutionary past it made sense for the body to store fats and sugars as these happened to be in short supply. This is what makes us vulnerable to obesity.

Similarly, the appropriate view is that the mental disorders are not adaptations in themselves, but are a byproduct of vulnerabilities and propensities that persist because of our evolutionary history:

This part details the six ways evolutionary reasons for 'vulnerabilities' that we have for mental disorders. I found reading through all of these illuminating about not only the mental disorders but something to keep in mind while thinking about all diseases, disorders and limitations of the human body and mind.

I will not be able to do justice, summarising them here, but I would encourage you to spend some time on all six of the reasons when you reach this section

Mismatch: our bodies are unprepared to cope with modern environments.
Infection: Bacteria and viruses evolve faster than we do.
Constraints: there are some things that natural selection just can’t do.
Trade-offs: everything in the body has advantages and disadvantages.
Reproduction: natural selection maximizes reproduction, not health.
Defensive responses: responses such as pain and anxiety are useful in the face of threats.

Part II: Reason for Feelings

We intuitively understand the evolutionary benefits of 'emotions' such as fear & panic.

The cost of not fleeing if the lion is present is 1,000 times greater than the cost of a panic attack, so the optimal strategy is to run like hell whenever the sound is loud enough to indicate a lion is present with a probability greater than 1/1,000. This means that 999 times out of 1,000 you will flee unncessarily. However, 1 time out of 1,000, fleeing will save your life.

If we think a bit, the same applies very well to all other feelings - positive, negative and even some of the pain and suffering.

Love joins hate; aggression, fear; expansiveness, withdrawal, and so on; in blends designed not to promote the happiness and survival of the individual, but to favor the maximum transmission of the controlling genes. (E. O. Wilson, Sociobiology, 1975, p. 4)

Another quote from the book expounds the same idea further.

So, all the emotions including the bad ones are part of the suite of tools that evolution has crafted to assist in the purpose of reproducing and passing on the genes. Our happiness, peace, satisfaction etc. were never its goals and they are mere few of the tricks to manipulate our behavior in service of selection.

So, our emotions are smartly crafted by evolution and this section does a great job of helping us appreciate the reasonable evolutionary logic of everything on the spectrum from pain, sadness, happiness to exuberance. The same conceptual line of thought can help us come up with a hypothesis for a few of the mental disorders.

For illustration, PTSD may be explained in this context. If a hunter found himself in an extremely dangerous environment, it makes sense to make semi-permanent changes in the brain functions to keep the hunter extra cautious of future possible dangers. But, in the current scenario, when the environment changes for a soldier, from a war zone to safety of home & family, these semi-permanent changes make it difficult for an ex-soldier to fit in.

Depression (and low moods) may also have one or several such explanations. The one I found interesting was that depression might be a signal to change tracks from an endeavour which has low chances of succeeding. A kind of subconscious mathematical calculus of marginal value theorem. The life-lesson bit herein is this line quoted by the author.

".....mood is influenced most not by success or failure but by the rate of progress toward a goal."

In many cases, depression might be pointing towards something in life that needs changing e.g. new job, new partner, divorce, better social life, healthier body etc. and making that change in life might actually make one get over 'depression'. There is another book 'Lost Connections' by Johann Hari which explores very similar ideas from an altogether different perspective.

But, we should also not get the impression that all mental disorders are for a good reason. Chapter 7 of this part is aptly named - Bad feelings for no good reasons. An analogy quoted right at the beginning makes it unambiguous.

Sadness is to depression what normal growth is to cancer. - Lewis Wolpert

There are plenty of cases where the individual suffers what the author calls "failure of moodostat". That effectively means that everything might be perfect in life, yet the individual may very well suffer from a mental disorder. I found the analogy with thermostat well applied here. Based, on our environment our moodostat is supposed to adjust our emotions to help us respond most effectively. But, if this moodostat is not working properly, this can very well lead to malfunction. This mood regulatory mechanism can fail in 6 ways:

Baseline is too low
Baseline is too high
Response is deficient
Response is excessive
Response is aroused by inappropriate cues
Response is independent of cues

These are fairly self-explanatory - and one of the good mental tools I found to self analyse my own moods and should be good food for thought for mental health practitioners as well. The fragility of moodostat, though remains an open question for which the author mentions promising if not an entirely convincing hypothesis.

Part III: The Pleasures and perils of social life

I found this and the next part, weakly written and slightly tangential to both the overarching theme of the book and the first two parts.

The second chapter of this part, mentions the vexing questions of the evolution of human altruism, our inherent social nature and our proclivity for cooperation. (This has been a topic of intense debate & discussion, on which a great number of books have been written. Links to a few of the books which I have read & found interesting over the years - 1,2,3,4,5) This context is important to appreciate various emotions and corresponding disorders pertaining to social nature - such as social anxiety, self-esteem, grief etc.

The third chapter talks about something again which has intrigued evolutionary biologists for a long while. We not only have an ability to deceive others but we somehow have a fascinating superpower to deceive ourselves. (Great book on this topic - Elephants in our brain).

Humans are often able to repress uncomfortable thoughts - to perhaps save themselves from the trauma. This inaccessible world of unconscious is perhaps crafted by evolution to save ourselves from pains of cognitive dissonance and to rationalise the situations that we find ourselves in. Its a fascinating yet disturbing facet of our mind, but may hold the key for several disorders including OCD and several of our biases.

Part IV: Out-of-Control Actions and Dire Disorders

Our fascination with Sex should not be a surprise in light of the fact that reproduction is all that evolution is optimizing for - but what is surprising is the huge range of unhappiness related to sex.

People long for partners they can never have, and many have little desire for the partner they do have. They want more sex than their partners, or less, or different. They are preoccupied by fantasies that can never be fulfilled in real life. They worry about impotence or lack of arousal. They have orgasms too soon, too late, or not at all. And jealousy creates frustration and sadness beyond meaure.

Male's and female's evolutionary interests diverge often, leading to surprising conflicts. A woman has to invest several years of her life in rearing one single kid to improve chances of passing her genes. While a man has an option of trying to increase the chances by trying to have multiple kids by having sex with several women.

I found the bit about uncoordinated climaxes pretty fascinating. There is a good reason why men end up climaxing so much earlier than women do, creating so many bedroom woes.

For a woman, any genetic tendency to sometimes stop intercourse before her partner ejaculates will be selected against. Imagine, for a moment, if women had teh same saexual response cycles as men. They would often have orgasms before their partners, then become senstive and stop, making conception exceedingly unlikely.

If you are a guy, you can try using this as an excuse next time you finish off earlier than your female partner.

After sex, perhaps the food is the next biggest evolutionary desire of humans and its not much of a wonder that there are problems of obesity in this modern age of easily available calories. Associated, disorders of anorexia and bulimia may also be better understood from an evolutionary perspective and the author does suggest a few interesting hypotheses, but I didn't find them convincing. The section wraps up with interesting thoughts on our evolutionary vulnerabilities for addictions to pornography and social media, and substance abuse - tobacco, alcohol and harder drugs. I found these topics lacking novel insights, for which I guess the reason is the lack of research and the intent to mention them here seems to be to encourage more focus and research on the area.

In conclusion, the author does end up convincing the reader, that evolutionary perspective has a lot to offer for not only understanding these mental disorders but coming up with creative ways to offer remedies, which is the author's key motivation for writing this book.

The eternal question of unhappiness

I think this is the revolutionary take away from this book, which the author mentions briefly in his introduction and in his conclusion, but remains explored only partially in this book. Perhaps it will need a philosopher rather than an evolutionary psychologist to take this thread further.

I had thought that selection shaped us to be healthy, happy, nice, cooperative members of a community. Alas, no. Natural selection does not give a fig about our happiness.

Selection shaped our brains and bodies to maximize reproduction at enormous costs to human happiness

He gives a really good answer (though a useless one) to the question of human suffering.

Nearly everyone has wondered why human life is so full of suffering. Part of an answer is that natural selection shaped emotions such as anxiety, low mood, and grief because they are useful. More of an answer comes from recognizing that our suffering often benefits our genes.

I think this is profound. What we need to understand and absorb is that we have not evolved for happiness, peace or contentment. These emotions are merely tools fashioned by evolution to nudge us towards passing on our genes as required in life. Sadness, anxiety and suite of bad feelings serve the exact same purpose as well.

Inside out. Feelings. Emotions. Psychology. — Inside out, in sweet animation on emotions with interesting parallels to what we understand from this book.

The idea, that happiness (or at least its pursuit) is somehow the default and sadness is a deviation from the norm is incorrect, and I think there is much wisdom here. This is also not to say that we should turn cynical about the inevitability of sadness, but rather have greater respect for all the emotions that we have and the immense role they have played over our evolutionary history and continue to play driving our daily lives.

This idea, also lets us better appreciate the immense capacity of love, goodness and caring that we have, how precariously all of it has come about via our evolutionary history and how wonderfully rich they make us as humans today.

You may buy the book here - Good Reasons for Bad Feelings.