Angst Origins of Anxiety and Depression

Why do so many people suffer the slings and arrows of outrageous angst? Some twenty percent of us are afflicted with common Anxiety and Depressive disorders. That's not just nervous or scared or sad - that is painful dysfunction without obvious benefit. This angst comes from an evolutionary inheritance that biologically shaped us into social communities. There are just five specific diagnostic subtypes that account for most of this modern-day angst: Panic Anxiety, Social Anxiety, OCD, Atypical Depression and Melancholic Depression. Each of the five comes from primeval social instincts that told our ancestors how to improve survival of their community DNA. These instincts are also very much alive and unfettered in other species today. Their potential link to our human distress was anticipated by both Darwin and Freud. We humans have greater instinctive consciousness than other creatures. Rational thoughts let us defy biological social instructions. One result of this uniquely human skill is that over-ridden social instincts complain to us in the painful language of emotional disorders. A few of us even tackle this pain head-on, in ways that can advance our intellectual creativity, social performance, and productivity. Our human intellectual abilities owe as much to our unique social software as to our greater brain processing power. Civilization is built upon our ability to maintain social harmony with ethics and government, and to find solace in technology, religion and beer. This novel theoretical synthesis offers a new framework for understanding what our knowledge of psychiatric neuroscience, clinical research, diagnosis and treatment. The central theory is explained in everyday language. It is supported by clinical observation, straightforward accounts of complex science, animal research, and quotes from both ancient writings and modern humor and lyrics. This fascinating new synthesis is written for the general public, mental health professionals and academic researchers alike.

Jeffrey P. Kahn, MD is Clinical Associate Professor of Psychiatry at Weill-Cornell Medical College, in New York City and Westchester County.