Anxiety and Depression

What are anxiety disorders?

Symptoms such as worry, social and performance fears, panic attacks, anticipatory anxiety, and avoidance.

What are depressive disorders?

Common feature is “sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.”

How high is the comorbidity of anxiety and depressive disorder?

~50–80% of people w/ depressive disorder meet diagnostic criteria for anxiety disorder.

How does culture shape meaning of depression?

Depression and anxiety can manifest and be experienced differently.

What is somatization?

The emphasis on somatic symptoms and de-emphasis of psychological symptoms

What are somatic symptoms?

Physical sensations, pains, or bodily dysfunctions (e.g., pain, fatigue, dizziness).

In an evolutionary perspective, how is some anxiety useful or used as an anticipation system for threat?

1. Detect potential threats

2. Prepare behaviorally and physiologically

3. Bias decisions toward safety when stakes are high

What is the smoke alarm principle?

Our brains evolved to favor frequent, low-cost false alarms (like anxiety) over the catastrophic high cost of missing a single real threat, effectively prioritizing survival over your daily peace of mind.

What are the evolutionary origins of phobias?

Phobias stem from a biological "mismatch" where ancient survival instincts are dialed up to an inappropriate intensity for the modern world.

Most phobias are not "random" fears; they are rooted in…

Ancestral threats—such as snakes, spiders, heights, or dark enclosed spaces—that posed significant risks to our ancestors' survival for millions of years.

How are symptoms interpreted differently between WEIRD and non-WEIRD societies?

In Western societies, people have a tendency to interpret physical and emotional symptoms through a psychological lens, while people in non-Western cultures may adopt a more holistic perspective, taking into account spiritual, social, and physical aspects when interpreting symptoms.

What is major depressive disorder?

Persistent sadness, hopelessness, and a loss of interest in activities (anhedonia) lasting at least two weeks.

What are theories for why we get depressed?

• An evolved strategy for coping with unfavorable situations

• A credible signal of need that evolved to elicit social support

• A form of psychological pain (response to adversity)

• A failure or bug in mood regulation systems

What are diseases of modernity?

Health conditions resulting from modern lifestyles (e.g., type 2 diabetes, heart disease).

What are modern conditions that favor depression?

• Inactivity (sedentary behavior)

• Obesity

• Social environment (less in-person social interaction)

What is associated with depressive symptoms among the Tsimane?

• Acculturation

• Physical injury

• Social conflict

• Modern lifestyles

What are Perinatal Mood and Anxiety Disorders (PMADs)?

Distressing feelings that occur during pregnancy (perinatal) and throughout the first year after pregnancy (postpartum).

How does PMADs affect parents?

Psychiatric illness is leading cause of maternal mortality in Western countries (suicide, drug overdose).

How does PMADs affect the baby?

• Developmental delays

• Preterm birth

• Impaired attachment

How does PMADs affect family systems?

Increases risk of separation

What are risk factors for PMADs?

• Infant self-regulation difficulties

• Maternal history of depression

• Traumatic events during childbirth

• Lack of social support

• Intimate partner violence during pregnancy

• Lifestyle factors (e.g., sleep deprivation)

• Structural factors (e.g., income inequality)

How are PMADs treated?

• Psychotherapy

• Medication (SSRIs, synthetic hormone)

• Other key interventions (Sleep support, support groups, family involvement)

What are the evolutionary mismatches that may contribute to the prevalence of PMADs?

• Loss of Alloparenting Care (Extended Family Support)

• Decreased experiences learning to mother

• Shorter inter-birth intervals