Do You Need a Pill to Relieve Your Pain?

Why do we feel bad after losing a loved one? What causes people to people panic and worry?? How can people pursue happiness even after heartbreaks? Understanding our bad feelings gives us real power. In his new book, Good Reasons For Feeling Bad, Dr. Randolph Randy? Nesse, a pioneer in evolutionary medicine, transforms our understanding of mental disorders. 

As opposed to asking why some people suffer from mental illnesses, Dr. Randy asks why natural selection has left us with fragile minds. Listen as Dr. Randy and Greg explore the deeper evolutionary questions of why our minds can be so vulnerable to mental illness.

Episode Quotes:

When can panic attacks be seen as beneficial?

One of them is that panic attacks are not just abnormal things that come out of a bad brain. They are a flight or fight response that can be life-saving if you're in the face of some predator or other life-threatening danger. And I had spent the last ten years in this anxiety clinic telling patients, no, it's not just your worries. It's a brain abnormality, and do what we say. With taking drugs and behavior therapy, you'll get better. They didn't believe me. They said, well, I know it's my heart, I know it's my brain. But once I started explaining to them, 'I said, listen, what you're experiencing is a useful response, but it's a false alarm.' That fast breathing, those tight muscles? Perfect for getting you out of danger. That wish to get out of whatever small room you're in? Perfect. That fear of open spaces? Open spaces were dangerous for us when we only had wooden spears. And all of a sudden, my patients' attitudes towards their disorders changed dramatically.

Thoughts on the profound implication of evolutionary medicine for everyday medical practice

I think the most profound implication of evolutionary medicine for everyday medical practice is how to use medications to relieve suffering correctly. Ninety-nine times out of a hundred, it’s okay. It's not going to hurt somebody. For instance, if you have fever and malaise when you have a cold, can you take some Tylenol to make it better? Yes, you can. Is it going to make you get better? Probably not. There are so many other mechanisms apart from the fever itself fighting the virus or bacteria that are causing your problems. On the other hand, there are times when it is not very sensible. 

Are experts doing a good job of debating implied normativity of negative moods experienced in the aftermath of a negative experience?

A bunch of excellent psychologists began studying positive emotions, but there is a strong tendency that we should feel positive emotions, and we should strive for positive emotions. There are easy ways that they suggest where you can feel better about your life, and simply writing every day some things you're grateful for, and connecting with people you care about can improve life. On the other hand, I also see people striving for happiness as a goal. And probably my deepest insight about low mood, the one that my residents tell me helps them more than anything else I've ever taught them, is it pursuing an unreachable goal? That's what sets off a normal, low mood. Because low mood is trying to make you stop doing stuff that's wasteful and hopeless. And if you keep on trying to accomplish something where you're not making any progress, then the ordinary low mood escalates up into a bad depression.

Time Code Guide:

00:00:51 What drove Dr. Nesse to this Discipline

00:03:29 Why it’s equally important to know what’s causing the problem, and not just how to fix it

00:05:15 How can biologists, psychiatrists, and evolutionary experts, and doctors work together to find out causes of mental health problems

00:06:26 Concepts from the book Why We Get Sick

00:07:22 Why are fevers good for the body

00:11:16 Work and research on anxiety

00:12:21 Signal Detection Theory

00:13:46 Thoughts on viewing disease as an adaptation

00:16:26 Covid, anxiety, and depression

00:17:13 How the body is sending false alarms on survival during stressful situations

00:18:52 Why do pointing at proximate mechanism can be problematic when dealing with mental illness

00:27:15 Mood and model foraging theory

00:29:35 Mental health not being about positive emotions, but rather well-calibrated responses appropriate for the signals from the environment

00:32:31 How social groups and environment affect our mental health

00:34:48 Thoughts on how the mismatch between the environment we’re and the one we’ve adapted to

00:41:24 Misconceptions on hard-wired behavior and environmental contingent

00:45:06 Reframing question about human wellness

Show Links:

Guest Profile

• Randolph Nesse’ Official Website
• Randolph Nesse Profile on University of Michigan
• Randolph Nesse on LinkedIn
• Randy Neese on Twitter

His Work

• Randolph Nesse on Google Scholar
• Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary Psychiatry 
• Why We Get Sick: The New Science of Darwinian Medicine

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