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Angst: Origins of Anxiety and Depression
     

Angst: Origins of Anxiety and Depression

by Jeffrey P. Kahn
 

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Some twenty percent of us are afflicted with common anxiety and depressive disorders—not just brief bouts of nervousness or sorrow, but painful dysfunctions without obvious benefit. Why do so many people suffer from angst?

In this path-breaking volume, engagingly written for the general public, psychiatrist Jeffrey Kahn reveals that angst ultimately results

Overview

Some twenty percent of us are afflicted with common anxiety and depressive disorders—not just brief bouts of nervousness or sorrow, but painful dysfunctions without obvious benefit. Why do so many people suffer from angst?

In this path-breaking volume, engagingly written for the general public, psychiatrist Jeffrey Kahn reveals that angst ultimately results from our transformation, over tens of thousands of years, from biologically shaped, almost herd-like prehistoric tribes, to rational and independent individuals in modern civilization. Kahn looks at five basic types of modern-day angst—Panic Anxiety, Social Anxiety, OCD, Atypical Depression, and Melancholic Depression—and shows how each derives from primeval social instincts that once helped our ancestors survive. For instance, the "panic disorder" which prevents some people from flying may have originally evolved to keep our tribal ancestors from traveling dangerously far from home. Likewise, the increased emotional sensitivity to social rejection that now triggers episodes of "atypical depression" may have helped maintain polite behavior and social harmony in our ancestors. Our distinctly human civilization and rational consciousness lets us defy these social instincts. But those over-ridden instincts can resurface as stressful emotional disorders. Kahn notes that some of us painfully tackle this distress head-on, in ways that can advance intellectual creativity, social performance and productivity. He also describes the interplay of instinct with the advance of civilization, and on how evolutionary perspective explains why modern treatments work.

Ranging from Darwin and Freud to the most cutting-edge medical and scientific findings—drawing from ancient writings, modern humor and popular lyrics, and with many amusing cartoons—Angst offers us an exciting new slant on some of the most pervasive mental health issues of our time.

Editorial Reviews

Doody's Review Service
Reviewer: Brett C. Plyler, M.D.(Northwestern Memorial Hospital)
Description: This is a study of five anxiety/depressive disorders and how their root cause may lie in ancient social instincts that were necessary for survival of our communal DNA.
Purpose: The purpose is to present the author's theory of evolutionary psychiatry and how it results in mental illness today.
Audience: The book is written for the general public, mental health clinicians, and academic researchers.
Features: It explores evolutionary psychiatry and the author's concept that a significant amount of anxiety and depressive disorders may have their origins in instinctual behavior dedicated to preserving our DNA over thousands of years of evolution. The five that he focuses on are: panic anxiety, social anxiety, melancholic depression, atypical depression, and obsessive compulsive disorder. The author contends that our "consciousness" allows us to override these ancient instincts, but this conflict leads to anxiety/depression. For example, social anxiety was meant to keep a person in line in tribal social hierarchies, but in the present time, results in painful embarrassment and shame when we try to step out on our own. Each chapter discusses one of these five and the theoretical and scientific underpinnings supporting it. The second half of the book analyzes the rise of civilization and the clash of societal instincts and an individual's consciousness. The resulting emotional disruption has numerous effects on the individual and society at large. The author explores how these disruptions can both contribute to and slow the growth of a civilization. The book closes with a chapter on instinct and reason and how to balance those choices.
Assessment: This is an interesting book by an author with a wealth of clinical and research experience. He has done a very thorough job on the research behind his theories and expresses them clearly and succinctly. I was intrigued by the evolutionary psychiatric explanation of the various disorders, and they do make sense when you think about them from that perspective — emotional disorders arising from the conflict between societal instincts and our consciousness. It definitely got me to think about these problems in a different way, which will be useful to both me and my patients. However, I found the treatment applications to be lacking and not well described. So, an intriguing and interesting evolution in the way we can understand some emotional problems, but not much in the area of clinical treatment applications. I would recommend the book because it is well written with humor and insight and without too much psychological jargon.
From the Publisher
"Why does mental illness persist when it would seem to be counterproductive in an evolutionary sense? Kahn argues that certain traits that promote group fitness can, in a modern context and if exaggerated, manifest as serious mental illness . . . A lively presentation." —Library Journal

"An amazingly insightful and timely book, Angst will make you think and rethink the way our brains deal with anxiety and tragedy." — Siddhartha Mukherjee, MD is a cancer physician and researcher at Columbia University. His book The Emperor of All Maladies: A Biography of Cancer won the 2011 Pulitzer Prize in general non-fiction.

"Most of the theorists who study mental illness through the lens of evolution have never seen a patient themselves. This is what makes Dr. Kahn's approach unique. Dr. Kahn refracts theory through his rich experience as a clinician and the result is a thesis on evolutionary psychiatry that is both conceptually rich and pragmatically valuable." — Sally Satel, MD, Yale University psychiatry faculty, popular author One Nation Under Therapy; PC, MD and regular Op-Ed contributor to The Wall Street Journal and The New York Times.

"This remarkable book presents a revolutionary and counter-intuitive theory of anxiety and depression. This theory reflects the author's careful clinical observations over decades of outstanding individual psychiatric care, and from his vital work in dealing with 'the wounded workplace.' This landmark book is a must read for everyone interested in mental health, evolution - or in humankind." — Richard K. Harding, MD, Past-President, American Psychiatric Association, Professor of Neuropsychiatry and Behavioral Science at the University of South Carolina School of Medicine.

"Kahn is a highly experienced clinician and researcher, and he offers some of the soundest, most up-to-date advice available about the diagnosis and treatment of mental illness." — Peter D. Kramer, MD, Clinical Professor of Psychiatry and Human Behavior at Brown University and author of Listening to Prozac and Against Depression.

"Jeffrey Kahn offers a novel and comprehensive evolutionary theory on the adaptive value of anxiety and depressive disorders. His insight into the social instincts in animal herds is compelling and is nicely integrated with psychiatric research and clinical observations. This is an outstanding book for the inquisitive reader, and a milestone in translating evolutionary theory into a new understanding of common psychiatric illnesses." — Eric Hollander, MD, Clinical Professor of Psychiatry at Albert Einstein College of Medicine, author of Textbook of Autism Spectrum Disorders, Textbook of Anxiety Disorders, and Coping with Social Anxiety Disorder, and International Expert on Psychiatric Diagnosis and Neuropsychopharmacology

"Dr. Jeffrey Kahn, a practicing psychiatrist for 30 years, provides a unique insight into the causes of modern day angst." — David Olle, New York Journal of Books

"This is an interesting book by an author with a wealth of clinical and research experience. He has done a very thorough job on the research behind his theories and expresses them clearly and succinctly. I would recommend the book." — Brett C. Plyler, M.D., Northwestern Memorial Hospital, Doody's

"Although this book is written in the style of popular science, it is, in fact, an innovative and scholarly work that deserves to be studied by mental health specialists. ... [T]his book makes a powerful case for a scientific approach to psychiatry firmly based within the framework of evolutionary theory." —The British Journal of Psychiatry

"It offers new models that can be used in psychiatry research, instead of the old fashioned nosographic constructs of mental disorders." — Asociacao Brasileira de Psiquiatria

Library Journal
Why does mental illness persist when it would seem to be counterproductive in an evolutionary sense? Kahn (psychiatry, Weill-Cornell Medical Coll.) argues that certain traits that promote group fitness can, in a modern context and if exaggerated, manifest as serious mental illness. Thus panic anxiety stems from the instinct to stay near home, family and safety; obsessive-compulsive disorder, from the urge to maintain safe and healthy living arrangements; social anxiety, from the need to follow more dominant group members; and atypical depression, from the need to maintain group coherence. VERDICT A lively presentation, not intended as treatment advice. Two groups of readers will be interested: those who want books that explore the relationship of mental illness and society, such as Kay Redfield Jamison's Touched by Fire: Manic-Depressive Illness and the Artistic Temperament; and those interested in books on sociobiology, such as Edwin O. Wilson's recent The Social Conquest of Earth.—Mary Ann Hughes, Shelton, WA

Product Details

ISBN-13:
9780199796441
Publisher:
Oxford University Press
Publication date:
10/23/2012
Pages:
312
Product dimensions:
9.30(w) x 6.30(h) x 1.20(d)

Meet the Author

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

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