Evolution therapyCreating Connections 2015

Witte Hoogendijk

Dept. of PsychiatryErasmus Medical Center

Rotterdam, The Netherlands

Cortisol

Influence of cortisol on cardiovascular system and brain during stress

Depressive episode (DSM-5)

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss/gain, appetite4. Diminished/increased sleep5. Psychomotor agitation or inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. Recurrent thoughts about death

Sleep disturbance

Depressive episode (DSM-5) Sleep disturbance

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss/gain, appetite4. Diminished/increased sleep5. Psychomotor agitation or inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. Recurrent thoughts about death

1. Depressed mood2. Diminished interest or anhaedonia3. - 4. Diminished sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

Depressive episode (DSM-5) Sleep disturbance

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss/gain, appetite4. Diminished/increased sleep5. Psychomotor agitation or inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. Recurrent thoughts about death

1. Depressed mood2. Diminished interest or anhaedonia3. - 4. Diminished sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss, decreased appetite4. Diminished/increased sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

Inflammation, fracture or sickness syndrome

Depressive episode (DSM-5) Sleep disturbance

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss/gain, appetite4. Diminished/increased sleep5. Psychomotor agitation or inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. Recurrent thoughts about death

1. Depressed mood2. Diminished interest or anhaedonia3. - 4. Diminished sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss, decreased appetite4. Diminished/increased sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

1. ?2. ?3. ?4. ?5. ?6. ?7. ?

8. ?9. ?

Inflammation or fracture Chronic stress in mice (monkey etc)

Chronic and unavoidableChronic and unavoidable

Depressive episode (DSM-5) Sleep disturbance

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss/gain, appetite4. Diminished/increased sleep5. Psychomotor agitation or inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. Recurrent thoughts about death

1. Depressed mood2. Diminished interest or anhaedonia3. - 4. Diminished sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

1. Depressed mood2. Diminished interest or anhaedonia3. Weight loss, decreased appetite4. Diminished/increased sleep5. Psychomotor inhibition6. Fatigue or loss of energy7. Fealings of worthlessness, guilt or

pessimism about health or future8. Diminished ability to think or concentrate9. -

1. Depressed mood?2. Diminished interest or anhaedonia3. Weight loss, decreased appetite 4. Diminished/increased sleep5. Psychomotor inhibition6. Fatigue or loss of energy?7. Fealings of worthlessness, guilt or pessimism

about health or future?8. Diminished ability to think or concentrate9. Recurrent thoughts about death?

Inflammation or fracture Chronic stress in mice

Comparable stress-regulating brain systems

Hypofrontality Hypofrontality

Mayberg et al.

Comparable DNA sequence

Monkey taking selfie

The Oedipus complex or any neurosis as an internal, The Oedipus complex or any neurosis as an internal, unconscious and out-dated stressunconscious and out-dated stress

Chronic and unavoidable!Chronic and unavoidable!

Conclusion

Evolution therapy:

1. Realize that your emotions are coming from outdated brain systems and act accordingly (relativize)

Conclusion

Evolution therapy:

1. Realize that your emotions are coming from outdated brain systems and act accordingly (relativize)

2. Behave more like you have done for 200,000 years now (enjoy nature, exercise, choose good food, take your time)

Conclusion

Evolution therapy:

1. Realize that your emotions are coming from outdated brain systems and act accordingly (relativize)

2. Behave more like you have done for 200,000 years now (enjoy nature, exercise, choose good food, take your time)

3. Mentalization and Mindfulness (Jon Kabat Zinn)