Evolution therapy Creating Connections 2015 Witte Hoogendijk Dept. of Psychiatry Erasmus Medical Center Rotterdam, The Netherlands.

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Presentation transcript:

Evolution therapy Creating Connections 2015 Witte Hoogendijk Dept. of Psychiatry Erasmus Medical Center Rotterdam, The Netherlands

Cortisol Influence of cortisol on cardiovascular system and brain during stress

Depressive episode (DSM-5) 1.Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss/gain, appetite 4.Diminished/increased sleep 5.Psychomotor agitation or inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death

Sleep disturbance

Depressive episode (DSM-5) Sleep disturbance 1.Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss/gain, appetite 4.Diminished/increased sleep 5.Psychomotor agitation or inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death 1.Depressed mood 2.Diminished interest or anhaedonia Diminished sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.-

Depressive episode (DSM-5) Sleep disturbance 1.Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss/gain, appetite 4.Diminished/increased sleep 5.Psychomotor agitation or inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death 1.Depressed mood 2.Diminished interest or anhaedonia Diminished sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss, decreased appetite 4.Diminished/increased sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.- Inflammation, fracture or sickness syndrome

Depressive episode (DSM-5) Sleep disturbance 1.Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss/gain, appetite 4.Diminished/increased sleep 5.Psychomotor agitation or inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death 1.Depressed mood 2.Diminished interest or anhaedonia Diminished sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss, decreased appetite 4.Diminished/increased sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate ? 2.? 3.? 4.? 5.? 6.? 7.? 8.? 9.? Inflammation or fracture Chronic stress in mice (monkey etc)

Chronic and unavoidable

Depressive episode (DSM-5) Sleep disturbance 1.Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss/gain, appetite 4.Diminished/increased sleep 5.Psychomotor agitation or inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death 1.Depressed mood 2.Diminished interest or anhaedonia Diminished sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate Depressed mood 2.Diminished interest or anhaedonia 3.Weight loss, decreased appetite 4.Diminished/increased sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy 7.Fealings of worthlessness, guilt or pessimism about health or future 8.Diminished ability to think or concentrate Depressed mood? 2.Diminished interest or anhaedonia 3.Weight loss, decreased appetite 4.Diminished/increased sleep 5.Psychomotor inhibition 6.Fatigue or loss of energy? 7.Fealings of worthlessness, guilt or pessimism about health or future? 8.Diminished ability to think or concentrate 9.Recurrent thoughts about death? Inflammation or fracture Chronic stress in mice

Comparable stress-regulating brain systems

Hypofrontality Mayberg et al.

Comparable DNA sequence

Monkey taking selfie

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