"At SHS, Peter Mensch and I had a weekly radio show on WFAS with mostly informational documentaries illustrated with popular music lyrics.  As a psychiatrist these days, I still trying to enlighten people (patients, the world at large, and hopefully myself).  "Angst" is a new popular non-fiction book from Oxford which proposes a novel theory that commonplace anxiety and depressive disorders are modern day expressions of primeval herd instincts.  That those instincts object to our rational choices is illustrated with Blues lyrics, of course, not to mention some less soulful scientific evidence."

-  Jeffrey P. Kahn (Class of 1971), MD is Clinical Associate Professor of Psychiatry at New York Presbyterian Hospital/Weill Cornell Medical Center, in New York City and Westchester County.


“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


ANGST
Origins of Anxiety and Depression
by Jeffrey P. Kahn (November 1, 2012 — 304 pp. — $34.95 — ISBN13: 9780199796441)

For many, understanding why they or a loved one has been diagnosed with a disorder such as depression or anxiety is itself a challenge. In a new book titled, ANGST: Origins of Anxiety and Depression author Jeffrey P. Kahn provides a meaningful answer to that question without oversimplifying or using too much jargon. While herd-like animals share a set of evolved social instincts, we humans use reason to defy our biology, and we experience five specific Anxiety and Depressive disorder subtypes as a result. Basically, we are built to be sheep, but for some reason prefer to be human. The downside of this is that our sheepish instincts complain in the form of Anxiety and Depressive Angst.  

ANGST asserts a new theory that common Anxiety and Depressive Disorders experienced by a large number of people—about 60 million according to Kahn—are modern consequences of biologically evolved social instincts. 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. He chose these five because they are not only the most common in the general population but are also the most common among people who are generally successful who walk into a psychiatrist’s office. Kahn examines how each instinctive syndrome evolved with the development of Homo sapiens, how they resemble behavior in other species, how they correspond to the five clinical syndromes and what we know about their biology, genetics, and epigenetics. 

Here is the short version of what the instincts are and what they once did for our primeval selves and tribes:

PANIC ANXIETY
Purpose: Kept us close enough to home and group that we could find our way back.
Motto: Catastrophes await if you can’t find your way home.

SOCIAL ANXIETY
Purpose: Kept us in line in our tribal social hierarchies to keep the peace at home.
Motto: Shame and embarrassment come from not knowing your primeval rank.

OBSESSIVE COMPULSIVE DISORDER
Purpose: Kept us on track for the work needed to let people live together safely.
Motto: Clean, arrange, save and behave for a sure and tidy nest.

ATYPICAL DEPRESSION
Purpose: Kept us well-enough behaved for a cooperative society.
Motto: Behave yourself to avoid rejection, remorse, and exile.

MELANCHOLIC DEPRESSION
Purpose: Death kept us from using scarce resources when no longer useful to the group.
Motto: Take one for the team if you are too old or too ill.

CONSCIOUSNESS
Purpose: Kept us responsive to our companions and environment
Motto: Thoughtful understanding leads to better solutions.

While other books have focused on these disorders and the drugs used to treat them, ANGST provides a reasoned and entertaining new framework for understanding our knowledge of psychiatric neuroscience, clinical research, diagnosis and treatment. 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.