to do so in recognizable ways, what engineers sometimes call “known failure modes.” A given make and model of a car, say, might have a fine engine but consistently suffer from electrical problems. The human mind is vulnerable to its own particular malfunctions, well documented enough to be classified in the human equivalent of Chilton’s
To be sure, symptoms vary among individuals, both in severity and in number. Just as no two colds are exactly alike, no two people diagnosed with a given mental illness experience it in precisely the same way. Some people with depression, for example, are dysfunctional, and some aren’t; some people with schizophrenia hear voices, and others don’t.
And diagnosis remains an inexact science. There are a few disorders (such as multiple personality syndrome) whose very existence is controversial, and a few “conditions” used to be labeled as disorders but never should have been (such as homosexuality, removed from the
When we see the same basic patterns over and over, there has to be a reason for them. What is the mind, such that it breaks down in the ways that it does?
The standard tack in evolutionary psychiatry, the branch of evolutionary psychology that deals with mental disorders, is to explain particular disorders (or occasionally symptoms) in terms of hidden benefits.[51] We saw one example in the first chapter, the somewhat dubious suggestion that schizophrenia might have been selected for by natural selection because of a purported benefit that visions conveyed to tribal shamans, but there are many others. Agoraphobia has been viewed as a “potentially adaptive consequence of repeated panic attacks,” and anxiety has been interpreted as a way of “altering our thinking, behavior, and physiology in advantageous ways.” Depression, meanwhile, allegedly evolved as a way of allowing individuals to “accept defeat… and accommodate to what would otherwise be unacceptable low social rank.”
If you’re like me, you won’t find these examples particularly compelling. Were schizophrenics really more likely than other people to become shamans? Were those who became shamans more successful than their non- schizophrenic counterparts in producing viable offspring? Even if they were, are shamans prevalent enough in history to explain why at least 1 in every 100 humans suffers from the disorder? The depression theory initially seems more promising; as the authors note, it might well be better for the low man on the totem pole to accede to the wishes of an alpha male than to fight a battle that can’t be won. Furthermore, depression often does stem from people’s sense that their status is lower, relative to some peer group. But does the rest of the social competition theory even fit the facts? Depression isn’t usually about
Of course, I don’t mean to suggest that one dubious theory is enough to rule out an entire line of work; certainly some physical disorders convey benefits, and there may well be analogous cases of mental disorders. The classic example of a physical disorder with a clear corresponding benefit is the gene that is associated with sickle cell anemia. Having two copies of the gene is harmful, but having a single copy of the gene alongside a normal copy can significantly reduce one’s chance of contracting malaria. In environments where malaria has been widespread (such as sub-Saharan Africa), the benefits outweigh the potential costs. And, accordingly, copies of such genes are far more widespread among people whose ancestors lived in parts of the world where malaria was prevalent.
But while some physical disorders do demonstrably bring about offsetting benefits, most probably don’t, and, with the possible exception of sociopathy,[52] I don’t think I’ve ever seen a case of mental illness offering advantages that might convincingly outweigh the costs. There are few, if any, concrete illustrations of offsetting advantages in mental illness, no mental sickle-cell anemia that demonstrably protects again “mental malaria.” Depression, for example, doesn’t ward off anxiety (in the way that a propensity for sickling protects from malaria) — it co-occurs with it. Most of the literature on the alleged virtues of mental disorders simply seems fanciful. All too often, I am reminded of Voltaire’s Dr. Pangloss, who found adaptive virtue in everything: “Observe, for instance, the nose is formed for spectacles, therefore we wear spectacles. The legs are visibly
It’s true that many disorders have at least some compensation, but the reasoning is often backward. The fact that some disorders have some redeeming features doesn’t mean that those features
At the very least, it seems plausible that some disorders (or symptoms) may appear not as direct adaptations, but simply from inadequate “design” or outright failure. Just as cars run out of gas, the brain can run out of (or run low on) neurotransmitters (or the molecules that traffic in them). We are born with coping mechanisms (or the capacity to acquire them), but nothing guarantees that those coping mechanisms will be all powerful or infallible. A bridge that can withstand winds of 100 miles per hour but not 200 doesn’t collapse in gusts of 200 miles per hour because it is
Even if we set aside possibilities like sheer genetic noise, it is a fallacy to assume that if a mental illness persists in a population, it must convey an advantage. The bitter reality is that evolution doesn’t “care” about our inner lives, only results. So long as people with disorders reproduce at reasonably high rates, deleterious genetic variants can and do persist in the species, without regard to the fact that they leave their bearers in considerable emotional pain.[53]
All this has been discussed in the professional literature, but another possibility has gotten almost no attention: could it be that some aspects of mental illness persist not because of any specific advantage, but simply because evolution couldn’t readily build us in any other way?
Take, for example, anxiety. An evolutionary psychologist might tell you that anxiety is like pain: both exist to motivate their bearers into certain kinds of action. Maybe so, but does that mean that anxiety is an
One could make a similar argument about the human need for self-esteem, social approval, and rank — collectively, the source of much psychological distress. Perhaps in any world we could imagine, it would be to most creatures’ benefit to secure social approval, but it is not clear why a lack of social approval ought necessarily to result in emotional pain. Why not be like the Buddhist robots I conjured in the last chapter, always aware of (and responsive to) circumstances, but never troubled by them?
Science fiction? Who knows. What these thought experiments do tell us is that it is possible to imagine other ways in which creatures might live and breathe, and it’s not clear that the disorders we see would inevitably evolve in those creatures.
What I am hinting at, of course, is this: the possibility that mental illness might stem, at least in part, from accidents of our evolutionary history. Consider, for example, our species-wide vulnerability to addiction, be it to cigarettes, alcohol, cocaine, sex, gambling, video games, chat rooms, or the Internet. Addiction can arise when short-term benefits appear subjectively enormous (as with heroin, often described as being better than sex), when long-term benefits appear subjectively small (to people otherwise depressed, who see themselves as having little to live for), or when the brain fails to properly compute the ratio between the two. (The latter seems to happen in