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Evolution therapy Creating Connections 2015 Witte Hoogendijk Dept. of Psychiatry Erasmus Medical Center Rotterdam, The Netherlands. Influence of cortisol on cardiovascular system and brain during stress. Cortisol. Depressive episode (DSM-5) . Depressed mood Diminished interest or anhaedonia
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Evolution therapyCreating Connections 2015Witte HoogendijkDept. of PsychiatryErasmus Medical CenterRotterdam, The Netherlands
Influence of cortisol on cardiovascular system and brain during stress Cortisol
Depressive episode (DSM-5) • Depressed mood • Diminished interest or anhaedonia • Weight loss/gain, appetite • Diminished/increased sleep • Psychomotor agitation or inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • Recurrent thoughts about death
Depressive episode (DSM-5) Sleep disturbance • Depressed mood • Diminished interest or anhaedonia • - • Diminished sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • - • Depressed mood • Diminished interest or anhaedonia • Weight loss/gain, appetite • Diminished/increased sleep • Psychomotor agitation or inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • Recurrent thoughts about death
Depressive episode (DSM-5) Sleep disturbance • Depressed mood • Diminished interest or anhaedonia • - • Diminished sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • - • Depressed mood • Diminished interest or anhaedonia • Weight loss/gain, appetite • Diminished/increased sleep • Psychomotor agitation or inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • Recurrent thoughts about death Inflammation, fracture or sickness syndrome • Depressed mood • Diminished interest or anhaedonia • Weight loss, decreased appetite • Diminished/increased sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • -
Depressive episode (DSM-5) Sleep disturbance • Depressed mood • Diminished interest or anhaedonia • - • Diminished sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • - • Depressed mood • Diminished interest or anhaedonia • Weight loss/gain, appetite • Diminished/increased sleep • Psychomotor agitation or inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • Recurrent thoughts about death Inflammation or fractureChronic stress in mice (monkeyetc) • ? • ? • ? • ? • ? • ? • ? • ? • ? • Depressed mood • Diminished interest or anhaedonia • Weight loss, decreased appetite • Diminished/increased sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • -
Depressive episode (DSM-5) Sleep disturbance • Depressed mood • Diminished interest or anhaedonia • - • Diminished sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • - • Depressed mood • Diminished interest or anhaedonia • Weight loss/gain, appetite • Diminished/increased sleep • Psychomotor agitation or inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • Recurrent thoughts about death Inflammation or fractureChronic stress in mice • Depressed mood? • Diminished interest or anhaedonia • Weight loss, decreased appetite • Diminished/increased sleep • Psychomotor inhibition • Fatigue or loss of energy? • Fealings of worthlessness, guilt or pessimism about health or future? • Diminished ability to think or concentrate • Recurrent thoughts about death? • Depressed mood • Diminished interest or anhaedonia • Weight loss, decreased appetite • Diminished/increased sleep • Psychomotor inhibition • Fatigue or loss of energy • Fealings of worthlessness, guilt or pessimism about health or future • Diminishedability to think or concentrate • -
Hypofrontality Mayberg et al.
The Oedipus complex or any neurosis as an internal, unconscious and out-dated stress Chronicandunavoidable!
ConclusionEvolution therapy:1. Realize that your emotions are coming from outdated brain systems and act accordingly (relativize)
ConclusionEvolution 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)
ConclusionEvolution 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)