Depression is one of the most prevalent mental disorders and the third largest contributor to global disease burden, outranking heart disease; it is the number one contributor to disease burden in developed countries, costing an estimated $81 billion in the U.S. alone and €118 billion in Europe, where it is the most costly mental disorder. Evidence-based treatments for depression are available and extensively used. There is evidence that cognitive-behavioural approaches (CBT) are among the best empirically supported, both in terms of theory and intervention. However, recent research in evolutionary psychology has shown a possible new therapeutic approach to depression.
Evolutionary-driven cognitive therapy for depression focuses on distal (ultimate or evolutionary) mechanisms, such as inclusive fitness or reproductive success, thought to lead to depression when prevented to function optimally. Such an approach enhances the CBT approach by including information about the hypothesized adaptive functions of depressive symptoms, along with direct interventions on fitness-enhancing factors. The present case study explored the effect of an evolutionary-informed cognitive-behavioural intervention on reducing depressive symptomatology on a moderately depressed patient. Ms Judy, a 22 year old student suffered from depressive symptoms after breaking up from a dysfunctional relationship.
Standard CBT techniques were focused on her perfectionistic And self-downing beliefs, while novel, evolutionary-informed techniques were used to guide behavioural activation and conceptualize secondary emotional problems related to anger. The treatment was effective in reducing symptomatology, negative emotions and dysfunctional cognitions as well as increasing evolutionary fitness. Evolutionary-informed CBT can be used as an effective treatment for depression, providing new insights and new techniques from the field of evolutionary psychology.