PMS City

As with labels such as “schizophrenia,” and many besides, premenstrual syndrome is a symptomatological diagnosis – a category formed not on the basis of any known cause but on a loosely associated set of symptoms, which are many and vary in severity.

And none of them should exist. Evolution has had a near-eternity to chip away at the reproductive system, and for normal bodily processes to induce pain or debility ought to be selected out unless there is some obvious adaptive trade-off (the only example that comes to mind is giving birth). Furthermore, since these problems are experienced by only a subset of women, they are not an inevitable result of hormone changes.

An alternative explanation is pathogens. During the luteal phase of the menstrual cycle, the immune system is weakened to avoid destroying new embryos, leaving women vulnerable to infectious agents. Empirically confirmed associations of PMS symptoms with pathogens include chlamydia and trichomonas vaginalis, but there could easily be others which have either evaded precise investigation or have been ignored.

The psychic pain brought on by menstruation is well documented. Hippocrates spoke of it, but he was clearly talking about the “madness” that could come as an effect of the physical symptoms such as dysmenorrhoea, not an independent mania or irrationalism brought on by what we now call “being hormonal,” whatever that means.

About one-quarter of women report clinical symptoms of PMS, which are likely to be pathogenic, but a fairly decent percentage of them, with or without the disease symptoms, report other problems such as killing people, screaming Love Island-tier insults at household objects, crying incontinently, losing the ability to turn-take in conversation, psychotic paranoia, and wasting other people’s money.

Lots of physiological processes happen all the time which, theoretically, could have a noticeable impact on mood. Levels of cortisol, the “stress hormone,” shift throughout the day, peaking in the hours just after waking, and drinking alcohol has a far more dramatic impact on nearly all aspects of brain function than anything menstruation does. Yet, the Morning Cortisol Rage has yet to breach the popular lexicon, and the effects of alcohol are closer to being psychosomatic than is ordinarily assumed: it is not a human universal that drinking causes chimpanzee-like states of aggression and disinhibition as it does in Britain. So it looks like another anomaly of our time and place, a thing that exists because people want it to. The same probably holds true for – well, lots of things.

Childhood was a fun time. Maybe it’s not surprising that people love an excuse to return to it; some periodically, others pretty much all the time.

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A World of Trauma – Civilizational Psychosadomasochism and Emptiness

According to Google’s vast textual corpora, there was nary an instance of the term “trauma,” or its distinctly psychiatric derivative “traumatized,” in written English prior to the 1880s. The first usage of “trauma” is documented in the 1690s, at which point it referred to physical wounding only. Its “psychic wound” sense did not pick up until the tail end of the 19th century, which is now far more familiar to us than the original sense. Exactly what took root in the world between then and now? The standard narrative is that the medical profession became wiser, but what of the wisdom embedded in our species’ genetic history? Note that even most doctors and biomedical lab technicians know little of basic genetics, or, one has to assume, of evolutionary reasoning. I recall being sneeringly told by one, on introducing her to the concept, that she was only interested in “proper science.” This is about when it set in that even many “grunt-work” scientists are basically morons. She certainly was.

Applying the principles of natural selection (i.e. evolutionary reasoning) to find the aetiology of disease tends to yield different answers from those that are now fashionable. In a 2000 paper, “Infectious Causation of Disease: An Evolutionary Perspective,” the authors compellingly argue that a huge number of supposedly mysterious illnesses are in fact caused by pathogens – bacteria or viruses. The argument is simple: any genetic endowment which essentially zeroes fitness (reproductive potential) can be maintained in a population’s genes only at the basal rate of errors, i.e. mutations, in the genetic code, with the apparently sole exception of heterozygote advantage for protection against malaria. Thus, anything so destructive which rises above a certain threshold of prevalence should arouse suspicion that a pathogen is to blame. This would include schizophrenia, an alleged evolutionary “paradox,” with a prevalence of ~0.5%, especially since, unlike “psychopathy,” schizophrenia has low twin-concordance, low heritability, and is discontinuous with normal personality. At present, direct evidence of the pathogen is scant, but that is to be expected: viruses are tricksy. No other explanation is plausible.

What, then, when one turns the evolutionary lens towards “trauma”? What is commonly called psychological trauma can helpfully be divided into two categories: non-chronic and chronic. The former is what most people would call distress. It is adaptive to have unpleasant memories of situations that could kill you or otherwise incur significant reproductive costs, which is why everyone feels this. It is good to have unpleasant memories of putting one’s hand on an electric fence for this reason. It is bad, and certainly not evolutionarily adaptive, for the memory to continually torture you for years after the fact. I have it on good authority that this does nothing to attract mates, for example.

In light of this, it becomes clearer what may be behind the apparent explosion of mental “traumas” in our psychiatry-obsessed world. One may observe, for instance, that there is no record of anything remotely resembling PTSD in the premodern world. It emerged in the 20th century, either as a result of new weapons inflicting new kinds of damage (brain injuries), or from psychiatrists’ egging people on, or both. If the received narrative about it were true, then all of Cambodia ought to have gone completely insane in recent times. It did not happen. Likewise with rape. One struggles to find any mention of long-term trauma from rape for most of human history. The ancients were not very chatty about it. Of course, they saw it as wrong, as is rather easy to do, but their notions about it were not ours. Rape does impose reproductive costs, but so does cuckoldry, and being cuckolded does not cause chronic trauma. Nor would claiming that it had done so to you do much for your social status. Sadly, exactly one person in existence has the balls to comment on this rationally. Many of these problems seem to originate from something more diffuse, something about the cultural zeitgeist of our age, rather than a particular field or bureaucracy.

It is generally agreed upon in the modern West that sexual activity before late adolescence, especially with older individuals, is liable to causing trauma of the chronic kind. This alone should give one pause, since “adolescence” is a linguistic abstraction with only very recent historical precedent, and many of the biopsychological processes which are conventionally attributed uniquely to it begin earlier and persist long after. The onset of stable, memorable sexual desire and ideation occurs at the age of ~10 (it was certainly present in me by age 11), commensurate with gonadarche, and is certainly almost universally present by age 12-13. The reason these desires arise with gonadarche is simple: they exist to facilitate reproduction. It would make little biological sense in any species other than humans to experience sexual desire but also experience some strange latency period of 1-8 years (depending on the country) during which any acting upon those desires causes inconsolable soul-destruction. Any time something seems completely unique to humans, one has to wonder if it has something to do with uniquely human cultural phenomena such as taboos. It is even more obvious when one observes human cultures which lack these taboos, e.g. Classical Greece. When they married their daughters off at age 13-14, they were concerned chiefly about whether the groom could provide her and her children with a stable living. But they were not concerned about soul-destruction. At least, I’m fairly sure of that. For the record: this is not an endorsement of lowering the age of consent. I am decidedly neutral on that question, but I do not believe Mexico’s answer is any less correct than California’s or vice versa.

It is wrong to say that psychiatrists, or therapists, have a superpower of changing people’s phenotypes. This is impossible, as any such change they could impart would be genetically confounded, i.e. it is genetically non-random sample of the population who are “successful” subjects to their interventions. So it seems fair to assume that a lot of mental health problems are explicable in this way rather than through straight-up iatrogenesis, and their prevalence is inflated somewhat through media hype and social media shenanigans. However, an interesting question is: how much of an evolutionarily novel phenomenon is the field of psychiatry? Are our minds equipped to deal with it? Well, not everyone’s. It seems possible to confect illnesses out of thin air if you subject the right person to the right conditioning, as is the case with the probably purely iatrogenic “dissociative identity disorder.”

Masses of people these days shell out large chunks of their finances on “therapy,” a form of psychiatric intervention which has shown itself to be of at best mixed efficacy. Many long-running randomised controlled trials of its effects turn up jack shit, which ought not to be shocking given what is known about the non-effects of education, extensively documented by Bryan Caplan and others. It has to change the brain in a dramatic way. Still lingering though, is the question of whether it may in fact make matters worse. Many social commentators have taken notice of the way in which mental illness, especially “depression,” seems to be afforded a kind of bizarre social status in some circles, such as within university culture in Canada. Even more galling is that it is not even clear whether “depression” of the garden variety is a disorder; it may be an adaptation that evolved to ward people off hopeless pursuits. Status is a powerful motivator, so this weird grievance culture cannot help, but encouraging people to make their living from talking to such people and consoling them with soothing words cannot be great either, since it is likely to induce the kind of institutional inertia on which the pointless continuance of America’s “drug war” is sometimes (correctly) blamed.

Legalising drugs and investing more energies into high-precision “super-drugs,” e.g. powerful mood-enrichers with no side effects, would do more for the true chronic depressives who literally have never even known what it means to be happy – a malady probably induced by rare mutations if it exists – than what is on offer today. Drugs are the only guaranteed way to do profound psychological re-engineering without gene-editing. It is not clear, though, if the psychiatric industry as it currently exists would be happy to see such problems vanish.