The Evolutionary Mismatch Behind ADHD, Anxiety and Poor Sleep
Season 1 Episode 2 20 min 4 sec August 27, 2026 No Comments See Transcript Comment Also listen on Spotify Youtube Apple Podcasts Amazon Music RSS FEED About this Podcast: What if ADHD, anxiety and insomnia aren’t three separate problems — but three expressions of the same overloaded system? In this episode of The Renaissance Doctor, clinical psychiatrist Elisabetta Burchi takes a dimensional and evolutionary lens to mental health, arguing that inattention, anxiety and disrupted sleep often share one underlying signature: an over-activated under-recovered stress system running in an environment it was not selected for. THIS EPISODE IS FOR YOU IF: you juggle scattered attention, a restless mind, and nights you can’t switch off — and suspect they’re connected; you’ve been told (or told yourself) it’s a lack of discipline, willpower or time management but that didn’t really help; you carry a diagnosis like ADHD, anxiety or insomnia — or recognise yourself on the spectrum without a label; you’ve tried apps, productivity hacks, or treating each symptom separately, with limited results; you are intrigued by an evolutionary systemic view to read biology and understand the why beneath your symptoms to better manage them KEY TAKEAWAYS: why ADHD, anxiety and insomnia may be different expressions of one overloaded stress system; the difference between homeostasis and allostasis, and what ‘allostatic overload’ means; what heart rate variability (HRV) reveals about your resilience and flexibility;the ‘evolutionary mismatch’ between your nervous system and the modern environment; the vicious loop of arousal, avoidance and anxiety — and where to intervene; why restoring physiological flexibility and recovery capacity may matter more than symptom-targeted treatments. Your Host Elisabetta Burchi. MD · MBA · Clinical Psychiatrist · Neuromodulation Researcher · Science Communicator Episode Transcript: Isn’t it a paradox that while our society has become safer, wealthier, more comfortable, we are seemingly less adapted to it? I mean, why do some of the innate capacities essential to human flourishing, such as attention, emotional balance, restorative sleep, appear increasingly fragile in modern society? Ciao. I’m Elisabetta Burchi, physician, clinical psychiatrist, and the host of the Renaissance Doctor. This podcast exists to explore an ambitious question: what does it mean to fully flourish as human beings in the 21st century?Today, I’m going to talk about mental health and environment, about how certain mental health issues do not derive by any intrinsic malfunctioning, but are, the expected expressions of regulatory systems finding to operate in an environment which they didn’t evolve for. The idea came from a recent talk I gave at a longevity conference. calm the adhd, I was, in fact, asked to prepare a talk around the following title: “calm the chaos: adhd, anxiety and insomnia”. Honestly, my first reaction to the title was irritation., I always feel the duty to be comprehensive, in front of tasks, and it was clear that I could not in a few minutes cover such a landscape that, by the way, put together apples with oranges. Because ADHD is a syndrome, anxiety is an emotion, and insomnia is a symptom. But a second excited thought replaced that first annoyed one quickly. That title, which might have probably been proposed by somebody that didn’t know much about the topic, could have become an opportunity to address what I consider to be one of the main shortcomings of traditional clinical what I consider to be one of the main shortcomings of traditional clinical psychiatry and showcase instead a more recent, innovative way to look at at mental health. If you have listened to my first episode, you might have perceived that I’m very inclined to talk about methods, definitions and frameworks. ILet’s then start from two key assumptions that I’m going to build my narrative on. First, I will assume a dimensional framework to look at mental health, which means that I would not use the traditional medical categorical lens, which means that I would not use the traditional medical categorical lens, which identifies conditions based only on the presence or absence of specific symptoms, but I will consider adhd, anxiety and insomnia as multidimensional entities placed on a spectrum. Second, I will also assume an evolutionary angle, because when we look Second, I will also assume an evolutionary angle, because, when we look at living systems, it is always very informative to inquire about the adaptive capacity of certain functions in relation to the environment. Only two assumptions. As the parsimony principle commands, the explanation with fewer assumptions is generally the best one available. I hope I will prove my thesis. Since I am not Agatha Christie, let me anticipate who the murderer is. I want to show that adhd, anxiety and insomnia might not be entirely separate conditions, but different expected manifestations of the same regulatory system under certain environmental conditions for which that system didn’t evolve for in the first place. My core thesis is that dysregulation of that system, -, which is the stress system – can explain comorbidity across different conditions and across levels of analysis. Let’s start with epidemiology – So the occurrence of diseases in the population. Over the last decade, diagnosis of subclinical or full blown adhd, anxiety disorders and sleep disorders have all been increasing. Current understanding often considers inattention, anxiety and insomnia and the relative syndromes as separate problems and consequently address them with different treatments. However, the rising impact and even co-occurrence of this triad suggest to me that there might be a common denominator behind this phenomenon. And since human beings are open systems and human physiology changes in geological areas, it is possible that what is changing might not be biology, but the interaction with the external environment. Modern environment indeed exposes us and our nervous system to conditions unprecedented in human history. Constant informational input, t digital attention capture, continuous social comparison and evaluation, blurred boundaries between work and rest. These conditions are very different from the ones we encountered in our ancestral environment, rather characterised by physical threats, natural day