This chapter looks back over the past 40 years of taking an evolutionary function analytical approach to mental health difficulties. One evolved motivational system that has been strongly implicated in vulnerability to mental health difficulties, especially depression, is the competitive motivational system. This gives rise to an orientation for resource control and sets cognitive systems for social comparison, self-evaluation (inferior versus superior), self-blame/criticism versus other blame/criticism and biases behavioural systems towards either submissive-withdraw or dominant-engaged seeking behaviour. Depression tends to be associated with the unwanted and fearful low rank positions whereas narcissism is associated with assuming up rank and entitled positions. Research has also shown that unwanted low rank, and competitive defeats have major impacts on range of physiological processes associated with depression. One therapeutic approach is to help clients switch out of the competitive motivational system into a caring system which utilises very different psychological and physiological processes that promote being, prosocial behaviour and affect regulation. This is the basis of compassion focused therapy.