Footprints of Schizophrenia: The Evolutionary Roots of Mental Illness

by Steven Lesk M.D.

Of all the mental illnesses, schizophrenia eludes us the most. No matter the strides scientists have made in neurological research nor doctors have made in psychiatric treatment, schizophrenia remains misunderstood, almost complacently mythologized. Without a reason for the illness, patients feel even more alienated than they already do, families are left hopeless, and doctors struggle to provide accurate care. Steven Lesk, though, after a medical career dedicated to those affected by schizophrenia and a determination to find the answer to its existence, presents a groundbreaking theory that will forever change the lives of the mentally ill. In Footprints of The Evolutionary Roots of Madness, Lesk threads evolutionary evidence with neurological evidence, turning the mysteries of our minds into a tapestry of logic. With his breakthrough theory and this unprecedented book, Lesk will invite necessary cultural dialogue about this stigmatized illness, provoke new psychiatric and pharmacological research, and provide unequivocal comfort to those afflicted and affected by schizophrenia. Lesk’s “primitive organization theory” is based in human evolution, from Neanderthals to Homo sapiens, and the specific changes to our brains after the emergence of language. We have existed in human-like form for six million years, but we’ve only had language for 50,000; within the vast span of evolutionary time, that’s hardly any time at all. Lesk elucidates us to the hormones affected by language, especially dopamine, and with brilliant clarity, connects human evolution, our brain affected by language, and those with schizophrenia whose dopamine doesn’t flow in our new, adaptive way. In other words, the twenty million people who have schizophrenia in the world don’t suppress dopamine in the way evolution has trained us, so their brains don’t process language well and function as if they’re in a hallucinatory, delusional dream state. Not only will Lesk’s theory focus treatment efforts for schizophrenia, but it will also affect that of other dopamine-related mental illnesses like Alzheimer’s, Parkinson’s, Huntington’s chorea, Tourette’s, ADD, and more. Publishing Lesk’s work will usher in a new era of psychiatric understanding, one that the field and the public desperately needs.

Genres: Science

256 pages, Hardcover

Published December 12, 2023

Reviews

[Andrés Astudillo · Rating 5 out of 5]

One of the coolest books you could ever read (if you are into this).
I've been reading evolutionary sciences from quite a time now. My first book on evolutionary psychology was "The parasitic mind" by Gad Saad, and I got hooked. This book, which to me is absolutely brilliant, talks about evolutionary psychopathology, being the main one "Schizophrenia".
This book is fucking AMAZING. I mean, the main premise of the book is saying that there's inorganic matter, and organic matter. We, as biological beings, contrary to inorganic matter, are struggling every second against a natural war against entropy. Entropy, by definition tends to overcome order because that is the nature of the Universe (I mean this non in a holistic way, but in a mathematical way). So, every living species, or living matter tends to deteriorate, because we have mechanisms to cope and fight time and entropy. Thus, the human brain is a product of nature trying to order organic matter. Hence we have language, symbol, numeric and logical reasoning, theory of mind, and so on. Every human psychopathology is, on the other hand, chaos trying to spice things up and take us back to an state closer to inorganic matter. The triumph of chaos and entropy is suicide (we cease to be a living being).

The brain, as any other organ, is the product of evolutionary times. Everything can be explained, so the human brain and some of its functions too. The main theory is -dopamine suppression-. This is a word that we are going to be seeing a lot of times throughout the book. Turns out that on the onset of language, that can be traced back to approximately 50.000 years, the brain started a process of "lateralization", meaning that our left hemisphere started to compute analytical thinking, a product of word processing that culminated in the development of our symbolic mind and the pre-frontal cortex being bigger than any other hominin. To get to this, nature had to suppress dopamine. Living in dopamine, is exactly like being a hominin in the African savannah. These species had no symbolic mind, nor the complexity of our minds; happiness is the product of the modern mind, because we now have an idea and an ideal of what it is. This did not happen before words.

To sum up, dopamine suppression is the product of evolution, and the 1% that suffers from schizophrenia, are part of the human species trying to adapt to modern living. I mean just like Jonathan Haidt mentioned, the "elephant" is the ancient brain and the "rider" is the newly-developed human brain. It is hard to struggle with million years of evolutionary baggage, we all suffer from it every time we see a Whopper, a Quarter Pounder, or porn. Schizophrenia is a step back in human evolution, and Parkinson, OCD, Tourette's and Alzheimer are part of the dysregulation of both dopamine and acetylcholine. Another important fact to mention about this book, is that is uses Freud's concepts from psychoanalisis, meaning that we are going to read about civilization and its discontents, ego, super ego, sex, and taboo.

My review sucks. It is not even 10% of the marvelous, and theoretical framework of the book. If you are really interested in evolutionary psychology, you are going to love this one hell of a ride.

[Mini · Rating 4 out of 5]

Thank you to National Book Network for the opportunity to review an advanced copy of this book! Disclosure: I work for a psychiatrist, however, it’s not Dr. Lesk. I hold a B.S. in Human Services/Psychology and will receive my MSW in 2024.



My first experience with a client who had schizophrenia was during a routine evaluation for anxiety.



“Do you find yourself worrying a lot about the same thing or different things?”



“Yes, the same thing. I really get anxious when the sheriff is on the tv everyday telling me that he’s going to kill my parents. I don’t know if I can stop him, and he scares me. I call the station every day to complain but they just laugh at me and tell me I’m crazy. I just want someone to help me.”



Other than the fact that she was convinced the entire police department of our New York town was persecuting her and her family, and that the sheriff was sending her direct threats between segments of daytime talkshows, my new client was perfectly polite and easy to talk to. Rarely are people with mental illness the villains you see in horror movies or in thrillers, but the labels are the same. Psycho. Crazy, nutty, schizo. A few French fries short of a Happy Meal.



If you’ve been there, or been there with someone you love, you know how frustrating it is to live life with a mental illness that camouflages itself as so many other things. The onset can be intense, or slow. It can look like mania or major depression. There might be a genetic link, or it might be random. Dr. Lesk does a wonderful job in this book of dissecting the neurobiology of schizophrenia in layman’s terms that any professional can understand. His theories that connect language, hormones, and behavior are fascinating, and he takes care to paint a picture of how the whole person might be affected by this disease from family functioning to self-recognition. He has created a tour of what major psychosis looks like from all angles, with no details spared.



I would highly recommend this read to anyone with more than a passing interest in mental illness. Dr. Lesk’s passion clearly lies with schizophrenia, but he also touches on the other dopamine related disorders and the behavioral effects of different treatments. Most of all, I enjoyed this book for its humanity and Dr. Lesk’s commitment to the belief that the mentally ill aren’t broken or wrong, they’re just using different rules of communication.



[Kate M]

This guy writes all the words from everywhere but ends up saying nothing. I was so looking forward to reading about evolutionary roots of mental illness, but alas, I will not know what survival advantage it may bring to suffer from psychosis. That’s if it’s correctly portrayed. Which is possible, because he got evolution wrong, stating that it makes a “precise correction” when in fact that is a teleological mistake and evolution nor natural selection are directional nor motivated to correct anything. It doesn’t WANT anything, it just is. And survival of the fittest never “switched” to sexual selection; sexual selection is a mechanism just like natural selection for how genes become fixed over time in a population. Civilization and rules have absolutely nothing to do with evolution. Evolution does not “take notes”. The author leaves out that human populations are really no longer under the influence of natural selection processes; we rendered those moot when we came up with medical care.
Nor do we call those with substance use disorders addicts any longer in 2023, which this author does. I cringed when I checked the date after seeing the language used for people who have mental health diagnoses and substance use disorders. Was there even an editor? Or maybe they just gave up slogging through the words like I did.

[GONZA · Rating 3 out of 5]

I had never read a book that provided toeries on the evolutionary and nongenetic origin of schizophrenia (and meanwhile of many other psychiatric disorders as well), and I found it very interesting though sometimes complicated. It certainly provides an interesting and different point of view, but I am not knowledgeable enough to evaluate the scientificity of some of the author's claims.

Non avevo mai letto un libro che mi fornisse delle teorie sull'origine evolutiva e non genetica della schizofrenia (e nel frattempo anche di molte altre patologie psichiatriche) e l'ho trovato molto interessante anche se a volte complicato. Sicuramente fornisce un interessante e diverso punto di vista, ma non sono abbastanza esperta per valutare la scientificità di alcune affermazioni dell'autore.

I received from the Publisher a complimentary digital advanced review copy of the book in exchange for a honest review.

[Ashley · Rating 3 out of 5]

Many repetitions throughout

[Julio Astudillo · Rating 5 out of 5]

One of the coolest books you could ever read (if you are into this).
I've been reading evolutionary sciences from quite a time now. My first book on evolutionary psychology was "The parasitic mind" by Gad Saad, and I got hooked. This book, which to me is absolutely brilliant, talks about evolutionary psychopathology, being the main one "Schizophrenia".
This book is fucking AMAZING. I mean, the main premise of the book is saying that there's inorganic matter, and organic matter. We, as biological beings, contrary to inorganic matter, are struggling every second against a natural war against entropy. Entropy, by definition tends to overcome order because that is the nature of the Universe (I mean this non in a holistic way, but in a mathematical way). So, every living species, or living matter tends to deteriorate, because we have mechanisms to cope and fight time and entropy. Thus, the human brain is a product of nature trying to order organic matter. Hence we have language, symbol, numeric and logical reasoning, theory of mind, and so on. Every human psychopathology is, on the other hand, chaos trying to spice things up and take us back to an state closer to inorganic matter. The triumph of chaos and entropy is suicide (we cease to be a living being).

The brain, as any other organ, is the product of evolutionary times. Everything can be explained, so the human brain and some of its functions too. The main theory is -dopamine suppression-. This is a word that we are going to be seeing a lot of times throughout the book. Turns out that on the onset of language, that can be traced back to approximately 50.000 years, the brain started a process of "lateralization", meaning that our left hemisphere started to compute analytical thinking, a product of word processing that culminated in the development of our symbolic mind and the pre-frontal cortex being bigger than any other hominin. To get to this, nature had to suppress dopamine. Living in dopamine, is exactly like being a hominin in the African savannah. These species had no symbolic mind, nor the complexity of our minds; happiness is the product of the modern mind, because we now have an idea and an ideal of what it is. This did not happen before words.

To sum up, dopamine suppression is the product of evolution, and the 1% that suffers from schizophrenia, are part of the human species trying to adapt to modern living. I mean just like Jonathan Haidt mentioned, the "elephant" is the ancient brain and the "rider" is the newly-developed human brain. It is hard to struggle with million years of evolutionary baggage, we all suffer from it every time we see a Whopper, a Quarter Pounder, or porn. Schizophrenia is a step back in human evolution, and Parkinson, OCD, Tourette's and Alzheimer are part of the dysregulation of both dopamine and acetylcholine. Another important fact to mention about this book, is that is uses Freud's concepts from psychoanalisis, meaning that we are going to read about civilization and its discontents, ego, super ego, sex, and taboo.

My review sucks. It is not even 10% of the marvelous, and theoretical framework of the book. If you are really interested in evolutionary psychology, you are going to love this one hell of a ride.

[Nataliesimmons · Rating 5 out of 5]

This book floored me. As someone who’s always been curious and admittedly confused about schizophrenia, Footprints of the Evolutionary Roots of Madness offered something I’ve never encountered before: a deeply researched, scientifically grounded, and evolutionarily logical explanation for this incredibly complex disorder.

Dr. Steven Lesk's theory that schizophrenia may be the result of an evolutionary lag in how our brains process language and dopamine is not just fascinating, it’s potentially groundbreaking. His “primitive organization theory” connects dots between ancient human history, brain chemistry, and modern psychiatric conditions in a way that feels both revolutionary and oddly intuitive once you read through his arguments.

What I appreciated most was that this book doesn’t just dwell on academic theory; it brings real compassion to those living with schizophrenia and their families. Lesk humanizes the illness while proposing a new lens through which we might understand, diagnose, and ultimately treat it (and other dopamine-related conditions). For me, it struck a beautiful balance between hard science and human empathy.

If you're at all interested in mental health, neurology, or the evolution of the human brain, this book is a must-read. It's dense at times, but worth the journey. I genuinely hope this work sparks the wider conversation it deserves in both the medical field and public discourse.

[Payton · Rating 2 out of 5]

I suspect I didn't read this book as it was intended. I have a feeling that this is meant to be an academic research book--as in student picks out relevant chapter(s) to their paper, writes the paper, and moves on with life. If I'd used it this way, it probably would have been a better experience.

I read this chapter by chapter in the order presented, and it felt way too long. This could've been shaved by at least 50 pages and still contained the authors main points and explanations. It was also poorly edited; there were at least two printing errors. Also, some of the author's phrasing didn't sit well with me in general. This was also a bit too advanced to be easily accessible to a layperson. I don't have a background in psychology, and, despite the author's many analogies, I still struggled to understand some of the brain functions.

All of that being said, I think there are some nuggets of good information in this book, especially if you are just starting out on a journey to learn more about schizophrenia.

[JP · Rating 4 out of 5]

Fascinating take, evolution and genetics. Primitive brain mixes with our advanced dopamine suppression system and goes haywire.

[Elenaharlow · Rating 5 out of 5]

Absolutely loved this one. The writing drew me in right away, and I couldn’t put it down. Definitely a book I’ll be recommending to friends.