Footprints of Schizophrenia: The Evolutionary Roots of Mental Illness

In this provocative debut, psychiatrist Lesk excavates the origins of schizophrenia and outlines possible treatments for it and other dopamine-related mental illnesses. In prehistoric times, man needed dopamine to survive—the “reward chemical” jump-started “survival-adaptive endeavors like food gathering,” according to Lesk. But the acquisition of language brought “our own mystical evaluator in the form of thought,” partly undercutting the need for dopamine. Nowadays, suppression of the reward chemical helps “strengthen the ego and keep out unwanted mental intrusions,” Lesk writes, while its overproduction fosters in the schizophrenic brain “more childish, primitive, and downright psychotic rules of thinking and much less secondary process thinking” and precipitates hallucinations. Lesk reassures readers that treatment­—which may include antidepressants, dopamine-blocking antipsychotics such as Clozapine, and electroconvulsive therapy—can be effective when administered in a timely manner. The author’s use of figurative language to convey his complex medical analysis can sometimes obscure meaning, as when he describes the schizophrenic’s experience with language: “words, now object-like and experienced as oddball intrusions... may become these phallic penetrations that can be cannon balled outward to others or broadcast forth as a sort of rejection of them.” Still, this is a fascinating study that never sacrifices complexity or interest, and a welcome resource for those eager to learn more about the disease and its roots. (Dec.)