Quotes from Randolph M. Nesse

Most of us want most of all to be loved by someone who cared about us for ourselves, not for what we can do for them. For many, the search is bitter and fruitless.

Thanks to subsequent years of conversations with evolutionists, especially Williams, and with medical school residents and faculty, he has found that an evolutionary perspective on patients' disorders has become steadily more natural and useful.

Chen H, Li C, Zhou Z, Liang H. Fast-evolving human-specific neural enhancers are associated with aging-related diseases. Cell Syst. 2018 May;6(5):604–11.

Some clinicians skip asking about personal details. They check symptoms on a list, put patients into diagnostic categories, and then recommend whatever treatment has been shown to help patients with that diagnosis. This nomothetic approach saves time, effort, and the emotional entanglements that ensue from creating relationships with individuals. Fewer midnight phone calls.

There is no such thing as a diet without toxins. The diets of all our ancestors, like those of today, were compromises between costs and benefits. This is one of the less welcome conclusions that arise from an evolutionary view of medicine.

During most all of human evolution, it was adaptive to conserve energy by being lazy as circumstances permitted. Energy was a vitally needed resourse and could not be wasted. Today this take-it-easy adaptation may lead us to watch tennis on television when we would be better off playing it. This can only aggravate the effects of excess nutrition. The average office worker would be much more healthy if he or she spent the day digging clams or harvesting fruit in scattered tall trees.

We can also, more than any other species, protect ourselves from being poisoned by learning about how to avoid it. Only we can read about the dangerous plants in our gardens and woodlands, and we are the the species whose diets are most shaped by social learning. A food our mothers fed us can usually be accepted as safe and nourishing. What our friends eat without apparent harm is at least worth a try. What they avoid we would be wise to treat cautiously.

Our capacity to create and manipulate mental representations has many benefits, and the ability to foresee new dangers is clearly one of them. This capacity also helps us to avoid repetitions of actual experiences of danger or injury without creating unnecessary phobias.

Some cues -for instance, snakes, spiders, and heights- readily elicit fear in ourselves and other primates. It should not surprise us to discover that we instinctively avoid certain cues that have long been associated with such dangers as falling and dangerous animals.

Except for professional athletes, dancers, cowboys, and a few other groups, most people in modern industrial societies have abnormally low energy expenditures. Workers sitting in swivel chairs or in driver's seats of cars or even pushing vacuum cleaners or electrically powered lawn mowers are being sedentary, and their leisure hours may be even more so.

In the meanwhile, people with anxiety disorders deserve recognition for their courage and daily determination to live full lives despite their symptoms.

The current danger for most of us is not the deprivation suffered bu our ancestors but an excess of nutrition.

Psychiatrists are supposed to help their patients get in touch with things they are trying to avoid.

The current danger for most of us is not the deprivation suffered by our ancestors but an excess of nutrition.

The kinds of attention we get on social media is really very much like crack cocaine. We have social obesity I call it—we can't stop our consumption of opportunities to display ourselves and get feedback from other people.

Mating without caring for the offspring benefits men's reproductive interests more than women's.

Categories make for efficient communication and statistical recordkeeping. They also satisfy the human lust for making things seem simpler than they are. We have been trying to map the landscape of mental disorders by drawing lines around clusters of symptoms as if they were island, but mental disorders are more like ecosystems...defying crisp boundaries.

Males are relatively more interested in fertility and sexual loyalty.

Most behavior is in pursuit of a goal. Some efforts are attempts to get something, others to escape or prevent something. Either way, an individual is usually trying to make progress toward some goal. High and low moods are aroused by situations that arise during goal pursuit. What situations? A generic but useful answer is: high and low moods were shaped to cope with propitious and unpropitious situations .

Like fever and pain, anxiety and low mood are useful normal responses to some situations.

Natural selection involves no plan, no goal, and no direction — just genes increasing and decreasing in frequency depending on whether individuals with those genes have, relative to other individuals, greater or lesser reproductive success.

Why has the medical profession not taken advantage of the help available from evolutionary biology, a well-developed branch of science with great potential for providing medical insights? One reason is surely the pervasive neglect of this branch of science at all educational levels. Religious and other sorts of opposition have minimized the impact in general education of Darwin's contributions to our understanding of ourselves and the world we live in.

Every textbook description of a disease should have, in our opinion, a section devoted to its evolutionary aspects. This section should address the following questions: 1. Which aspects of the syndrome are direct manifestations of the disease, and which are actually defenses? 2. If the disease has a genetic component, why do the responsible genes persist? 3. Do novel environmental factors contribute to the disease? 4. If the disease is related

Strong selection for extreme mental capacities may have given us all minds like the legs of racehorses, fast but vulnerable to catastrophic failures. This model fits well with the idea that schizophrenia is intimately related to language and cognitive ability.93 It also fits well with the observation that schizophrenia may be intimately related to the human capacity for "theory of mind," our ability to intuit other people's motives and cognitive abilities in general.