Opening the Black Box

From the moment our ancestors chiselled their first pictograph in stone andshaped the beginning of language, we humans have been trying to explain our own behavior. We've held responsible everything from gods to demons, animal spirits, Cupid's arrow, the stars, the moon, sunspots, alcohol, mushrooms, our dysfunctional parents, our mad and maddening culture, technology, war, peace, prosperity, the other gender, and most recently, the almost invisible but omnipresent neurotransmitter. These days, however, we are listening, not just to Prozac or Paxil, but to the brain and mind together.

"For the first time ever, we're able to say to people, `This is the way our brain work,'" says John Ratey, M.D., executive director of research at Medfield State Hospital in Massachusetts. From dyslexia to depression, we're beginning to understand the ways we can help balance our brains through everything from medications to therapy to behavioral coaching. Says Ratey: "That's magic. People start reframing their entire lives."

As Ratey explains in these pages, different disorders are reflected by unique alterations in brain chemistry and structure, and even "normal" variations in temperament seem patterned, in part, by the kind of brain you were born with. Our old distinctive between health and illness no longer hold up. Mild depression is not qualitatively different from the kind of drawn-blinds melancholy that sends someone to the hospitals; one is simply a whiter shade of pale. Even seemingly dissimilar disorders may be related: "I see more and more papers on the interrelationship between different illnesses," notes David Comings, M.D., director of the Tourette's Syndrome Clinic at the City of Hope National Medical Center in Duarte, California. Comings has found that disorders like depression, migraines, PMS and Tourette's syndrome cluster in families.

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These insights have freed us. Know the brain, scientists today are saying. And then, explains Peter Kramer, Ph.D., author of the bestselling Listening to Prozac, you can alter "your temperament with medication, or by choosing your challenges wisely, or through talk therapy, which has its own biological impact. The whole point is to be able to see the world differently, even for a moment. The goal is flexibility."

Psychology is indeed being reshaped, and what we offer here is a report from the frontlines of research--Edward Hallowell, M.D., the coauthor with John Ratey of the bestseller Driven to Distraction, dissects the disorders du jour, attention deficit disorder (ADD), explaining just what characterizes this condition and how to treat it; neuropsychiatrist Peter Whybrow, M.D, offers a lyrical, unforgettable tour of the soaring highs of mania and the lethal undertow of melancholy; and Ratey himself writes about "shadow syndromes," mild forms of known disorders that can subtly derail normal lives. Finally, psychologist Michaele Yapko, Ph.D., reviews some key strategies for avoiding depression. In every case, the underlying theme is the same: and integrated approach to treatment and diagnosis, a new openness to blending both biology and psychology, and a growing sense that we truly are a family of man, that ordinary moods and temperaments are second or third cousins of familiar, more severe disorders.

This compassionate and inclusive approach to treatment can radically improve our lives. In that sense, "psychology our lives. In that sense, "psychology is actually going back to its roots," notes Martin Seligman, Ph.D., president-elect of the American Psychological Association. "We want to learn all we can about curing mental illness, but we're also taking people who aren't in bad shape at all and making their lives even better. It's like taking talented people and turning them into geniuses."

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