Great, forthright article. But Yeow! The lack of a shared understanding among mental health practitioners about what works is astounding. What I don’t get is that even a logical sequencing of therapeutic interventions is not practiced.

For example, initially meaningful dialog in parallel with prescriptive exercise and proper nutrition along with meditation or biofeedback, followed perhaps with supplements like 5-HTP and SAM-e that appear to have some therapeutic value without the psycho-pharmaceutical side effect baggage. (Can’t hurt, why not give them a shot.) And finally, psycho-pharmaceuticals if the non-drug therapies are inadequate. I mean, why go to dope out of the box?

I just watched a final episode of the Sopranos. The young AJ character is depressed because his fiancé broke up with him. His parents send him to a shrink who waxes snobby elitist with some round about questions and then suggests Lexapro!

Why do I think that is not an uncommon psychiatric intervention profile? What the AJ character was burdened with was an experience that almost everyone goes through – a broken heart. Except the psychiatrist perhaps, because he was clueless about the need to explain life’s vagaries to his new patient. He just wanted to take out the script pad and bask in his pseudo-genius.

Psychotropic-centric psychiatrists appear to be almost idiot savants. They are brilliant at one thing, drugging people. While lousy at everything else required to deliver truly effective, empathic and holistic care.

BTW, the life management tools that should be incorporated in the treatment strategy map to “culture, psychology, lifestyle, attachments, diet” that Dr. Heydaya mentions in the article. Why is that so obscure to some people?

Again these drugs work well for some. Most likely for those who didn't drink and or do drugs in depressive episodes. Only so much can be done with brain damage. Are you asking too much in anger? Don't direct your agitation to the drug,take it out on the depressive for doing shots of Vodka. Your not cluing in Peter Kramer,He talks of all of this in his books,but i imagine you never got past the first one. Sincerely-David

This response is for the doctor. Your anger Steve doesn't interest me. Sincerely,David

I couldn't agree more with this article. It's about time that we woke up to the control that money has on our society, on our being.