2/24/10. Louis Menand reviews two books on the treatment of depression and examines psychiatry's claim to be a science.
My view is psychiatry can be a science, and has made significant progress --- but the field is still way behind the scientific accomplishments in all other medical specialties --- about 200 years behind.
A core reason for the elementary knowledge base in psychiatry is that we have no idea how the brain produces the mind and generates consciousness.
To compound matters, we have no reliable biological markers such as blood tests or brain scans for any mental disorder. And, we do not know the etiology of psychiatric disorders. We have a diagnostic manual of mental disorders crammed with too many lists of recipes, too many cooks, and too little science.
Yet depression is real and effective treatments are available. Read "Darkness Visible" by William Styron, or "The Unquiet Mind," by Kay Jamison.
Some depressions fit the etiology of the disease model and respond well to medicine.
Some people get life-saving benefits from antidepressants; some people develop self-knowledge, confidence, and coping skills from psychological therapy; and people who take antidepressant medication and go for psychological therapy often have the best outcome.
Both antidepressant therapies and psychology therapies are both underused. The stigma of mental illness still touches the lives of many people and their families. Many depressed patients never seek help, or when they do, they do not get the help they need.
It is not just politicians who labor under rigid ideologies. With so little and often contrary scientific findings, many mental health professionals still subscribe to either biological or psychological treatment ideologies.
http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all
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