For Mental Illness, Make Medication a Last Resort

You’ve probably heard that anxiety and depression are “brain disorders” that must be treated with psychotropic medication. That’s closer to a pharmacological marketing slogan than settled science. These conditions, along with ADHD and addiction, result from trauma, loss, psychosocial stressors and failed relationships. Even when there is a genetic proclivity to severe mental illness, such as bipolar disorder and schizophrenia, the environment plays a central part in triggering the disease.

Roland Kuhn, the Swiss psychiatrist who discovered one of the first antidepressants, imipramine, in 1956, later warned that many doctors would be incapable of using antidepressants properly “because they largely or entirely neglect the patient’s own experiences.” He was right. As a psychoanalyst, I often see patients who come to me after medication prescribed by psychiatrists—and even internists, who have no specialization in psychotropic drugs—has failed.