Perhaps the best way to describe the warts so prevalent in the field of psychiatry is by asking some pretty obvious questions for which medicine still doesn't seem to have the answers.

When people such as autists appear to think differently to the way the majority think, why do we insist on pathologizing them?  And why does society blame, shame & punish those people who instead of fitting in, succumb to emotional difficulties, either spontaneously or under duress?  Why do we tell them its all in their heads?  Why do we treat them for ever & ever yet never cure them?  Let's face it, without mind, nothing is real to us, so why do we insist on drawing a line in the sand, running between body & mind, as if only the body were real while the mind must be imaginary?  Why do we assume that all mental problems originate within the insubstantial substance of the mind itself & are fictions of this mind, instead of being physical & organic, as indeed they all happen to be?  Is the field of psychiatry a false construct, an intellectual projection, a house of cards?  And whether inherited or acquired, should we perhaps start thinking of emotional & though disorders as being examples of nano-neurology & neuro-degeneration instead of psychiatry, to be approached in a medical rather than a psycho-social manner, because of the medical drivers including hormones which they share?

Barking up the wrong tree

We have clearly been barking up the wrong tree for far too long, & a fundamental sea-change, a true paradigm shift is long overdue in the field of mental health.  We need to stop treating symptoms & instead address the forces that underlie them, forces based on the newly appreciated plasticity of the emotion-supporting brain.  Hormones are a critical factor in these equations.  Mental disruptions in both men & women are clearly amplified when the sexual & related hormones have been shifted into a state of erratic flux or imbalance, in response to a variety of endocrine insults & disorders, as are manifest during the stormy teen years, in women with PMS/PMDD, in women on birth control pills and those suffering from the hormonal disruptions typical of polycystic ovary syndrome (PCOS), during pregnancy and the post-partum time period, during the erratic pre-menopausal years & when the body becomes hormone depleted thanks to surgery or senescence.  In males testosterone depletion can certainly fuel dementia and major depression, whereas androgen receptor anomalies may fuel erratic testosterone patterns & excesses quite capable, when operating via receptor independent mechanisms, of contributing to ADHD, autism, OCD & psychosis.

The complex, generous links runnong between hormones & mind are undeniable, yet they have been persistently ignored, although over the past few decades neurobiologic & endocrine research have finally revealed the reasons behind these hormonal connections, in the form of novel ways whereby these hormones operate, particularly at the brain & the immune/inflammatory systems.  These mechanisms are faster, more urgent, more versatile & far more catholic in their influences.  Learning about and appreciating them can empower us, not tomorrow but today, to develop a more enlightened approach to brain & mind, while incorporating the powerful yet user-friendly & far more subtle benefits of hormonal modulation into our armamentarium.

A hormonal approach

Taking advantage of the hidden power of the sexual, thyroidal & adrenal hormones as they operate in concert, not in the distant future but in the now, can facilitate reductions in mind-altering drug doses & side-effects, can help us to break through the frequent obstructions posed by treatment-resistant disorders, and can ease the costs of the health-care burden.  So let's do it!