Several years ago I was speaking in a family practitioners office in Marshall, TX. I started out with a question, "If you were treating President Clinton, what would you prescribe him?"

He immediately answered, "Prozac."

I said, "Good, and that’s because …"

He said, "It causes people to commit suicide."

Of course, I was thinking more along the lines of reducing libido, but he had raised an interesting point.

Does Prozac or other SSRI’s increase the risk of suicide?

The best answer is, usually not. Studies have shown that overall, antidepressants decrease suicide risk. In one large study, patients with depression were twice as likely to commit suicide if they weren’t on antidepressants. So you could say that antidepressants reduce the risk but don’t eliminate it. But, can antidepressants sometimes increase risk? Unfortunately, yes.

How can antidepressants increase suicide risk?

1. Some patients are very sensitive to side effects and become very anxious or agitated on antidepressants, and anxiety is one of the main symptoms associated with acute suicide risk.
2. A second possibility is that a person with depression associated with hopelessness and immobility may be activated enough by the antidepressant to carry out a suicide plan.
3. More common would be a situation where someone is bipolar or at least has bipolar genetics and the antidepressants cause a dysphoric hypomania. This is one of the most suicidal states where someone has symptoms of depression and hypomania at the same time. (see bipolar newsletter for details of these states). Why would it be more of a problem in kids and teens? Because, the earlier the age of significant depression, the more likely they have bipolar genetics.

(1)"In June, the Child and Adolescent Advisory Commitee of the International Society for Bipolar Disorders issued a position statement on antidepressant medications for children and adolescents: ‘they (primary care doctors) should monitor their children for the emergence of specific symptoms that may warrant referral to a psychiatrist: anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity and severe restlessness.’

"The statement also identifies signs of mania in children, including a decreased need for sleep, exaggerated or inappropriate silliness, exaggerated optimism, behaving as if invincible, atypically high energy levels, exaggerated talkativeness, racing thoughts, extreme restlessness or impulsivity, and inappropriate sexual behavior.

"The committee stressed the need for extra attention when medication is first prescribed or when it is changed. In some children these events have been linked to an increased risk for suicidal behaviors, so they caution against abrupt discontinuation of medication, which can exacerbate the illness and its symptoms."

Would it just be better to avoid antidepressants in kids?

No. There are definite benefits, especially with anxiety disorders, but also some depressions. The important thing is that patients, parents and clinicians be aware that these paradoxical reactions occur. They must monitor for negative reactions, which usually occur in the first few days or weeks. Kids that have done well on these meds for several months are at very low risk of an adverse reaction.

(1)"A recent analysis of suicide rates in the Journal of American Academy of Child and Adolescent Pyschiatry (2004:43) showed no significant difference between SSRI’s and placebo."

But they recommend additional studies to separate the effects of the illness, the medication and the interaction of the two. Of course, in formal studies patients are more closely monitored than in most office practices.

A recent study of communities looking at number of kids/teens taking antidepressants and rate of suicide in them found that the highest suicide rates occur in the communities using the least antidepressants. So in general, the benefit outweighs the risk. But in any given individual a complete history, including family history, good patient/family education, and close monitoring are essential for good medical care.

Footnotes: (1) CNS News, October 2004

In 1999, the National Institute of Mental Health sponsored the most comprehensive study of ADHD children that had ever been done. They wanted to find out how various treatment approaches compared in outcome. It was called the Multimodal Treatment Study of ADHD (MTA). 579 children ages 7-9 with ADHD combined type were studied for 14 months. Patients were randomly assigned to one of 4 groups: A) Referred to doctors in the community for treatment as usual B) Treated with stimulants or placebo* according to strict dosing guidelines and frequent dose adjustments during the first four weeks. They also had daily feedback from the child’s parents and teachers. The children were first given methylphenidate (generic Ritalin) and then if not doing well changed to Dexedrine or one of 2 other medicines. After the first 4 weeks they were followed monthly. C) Comprehensive cognitive/behavioral treatment that included individual, group, and family therapy, aides in the classroom and summer camps. D) Combination of B and C *stimulants or placebo under blinded conditions Response rates were positive in 77% of the patients on medication. Cognitive behavioral treatment (CBT) added to medication did not provide any additional benefits to the medication alone. Benefits were noted even more in school than at home. Benefits continued throughout the 14 months but quickly reverted back to initial ADHD symptoms when medication stopped. Side effects were mild or none in 86%, moderate in 11%, and only a significant problem in 3%. (Irritability was worse in kids on placebo than medication). CBT did not significantly improve core ADHD symptoms, but did help with anxiety. Patients also on anxiety medication required slightly lower doses of ADHD medication. The MTA study very effectively demonstrated several principles about the treatment of ADHD: 1) Medication works well. Cognitive behavioral therapy alone doesn’t. 2) Patients respond well to the "right medication" at the "right dose." Most reports of bad reactions to stimulants were kids taking the wrong stimulant or the wrong dose. In this study only 3% had significantly negative reactions. 3) Benefits of medication were confirmed throughout 14 months (longer in other studies) without tolerance or sensitization. Three other long duration studies, two in the U.S., and one in Canada, had the same outcome. Other studies have shown continued benefit up to 10 years. Behavioral modification studies have shown some temporary benefit to some symptoms, but as soon as the treatment stops the symptoms return. ADHD is NOT the result of bad parenting. An observational study by Russell Barkley, a leading researcher and expert on ADHD, found that in ADHD families parents are more critical and controlling and less supportive than non ADHD families. However, when medication is given to the ADHD kids the parent’s behavior normalizes. In conclusion, ADHD is a disorder associated with different genetics, differences in brain structures and differences in brain chemistry. Abusive/traumatic childhoods can make it worse, as can excessive exposure to TV or computer games especially at an early age. In my clinical experience of over 30 years when I explain the medical basis of ADHD to kids, teens, and adults and we find the right medication and the right dose of medication, they like taking it. It makes their life easier. They are able to be normal - to pay attention in class, complete reading assignments and other homework, and get along with friends, teachers and family. As a consequence their self-esteem and self-confidence improve. The diagnostic tests and treatments recommended on the Dr. Phil Show by Dr. Phil and Dr. Lawlis are not based on scientific evidence. The treatments they criticize are supported by more scientific evidence than most illnesses in all of medicine. The worst thing is that potentially millions of people who have faith in Dr. Phil may rule out the use of medication for their kids and risk adverse outcomes not just to their academics but social skills and self-esteem……but the ratings are good. See ADHD Newsletter

When I first heard that Dr. Phil devoted a program to ADHD (Sept. 28 ‘04) called "Parenting with Pills" in which he sharply criticized the overuse of medication to "control behavior," instead of using good parenting skills, my response was "if all you have is a hammer, you treat everything as a nail." How ironic that when I went on his website, the first thing I read was a comment from Dr. Frank Lawlis, who has written a book, The ADD Answer, in which he criticizes doctors by using the same comment about treating everything as a nail (He credits Maslow as being the source on this quote.).

He implies all doctors have is a prescription pad for medication. The fact is the opposite. We physicians can prescribe meds or use education or therapy, but psychologists/counselors can only use talk therapy. For them to criticize meds has a stench of "sour grapes."

But it gets worse. In lieu of medication (they prefer to call them drugs), they recommend "snake oil," specifically diets and biofeedback. These are treatments with no scientific validity or endorsement by any of the reputable organizations, including the National Institute of Mental Health.

What exactly is "snake oil"?

Snake oil is anything that is highly recommended and especially endorsed by a person who has credentials or position of influence. The confusing thing is that due to the placebo effect, "snake oil" has some benefit.

What is the placebo effect?

Placebo is not a sugar pill. It is everything involved in treatment except the active treatment to which it’s being compared. It is the commitment and optimism of the patient, the interaction with staff, especially the doctor, the monitoring of symptoms, etc.

Sometimes the placebo effect alone accounts for over 50% improvement. The more a patient feels understood and cared about by the treater and the more confidence they have in the treater’s experience, the greater the placebo effect. For a treatment to be considered scientifically helpful, it has to add significant benefit above and beyond the placebo effect.

So what’s the problem?

There are several. First, the more charismatic the treater, the greater the placebo effect and more success they will have with "snake oil." To be fair, they may not know it’s snake oil because they see benefit.

A second problem is that the "snake oil" may not just be useless, it may actually make the condition worse. Two recent examples are Neurontin for bipolar disorder and progesterone for PMS. Both had been found to be helpful in open (not placebo controlled) studies. But when the controlled studies were subsequently done, the placebo group actually did better. The Neurontin and the progesterone had actually taken away from the placebo benefit.

Many pseudo treatments for ADHD result in delay of effective treatment at best and possibly worsen their symptoms. Ironically, one of the most comprehensive studies ever, the Multimodal Treatment Study of ADHD in 1999 (MTA) showed conclusively the overwhelming superiority of medication in treating this condition. I will describe this study next, but suffice it to say, "snake oil" won’t cut it.
See ADHD Newsletter

I am a bibliophile, a person who loves books. My friends and family would probably say I am more a hoarder of books, journals, magazines and notes. (More about what causes hoarding later.) I love going to book stores and I always see what they have on medicine and neuroscience. I don’t think it’s a coincidence that there are more books on thyroid than any other subject. I believe the reason is low thyroid is an extremely common, fixable problem that may be more frequently mismanaged than any other medical condition. Proper treatment improves fitness and quality of life but most doctors don’t get it.

There are two maladies that I have noted in some physicians, PRE EXTRACTION DISORDER and MILK OF MAGNESIA DEFICIENCY. In the first condition they lack important information or don’t understand key principles because their head is somewhere in their sigmoid colon. In milk of magnesia deficiency, they believe things that are sometimes creative or at one time believed, but unfortunately not true - ergo they are full of crap. You may think this point of view is unkind, and you’re right. I believe that as an ADHD person I was put on earth to stir things up and challenge the system, so I won’t apologize for being at times "tacky".

Why are there so many books about thyroid? I believe when a doctor "gets it" and starts treating low thyroid effectively, they realize how often it is mistreated and how many patients suffer the consequences. I could regale you with case after case of examples, but suffice it to say, I too feel compelled to try and educate the public and my physician peers about the physiology of thyroid hormones.

The thyroid gland in the neck secretes two primary hormones, the more abundant T4 and the more active T3. Most of our T3 is made in other parts of the body by converting T4 to T3. I am working on a thyroid article that will go into detail about all the important nuances, but the key points are:

• Thyroid regulates the activity of every cell in the body.
• Many people, for various reasons, are low in T4 and/or T3.
• Most doctors will order only part of the tests needed for accurate diagnosis (the TSH).
• Total T4 and T3 uptake and a multiple called T7 or free thyroid index (FTI).

The FTI is preferred by insurance companies because it’s cheap, not because it’s adequate. This test is unreliable according to many reputable texts, so I consider it to be useless. The most important test is the Free T4 and sometimes the Free T3. Even when the Free T4 is within normal range, it may be too low for the individual. It would be analogous to giving you an IQ test in which you scored 90, and I told you this range was normal. The normal average range of IQ is 90-110, but what if you said "my IQ used to be 130"? … Something’s wrong. That may be the case with your thyroid.

One reason that this is missed is that most doctors don’t ask about thyroid symptoms (or a lot of other symptoms for that matter). But if you have fatigue or easy fatigueability you need to review all the possible symptoms: Dry skin, hair loss, sensitivity to cold, constipation, swelling, decreased memory, depression, or mood sensitivity, weight gain, difficulty losing weight, and infertility.

Even when low thyroid is treated, it usually is undertreated. The main medication used is Synthroid (the generic is especially unreliable). Many patients also need T3, either Cytomel, or in combination Armour or Thyrolar.

In the past 2 years I have attended two lectures by different Endocrinologists who talked about treating low thyroid. They talked about TSH, estimated Free T4 and treatment with Synthroid. No discussion of secondary hypothyroidism (low thyroid) which means due to causes other than an underfunctioning of the thyroid gland. Neither presenter talked about the role of T3 or use of T3 in treatment.

The books on medicine and endocrinology all say that for secondary hypothyroidism the TSH is useless, and yet, that is frequently the only test they get. At the second talk I asked if they believed that the soul was in the pituitary. This is the gland that helps regulate thyroid by monitoring levels and secreting TSH. But the problem is the pituitary (the master gland just outside the brain) is regulated by the hypothalamus in the brain.

Years ago a study found that if post menopausal women not on estrogen were treated with too much thyroid it could worsen osteoporosis. Ever since there is a fear of causing bone loss, and the result has been a lot of undertreatment. The problem is over reliance on the TSH and fear of osteoporosis, "osteophobia."

In secondary hypothyroidism the thermostat for body temperature and the set point for basal metabolic rate is set too low. I believe a common cause is "hibernation."  Many of us are mostly indoors and some are mostly sedentary. But we adapted over 1000’s of years to being outside all day and physically active. Our energy and sleep were regulated by the bright outside light. Even on a cloudy day it is 10x’s brighter outside than inside. If our brain thinks we are hibernating, and especially if we have cultural heritage from the northern countries, then we compensate by reducing our metabolism until the weather permits productive outside activity. By reducing our temperature and metabolism we conserve energy (stored as fat). This is also why it’s very difficult to lose weight.

If our hypothalamus is set too low the pituitary will read our level as too high when we take an adequate healthy amount of thyroid medicine. The TSH will then be below the normal range - this is fine. But most doctors overreact and lower the thyroid medicine. Now the patient feels terrible, but their TSH comes up and the doctor is happy - pre-extraction disorder. Most doctors are conscientious. They want to do what’s best for their patients, but in the case of thyroid, they mostly don’t get it.

Low thyroid can cause or worsen depression. In women it is:

Thyroid x Estrogen x Brain transmitters (norepinephrine, serotonin, dopamine) = MOOD

It’s like for your car you have to have gas, oil, and water. You can’t compensate for no gas with more water. You can’t compensate for low thyroid with an SSRI (antidepressant such as Lexapro). In men testosterone is more important than estrogen. The brain converts testosterone to estrogen in men and women. Older men have more brain estrogen than older women (who are not taking estrogen). Older men have half as much Alzheimers - the only common cause of premature death more common in women.

In bipolar disorder Synthroid or T4 needs to be in the upper part of normal range to help stabilize mood. T3 is more of an antidepressant but obsession by "osteophobic" physicians results in inadequate treatment doses to help with mood. "The operation was a success (we kept the TSH up) but the patient died."

I will cover osteoporosis in detail later but just a note - adequate estrogen/testosterone/DHEA, weight bearing exercise, and adequate calcium is the prevention/treatment.

Other than that I have no opinions.

Read Part 1
A very successful friend of mine recently said - "I need to come see you. I’m depressed half the time, and I’m having panic attacks." Other than the pressure of a successful business, he has no reason to be depressed. He’s tried a variety of treatments before and still occasionally takes medication.

In all likelihood, he has a form of mood disorder called bipolar. In practical terms it means common treatments like antidepressants or stimulants for ADHD given without first being on a "mood stabilizer" would cause more problems than they would solve.

According to Dr. Fred Goodwin (arguably the leading authority on bipolar disorder in the world), Dr. Emil Kraeplin more than a hundred years ago had a better understanding of bipolar disorder than the criteria in DSM IV. Dr. Goodwin believes that highly recurrent episodes of depression - especially disproportionate to life stressors - is closer genetically to bipolar disorder and responds better to mood stabilizers than to antidepressants.

Mood stabilizers are medications that help both depression and symptoms of mania (euphoric grandiosity or agitation/irritability), or at least mood stabilizers help depression or mania without making the other worse. The name bipolar refers to the two extremes, up and down; but the cyclicity component is equally or more important. Hence, Goodwin believes the old term manic depression illness is more accurate and useful.

What does this mean for my friend? His life would probably be a lot better on a mood stabilizer, but given his history, he’s unlikely to take action any time soon. When he’s feeling good - he’s hopeful that down days are over, so he doesn’t really need help. On the other hand, when he’s down, he barely has the drive and capacity to get through the essentials of the day - he doesn’t have the energy to call and make an appointment and then to go in for an evaluation. It’s "Catch 22" all over again.

Some sad facts about bipolar disorder: 

National Depressive and Manic Depressive Association (500 & 600 people) in 1990 and again in 2000 show that the medical establishment is making very, very slow progress.

     Bipolar patients misdiagnosed as unipolar depression:

     1990 - 73%

     2000 - 69%

     Bipolar patients whose diagnosis was delayed by 10 years or more:

     1990 - 41%

     2000 - 39%

Why are we doing such a poor job? The system is broken. We need a complete shift in paradigm. Patients and doctors need to take the controls back from insurance companies.

The last 52 years in psychiatry reflect the lack of solid scientific foundation. We need official diagnoses so we can use our insurance for medications. But diagnoses are not the "be all, end all." I tell patients I’d rather not know exactly what the problem is and be able to fix it, than understand it perfectly and be unable to do anything about it.

If you’re struggling more than you think you should be, or more than a lot of people you know - there may be help available to make things easier or enhance your quality of life. You need to find a physician or counselor who treats patients, not just symptoms or diagnoses. Two cases in point - ADHD and bipolar disorder.

A great example is the diagnosis of ADHD - one of the most important disorders in medicine because of the negative consequences to productivity and relationships and the relative ease of highly effective treatment. Ironically, in a recent survey, 15% of primary care physicians felt comfortable diagnosing and treating ADHD - in contrast to 85% anxiety and 95% depression. This lack of comfort and confidence in treating ADHD is undoubtedly related to the higher regulatory controls and requirement for written prescriptions in many states - even though pain meds (esp. hyrdrocodone) and tranquilizers (esp. butalbital, diazepam & alprazolam) are much more likely to be abused according to a recent government-funded study.

I remind patients in the office and doctors when I’m teaching that our diagnostic manual (DSM) was not given to Moses on the mount. We change it every few years. It was published in the 1930’s that hyperactivity and behavioral problems improve through use of stimulants, but the first version DSM I (1952) made no mention of the disorder.

In DSM II (1968) the diagnosis was hyperkinetic disorder of childhood, and concentration problems were thought to be due to hyperactivity. I’m frequently reminded of Yogi Berra’s comment "I wouldn’t have seen it if I hadn’t believed it." Because in 1980 (DSM III), the diagnosis was changed to attention deficit disorder with two subtypes - inattentive and hyperactive. Symptoms of impulsivity were required for both types.

In 1987 DSM IIIR, they flip flopped on panic disorder and said that agoraphobia was caused by panic attacks instead of vice versa in 1980. The diagnosis of ADHD was changed again. They eliminated subtypes and included inattention, hyperactivity, and impulsivity symptoms. You had to have at least 8 of 14, and since there were less than 8 inattentive symptoms, this subtype fell off the radar screen.

Then in 1994 a factor analysis showed there were 2 symptom clusters - inattentive symptoms and hyperactivity/impulsivity symptoms. This is reflected in our current manual DSM IV published that year. So now you can be diagnosed either inattentive, hyperactive/impulsive, or both. Each subtype requires 6 different symptoms before age 7 with significant negative consequences in at least 2 settings.

There are several reasons these criteria are problematic, the main one being that the highest levels of brain function are not fully developed until the very front of the brain is matured - but this doesn’t occur until the early 20’s. Furthermore, scattergram analysis reveals the higher the IQ, the more likely the diagnosis will not be made until early adulthood or even midlife. Fortunately the current manual includes a category ADHD NOS (not otherwise specified) for people with enough symptoms to cause problems in at least one area of their life but not enough to get a full blown diagnosis.

In a few years we’ll have DSM V and all new rules - meanwhile, we’ll make due with what we have.

Read Part 2

Jane Pauley in August of 2004 went public with the fact that she has bipolar disorder and takes a mood stabilizer (Lithium). She details the development of her illness in a new book, Skywriting. How did the "all American girl" become "mentally ill?" I don’t like the term mental illness. It has too many pejorative connotations, including insanity and craziness. Even in patients with schizophrenia the label "mental illness" implies a hopelessness and pessimism about treatment.

So l will rephrase. How did Jane Pauley develop a serious mood disorder that for a time resulted in impaired reality testing and caused her to go many months before she could return to work? While hospitalized for a manic episode she said she cried for the loss of Jane, the "most normal girl on TV." WHY?

Probably most important is genetics. Her father was a closet alcoholic. She had evidence of biorhythmic sensitivity, suffering from severe hives on a 7 year cycle at ages 7, 14, 21, and 49. She reports having thyroid problems, which increase mood swings. And she was perimenopausal. Then, while doing a feature article about her father she was forced to deal with the reality that in some ways her "whole life had been a lie" since she had spent most of it in denial about her father’s alcoholism. The stress of this and her seven year cycle caused a severe outbreak of hives which required 2 courses of steroid treatment.

Bipolar episodes are more likely precipitated by hormone changes or certain medications, especially steroids and antidepressants. Jane Pauley’s second round of steroids caused symptoms of depression, and she was prescribed an antidepressant. The beginnings of hypomania induced by steroids and antidepressants cause problems with sleep, and lack of sleep is one of the most powerful mood destabilizers in susceptible individuals.

The fact that she had genetics for bipolar disorder is not the reason that she decompensated. Were it not for the steroids and antidepressant, she may never have developed overt bipolar disorder. The brain has remarkable plasticity (adaptability), and a lot of our genes never get turned on or are modified by experience. In the future we will know who is vulnerable to certain kinds of treatments, and hopefully be able to protect the Jane Pauleys of the world from bipolar and other dreaded diseases.See Bipolar Newsletter

What possessed me to take on such a huge project as this website? What makes me think that I’m qualified to do it? Maybe it’s partly being in my sixties, but mostly it’s my personality that I feel compelled to challenge the system when I see or hear things that I know are wrong.

I have been involved in many research projects over the years including being the principal investigator for many medication studies. One of the things that this teaches is a systematic and thorough approach to diagnosis and careful monitoring of response to treatment. For these studies to be useful, patients need to be randomly assigned to either a placebo or an active treatment, and patients and researchers need to be blinded to who is getting what (i.e. double-blind).

Another fun thing is when a medical treatment is believed to be useful for something, but in a placebo controlled study, the placebo does better. This is what happened when progesterone was studied for PMS and when Neurontin was studied for bipolar disorder. This is the way science works. If the findings don’t support theory, we modify the theory, or we come up with a plausible explanation.

I wrote my 1st prescription as a psychiatry extern in 1966. Ever since then my patients have been my best teachers. "This medicine is great. It’s changed my life." Or, "this medicine made me sick, or numb or crazy." There are few things more satisfying than someone saying, "Dr. Jones I want to thank you. You have helped me make my life better." Implicit in that statement is the patient taking responsibility and giving themselves credit for their progress.

I believe one of my best talents is knowing a great teacher when I hear one and then spending as much time as I can learning from them. As Carl Jung supposedly said to Freud, "Even a midget on the shoulders of a giant can see further than the giant." [Probably not relevant for our purposes - Freud apparently was not flattered, because he's reported to have responded, "But a gnat in the giant's hair can't see anything."] I’m not particularly a big fan of Freud. 

When I was in training in the 60’s, psychoanalysis was the dominant force in psychiatry and my field of interest - medical psychiatry - was just beginning. To Freud’s credit, he did say that ultimately the definitive treatments would be medical. Freud did spend several decades listening to patients and making observations. One of my favorite Freud comments was "a boy who feels that he is his mother’s favorite has a feeling of specialness and often grows up to become very successful."

One of my mentors, Dr. Asa Deloach taught me, "If what you’re doing is not working, do something else. Even if it’s wrong, it will get you unstuck." Through trial and error over my career, I have found the treatments that usually work best. Most importantly, I have found the ones that keep working long term (I will share all of these with you as we go along).

From Dr. John Roberts, a surgeon I ran with when stationed at Sheppard Air Force Base the last year of the Vietnam War, I learned "a difference that makes no difference is no difference." In other words, don’t obsess about what type of schizophrenia it is - we only have one type of treatment. On the other hand, bipolar depression may look like the more typical stress induced depression, but the treatments are very different.

I love this stuff! I love learning and I love teaching. In 1969, I presented my first grand rounds to the Department of Psychiatry, University of Texas Southwestern Medical School. I had been inspired by Dr. Bob Beavers to appreciate the power of the family dynamic. The topic I chose was the role of family constellation in the development of personality. I was a first born with two younger sisters. Imagine how different the experience of being the youngest of five sons is. I still believe the family dynamic is one of the main determinants of who we are - perhaps second only to genetics.   

I have been teaching ever since. I teach doctors, and I teach patients. I have given over 1200 talks. I have spoken in most of the states of the U.S., Canada, and Puerto Rico. I have spoken to national organizations and the National Institute of Mental Health. I’ve served on the clinical faculty of the UT Southwestern Department of Psychiatry, and for years, I was the medical director of the Anxiety Disorders Clinic of the Southwest (which had one of the two intensive inpatient programs in the country).

As I travel and speak and in my private practice, I spend a lot of time and energy exposing and debunking wrong information. It drives me crazy when I hear things or read things that I know are wrong. Not long ago, the media reported on the Women’s Health Initiative Study. The media spin led to forty percent of women stopping their hormones. Ann Curry (of the "Today Show") said a lot of women are angry about doctors prescribing estrogen for menopausal women. But this study didn’t apply to most women, and the media didn’t report on the studies that showed significant benefits. I see the benefits of hormone treatments almost every day in my office. Unfortunately, the media is motivated by ratings, controversy, and sensationalism - not truth and practical information.

The sciences of medicine are going through an explosive period of growth. We have learned more in the last 10 years about the mind than in all of previous history, and yet we are just beginning. I can’t wait to see what we learn next. And whatever it is, I will share it with you, so you can make more informed decisions about your health, your life.