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Psychic suffering has increased, even as more of the population receives care.

Some help: Social prescribing, less faith in the DSM, and understanding neurodiversity

Medicine often loves a good bout of cockeyed optimism. Psychiatry’s latest came in the latter twentieth century. A review in the Lancet calls it a time when “it seemed that even the most intractable conditions like schizophrenia would yield their genetic and biochemical secrets and thereby offer targets for drug intervention.”

But there’s been little yielding.

Mental distress isn’t and never will be “a disease like any other.” Depression doesn’t come from “brain chemistry,” and the idea of lifelong drug treatment would have bothered practitioners living in the time of Hippocrates—400 BC. Psychic suffering has increased, even as more of the population receives care.

Distress is complex, involving trauma, things happening to and in the body, and a FOMO-filled, inequitable, and stressful world.

But much psychiatric training, and public awareness about psychiatry, focuses on biology. Psychiatrists begin their career with an M.D. degree before doing residencies in the field. Media pieces about mind care still focus on biological solutions.

The Greek Hippocrates created the longest-running theory of depression, one that influenced treatment well into the 1700s. Hippocrates believed what he called “melancholy” came from an overabundance--of an imaginary substance called black bile.

So the question about mind care isn’t whether it exists, but how to approach it. The field has moved beyond Renaissance prescriptions to combat bile by shunning the meat of the hare. But to where, exactly?

My friend Roger Jou, a psychiatrist who co-directs........

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