Drugs are indeed crucial in treating most mental illness. Whether short-term (to help restore a chemical balance which the body maintains later through behavioral changes), or long-term in cases where that is not possible, medication makes it possible for people to heal, or at least to reach some kind of balance and decent quality of life.

You are mistaken, however, to exclude other forms of therapy ("Just like for any other organ disfunction [sic], drugs tend to be the only tools available for treatment"). CBT, for example, affects parts of the brain that neurotransmitters do not, and vice versa. From a 2004 study:

Of the two groups, only those participating in CBT showed decreased over-activity in the medial frontal cortex, an area of the brain implicated in self-monitoring and self-assessment. By comparison, the people who took paroxetine showed no change in this area, but they did experience decreased activity in the subgenual cingulate area, a limbic system region associated with mood regulation--an area apparently unaffected by CBT. (http://www.apa.org/monitor/apr04/cbt.html)

Other research shows that patients pursuing treatment with drugs or therapy alone, as opposed to a combination of drugs + CBT, do not experience as much success. This may be because as yet, we don't know how to pinpoint which kind of treatment best suits which kind of depression. Right now the state-of-the-art treatment is a targeted combination of medication and therapy; this has the best chance of success for illnesses such as depression, anxiety, PTSD, and even, recently, insomnia.

People seem to think (I'm not saying you specifically, it's just a common attitude) that if a problem is physical, then talking can't possibly affect it. But *everything* we do affects the brain, including talking, thinking, and writing. Words are the language we program ourselves with; this is why marketing firms are spending huge sums to study what sells and what doesn't, and the neurological underpinnings of the same.

People need to see themselves as whole, dynamic entities, and psychiatrists and psychologists alike need to see treatment in the same way. I write as someone seeking to make neuroscience her career. I've also worked as a supervised lay therapist for autistic toddlers, and seen how training and therapy dramatically helped them. I hope my minor jumping on to my soap box has not been offensive, but informative.

Ann, your letter pierced my heart for two reasons. One, I'm a high-functioning autistic like your son, misdiagnosed (because of a catatonic state) as having some rare, unspecified epilepsy when I was three. The diagnosis wasn't corrected until I was sixteen.

Two, my husband (who has bipolar disorder), has experienced very similar mistreatment at the hands of ignorant doctors. For two years, he struggled with a misdiagnosis of simple depression and terrible prescriptions. They put him on medication which increased his mania, and put him on klonopin to control the results.

At one point he was on high doses of Prozac, Celexa, and Buspar; a low dose of lithium to "enhance" the effects of the above; and 12 mgs daily of Klonopin to suppress the sometimes uncontrollable and frequently angry manic symptoms resulting. The recommended range for Klonopin psychotropic dosage is 1-4 mg. daily, which knocks most people out. 12 mgs. didn't even make my husband drowsy, and barely controlled the symptoms. And of course he suffered side effects from all this medicating.

While this should have been a clue to his doctors (all within the same healthcare system in our small town location), it was not. It wasn't until we moved to a city and got a doctor who kept up in the literature that he was properly diagnosed. He is now on appropriate medication, and only takes 1 mg. of klonopin on those rare days his meds don't manage his symptoms properly. When he does, he gets drowsy, which tells me he's responding like a normal person, not on in a long-term, medication-induced mania. The sweet, brilliant professor I married is back, after over two years of nightmare. We have hope, and we're working toward a balanced, long-term solution.

Re: autism.

I think your son is extremely lucky to have people such as you and the rest of the family caring and fighting for him. I was particularly struck by your appreciation of the advantages as well as problems accompanying this diagnosis. As your son grapples with adulthood and dealing with the non-autistic world more and more on his own, that will give him the strength he needs to trust and fight for himself. I know very well the peculiar mix of challenges and gifts he has, being autistic myself. I'm sure, with the lessons learned from this experience and the love from those around him, he'll be able to manage them in the long run.

Best wishes to you all :-)