'It is all in your head' is no more helpful an answer to the patient's puzzling and troubling question than were 'the spirits are angry' or 'the gods are punishing you' or 'your four humors are unbalanced.'

The American Psychiatric Association has proven itself incompetent to produce a safe and scientifically sound diagnostic system. Psychiatric diagnosis has become too important in people's lives to be left in the hands of one small and insulated professional organization.

The golden rule: an underlying medical illness or medication side effect has to be ruled out before ever deciding that someone's symptoms are caused by mental disorder. And the underlying medical illness may take time to declare itself.