In the mid-1990s, child mental health researchers at top New York institutions injected grade-school boys with fenfluramine, also known as the diet drug "fen-fen," a substance that was later banned by the Food and Drug Administration, due to its links to valvular heart disease and pulmonary hypertension. The boys were all Black or Hispanic by design: Eligible participants were required to be African American or Hispanic because they were deemed to be at higher risk for developing disruptive behaviors.
Yes, there has been a shocking lack of progress in developing transformative psychiatric medicine (We need new drugs for mental ill-health, 5 February), but this may be because in mental health, drugs are not always the answer (see, for example, Richard P Bentall's Doctoring the Mind). Huge progress has been made in the effectiveness of talking therapies for example, free effective treatment for post-traumatic stress disorder (PTSD) is available to all UK army veterans through the charity PTSD Resolution.
Statistics show that about one-third of people with depression achieve remission-meaning their symptoms are gone-with traditional antidepressant medications. This matched my experience treating people, and I had grown to accept that this was as good as it gets. Although I wasn't thrilled with the fact that many people continued to struggle with significant symptoms of persistent depression, it seemed this was as good as we could do.
For decades, we've divided health into neat categories: mental health on one side, physical health on the other. The brain over here. The heart over there. Different specialists. Different appointments. Different silos. But biology doesn't respect those boundaries-and neither does depression. A growing body of research now makes something unmistakably clear: Depression is not only a disorder of mood and motivation; it is also a condition that affects the heart, blood vessels, and our long-term cardiovascular risk.