ADHD Medication, Psychoanalytic Therapy and Mental Illness


Getty Images/iStockphoto

In “For Mental Illness, Make Pills a Last Resort” (op-ed, April 5),

Erica Komisar

writes that ADHD results from trauma, loss and failed relationships but provides no evidence. I have practiced psychiatry for 53 years and have seen over 1,000 patients with ADHD. Almost all respond beautifully to medication. With gratitude, they report a huge improvement in focus, concentration and productivity.

Forget “last resort.” The main objective of psychiatric treatment should be to improve the quality of a patient’s life and reduce suffering—as quickly, effectively and durably as possible.

Alan S. Ruttenberg,


Canoga Park, Calif.

There are good reasons that psychoanalysis, presented by Ms. Komisar as the solution, has gone the way of the buggy whip and, at best, will be a niche luxury for the wealthy. There is no compelling evidence after decades of research that it is uniquely effective. To the extent it helps some people with ordinary life problems, the benefits are most likely due to factors common to most therapies that emphasize empathy and listening.

Assoc. Prof.

Tom O’Hare

Boston College School of Social Work


John Graves

suggests research has validated anxiety and depression as “legitimate brain disorders” (Letters, April 14). In fact, decades of research have failed to show any proof of that. There isn’t a single abnormal biologic or medical test—blood test, X-ray, biopsy—that psychiatrists use to diagnose “mental illness.” No medical tests can fully assess the brain alterations in patients given pharmaceutical treatments, either.

Our society is awash with disorders of all sorts according to psychiatrists. Antidepressants and antipsychotics used to treat these supposed disorders come with warnings that their use, as well as their discontinuation, may cause the very same thoughts and emotions for which they are prescribed, or worse.

Emotional distress is common, and it is sometimes severe. Counseling can be very useful, but drugging people to cloud out thoughts should be short term and reserved for extreme cases, as Ms. Komisar argued.

Daniel Zeidner,


Cheswick, Pa.

I have been delighted to read Ms. Komisar’s op-ed as well as the letters to the editor on all sides of the argument. It occurs to me that if Ms. Komisar’s recommendation had come from the CDC, perhaps every other opinion would be attacked as disinformation or banned. It is refreshing to see debate in the public square regarding a medical treatment.

Lary Schulhof,


Asheville, N.C.

Copyright ©2022 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

Appeared in the April 22, 2022, print edition as ‘Mental Illness, Treatment and Open Debate.’