I found this bit on St. John's Wort fascinating from a number of perpectives.
2) On a more serious note, Jim's thoughtful explorations of the internal mixes (ecological balances) among altered chemical substrates and behavior deserves the strongest possible emphasis. Too often have I seen physcians seek a single magic bullet without explicit concern for the range of ramifications that this bullet might have. Sort of like cleaning the factory by dumping garbage into the stream.
3) Here is the most impressive part (to me, a novice in such matters): Tied to chemical "manipulations" Jim brings an obvious sensitivity to what Lorenz called "knowing (and loving) your animal". Subtleties on the behavioral side, involving multiple and potentially conflicting dimensions of expression, offer challenges in all attempts to "fix matters". Psychological adaptations may in some sense have individual lives, but from other perspectives they are linked together in a web. Tweek part of the web and other parts wiggle. Its good to see someone like Jim concerned with these potential peripheral wiggles. His clients are lucky!
4) I really like the asides to folk wisdoms (green and white vegetables) in discussing these matters. I have seen a lot of crude dismisals of these wisdoms, as well as many uncritical acceptances (new age "medicine"). A balanced appreciation for what these wisdoms may and may not offer (and why) is refreshing. So thanks, Jim!
5) Even if mistaken in detail, these "wisdoms" obviously tell us something important about how people have historically sought routes to happiness. That is important stuff in itself.
6) And, finally, there must be (and is, in Jim's note) a deep appreciation for the fact that behavior is multidimensional. This is not a silly slogan. Aspects of our adaptive (or not so adaptive) actions are part of a larger web. What is the most important strand to tweek, and what are the ramifications? Knowing your animal is a key to answering such questions. This is an animal that has many sub-ecologies (home, school, etc.) as well as many goals, hopes, fears, and sources of confusion.
I have seen ADHD children, and know individuals whom have been labeled as bipolar. I know many whom others could call grandiose. I have also seen intolerance for those who are different, who don't fit the mold. I have read those horrible stories about frontal lobotomies, where renegade personalities are surgically tamed, as if this is a cure.
What I have less often seen is written discussion that reflects a sensitivity to biochemical realism combined with a sensitivity to the multiple strands of minds striving to perform in a way that is personally adaptive - thus giving yet another individual life the dignity it deserves.
I was moved by Jim's sensitivity re. all these issues. His comments make the forum special.