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There is a subtle reluctance to admit that, at least in the field of medicine, the doctor knows more than the patient and is the expert in the area in which the patient is having trouble.

When critics of psychiatric diagnosis insist that terms like “schizophrenia” or “bipolar disorder” are inherently stigmatizing, they are unwittingly perpetuating the very prejudice they wish to end. It is time to shine a bright light on this self-fulfilling prophecy.

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.

About a year ago, I wrote the blog “Are Dogs Man's Best Therapist?” To my surprise, it turned out to be a very popular one. Since then, dogs continue to be in the news for their therapeutic effect, including being brought to Newtown right after the mass murder there.

Crucial changes occurred that will greatly influence the organization of services, reimbursement, and diagnosis. It even ended in an exclamation point, as the tragedy in Newtown, Connecticut punctuated the need for improved mental healthcare services.

What we know for sure is that for all the young children and adults who were killed in Newtown, their world ended a week ago. Soon after the tragedy, one of the fathers of a child killed tearfully pleaded for society to learn from what happened in order to prevent future mass murders. Here, recommendations from a psychiatrist.

Patients with major depression or bipolar depression have a 20- to 26-fold increase of mortality rate over the general population. Suicidal behavior can be quite complex as well deadly. It should go without saying that psychotherapy is usually necessary in treating patients who have suicidal ideation or who have demonstrated such tendencies or actions. Frequently, it may be combined with medication and sometimes it is the treatment of choice without medication.

A recent article in the New York Times reports that doctors are prescribing stimulant drugs to compensate for the bad schools their child patients have to attend. Rates of ADHD have tripled in the last 15 years-precisely because many kids are being diagnosed with fake ADHD to make them eligible for medications and/or extra school services.