I'm Dr. Norman Rosenthal, Psychiatrist, Author and Scientist who first described Winter Depression (SAD). Most recently I have been researching the effect of meditation on the brain. My findings are astounding! AMAA.

Hi Dr. Rosenthal!

I'm a patient of your son's (Josh) in Maryland. I've been seeing him for 8 years, since age 20, for bipolar disorder II and severe ADHD. My moods usually follow an SAD pattern, and he has had me using light therapy in the winter for years, as well as worked with me very closely in managing my medications and treatments, currently Adderall, Lamictal, and Wellbutrin. (this is a throwaway account for me, as my main one is not so anonymous)

First, I just want to say, you must've been quite an influence on your son, because he is a truly fantastic doctor. He is attentive, treats me like an equal partner in managing my disorder, discusses treatment options with me in depth instead of just telling me what he's going to try next, clearly stays extremely informed and up-to-date in his field-- he's the only psychiatrist I've ever had, but I know I got lucky with him. So kudos to him, and to you, for everything you both do! I've looked into your background with light therapy for SAD a bit in the past-- Dr. Rosenthal (Josh) actually never mentioned that his father pioneered the practice, so I was fascinated to find out and read about it!

I'm really interested in your new ventures into non-medication based interventions. What place do you think meditation could have in the treatment regimen of someone like me? Obviously a reddit AMA answer is not how I will make huge decisions about my treatment, but I'm curious what your thoughts are about this specifically, especially regarding its conjunction with medication and if you think somebody with bipolar disorder could ever manage long term without medication.

Thanks!

First of all, thank you for your lovely comments. They have made my day.

I find that most people can benefit from TM, but I know your doctor is very familiar with the practice, so you could not have a better person to think the matter through than him. Curiously, the person who got me meditating again has bipolar disorder and said that TM was crucial in helping him feel really happy 90% of the time.

Best of luck to you.

Does SAD affect people who migrated from none winter climates more than those who are born and raised in it?

This is a wonderful question that has never been satisfactorily answered. It is of special interest to me as I was born in sunny South Africa, where I never did have SAD -- until I moved to the United States. But it is very difficult to dissect apart place of birth from place where you get the symptoms. In other words, had I been born in the U.S., my guess is I would have developed SAD earlier -- but unfortunately that doesn't answer your very astute question.

Thanks for responding. I was also born in warm climate and didn't experience winter until my teen years.

After my 1st winter it felt like a weight had been lifted. I don't remember the 1st time wore a winter jacket but I recall vividly the 1st time I didn't have to wear one after winter. Also I had spent a lot of time outside trying to enjoy it.

That is in accordance with my experience. It is such a joy for people with winter SAD to hang up their winter jackets for summer and put on their summer duds.

How close are we to objective testing to diagnose disorders? How close are we to actually knowing what the problems are on a brain level?

I've been through the mental health system since I was a preteen. As an adult I am very frustrated with the many labels I've been given and expensive drugs that don't work.

It is very difficult to know how close we are to answering these important questions. I think about cancer and how impossible it seemed to crack that nut. Now we are finding treatments that modify genes and treat cancers previously thought to be incurable. I think that's how it will be with psychiatric illnesses as we learn more about the genetics behind them and imaging studies become better at pinpointing the regions of the brain involved.

I can relate to your frustration with the mental health system. It is a sad truth that we are not as smart as we'd like to be and cannot be as much help as we eagerly seek to be.

Thank you. I try to be positive about it because I know you guys do your best.

And remember, novel things happen regularly and sometimes a new discovery is a a game-changer, so it is important not to despair and to seek out anything that makes life feel better. Best of luck to you.

Hi Dr. Rosenthal, how are you feeling today?

I feel just great. Thank you. How about you?

My girlfriend suffers from depression for about 8 years now, how can your findings (and also overall knowledge) help her free herself from it?

What treatments has your girlfriend had so far?

Long-standing depression is a very sad and difficult situation. Part of the answer to your question would depend upon what treatments she has already received.

Has there been any research on the value of TM for young people with Borderline Personality Disorder?

Not to my knowledge.

Have you done any studies with LSD or ayahuasca and their effects on the brain?

No, I have read about such studies, but currently I am focusing on various non-drug interventions.

Have you looked into positive thinking exercises and their effectiveness?

It depends by what you mean by positive thinking. Cognitive Behavior Therapy (CBT) relies on challenging negative thinking and exploring positive thoughts as long as they are in line with reality, and CBT has a huge amount of data supporting its effectiveness. Simply thinking positive thoughts however, if they are not in line with reality, such as, "if Einstein could do it, so can I" is not helpful and a formula for disappointment and frustration.

"if Einstein could do it, so can I" is not helpful and a formula for disappointment and frustration.

Not if you do it without expectation.

In my experience, it's very difficult to have a goal or aspiration without expectation. I think if we keep our goals in line with reality, it's okay to have expectations. Meditation, on the other hand, often works best without expectation because that way wonderful things occur unexpectedly.

Dr Rosenthal, I noticed in your first book Transcendence that the only 'negative' side effect of Transcendental Meditation (TM) was some irritably if the person came out of meditation too fast. Some remarks on the web have noted instances where extended periods of meditation have also sometimes resulted in a sort of disorientation. Any comment on this since with SuperMind I imagine that some folks may be inclined to just dive in and perhaps meditate either too much or come out too fast to achieve their goals ?

People are advised to meditate only for 20 minutes twice a day unless they go on to take advanced programs. One reason for this is that it is regarded as sufficient to accomplish the goals of meditation, but another could well be that it is not advised to "over-meditate." As far as other side effects are concerned, meditating too late at night can cause insomnia.

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Paradoxically Transcendental Meditation can be both soothing and activating. People often find a surge of activation after a refreshing TM session. So if you have such a session late at night, that sort of activation can interfere with sleep.

I love TM and have been back doing it for now over 6 years! I first learned it in 1975, or so but hadn't done it for years!

But one thing I find as a MAJOR turn off to TM is the COST! I have heard of non-existence social ships and the like!

I know you are not directly involved with TM policies but you are close to many there!

What is the answer to the HIGH price?? As most feel it should be FREE or at least a lot cheaper!

I wish we could get it to people for free, just like I wish everything would be free, but the cost is now down to $800 and, since it involves hours of professional time plus a lifetime free follow-up regardless of where you are, plus the opportunity to access and attend many TM-related events for free, it seems not unreasonable. For those who can't afford this, grants and scholarships do exist and should be explored.Also, it would be great if there were insurance reimbursement given the established health benefits.

Yes I saw the price at least for now is $800, and understand the professionals time and living expenses are needed to be paid! As I said I learned in 1975, TM in Mill Valley, Ca (just north Gold Gate Bridge) one of the first cities in the USA that had % representation of people meditating for I believe $50! Even though at inflation $800, is much higher than that price! But no matter TM and many other non-traditional and traditional therapies have brought me out of a deep dark hole these's late 7-8 years! Thanks for all you have done Dr Rosenthal and I have purchased long ago and rereading now Transcendence, The Gift of Adversity and will buy Super Mind soon! Here wishing somehow all can meditate TM or otherwise and change the attitudes of the world!

Thank you for your kind words. Best of luck to you.

Have you done any research about mindfullness meditation and drug resistant depression?

I have not done research on Mindfulness. My research both with patients and through the literature has focused on Transcendental Meditation. I know of no studies that support the benefit of any form of meditation in drug resistant depression. Curiously, one of the other treatments I have been researching along with my colleague Dr. Eric Finzi -- the benefits of Botox injections -- has in fact been effective in drug resistant depression.

How much of SAD includes some level of hypomania in the summer? Unless I am not remembering correctly, I thought I had read in your excellent book, "Winter Blues", that this was not uncommon. However, I have started seeing a psychologist for CBT recently and she suggested I may be at some level bipolar, due to this. The energy I have in the summer doesn't really affect my functionality, in fact I feel quite good normally and get a lot done, the main thing is, I can have trouble sleeping. I am mostly affected by the depression in the winter. Thanks !

Nowadays when we speak of hypomania, we imply some degree of dysfunction. When exuberance, increased energy and decreased need for sleep is not accompanied by dysfunction, we call it hyperthymia -- a delightful state that is common in people with SAD. And as an author, I have to thank you for your kind words about Winter Blues.

Thank you for your work and this AMA. There has been huge progress in handling mental health, but there's still a long way to go. What do you believe are the top 3 issues related to mental health as an individual and/or societal experience and what can be done, as individuals and as a society, to work on bettering these issues for those with mental illness?

This is a very broad question, but top of the list is to get mental health insurance reimbursement on parity with physical problems. Second, more funding for research would be nice -- and smart funding. For example the recent private grant for cancer research seems to take a different emphasis from traditional approaches. Maybe we need the same for mental health. Finally, I would like to see more kindness towards mentally ill people. I have just been reading about the cruel treatment of the mentally ill in the New Yorker -- pertaining to Florida jails. Many of our mentally ill people languish in jails where they don't get ordinary care let alone proper psychiatric treatment. Thanks for your question.

As a longtime SAD sufferer with debilitating symptoms, are there any new treatments available? I have upped my SAD lights to 3 in one room on all day, taken vitamin D and magnesium, have tried exercise, etc. and nothing seems to work. Nothing! I'm desperate for something that works.

Cognitive Behavior Therapy, exercise and anti-depressants may all help and -- surprisingly -- so may Botox.

Thank you for your reply! I will look into CBT and Botox. I'd also like to add that my SAD does not involve sadness, crying, or depression. I feel like I am drugged and fight to keep my eyes open at all times during SAD season, which for me is 5-6 months out of the year. Is this normal for SAD?

Sometimes SAD presents mostly as an energy drain, but often a lack of energy causes people to fall behind in important areas of their lives, and that is where depression or anxiety may occur.

how do you convince PTSD patience to stop their vengeful intentions when you come across one?

what do you find PTSD patience have in common that many website have not talked about?

When I encounter a vengeful person, I am often tempted to remind them of the famous Chinese saying, "if you're planning revenge, be sure to dig two graves." Vengefulness can often injure the avenger as much as or more than his victim. I have not made a study of PTSD web sites, so cannot say what they omit.

If I'm not mistaken, isn't there recent research asserting that meditation is no more effective than other techniques, such as playing music, progressive relaxation, or even walking?

Is there research demonstrating that meditation has special effects that extend beyond general modes of relaxation and focus?

We have a lack of direct comparison between meditation and other activities that affect the mind. There may be assertions, but I doubt whether they are well substantiated. As far as TM is concerned, its brain effects (such as predominant alpha one rhythms and brainwave coherence) set it apart from relaxation and focus.

• Aside from the more well-established research in meditation (i.e. anxiety and mood disorders, chronic pain), what are the most recent and novel areas being researched in the field of meditation?

• Is there anything in particular that influenced you to study meditation?

• What is the most interesting observation you've observed through studying meditation?

• How do you think meditation-based practices are going to evolve in society through the next couple decades?

Here are a few promising areas that deserve to be researched: People with pain problems, migraines, addictions, movement disorders, and autism spectrum disorders. Funding is unfortunately in short supply.

As I mentioned before, a patient of mine suggested I should meditate. I listened to him, and I'm so glad I did.

The most interesting thing for me is the growth of consciousness such that not only when I meditate but even during regular waking hours, I feel an inner calmness side by side with activity that has led me to be more creative and effective. I have studied in others as well and they appear in my book. Some people who mediate are very famous and find the practice invaluable -- but anybody can benefit and become a better person through their regular practice.

In the next few decades I see meditation skyrocketing as people realize its enormous benefits. There will be more research in the field and it will truly help the world become a better place. That is not only my hope. It is my prediction.

I have depression all the time but there's a very obvious and huge spike in severity in the summer for me. I actually feel mostly fine in the winter. Is reverse SAD a thing, or is it likely coincidental?

Although doctors are discouraged from making diagnoses in people they have not examined, this sounds like reverse SAD to me. One value of recognizing the seasonality of depression is that you can anticipate and hopefully preempt the depression with treatment. I hope you have a good psychiatrist who can help you resolve the problem.

You might want to check my response lower down to "KaraThraceAnders" who also reports reverse SAD. Besides checking your thyroid, antidepressants given at the beginning of one's season at risk can sometimes be helpful, and you may be able to get that help through your primary care doctor.

1) I personally suffer from very mild Seasonal Affective Disorder (SAD) in the Winter but never in the Summer. I remember reading that some people get SAD in the Summer but not in the Winter. Can you please explain the mechanics of how this is possible?

2) I’m curious about your meditation research and what makes your findings “astounding”?

Let me start with the second question first. I was astounded to find that after practicing Transcendental Meditation for a while, the very peaceful experience that I had during meditation sessions began to enter my daily life, and all sorts of improvements occurred.

As far as Seasonal Affective Disorder is concerned, different people are vulnerable at different times of the year. Those with winter SAD are susceptible when there is not enough light during the short days. Those with summer SAD may have trouble either with too much heat or light or both.

I have "reverse" SAD, with intense anxiety in the summer months (late spring through early fall, really). The intense light and heat are miserable, and I usually try to sleep thorough the daytime just to get through it. I live for the cold wintry months, hitting peak happiness around January. The light is perfect then, gray and not piercing. I'm not the expert and don't know the "mechanics", just thought I'd volunteer as someone who has it. All my life I've felt like Popular culture- even before SAD became known as a legit thing- always used winter as a metaphor for misery, which was wild to me. I saw a joke recently that said "Say what you will about Florida, but no one moves up north to retire!"... and that's actually my lifelong dream.

It's important to realize that you are not alone and that many people hate the summer. You have already devised ways to get away from the intense light and heat, but it must be lonely to have to be indoors so much of the time. You might want to talk with some expert and brainstorm how to feel better in the summer. Be sure to have your thyroid checked because overactive thyroid can cause intolerance to heat. I also have more tips available in my book Winter Blues, which despite its name, considers other seasonal problems as well. Best of luck.

As someone with a number of psychiatric issues myself, it's always nice to see these issues being brought to light in a way that isn't just labeling people as loonies. One thing I remember my first psychiatrist asking me that really perplexed me to this day was "Is a hamburger a sandwich?"

Thoughts?

Goodness me! It would have perplexed me too. After all, a hamburger kind of is a sandwich, but kind of isn't. So I would have been stumped too.

What about a hot dog? Is that a sandwich?

Is cereal in milk a kind of soup?

These are the important questions.

I think a hot dog is a sandwich. What do you think?

I don't think cereal is a kind of soup. It doesn't taste like any soup I've ever eaten. What do you think?

Do you belief that meditation and mindfulness with a strong dedication to what is termed 'liberation' or 'enlightenment' is possible for everyone? And thus can be a potential cure for depression for everyone when used with enough persistence?

I know how unlikely that may sound though I must say, in my experience it's true that this path works, and that it first eliminates all mental suffering and brings peace and joy, and that it has the potential to eventually reach even a much deeper state beyond that of pure bliss (though I cannot attest for that yet).

I believe that we can all do better and that meditation is one path towards that. That is one of the astonishing findings -- based on personal and clinical experience -- that motivated my new book Super Mind: the recognition that consciousness -- or enlightenment if you prefer that term -- can just keep growing if you practice a technique that promotes that path. For me that technique has been TM, but I recognize that there are many paths to enlightenment and rejoice in anything that gets you on that path.

Hi Dr. Rosenthal,

Glad to see you've made the big leagues with an AMA. Congratulations!

About two years back, had just earned a bachelors in psychology, and took a job as an operations mover/maintenance worker at the university without an inkling of a next step. During my year long stint as a college-educated laborer (joining the masses), I picked up a copy of The Gift of Adversity. I wouldn't go as far as claiming it was a life-changing book, but it certainly helped me see the silver linings within the social constructs I just wrote off as failures, as well as helping me try to learn something from everyone. Thank you for the extensive insight that's assisted me in earning a master's in applied community psychology, where I too am conducting research on meditation and its benefits for at-risk adolescents. Your book contributed to my continued education.

Now for my questions.

Now that more holistic and eastern traditions are entering the limelight when it comes to psychological research, what is your personal stance on the treatment of disorders like PTSD, GAD, depression, etc. with medical cannabis? Do you think there is substantive research being conducted now that it's legal for recreational use in states like Washington and Colorado? Additionally, is this an area of research someone looking for experience like me should watch for on the scientific horizon?

Personally, I believe that its use, in combination with meditation and psychotherapy, could alter the status quo regarding psychopharmaceuticals and their overprescription. Especially considering some of the damaging side-effects of some drugs both short and long-term.

I understand this may be a touchy subject from a PR standpoint so please PM me if you're not comfortable answering on here.

Thanks !

AirForceRun

Dear AirForcRun, I am glad that you found Gift of Adversity helpful.

One of the big problems about using cannabis in medical situations is that we have a huge information gap. In other words, there is a dearth of research on the subject. What that means is that doctors don't know how to use it and lay people, fueled by those with economic interests, are often inclined to believe that it is innocuous and only beneficial. In my experience, however, you rarely get a free ride with any mind-altering drug. That is not to say that some where down the line there will be evidence for benefits that outweigh the costs, but we just don't have a good sense of the cost/benefit analysis at present. I should add that I have seen several cases of people with real problems from marijuana use, including addiction, a motivation, and relationship difficulties. The current situation with marijuana reminds me of how cigarette smoking used to be, where people thought they could smoke forever without consequence.

https://www.scienceandnonduality.com/videos/exploring-the-self-scientifically-magic-mushrooms-or-meditation-gary-weber/

Thoughts?

Obviously it is easy to generate thoughts; harder to have useful ones. Let me just say that having dealt with dozens of drugs -- prescribed and non-prescribed -- over the years, I have found none that replicates the full, rich, and very subtle effects of meditation. Consider this: a meditator can be in profound state of transcendence, yet can be brought out by the slightest touch and emerge into full wakefulness in a moment. In my experience, that is not possible when someone is under the influence of a potent mind-altering drug.

What are your thoughts on trans-cranial direct current stimulation?

Trans-cranial magnetic stimulation (TMS) is a novel treatment for depression that may help in certain cases, but it is expensive and not covered mostly by insurance.

I understand there are different kinds of meditations. Your new book SuperMind seems to focus on Transcendental Meditation. Aren't all meditations pretty much the same?

You know, there are few if any studies that compare meditations to one another, but people have very distinct preferences for what sort of meditation they prefer and serves them well. Some people I know who do two different kinds of meditations -- Mindfulness and TM -- report different effects from them. Also, proponents of different types of meditation make different claims for what they accomplish.

How beneficial is meditation for depression and anxiety? And what kind of meditation is the most beneficial?

Thank you!

I think meditation can do a lot for anxiety, though I must confess most of my experience is with TM. Depression is less clear cut. As I mentioned before, there are head to head studies on effectiveness on different forms of meditation for different conditions. So for now, people should educate themselves about the different offerings on the market, and make their own decisions.

Is there a causal link between anxiety and depression?

Thank for you for the AMA and your work.

The relationship between anxiety and depression is quite mysterious. Sometimes they co-exist, and other times they appear as distinct entities. Genetically anxious people have depressed relatives and vice versa. In terms of geneticists, they don't breed true. They often respond to similar medicines -- except when they don't. I am eager for these two entities to be untangled or finally exposed as different aspects of one and the same thing.

Are there any connections between SAD and creativity?

Side note: I'm sure your tracking that David Lynch is a strong champion for TM.

I absolutely believe that there are connections between SAD and creativity. Many very creative people clearly suffered from SAD, to judge by their writings. A few of these include Emily Dickinson, TS Eliot and Vincent Van Gogh. I deal with this issue in some detail in my book Winter Blues. And yes, David Lynch, a good friend of mine is a longtime TM practitioner and founder of the David Lynch Foundation, which supports TM research and grants to those in need to learn TM.

Thanks for responding!

I just read David Lynch's book Catching the Big Fish and learned a lot.

I'm a former Army Chaplain working with PTSD programs and have a documentary coming out called, No Greater Love. I came across TM from David Lynch's foundation and became very interested in it as a way to help vets struggling with PTSD. I've become a strong proponent for drugs being the last course of action and only after all other methods have been tried and a SPECT scan and full eval shows a definite need. I've had too many chases of guys coming back like pharmaceutically induced, lobotomized, zombies; unable to function and unable to process their trauma. Please understand, I'm not anti-pharma, just believe we are mismanaging it as a whole with our service members and veterans.

Have there been an studies done to introduce TM into the military?

I'm very interested in your books and will definitely be checking them out. Thanks for doing the AMA!

There are currently reasonably large controlled studies of different forms of meditation being conducted on veterans but the results of these studies are not yet known. Drug therapy for PTSD has not been very successful, and I am all in favor of using drugs very sparingly. By the way, I have not been impressed with what SPECT scans can do in this area. Thank you for your excellent comments.

Dr. Rosenthal, thank you for your work. I learned TM in 1972 when I was a new masters student in public health. Some years later I realized that it had tremendous potential to advance public health. After several decades as a faculty member I decided to work to help make the public health profession more aware of TM and its potential. I've been somewhat surprised at the reluctance of several public health leaders and other colleagues to be open to learning about TM, even though I know some major public health leaders who are (quietly) TM meditators. Do you know public health professionals who are advocates of TM for public health? I did see an encouraging post on the new Surgeon General's Facebook page.

I don't specifically know of public health officials who are TM advocates -- which doesn't really mean very much since there is no reason why I would. One goal of my writings has been to bring mental health issues and unconventional ways of approaching them -- such as light therapy, TM or Botox -- to the public attention, to destigmatize mental health problems and promote discourse of the kind we're having right now.

What type of meditation do you consider to be the most effective, and why?

You mentioned in another answer that mindfulness and TM affect the brain in different ways- could you elaborate on this? Also, what about zazen, and other concentration-type practices?

As I've mentioned, in the absence of good comparative studies, we should not make claims for superiority for one versus another type of meditation. In mindfulness the emphasis is on focusing on the moment -- one's thoughts, the breath, loving kindness etc. A deep-seated set of brain structures called the default mode network (DMN) shuts down. On the other hand, in TM which encourages the automatic access of a mantra, the DMN lights up. Different forms of meditation are also associated with different predominant brainwave patterns.

Hello Dr. Rosenthal

Are there any special meditation guidelines for people with ADD?

I have tried many times to get into meditation because when I can get into it, I do feel temporary benefits. But I have a really really difficult time quieting my mind with the guided meditations. It's usually just an exercise of trying to focus on breathing (or something), getting distracted, realizing I'm distracted, recentering, repeat over and over until the meditation is over. I spend way more time thinking about random things than focusing on breathing. And consequently most of my meditations are wasted time. After a while I gave up.

I must tell you that there is good news for Transcendental Meditation and ADD. A small clinical study showed very promising results and a controlled study showed favorable changes in the EEG, suggesting improvement in people with ADD. These findings are summarized in Super Mind. Most exciting, however, is that many ADD people say that the TM technique is much easier for them than techniques that require focus and concentration.

What's your favorite sandwich? Also, because I feel like I've found no real good answers and I'm new to your research, can you elaborate on the effects of meditation on the brain?

Let's start with question number 2. I can speak mostly for TM, which is my specialty. When you go into a transcendent state during meditation -- a state of calm, bliss during which you are alert but not thinking of anything in particular -- a slow brainwave rhythm called alpha fluxes over the frontal part of your brain, reflecting this blissful calm. Different regions of the brain show these alpha waves occurring at more or less the same time, suggesting that they are collaborating more efficiently with one another. I recommend that you read either Transcendence or my new book Super Mind if you are interested in more information on this topic.

As far as sandwiches go, you'll go a long way to beat a turkey plus swiss on whole grain with lettuce, tomato, and just a bit of mayo.

Do you think or know if with enough practice/meditation etc one can "get into the zone" on will? Also what are the requirements for "getting in the zone" and how does meditation help with that? Last question is which parts of the brain is associated with getting into the zone?

Thanks!

Yes. TM can help you get into the zone both while you're doing it and even when you are not meditating. In Super Mind, I feature former all star baseball pitcher Barry Zito who helped his team, the San Francisco Giants win the World Series by regularly meditating so that he could get into the zone during the game.

Hello, Doctor.

Have you done any research on the effectiveness of Transcendental Meditation as way of treating issues other than combat-related PTSD?

If so, did you reach any conclusion(s)?

There are studies done suggesting benefit of TM for anxiety and depression, though I haven't done those personally. In my practice, I find TM very useful for people with anxiety and anger management problems and PTSD even when not combat-related.

Hey doc

Thanks for doing this ama! I am loving the research coming out about the effects of mindfulness on the brain but can only really find two studies (sarah lazar re grey matter and cortical thickness) on physical changes to three brain or how the brain works as a result of meditation. Will you report any findings on these changes?

Or do you know if any other changes?

Thanks!

Hi there. I'm aware of Sarah Lazar's work, but am not an expert on mindfulness. There are, however, hundreds of research papers on Transcendental Meditation included in my new book Super Mind as well as my earlier book Transcendence.

I've been experiencing waves of depersonalization and intense depression. It comes and goes every few months. It's been a reoccurring disorder since childhood. My medication makes my depression less severe but I find myself stuck in episodes where I become sociopathic and irritable. Most of the time I feel normal until I experience the depersonalization. I completely lose my personality because I'm scared I'm losing my mind. Have you had any experience in treating someone with these symptoms ?

Long ago during my training -- and we are talking 40 years ago now -- we learned about a condition called depersonalization-dissociation disorder, which supposedly responded to the MAOI anti-depressants, which are now little used because of their potentially bad side effects. I never hear about this disorder these days. Instead dissociation and depersonalization are mostly discussed in terms of passed trauma to which they are thought to be a reaction -- a way of distancing oneself from previous pain.

Hey doc. My mother takes pain meds and vicoden and many many other types of medication and over the years she has become more and more unwieldy with insults, threats and sudden changes in attitude. My question is, how much can medicine effect her brain and are the effects permanent?

I'm sorry to hear about your situation. The truth is that medicines such as painkillers or psychiatric drugs can have enormous effects on the brain, including highly disturbing ones. That's why they need to be carefully regulated. It's hard to know whether changes are permanent or not until one gets off a certain drug. Clearly this is something where a doctor should be involved, so that drugs can be withdrawn in a supervised way -- assuming your mother has any willingness to work with a doctor on that problem.

Why the hell is it seasonal affective disorder and not seasonal affected depression?!?!?!

Dear Doctor Faust (great handle by the way). At the time when the diagnosis was created, the mood problems were called "Affective disorders," so it was natural to call it what we did. And remember, many people with a problem also suffer hypomania or mania, so it is not simply depression.

SAD? ADD? Etc?

Do you feel that many of these diagnoses of malaise are truly internal problems or symptoms of society? Other nations and cultures don't seem to experience the same level of nerosis that happens in Western culture, America in particular.

I would refer to the number of people who suddenly feel themselves to be gluten-sensitive absent and contrary to any scientific evidence as a similar example of "band-wagon diagnosis."

I certainly understand and have seen the studies on Vitamin D and sunlight and UV. I am just curious how many folks you see that you truly think suffer from it versus their own preconceived notions.

I think you get where I am going with this. I would love to hear the response of someone who is actually versed in the area.

As a psychiatrist I see people with very real problems. It is useful if you can give them an accurate name as a guide to good treatment. Of course, people can claim to have problems that may not be genuine, but I am inclined to believe what people tell me until proved otherwise.

How much do you make per book sold?

Charlatan

I'll reply to this question because I can't figure out how to ask a question directly (this is my first time using reddit).

I recently purchased some 40 copies of Transcendence and have given away about 25 so far. The paperback 2nd edition is very reasonably priced. Even if Dr. Rosenthal were to receive the entire amount personally, why should that be troubling? Why should an author not be able to earn money by writing/publishing/marketing a good book?

Thank you so much Victor for your support. Samuel Johnson, when asked why he wrote, responded "Nobody but a blockhead writes for any reason other than the money." Nowadays, I would respond by saying, "Nobody but a blockhead writes books for the money." It is not a lucrative profession, but is extremely rewarding especially when I see comments such as yours.

I love Transcendence too. I'd like to ask Dr. Rosenthal about his new book coming out soon called Super Mind. What is Super Mind about and how can someone develop a Super Mind?

After I wrote Transcendence, I thought I had said everything I had to say about TM, but as I continued to meditate, I found this no longer to be true. While Transcendence dealt mainly with the ability of TM to reduce stress and help people with a variety of problems, Super Mind deals with the remarkable growth of brain capacity that occurs with TM. I found these changes developing within myself and my patients -- an expansion of consciousness and all types of gifts -- and I felt eager, actually compelled, to share these findings with others. So I wrote Super Mind. It is due to be released on Tuesday, May 17 and you can pre-order it now from Amazon or any online vendor