The good-news stories in medicine are early detection, early intervention.

Nearly every business collects metrics on inventory, sales, and workplace process. Health care has been slow to measure these kinds of outcomes. Increasingly, general medicine, via either managed care or large practice settings, is improving by collecting data through electronic records and refining practice based on what works.

Because the first five years build a lifetime

A lot of early intervention is key.

For bipolar in adults, I think there's pretty good agreement about what this looks like. For bipolar in children, there is some considerable debate about where are the boundaries. At the mild end, are these just kids who are active? Is this the class clown at the very severe - is this something other than a mood disorder?

I trained in psychiatry in the 1970s, and much of our training was about what was then psychoanalytic theory, with a little bit of theory from Jungian psychology and a few other places.