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In the half century since I wrote my first booklet, "Do Cows Have Neuroses?" many things have changed in the field of mental health (formerly called mental hygiene), but some, alas, have not.

The best of changes is the breakthrough in brain receptor research and the many new drugs resulting. Because of new medications and the improved psychotherapy recommended to accompany their use, millions of patients with a "serious psychiatric disorder" (still called psychosis), together with those with a milder sort (still called neurosis) have joined the category that Fritz Redlich, M.D., former Dean of the Yale Medical School, named to cover the rest of us, namely the "normal neurotics." Another change for the better is that neurotic people are not stigmatized the way they used to be. Indeed, some, like Woody Allen, are almost as famous for their symptoms as for their accomplishments.

On the other hand, a lack of change remains in the attitude of many people toward those patients who suffer-or at any time have suffered-from a "serious psychiatric disorder." Nor do most people distinguish among its three main kinds, the mental disorders, the mood disorders, and the personality disorders.

An example of the mental disorders is schizophrenia (now called "the schizophrenias" because the disease is considered a multiple one). An example of the mood disorders is bipolar disease (formerly called manic depression). An example of the personality disorders is sociopathy (formerly called psychopathy). While the mental disorders and the personality ones may cause the patient to do "crazy" things, or hear non-existent voices, or be driven frantic by paranoid delusions, the patient suffering from "clinical depression" (also called "uni-polar" depression so as to distinguish it from the bi-polar variety) is likely to wish 24-hours a day, that he or she had never been born. "I felt as if my brain was screaming," said one patient. "I was convinced I was the most worthless person in the whole world," said another. Yet depressed patients remain capable of sanely observing and accurately reporting on the bleakest of their moods. What they lack is the power, unaided, to alleviate these (just as all of us, for varying periods of time, may be unable to alter our moods).

Today the clinically depressed patient's self-loathing can be mitigated, even dispelled, not only by the new drugs but also by a stunning-though still controversial-procedure. This is shock treatment, also known as E.C.T. (electro-convulsive therapy). Fortunately, the administering of E.C.T. is thoroughly different from that of 50 years ago. Indeed, the most anachronistic of popular old movies is One Flew Over the Cuckoo's Nest.

Today the patient is given a muscle relaxant and a mild anesthesia and suffers no pain. There may be temporary memory loss and a bit of confusion, but in time these totally disappear. A benign result is that if the depressive moods should recur, a much smaller dose of psychotropic drugs than had previously been helpful can now alleviate these. On the other hand, as with all forms of treatment, some unwanted or even unexpected side effects may occur in a few individuals.

Fifty years ago depression of every variety was viewed as a disgrace, a failure of willpower, almost a crime. To help counter this attitude, I wrote "Do Cows Have Neuroses?" a pamphlet whose first line was, "No, cows don't have neuroses… BUT PEOPLE DO." The implication was that because we humans are more intelligent and more sensitive than cows, we also may suffer from more emotional (or mental) woes. But furious dairy farmers wrote me to say that cows do get neuroses, and what's more, they produce less milk. In the next edition, I changed the first line to, "No, in general, cows don't get neuroses…."

The pamphlet was translated into many languages, including Hindi, Gujurathi and Marathi, as well as European ones and Hebrew. One effect, I hope, was to encourage ordinary people to be more tolerant toward those with serious psychiatric disorder. After all, many highly creative individuals like John Keats, Abraham Lincoln, Sigmund Freud, and Winston Churchill, or, more recently, Mike Wallace suffered from severe depression, yet their contributions continue to enrich our lives.