> Wait ... an "objective, scientific diagnosis" that doesn't identify the cause of the ailment? If I visited a doctor and she said, "You're running a fever, and your blood has cooties," I wouldn't think of that as the height of medical expertise, and it's certainly not science.

GPs will tell you that this is wha they say to most patients. Why do you think antibiotics were overprescribed by so much for so long? To treat cooties. Plenty of illnesses have weakly defined causes but are treated anyway. Your refusal to subject physical health treatments to the same level of rigour that you subject mental health treatments is one sign of your kookery on this subject.

> therapy is indistinguishable from the placebo

This is nonsense. Perhaps you're confused? We know that "counseling" doesn't work. But no one credible suggests counseling as treatment, they suggest things like CBT. Here's a meta-meta-analysis. Given the evidence for CBT is so strong and the evidence for counseling is so weak it's telling that you recommend "chat's with your aunt" as being an effective treatment - totally misreading the literature.

http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Th...

> This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT. D 2005 Elsevier Ltd. All rights reserved.

It should be obvious why you don't see placebo controlled studies for CBT - it is unethical to provide patients no therapy and so it's hard to get studies approved and it's hard to creat a sham talking therapy that would blind the patient and therapist.

> and existing medications have a terrible reputation

Medication is not recommended as front line treatment anymore. Medications for any illness can be unpleasant. I'm not convinced that anti depressants are any worse than any other medication. Comparing anti-depressants with placebo shows similar rates of drop-out.