Transcription
This is one of the most common times of the year for doctors to hand out anti-depressants. And the uncomfortable [music] truth is this. For a lot of people, they're being medicated for seasonal stress and not a chemical deficit. And while anti-depressants are often presented as safe, routine, and necessary, this framing usually hides a messier reality. And these drugs come with real risks that are routinely ignored. And that's what we're going to talk about today.
For those of you who don't know me, I'm Dr. Yseph During. I'm a board-certified psychiatrist, former FDA medical officer, and I specialize in helping people come off psychiatric medications. So, let's jump into it.
Every year, as daylight drops, stress rises. More people report feeling low, anxious, exhausted, and disconnected. And those symptoms are real. But instead of asking why modern life produces them so predictably, we usually jump straight into using a medication. And why is this a problem? Well, it's because it individualizes what is a lifestyle problem. Placing the burden on the person instead of examining the system, the habits, the environments that put them in this situation.
For instance, these are things like the shorter days in the winter. Hormone changes, mood problems. People move less when it's cold. They drink more. They isolate more. Work pressure usually spikes as people rush to get things done by the end of the year. and family dynamics, well, you know, they resurface and then the holidays add financial stress, grief, and then you have to force being cheerful on top of everything else. None of that means your brain is broken if if that stuff upsets you. But in a rushed medical system, those symptoms often get treated in the same way, with a prescription.
And now, where the rubber really hits the road here is with the family medicine doctors, because that's where 80% of our psychiatric drug prescribing takes place. Now, here's why. Well, that they have incentives to kind of move quickly during this. And who here has had this experience when you go in and see your family medicine doctor and you get maybe 5 minutes, maybe 7 minutes of FaceTime and you report, hey, you're having anxiety, you're having some brain fog, you're feeling low, and they really don't have the time to dig into things. And all they really have to say at the end of it is like, "Hey, I'm really sorry that's going on, you know, and they mean well, but hey, you know, if you really want some help with this, maybe I can give you this SSRI."
Unfortunately, this lackluster care is really the standard of care these days. And I talk about this a lot on my channel, but there this is because of a financial incentive. In our insurance-based model, you're essentially not profitable unless you're seeing four patients an hour. And when you have 15 minutes to do those appointments, it's way easier just to have diagnose someone off a list of symptoms and say, "Hey, I've got an FDA approved drug to help you with that." That's fast and that's efficient. Because do you know what is complicated? Getting to know the person, finding out the unique issues happening in their life, offering solutions, and sometimes those things are hard. You know, we might be talking about cutting down alcohol use, changing your diet, getting moving, you know, reaching out to more people and then motivating them to make those changes. That stuff takes a lot of time where these doctors simply don't have that time.
And so what happens is this. Someone is struggling because of sleep deprivation, loneliness, stress, burnout, you know, all of the stuff we've talked about. They go into a clinic and 15 minutes later, well, you know, they leave with a prescription. And these people, and this is like the worst part of it, they are rarely told the full story about these medications. They are not told that these drugs do not correct any kind of chemical imbalance. They're not told that you're essentially taking a drug just to mask symptoms of underlying problems. They're not presented in that way. And as many people know, this theory of the chemical imbalance has completely fallen apart since Joanna Monree's umbrella study in 2022.
And to make matters worse, many of these patients are not told that they're going to experience some emotional blunting. You know, they're going to blunt the highs as well as the lows. They can have problems with sexual dysfunction, agitation. They can feel detached from their emotions. And then most importantly, they're not told that getting off these drugs can be one of the hardest things that many people do. Instead of that, they're told, "Hey, this is safe. Using these meds is common, and this is simply what you do."
So, now we've talked a little bit about the safety. Let's talk about the outcomes. On a population level, the use of these medications is not making things better. You know, the use of anti-depressants in adults has increased by 500% since the early '90s. But when we look at the rate of suicides in the United States, we just see it steadily going up over time. This is a sign that this model of helping people with these medications really isn't changing outcomes. So, in other words, we're medicating more people than ever, but we're getting worse outcomes. And this should really raise questions.
And when we look at these issues in the context of all of the major news coverage about the problems with anti-depressants this year, I mean, we had the tragic story in the British royal family where Thomas Kingston took his life and the coroner ruled it was because of an anti-depressant side effect. And we've had more and more mainstream coverage of the hundreds of thousands of people online in the anti-depressant support communities like surviving anti-depressants who are not able to come off these medications. It shows that we really need to be paying attention to the overuse of these medications because I'm not trying to say that medications they cause harm in every case. It's obviously not true. But these stories reveal the cracks in our system about how freely we're prescribing these medications and oftent times how poorly people are monitored after they get on them.
And when I look at this and think about my profession of physicians out there, we need to do a better job because what is really concerning to me is how rarely we discuss alternatives in our medical visits. For instance, light exposure early in the day is one of the most evidence-backed treatments for seasonal depression. Regular daylight or light therapy can significantly improve mood and energy. Sleep consistency matters a lot as well. Waking up and going to bed at the same time can reduce symptoms of insomnia and also depression and also movement. You know, exercise. This is not a mindset hack. This is a biological intervention. Regular physical activity changes brain chemistry in measurable ways. typically makes patients a lot less anxious and depressed. Psychotherapy also really important whether it's relational problems or you're dealing with trauma or just anxiety. Therapy often performs just as well as medications for depression and anxiety. In addition, social connection is protective because isolation they make everyone worse. This is one of the most consistent findings that we have in psychological research. And finally, alcohol and other drugs, they will worsen anxiety and depression. full stop. Many people are unknowingly sabotaging their mental health by overusing these substances when they really need to be used, not at all or in moderation.
Now, the reason that doctors aren't helping people with all of these interventions with great evidence is because they don't fit neatly into a prescription pad. They're messy. They require motivation and they require a lot of time. And so, the real problem isn't that anti-depressants exist. It's that they're treated as the default, easy, convenient solution for distress that's often situational, seasonal, and understandable. Feeling bad in a high pressure, low sunlight, socially fragmented society does not mean that you're broken and you need a lifelong medication. There's many other options available.
And if you're someone out there who's already on these medications and you're thinking, "Is it too late for me?" Well, that's not true either. Many people who were prescribed anti-depressants during a difficult season of life and were never given a clear plan on how to come off these medications have been able to find an exit strategy. And that's really what we do at the Taper Clinic. So, at the Taper Clinic, we help patients come off medications, but we also create free guides for people to come off. And so, linked below this video, you can check out our free drug tapering guide. It has everything in there that you need to do a safe taper with your own doctor. And if you're interested in learning more about our practice, the details are in the description below as well.
Now, getting help to come off these medications, I just want to make this clear. This isn't about being anti-medation. It's about using medications intentionally when you need them and then being able to come off instead of just getting stuck on them by default, which is what happens to many people, unfortunately.
And so, to wrap things up, I want you to know if you're struggling right now, especially during the holidays, you're not broken. You're just responding to conditions that would strain almost anyone. And so, if this video changed how you think about anti-depressants, please share it with someone that you think would appreciate it. and subscribe to this channel if you want an honest discussion about mental health that does not start and end with a