Antidepressants: Why the ‘Overmedicated America’ Narrative Is Harmful | Dr. Drew Ramsey

I think the big question in people’s minds
is who can they trust for their information about mental health? On the one hand we have big pharma, and there
have been some incredible breakthroughs. I’m a psychiatrist. I prescribe medications and I find some people
really it saves their lives. And you don’t hear that in the media. This week I’ve heard a number of antidepressants
called a miracle drug, a miracle cure and I don’t take any money from big pharma I’ve
just used these medications for over a decade now. For some people they’re lifesavers. Then there’s the supplement industry. And the supplement industry is really largely
unregulated. They make a number of claims that really aren’t
supported by the evidence and it gets people into a notion, this happens a lot where instead
of taking a medicine that’s been closely studied and brought to market and closely monitored,
they’ll be taking five, ten, 15 different supplements. It’s hard to know as a physician whether that’s
safe or not and whether that’s really warranted. There’s a lot of delay in terms of people
getting appropriate treatment. Then, of course, we have talk therapies, which
tend to take a longer time and cost more money. So this is where I think food comes into the
picture. One is we all can agree we trust. For the most part if it’s a whole food it
grows on a farm. There are concerns about big pharma out but
I’ve never heard a concern about little farmers so that’s where I try to direct people. And I also like it as a psychiatrist that
it’s one of my interventions that is absolutely delicious, that people like, that people can
do for themselves. We’re in an epidemic of mental illness and
we’re also in an epidemic of misinformation about mental illness. The amount of stigma that we see still and
the embarrassment that my patients have for a victory over some of the most debilitating
and disabling illnesses and deadly illnesses in the world, it’s concerning as a doctor. I see people just profoundly ashamed by how
they’re feeling and the illness that they have. So I think we have a long way to go. I think we’re getting there. I think more and more – I’ve been a psychiatrist
for 16 years, there’s a change in the conversation. People talk about having bipolar illness. People talk about being treated for depression. Men talk about being treated for depression
really for the first time in history in a way that it gives me some hope that if we
can have a more open conversation we can make a bigger dent. Now it’s what more than 40,000 suicides a
year in America. We have 600,000 veterans with severe traumatic
brain injuries. We have a lot of work to be done. And on the front lines of mental health I
think I just try to remind myself to sit with my patients, to do no harm and to give them
a menu of options. I think that’s one of the things that’s gotten
missed in this whole discussion about mental health. People talk about how many people are kind
of overmedicated in America and I always like to point out that ten percent of Americans
that take antidepressants in the morning, they do that voluntarily because it’s something
that helps them. And I think that when we talk about an overmedicated
society sometimes we miss the point. I would say that we’re a mis-medicated society. I’ve seen a lot of people in my practice who
are just on the wrong meds for the wrong reasons and I’ve met even more people who’ve never
ever had a trial of even something natural like St. John’s wort that has incredible evidence
that it’s a very, very good antidepressant. And I think that’s the part, the folks who
aren’t getting any help that’s the most concerning part to me because that’s when people end
up in real, real trouble.

85 comments

  1. Pharmaceuticals are fantastic, the problem is actually the view of what they do. For depressed patients, the drugs help manage symptoms while the person deals with the underlying problem. Issues arise when people think "I'm taking this drug, it'll fix things" and that's horribly unfounded.

  2. If we are having an epidemic of mental illness, then what is causing it?

    Is the over-prescription of medication causing our bodies to become dependent on chemicals our bodies don't produce?

    Is it from increasing amounts of dangerous chemicals/hormones/pollution in our food and water?

    Is it because life is easy enough that we've mostly taken natural selection out of the reproduction and survival process?

    What's the root? What is causing every generation of people to become more and more dependent on drugs to even function correctly?

  3. "We're not overmedicated, we're misprescribed" Those two things aren't mutually exclusive, it can very easily be both. But as a psychiatrist it's not like you have any kind of biases in favor of overmedicating. coughhttps://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/cdc-warns-that-americans-may-be-overmedicating-two-to-five-year-olds-with-adhd/?utm_term=.34072d972a4b cough

  4. I have come so far from the symptoms I had as a teen but the ostrisation that I get from friends and family leads me to live alone.

  5. The research on Psychedelics and mental health will most likely lead to some major breakthroughs in the near future. As long as this new administration doesn't stop that research.

  6. The over-medication theory is harmful to big pharma lol….this guy literally sells medication for a living and we listen to his opinion on why we need to buy what he is selling. Americans are fucking stupid.

  7. lying devil, wants us to take expensive cancer causing medicine instead of omega 3 fatty acids, ginger, cinnamon, turmeric, vitamins…..what an evil liar. No one takes supplements for brain damage, supplements are taken for things like arthritis…. fucking misleading liar.

  8. Here's a thought maybe most peoples lives are shit because they are being corporately fcked and don't see an enjoyable future ahead of themselves

  9. The only thing working at a pharmacy taught me is how uninformed, weak, irresponsible and helpless most prescription drug users are. I am not bashing any user of medicine as a whole. There are just too many drugs being dispensed needlessly.

  10. Big think question: since there are people that exist who are considerably sensitive(ex: skin), could these attributes clue us to what the human body is capable of, but only in replicating the precursors that made such sensitivity? (Field of thinking: evolution)

  11. how about we start working on why more and more people are suffering from mood and anxiety disorders and are in need of medication in the first place

  12. Antidepressants saved my life. I had the suicide plan, I went to book the hotel and I emailed my therapist at the time and I said "I need help" instead. I was in the best shape of my life, on a no sugar no flour food plan, in therapy, etc. I fought medication for the majority of my life because of that narrative and finally gave in when it was life or death. Antidepressants saved my life and gave me a real life.

  13. I struggle with depression a lot, and one of the things that upsets me most about people today, is that they think they have depression, and complain about it, and say they are taking things for it.. When they don't have it, it's clear they just don't know how to handle their own emotions. They think they are depressed at the drop of a pencil…

  14. A medical doctor who benefits from prescribing medications, is saying that we are not over-medicated, we are mis-prescribed. You guys don't see the irony here? Food is real medicine, and medications is sick-care.

  15. Having any feeling is considered a disease by these pseudoscientific marketers, so there is a pill to stop it. They just want people to make themselves zombies, not to question the root causes, like the profoundly sick societies and cultures.

  16. Some people don't want to think, but the world is complicated… What works for one situation might not work for others, we each have to sit down and think about things on an individual basis… There are people that like to make broad statements, without knowledge of evidence to support their claims… A key for success in this world as cliché as it sounds is to be knowledgeable, and to really develop your critical thinking skills. Learn to inform yourself, and learn to make your own decisions… That's all I know :/

  17. Does anyone know why ECT is so rarely used today? I've heard the side effects are bad, but the only ones I've found online are brief disorientation and memory loss directly before and after the treatment. It's not like it is traumatic, you are asleep the whole time and they give you muscle relaxants so you don't move.

  18. Ya the misprecriptions are not good. Especially if a drug is pushed for its profit base not its efficacy. Plenty of drugs out there that are cheaper and can get more done for less side effects… like marijuana to name just one. Other drugs get overused past their efficacy due to some addictive property or simply due to doctor error. We live we learn eh.

  19. Honestly. I've spend time in mental health care facilities fifteen years ago. For some people it might work fine, however, IMO we are over-medicated. I've seen the results of this with my own eyes. A pill to combat the effects of a pill, to combat, etc, etc. I've been diagnosed with pretty much everything in the book, you want to know what my real diagnose turned out to be? Originally a mild personality disorder that turned into PTSD from the mental health care system, narcissistic psychiatrists and years of being subjected to emotional abuse from that system aka gas-lighting.

    The stuff i've seen in those places, is the stuff of nightmares. I'm glad the mental heath care industry is finally taking a more neutral position on things now that society in general is becoming more knowledgeable on the subject matter themselves.

    Thank you.

  20. I agree completely with him.I was on antipsychotics for years that were ineffective.then I met my current doctor. who took a look at everything and after two hours said your not schizophrenic. you are suffering from both an anxiety disorder that creates psychotic symptoms and add which is impacting your focus and your emotions.so he put me on vyvanse and mirtazapine which are add and depression/anxiety medications respectively. in the 4 months since I started with him I now have no visions voices delusions anything.I'm actually content with who I am.I'm excelling in college.I have a future. never would have happened if I had not found the right solution.

  21. 10% Of people wake up in the morning, and take there drugs like every other "HABIT" that they have. This is a big problem that needs to be looked into.

  22. I cannot disagree with anything he just said, and that is rare when it comes to Big Think videos.  I would maybe just add that the U.S. is running short on mental health professionals.

  23. my girlfriend was prescribed antidepressants for her severe depression 7 moths ago. two days after she started taking them, she jumped from her balcony, and is still recovering from the damage she received to her brain and the physical implications it has caused. Fuck anyone who is saying that antidepressants are the way to go, prescribing medications purely through trial and error is not only unscientific, but life ruining. I miss having my girlfriend of 5 years around…

  24. Thank you. OCD medication has changed my life for the better. I hate when people pretend no medication is better than any, even if it works for you.

  25. In addition, i would also like to point out that with these drugs, 50% or so of the effect is placebo. I'm not saying tic tacs are just as good. I'm just saying, maybe looking for alternatives isn't a bad way to go. Anxiety, depression, low self-image. Ask the one who took the oath of Hippocrates first what a neurosis is, before you take their suggestion on their drugs.

    Go cuddle yourself, pill pusher.

  26. As an individual who has gone through depression an anxiety, although a mild case of it, I can say that medication does help, It helped me, it helps others.

    Food and diet has little to no impact on mental illnesses, if you think it does, you do now know what you are talking about.

    Saying someone needs to "get over it" does not help. Depression is not feeling sad for a short period of time, it is always being sad.

    If you have never gone through it, you do not know what you are talking about. If you have never gone through it, and you are spreading the misinformation that drugs don't help, you need to grow up, or america is over medicated then you are part of the problem.

    If you are depressed, if you feel like harming yourself, then get help. Go see your doctor. Go to the ER. Get help! Don't listen to what the ignorent have to say, you can be helped, you can be happy again, you just have to seek it.

    If you know someone who you are worried about, help them get help.

  27. He brings up the topic but doesn't articulate the issues around it very well. Ok, so people are mis-prescribed… then what? What was his answer to the problem? Do doctors need to further their education on the latest medications and their side-effects, should their be a central database with this kind of info? Is he waiting for super-computers that can scan a patient and deliver the perfect custom-combo of drugs? Is his message to patients not to be discouraged and they should hang onto their path of prescription exploration?

  28. medication will numb down your depression but will not cure it

    it's your job to work through whatever is making you depressed

    sweeping it under the rug with medication won't fix anything

  29. I think this failed to address one of the core issues of the debate: How modern medicine is developed, tested, and patented.

    There are issues with our understanding of exactly how SSRI, SRNI, and TCA medications function to reduce symptoms of anxiety and depression, because we still have a poor understanding of the underlying causes of anxiety and depression. We develop new versions of these drugs with a limited amount of reasoned intent, and work backwards through clinical trials to determine efficacy.

    The clinical trials we use to test this efficacy are opaque, and give greater status to attaining regulatory approval, than they do patient outcomes or good ethics. A lot of this is because of the commercial value of new medicines, which hinders open independent study and good science.

    Finally, the patent system encourages the development and marketing of simple or unreasoned analogues. This is primarily for commercial gain over patient outcomes, or the furthering of scientific understanding.

    Antidepressants are an important class of drug, and we have good evidence that they are clinically effective for some patients. However, we also have good evidence that they are not clinically effective for others, and that they induce serious side effects (e.g. withdrawals from SRNIs). There are problems with their development and use that are greater than simple mis-prescription, and waning cultural narratives.

  30. The only things psychiatrists have given me are conflicting opinions, an addiction I'm struggling to break and drugs with unbearable side-effects that do nothing to help me.

  31. The problem is, people get on medS, and decades later they are still on them and are still not happy. Be careful, people need to get to the bottom of what is causing their unhappiness, i believe there are always reasons, be that guuilt over something you have done, be that abuse you suffered as a kid, be that loneliness, be that anything.

  32. I'm no expert in this field, but I believe that most depression will be curable with sources besides medication. Yes for some it might be necessary, but for many it is achievable by other means. It baffles me how many people don't work on themselves and their problems. I had mild depression during my high school years for several reasons, but started exercising, socialising and facing my problems head on. it's amazing how much those things do. Psychedelics also played a big role in facing my demons. Those I think are the real medications, with barely any downsides. Face your problems, don't bury them.

  33. The "over-medication" argument is not harmful, and it's a catalyst to a discussion that needs to take place. No critical thinking person believes that these medications don't have a real purpose for mental health care overall. The argument(s) that need to be debated is whether or not they're incorrectly prescribed to patients due to incompetence by their doctors; pressure from pig pharma (spelling intentional); or some combination of both along with other factors (doctor / patient load unmanageable).

    It's not hard to see that the profit motive of pharma companies, lobbying, and other factors are contributing greatly to opioid addiction in our country. It's also fairly easy to transfer that realization into the realm of antidepressants and other psychoactive drugs used to treat particular mental conditions or brain chemistry issues. It's just too easy for GPs and certain other doctors to write scrips for medications, which often lead to the need for other medications to counter the side affects, rather then spending the time needed to get thorough evaluations of their individual patients and advise accordingly.

    When you're a hammer, everything looks like a nail. In this case the hammer (pharma) is a trillion dollar industry with major influence over government and NGOs (such as FDA, CDC, ALA, AHA, etc.). Altering your brain chemistry should be the last line of defense, not the first option presented by those that are charged with caring for other humans.

  34. Don't take pills!!

    Some of the side effects like to your digestive health or deterioration of other areas of the brain are censored due to lack of evidence.

    If you feel suicidal talk to someone immediately and try to conceptualise how precious one life really is.

    Most of these pills give subjects their side effects way later on in life. And some even make the symptoms worse when you get off the medications.

    Don't mess with your brain, humans have so little knowledge on this organ at the moment and cannot accurately determine the full scope of what the pills are doing to the body and brain as a whole.

    Thank you 😊😊😊😊

  35. Of course, we're misprescribed… Ramsay's methods to get over depression are much better and enjoyable… who would pop pills if you could hunt down girls and collect their skins for trophies.

  36. Trust your doctor!! Don't go for commercials, listen to the person who studied for years to learn how to treat people as well as possible! They really do know best.

  37. Few of my opinions on mental health:

    * First line treatment for depression is SSRI because it's considered 'safe' but that's arguable. SSRIs are known to commonly cause loss of libido/sexual dysfunction, emotional blunting, lowered motivation/interest (apathy), anhedonia and fatigue.

    * "Depression is caused by low serotonin" is false. It's believed that serotonin, norepinephrine, dopamine and other neurotransmitters are involved in depression. It's just that there's more studies done on serotonin for depression.

    * Depression doesn't only cause chronic low mood. But it can also cause other cognitive dysfunction including problems with memory, executive function, motivation, energy etc. So it can sometimes be mistaken for ADHD.

    * Besides your mood, GPs don't really care about your other cognitive symptoms. I had low drive, energy and problems with memory mediated depression and it was only worsened by SSRIs that they put me on. My symptoms only got better finally switched to seeing a psychiatrist and got put on SNRIs.

    * Doctors nowadays are quick to heavily push you on atypical antipsychotics for depression just after one SSRIs fails. SGAs, even when used at low dose (which tend to preferentially target 5-HT1A/2A receptors) are still a very potent dopamine antagonists. And dopamine antagonism has no role in treating non-psychotic depression. As a result, they're known to have myriad of side effects including increased risk of diabetes, galactorrhea, gynecomastia and tardive dyskinesia. So how did SGAs end up becoming a second-line treatment for depression?

    * In contrast, NaSSAs like Remeron is also a 5-HT antagonist and has less side effects due to lower lower affinity on DA receptors. Thus, it appears to be preferable over SGAs as an adjunctive medication to SSRIs. But for some reason, it's not used very often anymore. I really hope that when S32212 comes out, it's going to replace SGAs.

    * There are some doctors who gets kick backs by prescribing certain medications. Patients no longer comes first, it's the pay check.

    * Public psychiatrists takes forever to see and private ones are too expensive. GPs are only comfortable in prescribing SSRIs. So if you're a non-responder, you must wait months to be able to see psychiatrists.

    * Addyi (flibanserin) is a 5-HT1A full agonist and 5-HT2A antagonist. Thus, it would be a great adjunct med to boost the antidepressant effect of SSRIs. But it somehow got rejected by the FDA for treating depression. So it's now only being sold as female viagra.

  38. He mentioned "talk therapy". If he meant psychoanalysis, then he's right about that. However, there are types of psychotherapeutic approaches that are many orders of magnitude more effective and efficient than that. And much more so than SSRI antidepressants.

  39. That's because Psychiatry intentionally misdiagnoses people for disorders that – conveniently – have specific medications that treat the diagnosis itself. For example, many of the people with "depression" are suffering a trauma-stress disorder and its related emotional shut-down/numbing effects, however, Big Pharma has not yet come out with the pill that cures PTSD. So instead, psychiatrists misdiagnose those with PTSD and childhood CPTSD with "depression" or "anxiety disorders" in order to be able to prescribe them meds that do not treat those conditions, because no meds exist that effectively treat psychological trauma currently. That's why Big Pharma and its drug pusher Psychiatrists have a well-earned bad, bad name.

  40. Misprescribed healthy lifestyles, medications are used too much as a easy fix. Anti depressants do work but there are better alternatives. Overprescription just not only involve antidepressants, how about anti bacterial this that and the other. Big Pharma cares about profits not people. It's a business not a charity.

  41. We're fucking both actually. People are being medicated for their personality differences. World problem on the verge of collapse.

  42. Well, if you have no reason to be depressed (your life is going well, you do what youd like to do, etc) and still have depression, than you have a biological problem in your brain and medication makes total sense.

    But if youre depressed cause your life either sucks or are not turning out how youd like, Id rather have you lame ass suicide than kept alive in medication. You go solve your fucking problems, not mask it with drugs, you little shit.

    Psychologists these they all be like "the problem isnt you, its everyones else, if society were different youd be ok" like saying this shit, which is basically putting the blame on others rather them helping the person solve theyr issues, will help in anything. All they want is theyr patients to create a dependence on them. That already happened, ppl arent going to therapy to solve their issues anymore: they never leave therapy! It become just another drug.

  43. The act of taking drugs to change "yourself" instead of changing your life… always confuses me. Choose to change of life before taking a pill to cope with it.

  44. I firmly disagree. I was practically medicated to insanity until I went cold turkey from antidepressants. The vast majority of people who take anti-depressants (I believe) could be weaned off or significantly reduce their medication intake if they developed healthier lifestyles.

  45. Regardless of how you feel on the subject of psychiatry, medication, or mental illness – patient populations should be better educated; for example, via explicit clinical informed consent. This is moot, however. The real issue is establishing an assertive, proactive voice of some kind that is integrated with basic education and reasoning skills. We cannot rely upon the medical community at all, so immediately this poses quite a problem. The first step should be revolutionary in essence and approach: an audible – even clamorous – proclamation to the masses.

  46. I see in the near future that every American will have to take 10 pills a day just to not collapse and die. We have become so dangerously dependent on unnatural drugs and chemicals that are not produced by our bodies. If we were to suddenly lose a production plant of a specific medication, people will begin to drop like flies

  47. "…instead of taking a medicine that's been closely studied and brought to market and closely monitored, they'll be taking five, ten, 15 different supplements." This is the entire point – psychiatric medicines have not been 'studied closely' or closely monitored…If you actually looked at how poorly studied and poorly monitored most psychiatric medications are you would be less optimistic about this. The trials for Prozac- only lasted 3 weeks…so much for closely monitoring… Whatever you want to tell yourself Drew – misprescribed instead of overprescribed…?  Nice try. Your psychiatric medications cause more harm and suffering than they alleviate… SIMPLE.

  48. The director of placebo studies at Harvard says antidepressants don’t outperform placebo. I’ve been on 5 different ssri’s and Wellbutrin, and nothing but the Wellbutrin has worked. The ssris make me emotionless and flat after about a week every single time. I believe the risks outweigh the benefits. A new study suggests that Effexor and Paxil can slightly outperform placebo, but they are highly biased studies sponsored by the companies themselves. The risk of suicidal ideation isn’t worth it. It’s been 4 days since my last Effexor dose, and I’m done for good. I believe Benzos and ssris have damaged my brain somewhat, and I’m only 22. I was prescribed these drugs for my ocd and anxiety when I was 18. If you’re depressed exercise, eat right, take up a meaningful hobby, and go through CBT! Don’t play with the one brain you have people.

  49. it's more stressful and shameful for me to seek treatment these days. i have been accused by pharmacists of drug abuse,refused medication and even my doctor can't help, the pharmacy has become all powerful.our lives are in their hands but good luck finding a pharmacist that gives a shit

  50. All my life I was told I needed to take antidepressants for my pain, I had surgery and found out I have spina bifida, tethered cord syndrome and MS I don’t think antidepressants were gonna help me but that’s all they ever wanted to give me they told me the pain was a symptom of depression it works both ways pain can cause depression

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