Why do we get Depressed? ft. Dr. Mark Horowitz, Depression Researcher

[@Chizuru94]

2:44:50 - "Just because someone is emotional, doesn't make them wrong" - Dr. K Thanks, I needed to hear that. I really did.

[@rohanking12able]

Shouldn't this be evident for most people. Especially if you say it our loud

[@lBlackOuTl101]

❤❤

[@samueltheriault4790]

Sometimes in an argument the person getting angry is automaticaly wrong because « I’m not the one getting all worked up » which is pretty bad if you think about it

[@whatsthisidonteven]

What's extremely fascinating (and also valuable) about this conversation, is that it's two psychiatry academics talking to each other in (mostly) layman's terms (with some necessary medical jargon in between) in front of a lay audience. Think about how rare that is and how common it should be.

[@noahwig500]

Spot on

[@AXharoth]

great point

[@hdshjs]

That's why I think Heathy Gamer is amazing bridge between mainstream crowd like gamers age 15+ and academic stereotypically 'boring' work, that is awesome and life changing but hard to advertise to a wider audience.

[@cxxmax]

Psychiatric terms are easy to learn. It's a shallow field filled with wonder. Easy to talk about in laymen terms.

[@d4mephisto]

Therapist here. This episode is WONDERFUL. I'm learning a lot. Thanks, Dr. K and Dr. Horowitz, for combining your brilliance for us!

[@N22883]

Thank you for your work and watching this stream!

[@outrohealth]

Super important stuff for therapists to be informed on. Keep up the good work!

[@hdshjs]

There are just so many mediocre or plain bad therapists. I'm so happy that some of you folks are in sync with Dr K's teachings. It means there is still hope for us.

[@katehamilton7240]

It IS scary that people with normal Life Problems are being told they are broken and cannot solve their own Life Problems, they must take drugs that may make things worse. HOWEVER, it is much more complex for people with Psychosis, severe Mood Disorders. If we had unlimited money to provide safe places to recover without anti-psychotic drugs, then that would happen. But most people are not willing to pay the necessary taxes to pay for high cost therapy like that. Do you agree/disagree as a therapy professional?

[@herogamer555]

As someone who was forced on to various medications at a very young age because people told me that I had a chemical imbalance, it was extremely validating to hear Dr. Horowitz saying what I've felt since I was a kid.

[@kayleighohler9999]

it was "extremely validating" to hear anecdotal evidence presented to you? be careful friend, this is the same way extremists groups are formed. just because it resonates, if there isn't actual evidence you should be cautious. not calling you extremists or anything like that, but just continue to use your scientific method to evaluate the evidence presented to you, always, and keep re-evaluating your position. your position can change over time as you are exposed to more experience, don't let your past beliefs define your future self

[@bapbirb]

​@@kayleighohler9999 I think its aways good to keep your position in the middle and make sure to not form any radical opinions, but as someone who heard 'who are you to question doctors? What do you know more than doctors?' even from my own family everytime I questioned antidepressants and told them that I got permanent brain change/withdrawal syndrome from ssri use, this interview was validating for me as well. It all depends on the situation you're in. But its true that antidepressants and mental illness in general are overdiagnosed nowdays with many doctors being inconsiderate of what they're giving to their patients. I've seen so many cases of people ruining their lives because of doctors giving medication after medications that they take 7 freaken pills at the same time. That cannot be good for your body or brain whether you are depressed or not.

[@dekumutant]

​​@@kayleighohler9999what an emotionally awkward way to respond to someone stating they feel validated lmao

[@JohnSmith-mc2zz]

I disagree with the guest but I do agree people with moderate depression shouldn't be told a bag of goods about antidepressants or forced by their parents to go on them. I know some psychiatrists who only work with young children because the children are forced to comply. Truly sick.

[@darinrhoton4919]

@@kayleighohler9999 I have a feeling you aren't so scrutinous when it comes to information presented to you that confirms your bias. I guess its less of a feeling and more of a comment history.

[@PappyTrading]

Maybe its just the state of mind that I am in currently but I have been glued to this conversation with almost 100% of my focus.

[@mboonetdf]

Dude same I came into this thinking "no way I'll sit through this full thing in one sitting I'll just preview it for later" then before I knew it 3 hours of my undivided attention passed

[@outrohealth]

Seriously! It was Pay-Per-View quality stuff!

[@Knooblegooble]

Instead of my diagnosis being "disempowering" it was actually the opposite for me. I finally had an explanation for my thoughts and emotions and understood that it wasn't "just the way I was" and it was actually something objective that I could work towards improving. Accepting myself for who I am and realizing that there are practical things that I can do to improve my mental health was very empowering for me.

[@SvayaG]

My diagnosis wasn't depression but I found the same thing. It's given me a reason instead of "it's your fault, try harder" so I've done way more work on trying to improve things with a diagnosis then I did without. If nothing else, it gives me a direction to look for "better for me" solutions vs "better for most"

[@juneelle370]

@@SvayaGI heard a show w a psychiatrist on NPR who spoke of the upsides and the downsides of giving a person a label… he spoke about how it can feel good to feel there is an explanation for what is happening to you and that there are many others like you… however, he spoke about the massive downsides to labels as well… it takes away agency/growth mentality because of how labels are used in today’s psychiatry… they aren’t used as a way to just describe what one is experiencing that can help you understand and be very validating/non-isolating… positive use of labels is labeling the experience not the person and teach that there are ways to grow out of it &/or positively adapt.

[@katehamilton7240]

Me too. It IS scary that people with normal Life Problems are being told they are broken and cannot solve their own Life Problems, they must take drugs that may make things worse. HOWEVER, it is much more complex for people with Psychosis, severe Mood Disorders. If we had unlimited money to provide safe places to recover without anti-psychotic drugs, then that would happen. But most people are not willing to pay the necessary taxes to pay for high cost therapy like that. Do you agree/disagree as a mental health patient?

[@soorian6493]

I'm glad you challenged him on his bias, and it seemed he was glad too! Helps make a strong point stronger, and gives us the nuance we need.

[@izio1111]

My thoughts exactly. I hope he doesn't disregard evidence just to prove his point.

[@juneelle370]

Yes, I’m very glad Dr. Horowitz challenged Dr. K’s bias. Doctors can often (and often unintentionally) become crusaders by proxy for big pharma/big med profits. I think Dr. Horowitz could work a bit on his conversation skills so he could keep people off their back foot, defensive mode. He has to understand that doctors have been so indoctrinated by those with financial interests in their studies that criticisms need to be explicitly pointed at those interests and away from individual doctors in order for the doctors to avoid being defensive and not hearing them. Stating that you know many doctors are doing their best and explicitly voicing confidence in the motives of the doctors he is speaking to directly would go a long way in helping his message being received… even those who DO have financial motives to not question the motivations of big pharma and the infiltration of their interests into psychiatry/big med. (I think Dr. K has very good motivations!!!… good motivations don’t prevent deception by other people’s interests.)

[@FrznFury27]

One of the things that really keeps me on HG is the way that Dr K pushes back on his guests.

[@EvanLandry221]

Dr. K is super professional but there's some moments here when you can tell he's getting super sick of Horowitz's shit. Particularly when he asks him a straightforward question and gets some long winded run around to try to force things back into his world view.

[@whateverimake9350]

@EvanLandry221 i dont think its fair to frame it as "Horowitz's shit"

[@katehamilton7240]

Yes. It IS complex. Whilst it is scary that people with normal Life Problems are being told they are broken and cannot solve their own problems, they must take drugs that may make things worse. HOWEVER, it is much more complex for people with Psychosis, severe Mood Disorders. If we had unlimited money to provide safe places to recover without anti-psychotic drugs, then that would happen. But most people are not willing to pay the necessary taxes to pay for high cost therapy like that.

[@Alex-js5lg]

It's refreshing to hear Dr K acknowledge that suicide is sometimes a measured, rational decision that's an alternative to daily suffering/struggling. While it's important to encourage others to keep fighting, we often unintentionally gaslight people who are on the brink: "you have so much to live for" and "it'll get better" don't line up with the experience of a person who feels empty and hopeless.

[@shan4145]

Reminds me of dr jack Kevorkian. He helped people pass away because they were suffering in pain and tortured but he got jailed for it . That sucks

[@dumfriesspearhead7398]

​@@shan4145It's not quite the same thing though.......

[@Echo81Rumple83]

48:55 - 50:17 THIS. EXACTLY THIS. this is why we're more depressed than ever, especially when forced to live in a economic system that doesn't care for us, a culture of hate, and a society that's on the brink of collapse. couple that with ASD-like tendencies to see patterns in a pessimistic way and that's why folks have given up on trying. even me. and unless a systematic paradigm shift happens yesterday, i've given up hope, because no one can understand what i've been through and how i think and feel.

[@JohnSmith-mc2zz]

By your definition there's never been an economic system that cares enough about your or an event that was powerful enough to inspire hope, so you have adopted a recipe for stagnation.

[@Echo81Rumple83]

@@JohnSmith-mc2zz "stagnation," which is also happening in the current economic system in the US as we speak. take a look at the monopoly in the patent system for example: the stagnation is happening on a profit motive, so hardly ANY innovation is happening because there's no money to be made. meanwhile, the Scandinavian countries have it figured out; it's not perfect, but you can't argue against results when it comes to human happiness especially in Denmark. the bootstrap mentality is about as fictitious as Horatio Alger.

[@JohnSmith-mc2zz]

@@Echo81Rumple83 Economic stagnation is happening worse in Europe and Asia so I don't know what you're comparing to. Social democratic politics are fine by me, so if you hate living in a country run by liberals then actually do something to help or go live in "Scandinavia." If you look at the economy of "Scandinavia," they have lots of easy to access oil and minerals, and they socialize a lot of the profits from these industries. It's sort of an apples to oranges comparison to put Norway side by side with USA or China. If you put USA beside a nation of comparable size, or the average nation for that matter, it's doing better economically.

[@juaecheverria0]

Blame our govt for making us financially dependent. Such as policies like housing tax which we literally need a shelter for survival. So thats just a stupid thing to tax us on. Property. Yet we still see people fighting for it. Its a basic necessity it shouldnt have ever been taxed.

[@LFanimes333]

Uh, what? Culture of hate? Society that doesn’t care? Brother in Christ humanity has never been even REMOTELY as companionate and caring as it is today. Not even close.

[@XorusVII]

i love how this talk is "i agree with you but" and the butts are adding more layers of complexity or different point of view about topic, all is done with great respect. I wish one day our public debate will reach this heights of cultural discussion

[@Iudicatio]

I once went to a sleep lab because I couldn't sleep through the night and was tired all the time. They told me everything is normal except that I am waking up frequently throughout the night. They asked if I had EVER been on antidepressants and I said yes, about 8 years ago. They told me this is a normal side effect of taking antidepressants that often does not go away when you stop. I was completely shocked! I experience this and it is noticeable. Why was I only being told this now when it was too late? Why did nobody tell me this before I started??? If I had known that I would have to live with this problem the rest of my life, I never would have started them.

[@WarLoqGamer]

WAIT WHAT I HAVE THIS PROBLEM i took antidepressants, and i have the same issue ...what the f

[@Iudicatio]

@WarLoqGamer Yeah, I live in Germany, and German doctors are complete assholes sometimes. She acted incredulous that I don't still take antidepressants and pressured me to take them again, and when I said no thanks, she revealed this. Ugh

[@-MiseryLovesCompany-]

@@WarLoqGamerwhich medications?

[@WarLoqGamer]

@@-MiseryLovesCompany- i dont remember, i need to go find the prescription

[@kaitlan7284]

Poor sleep can also cause symptoms of depression, so could be the sleep problems came first.

[@ellairax]

This video is so timely for me. I stopped my antidepressants (lowering over the course of months) three weeks ago, and then I started feeling very severe “relapse” symptoms. I’m still going through them right now. I thought it meant that something in me was inherently wrong and needed the medication to fix since this is far from the period that they say withdrawl symptoms should happen, but after listening to this, I feel a lot more hope about my situation.

[@Chizuru94]

Good luck with your journey and it getting better (quickly)

[@Michael-jq5pf]

Go slowly. It can be done. I got off after 8 years (not my first taper protocol but my first with an ssri), just go slow. If you've only been on 6mo or even a year or two I reckon you can go a bit quicker dependent on dose. Fwiw a taper off of SSRIs (was on a handful of them, but sertraline was final one and the one I jumped from) was pretty easy if you go slow. But ymmv. The real turbulence doesn't start until some months after the last dose.

[@Oatmilk345]

@@Michael-jq5pfdo you have any advice to deal with the turbulence after the last dose and how long in your experience does it last?

[@Liliarthan]

@@Singerandafan3 weeks is nothing in terms of time given to clear the drug. Esp when it takes 6-8 weeks for the dosage to get to 100% effect, then it goes to reason that it would take *at least* 6-8 weeks for the brain to adjust to removal of that -dose- of the drug (and depending on how high a dose you’re on then how long it takes to take off).

[@jameswilliams2269]

What was your last dose before quitting? For most SSRIs you should get it down to 1mg or less before going down to zero.

[@Fattz86]

I'm a big fan of Mark Horowitz' work. He has helped so many people. Thank you, Dr. Horowitz!

[@screwhalunderhill885]

There was a really funny moment for me personally in the stream at 1:50:21, when Dr. K adresses that Dr. Horowitz may have trouble emotionally processing contradicting evidence to his point. This moment was like a clash of eastern vs western perspective, where Dr. Horowitz argues correctly that it doesn't matter what his personal view is as the peer review process takes into account biases leading to objective knowledge, whereas Dr. K was talking about the subjective experience Dr. Horowitz brings to the table, who might have trouble accpeting use cases of SRI's. Both are actually correct.

[@Hawkenwhacker]

*_"Dr. Horowitz argues correctly that it doesn't matter what his personal view is as the peer review process takes into account biases leading to objective knowledge."_* This statement alone makes it sound as if his search for objective knowledge goes against his own experience. Gotta love that _objective bias._

[@abbasballout4441]

Well academics told him that meds are easy to come of so

[@iahkrishnashiva]

@@Hawkenwhacker sheesh

[@izio1111]

Dr. K put it to words so perfectly on what I think about Dr. Horowitz 1:43:15

[@n0Corn330]

Please have discussions with more doctors, this was amazing

[@tajniak0811]

It's so refreshing to listen to two people openly discussing and challenging each other with strong grounding in scientific evidence

[@AnxMa]

To anyone who's ever been a victim of bullying / hate / violence because of their appearance, gender, orientation, race : DO NOT ever let a hateful notion 'there's something wrong with me' sink in. Trust me, it's a recipe for self hatred, I've wasted half my life feeling it. When we suffer and we need a break, it's only natural to think: 'maybe if I wasn't 'different', if I was 'normal' I would be accepted. No, haters will always find something to pray upon. I've always had kinda androgynous look, which was a fuel for bullies when I was growing up. I embraced it, used it to my advantage in my acting / modeling career, I was almost the face of Leon in these new Resident Evil games :) Remember; There's never anything wrong with you.There might be extremely toxic people around you who can see our potential and value but will keep and drag us down with intent and hideus determination. They do it out of jealousy, they don't want to see us happy or sucessful. They want us docile so we can be manipulated.

[@gayu8695]

I needed to hear this, thank you ❤

[@johndeaux8815]

Thanks, now I just have to systematically dismantle my life mottos 😂

[@seanocd]

If you don't mind the question, I'd love to know if you have any ideas of what 'allowed' the "there is something wrong with me" concept to penetrate your self conciousness and/or (more importantly) what things helped break that concept for you? If there was a pill for that I think 90%+ of psychological issues could be resolved instantly 😅 Also, I can totally see how you ended up modelling. Your profile pic shows a both handsome and beautiful man. Glad you found a way to utilise that gift in a self affirming way.

[@raze956]

"There's never anything wrong with you" except sometimes, there actually is. if multiple people on different circumstances and different social settings dodge you, if you have conflict with you regardless of where you go, when you go to new places and you have conflict there as well, then there is a strong chance that it indeed is on you.

[@KartikayKaul]

​@@seanocdIf we can find ways to understand deeply our brain and what it invokes when we have an emotion or we react we can make great progress.

[@vhs5859]

Could you please talk about pssd in the future. Its a delibitating condition caused by antidepressants and symptoms include persistent genital numbing and emotional numbing even when you're off the drug and this can last for years and in some cases its permanent. Doctors dont know much about it if at all. Our community of sufferers are desperately trying to get this condition recognized so a cure could be found sooner than later. We just want our lives back, many thanks ❤

[@mattw-cx50]

This video has completely changed my perspective and understanding of my depression and anxiety. Literally EVERYONE needs to watch this video. Thank you so much Mark Horowitz and Dr. K for helping me.

[@MattBorchert]

I am thankful to be able to listen in on this discussion and in some ways debate. Really appreciate this quality of information being put out for free.

[@mycrazylife408]

had no idea the serotonin deficiency causing depression was debunked wow i’ve always heard about that theory thank you Dr K you’re the best most informative mental health channel i watch by far

[@austinz9310]

It’s not an accident that so many people still believe the imbalance theory. The pharmaceutical industry has too much to gain by continuing to push this story.

[@tomwright9904]

@@austinz9310 there was a bit of drama surrounding moncrieffs paper where a bunch of people were like "we never said that".

[@seanocd]

Be careful with definitive statements like "serotonin deficiency causing depression was debunked". It's probably more accurate to say that there is strong and growing evidence that the theory of serotonin deficiency causing depression is incorrect. I worry that inappropriate definitive statements are what got modern psychiatry into the danger points we now find ourselves in, so we should be careful not to repeat the mistakes while digging ourselves out of this hole.

[@tomwright9904]

@@seanocd sure... but also maybe "medicine overstated the biological model without evidence too"

[@seanocd]

@@tomwright9904 Yeah. Totally. But like... *Points the gun* "Always has been"

[@jambi1527]

The experiences Dr. H describes very much reflects my experiences coming off of ssris after 5 years. The numbing is real and was actually helpful in that first year when I was stressed in grad school, but after that period was done, I had a job and making a stable income, I had the time to explore life changes to help in the long term and shouldn't have had continued use for the remaining few years. I'll go easy on myself though while I struggled finding a good therapist and ssris helped trying to navigate the therapy system. It was actually this channel and HG coaching that helped my life perspective the most and gave me the tools to make my life and therapy experiences better. Thanks for all you do HG 😊

[@VA-ie4qq]

Man Dr. K’s communication style is so solid. Guy is humble too.

[@_ze5742]

This is phenomenal. I want another podcast by psychologists for psychologists

[@momobec1]

best content on youtube. thank you for videos like this.

[@minesmit3214]

Dr k asking questions that sounds like its about to attack the logic only to agree but getting detailed information in the process. It sounds frustrating to answer the questions but it's awesome to hear and extremely informative.

[@N22883]

Dr Horowitz, if you see this, thank you so much for coming on! It was an amazing discussion!! If you’re looking to peruse through Dr K’s content, I’d recommend checking out the HealthyGamer Bootcamp playlist, as that has the majority of his ideas I also really, really love the 4 Part series where he live trains coaches on how to do effective motivational interviewing, which would be crucial for your ideal clinic. Lastly, the interviews are my absolute favorite type of video. Feel free to ask the subreddit for video suggestions as well! Thank you again, as someone hoping to go to medical school, this was a thoroughly engaging talk

[@NickRuedig]

I have searched for about 15 minutes now and I can't find the four part series on training coaches on motivational interviewing, can you tell me how I could find those?

[@N22883]

@@NickRuedig For sure! The video is titled 'Motivation and Goals | Part 1: Intro to Motivation and Coaching' with subsequent videos being titled Part 2, and so forth. There's four in total

[@theelectricant98]

What an incredible guest and conversation. Thank you so much for this

[@HowToActivateNeurons]

I don't know why some comments are triggered by the fact that one is bias? From what i see is both Dr.s trying to reach a common ground moving towards a noble goal. Despite their personal biases, both are acknowledging each other. If anything, these comments seems like they are being bias without acknowledging the other party.

[@SacredSilence95]

Yeah I'm reading the live chat from time to time, while watching the video. Some people were very hostile to the guest. Weird

[@missnikkigiron]

I would love more content on PMDD, I was really surprised when that was brought up since it doesn’t seem to be talked about as much. It literally turns me into a different person, I literally feel like there was a switch in my brain and I literally feel like my entire outlook changes. I tried SSRIs for PMDD, and would love to find more options since I don’t think SSRIs luteal phase and taking it everyday worked for me. personally of course

[@franjkav]

Agree, very relatable

[@mrs.quills7061]

Same same! It makes my anxiety insane too and I get so moody and worried about my body and life. Hormones have such an effect on us and I can’t take birth control either because that messes with me bad.

[@SuperReznative]

Be careful with SSRI the Dr. prescribe but the side affects arent great, and the withdrawal can be horrible.

[@westfield90]

2023 was the most stressful year I’ve had with zero control of events in my life. The nonstop stress caused me to gain 20lbs within a month and never was able to drop it despite having lost weight and been disciplined in previous years but also not able to temper the stress has become very destructive and I fear it’s getting out of control.

[@mrs.quills7061]

This was such a good stream and I think a reason why so many have mistrust in doctors and pharmaceutical companies. If it’s not watching a loved one battle with opioid addiction or overdose, it’s feeling gas lit over real and debilitating symptoms from psychiatric medication. I think that’s been a lot of the starting point for many anti vaxx and new age type people too. It’s also why many are hesitant to start ssris and stuff as these few pills don’t fit everyone’s needs especially when depression can come on for a variety of reasons-hormones, environment, trauma, burn out, stress, genes, etc. they treat symptoms, not cure the issue at hand usually. We also aren’t allowed to properly process and grieve and breathe either. Covid changed so much yet we were supposed to return to normal. For me, I get very bad seasonal depression during the winter months as I live up north and have limited exposure to the sun and before my period my anxiety goes through the roof and nothing works. I can’t take hormonal birth control either because it messes me up bad. I feel like sometimes doctors don’t try to look at all the symptoms and how to fit them and give us a generic bandaid in hopes of alleviating some of our complaints. During the periods I struggle with like winter I’m expected to be how I am in the winter or when I’m not on my period, when I literally cannot be that person I was. I’m at my lowest energy point yet instead of resting like everything else does, we have to work, go to school, work out, clean etc.

[@nnarcus]

this talk was amazing for the indepth discussion (even tho could only follow along 80%), and the last 40 minutes is a perfect example of Dr K's incredible insight and rhetoric. Great work 👏

[@psydrone8]

This certainly put the research into perspective. Knowing that it cames from someone affected by the drug. It makes sense that he is putting so much effort in the research. Because he can be easily get descrited by that declaration.

[@christopherp.8868]

Dr. Horowitz I wish you mentioned PSSD. Many people are coming out about this condition post-discontinuation. I hope it's something that will be more open to discussion. Just trying to spread awareness!

[@batman1776]

Starts 7:11 disclaimer end 7:35

[@eoxico]

Subscribed yesterday and that is already one of the more informative content I ever watched. Congratulations and keep the great work

[@N22883]

Definitely check out the mental health Bootcamp series on the channel too! That’s some of his best content imo. That, and his 4 part series on Training coaches on Motivational Psychology

[@hieplu1037]

Thank you Dr K, I have been enlightened by your conversations with other streamers in these couple days. When you were talking with them it felt like you were just talking with me. I'm felt so related and eye-opening with some new thought that you have taught them

[@kimberlyk1437]

I am so eternally grateful that AD withdrawal is finally being discussed. Tens of thousands of us have had our lives turned completely upside down by this. Also, fun fact, in the book Children of the Cure, David Healy discusses that the man who came up with the hypothesis actually abandoned it after a few years. Also, the book called the Emporers New Drugs gets into the nitty gritty of the data of dozens of clinical trials and how ADs do not out perform ADs on a long term scale. It’s a very dry read and kind of boring but it is highly informative.

[@jakebaddios577]

This conversation was phenomenal!!

[@entropy2644]

Really intelligent and enlightening discussion. Thank you.

[@Chizuru94]

1:09:18 Same here. My depression(s) were from environmental stuff, things that happened, situations, (financial) insecurity and my needs not getting met. When all of that resolved or some of it, I got significantly better sometimes, but it never lasts and always coems back when the life circumstances change again. I can agree with him here (like with most stuff both said and brought to the table) that this is the case for some of us.

[@mrs.quills7061]

I think that’s why people get depression. A lot can be chemical and hormonal, but it’s like the brain’s response to serious shit and wants us to do nothing or feel nothing until we cope and grieve, but society allows none of that.

[@-MiseryLovesCompany-]

@@mrs.quills7061 bingo , and the less religious we become the more depressed we are, that’s not a coincidence

[@anthonycastro2146]

I was able to get off my SSRIS doing meditation and running for a year before i got off. There is significant studies showing these works and their free so there is no profit motive. I also got rid and resolved of the issues that were causing my depression. Turns out that family that acts less than family can be a major cause. You can find better family out there in the world, there is a lot of good people out there.

[@theflash9735]

This interview literally changed my entire view on my approach to my own mental health. Thank you from the bottom of my heart Dr. K, Dr. Horowitz and the entire HealthyGamerGG team ❤

[@N22883]

As a Premed student, this was a fantastic stream!

[@girbles880]

The last few videos have really resonated with me, thanks you making them

[@BOSSDONMAN]

Hearing Dr. Horwitz go off about SSRIs reminds me when I watched Dope Sick (short series covering Purdue Pharma's involvement in the opioid crisis).

[@PTrey]

As a resident psychiatrist, really enjoyed this conversation and the topics it touched on. I would have been interested to see Dr. K ask Dr. Horowitz on his opinions on diagnoses such as Schizophrenia or Bipolar I. Compared to typical cases of MDD, these diagnoses (in their severe forms) certainly appear more "biologic" in multiple ways. Episodes often dramatically improve with antipsychotics (for psychosis) or mood stabilizers (for mania). Dr Horowitz made a couple of statements regarding psychiatry as a whole when it seems this conversation is mainly discussing unipolar, nonpsychotic depression. We regularly use antipsychotics and mood stabilizers with well known (and potentially more severe) side effects due to the favorable benefit/risk ratio in these illnesses for many patients. Is he as skeptical of an appropriate use of these meds as well compared to SSRIs?

[@Iliketurtlezz]

He is not. I know this from following him for a long time :)

[@ControversialChristian]

Is it possible that yhe emotional numbness can make the depression worse? When I was in my late be ths tried the medication route to solve depressive episodes. This ended up making me so numb i became suicidal, though this was more like a logical choice (which some say isn’t possible). I was like i can't feel saddness but i can't feel joy, so why do i keep living. This almost ended badly, with even my therapist telling me I can't that depresseed because I'm medicated and that we can discuss it at my appointment. Somehow i survived but i left that therapist and the meds that i was on. I honestly feel like surviving without mrdical intervention was due to divine intervention as i went into that with a lot of information. Point being I felt nothing and remember nothing fo the two weeks following that. This was in 1983, i was 18 almost 19 and now iam two and a half months from 60

[@Chizuru94]

1:32:10 Yup, same without ADHD meds. I'm not able to really feel or control or do whatever with my emotions without dopamine. Not having dopamine numbs every part of me and my body and mind as well, which is why without meds, therapy and changes never worked or lasted.

[@SharockoRAZR]

1:02:50 i really like his explanation of "depression caused by a chemical imbalance" is a category error, in a way i think the chemical imbalance explanation denies the personal experiences that might have led up to why you have depression in the first place.

[@eawil-sunart]

Every issue in my life rn is a result of medical malpractice… a marathon runner, triathlete now I’m a mess but getting better w the help of photo bio modulation, HBOT,methane blue and other vitamins and meditation

[@terribleted9529]

You want another whacky treatment that actually works, try a sensory deprivation tank, it is like experiencing expert level meditations effect on the brain, but you don't have to spend years practicing. Its all very evidence based and a good treatment for anxiety depression and PTSD. But you won't see any psychologist recommending it anytime soon.

[@jessyka9823]

@@terribleted9529 float tanks are incredible I used to run a spa that had them. Absolutely life changing for me and even reduced the frequency of my migraines (think it was the magnesium but there’s not hard evidence for that)

[@cxxmax]

Two brilliant men and a great conversation that could have been had anywhere. Please have him back on

[@miikavuorio6925]

My mind was absolutely blown when Horowitz said that 1 in 6 people in the western world are on antidepressants. I'm certain these drugs have their place, but just based on intuition that seems like an absurdly high number indicating overprescription

[@deleted01]

Half of the western population also have elevated blood pressure. Perhaps the root cause is that modernity is not totally compatible with how humans have evolved to live. We live like farmed animals.

[@Mutantcy1992]

Also women are more likely than men. I don't know the statistic but it could be something like 1 in 4 women

[@prismatic1239]

My friend got prescribed SSRIs by his GP because he brought up a concern related to heart palpitations. The GP chalked it up to anxiety and wrote him a prescription like it was candy.

[@meganjohnson9540]

This person is speaking truth…same here. No one will be making money off it.

[@yoga_iaini]

Great interview! Love to see the enthusiasm in both of you. Dr. Mark Horowitz 👏👏 Go Mark go! 🔥 1:54:14 "when there are peer-reviewed studies suggesting antidepressants are effective" those clinical trials have methodological flaws as Dr. Horowitz had mentioned, so the conclusions or interpretations of the data of those studies is misleading. 2:22:38 so interesting, thanks for sharing it. Meditation as a technology to remove the subjective bias of our mind, it's to cultivate the metacognitive ability to observe ourselves, placing the locus of control in ourselves.

[@carolinecraig1786]

Dr. K, will you please make the audio available on a podcast platform, like Apple Podcasts? I’m struggling with spending too much time on KZbin and am going to remove it from my phone. I’d like to be able still to listen to your channel though. Thanks!

[@examinethose]

you should check in more often with dr. horowitz, great dialogue.

[@isisandreialimacaetano3694]

This was an amazing conversation! So much information. Extremely useful. Love it.

[@Awunga]

1:16:21 - I really liked this discussion about "What does get better" mean and the different models/perspectives by which to view drugs. Very insightful!

[@ToxicHorsePucky]

Those last 20 minutes were incredible. Not to diminish the fascinating talk with Dr Horowitz, but the discussion on the invalidation of issues being the cause of so much discourse in todays society was so beautifully stated.

[@skidrat55]

Coming off Effexor was hell. Doctor gave me zero warning.

[@cowabunga2597]

What were the side effects ?

[@skidrat55]

@@cowabunga2597 Honestly while being on it I felt fine for the most part. The problem is if I ever happened to miss a dose it was VERY noticeable. I cant remember many side effects other than the usual youd get with any antidepressant. One thing that was different is if I drank or maybe the day after having a few drinks my lips would feel numb.

[@skidrat55]

If you're asking about the withdrawal symptoms...Kind of felt similar to quitting smoking. Shakes, irritability, loss of appetite, nightmares and night sweats, increased anxiety....except smoking was only bad for like 2 or 3 weeks....I was messed up from kicking effexor for almost 2 months

[@adrianwheeler1936]

Doctors are surprisingly uninformed and more often than not are highly lacking in empathy. There's a reason why positions of power tends to attract narcissists

[@georgieeve2026]

The only reason I still take Effexor is because of the side effects I get when I miss it or reduce the dose 😬

[@Chizuru94]

1:19:45 - Okay, that numbing effect from antidepressants regarding physical tissue was new for me and I never read about that from others (never took antidepressants myself and I choose not to for several reasons, them being a harm for ADHD people usually also or straight up not working included - and there are studies on pubmed over this also and they confirm this, btw). So that is interesting. And glad he'll release a book about things like these.

[@thomasdtrain]

This was a very interesting conversation. Thanks for sharing.

[@vanessam4980]

I’m really glad Dr. K asked such penetrating questions to Dr. Horowitz. However, in terms of clear bias, I would say Dr. K appeared to be the one less open to contradicting evidence and more defensive of his own practices/what was taught to him by mentors he clearly respects. His questions, to me, seemed more critical/“gotcha” type of questions (sort of like he’s trying to find ways to poke holes in Dr. Horowitz’s position, but with an attitude to discredit rather than to truly take in what he’s saying and consider it evenly) throughout the whole interview. On the patient side, I (and lots of other people, including those for whom SSRIs have improved their lives) have had the experience of going to a psychiatrist and very easily/immediately getting prescribed drugs, sometimes a cocktail of them, and getting into a cycle of taking them, them not working (or working then not working eventually), taking different ones, trial and error, dealing with side effects, then either resigning oneself to what little they offer (which is not more than placebo) or trying to get off them and REALLY going through a tough time. Dr. K, your bias in this interview is that you place a lot of your self-worth on making it into Harvard and Mass Gen, and also in being a successful medical doctor after your early failure, and therefore part of what he’s saying with passion (not a “crusade”- which implies unfounded fanaticism/intensity) and as an activist threatens *your* identity. Frankly, I’ve never seen you do an interview like this- where you invite someone to your stream and spend 2+ hours criticizing and minimizing everything they’re saying. Dr. Horowitz’s opinions and experiences aren’t fringe experiences. And he is indeed an MD/Ph.D- he likely knows more about this than you do, especially because the stakes have been so high for him. Someone who has battled treatment resistant depression for decades as he has wouldn’t caution against casual SSRI prescribing (or anything that could potentially work) lightly when the stakes of being wrong are literally life and death. Great informative interview, but I think some humility (and even empathy) would have gone a long way.

[@reallyanotheruser7290]

This interview was more like a academic discussion than a normal interview. As such it is important to detect and question possible caveats in the argumentation. Thats also part of the scientific process, you postulate a hypothesis and test it, you actively try to disprove it, and by being unable to disprove it youre showing that it is solid. Dr K is the one who takes Dr. Horowitz research into his clinical practice, so Dr K HAS to make sure that it is solid and that there are no obvious holes in the theorie. You dont trust any opinion blindly in academia just because it comes from someone who has done important research in the field. Especially if you inform your decisions on how to treat someone who is suicidal with it. That would be highly irresponsible. To the average internet viewer this interview might come across as unnecessarely confrontational, but it is very very important that it is like this. Also i think you are completely ignoring half of the story, which is that Dr K already has adapted his approach based on Dr Horowitz research and that he is highly supportive of it. One of the key things thats missing in all of online pseudoscience and people cherrypicking research to support their biased view is their inability to do exactly what Dr K did here. Questioning the very thing you agree with. And who is more qualified to clarify any ambiguities of a new theory than the very person who thought of that theory?

[@Chizuru94]

Yup. I was wondering what you meant, but when that started or earlier at around 1h 30m or smth, I noticed that weird shift in the air (also Dr. K's behavior, IF I am even right since I can't know ofc and all that). And now, it got kind of, well, uncomfortable to watch and like there is seemingly some tension there (even if there might not be)? Not sure how else to describe it, but I don't like this :(

[@Chizuru94]

@@reallyanotheruser7290 Yup, 100%. I think what they meant was also how it was asked and or the tone, though. I don't know, smth just seemed to shift a bit after halfway through the interview, kind of.

[@Hemlocker]

I agree to an extent, but I think you're exaggerating. I don't think Dr K comes across as more biased than Dr Horowitz, but also not really any less biased either. They both have their own perspective, and I was really glad when Dr Horowitz basically said (in a more polite way), "you're just as likely to be biased, because you have your own reputation and self-perception to uphold". I agree that the use of the word "crusade" was a bit strong, though I think that might have been the point. Overall, I think Dr K was just playing devil's advocate a lot, and taking the academic approach of trying to poke holes in a theory.

[@franjkav]

I don’t mind the devils advocate but Dr K was a bit too aggressive

[@UncutWarrior23]

I'm really glad you upload these 👍

[@outrohealth]

Thanks for having Dr. Horowitz on! 🙌

[@OfficialRogue]

I loved this talk, always a lot to learn from. Although I know it wasn't the focus of this stream or the studies mentioned, I wish they would've touched a little on depression in bipolar disorder since the mechanism seems very different (and mostly so is the treatment, when done right), yet at the same time bipolar depressive episodes are still viewed as MDD episodes, at least diagnostic criteria-wise (although they can be even more severe especially after crashing from mania/hypomania), given how similarly they present, I feel that it's relevant to include bipolar depression when talking about depression. It's interesting because on another stream, even Dr. K answered a question about bipolar disorder being different, in that there's still a strong case for a "chemical imbalance" hypothesis there, unlike classical depression, or at least that it's definitely an illness/disability, defined by such a tell-tale presentation of symptoms (i.e experiencing at least one hypomanic/manic episode), and much more dependent on genetic predisposition & hardwired brain circuitry rather than circumstance. Whereas a lot of things can fall into the (unipolar) "depression"/MDD bag, and they often get conflated ("feeling depressed"/subclinical depression, clinical/MDD, dysthymia, adjustment disorder, etc.), in this talk they are even talking about a different perspective, about whether we should even think of the latter as an inherent illness or not; which does not seem to apply to bipolar disorder (or a lot less so). I would be curious to know their take on it. While I do find the "numbing" theory about SSRIs compelling and justified, it feels less intuitive when thinking about how they can cause manic switches in bipolar (almost suggesting that they at some level they induce genuine activation, rather than the usual numbing mechanism). But I realize it's probably a lot more complicated than that (most likely coming down more to how the brains of people with bipolar react to these agents differently, rather than the inherent function of the chemical itself).

[@EM-fi6yq]

I think it's interesting that the general consensus is that antidepressants help because they numb your negative feelings. While I would describe my depression as being numb. I'm on my third type of antidepressant and it's the first time that my emotions have come back and with that, I can just feel sad instead of numb/depressed... Am I the only one who has experienced this the other way around?😅

[@annarose477]

Yeah listening to all this seemed to completely go against all my experience. I wouldn’t say it’s like your experience, but for me I had depression and anxiety. I have also been in therapy for PTSD for a few years and working really hard on working through all my traumas to the point where healed. I also exercised and ate well. I did everything but just still felt so exhausted all the time. I really struggled to keep exercising enough (but for the most part managed). I had no motivation. I wouldn’t say I felt sad, I just didn’t care and felt extremely unmotivated and also struggled to think clearly. I’ve been on an SSRI for 2 months now and my god… I can THINK again! I feel motivated. I feel great. I look forward to things again. I also cry in sad movies. I dunno, I definitely don’t feel numb. I feel like I just restarted my computer and all the software works again

[@KxNOxUTA]

Fantastic stream. It was challenging cause it was a lot of scientific discussion AND I absolutely loved that! Also, knowing Dr. K he'll also be repeating that stuff in even more digestible ways down the road! Cause it's bound to come up again

[@Remixed_Horizon]

I know this may be lost, but do you ever plan on posting the trauma workshop videos anyway? I know there are other people like me who love to listen to these for hours at a time (personally, I listen to them during my 10 hour shifts). It may not get as many views as other videos, but it would definitely be a great listen. Even if it has to be broken up into 2 hour videos each or something. Personally, I see no harm in posting them since it will be available for those who need it and/or will listen for that long and those who won't listen for that long or don't need it will just let it be.

[@Chizuru94]

Yup, antidepressants are sometimes given out like candy and without exploring much more about the why's and other stuff of a patient and other possible conditions. Not to mention those post-antidepressant effects that cause lasting numbness and more and last quite a few years or longer for some. It's irresponsible for stuff like this to keep going and being prescribed so easily etc.

[@followthewayTRUTHlife]

Yes, a neurologist gave out a tricyclic antidepressant for migraines. Totally numbed everything.

[@dewanacoffey]

This was a great show. We have so much more power over our health and mind than Doctors. I think your experience with Eastern Medicine combined with Your Western Medical Training is what makes you more open to knowing what is happening within the mind and body.

[@Chizuru94]

The book by Johann Hari Lost Connections as well as his TED talk is also highly recommended.

[@A_tiny_chihuahua]

Question: How does postpartum depression fit into this view? Would the idea just be that the stress of having a newborn triggers depression in some people? If that were the case, we'd expect to see similar rates of "postpartum" depression in parents who adopt infants at birth as we do for parents who raise their own biological infants from birth, and no postpartum depression in mothers who give up infants for adoption at birth. Is this true? Has this been tested? Great stream and interview, thank you both!

[@martinheidegger458]

Dr. K is a master of having conversations

[@elliexir9091]

I feel like one thing that isn’t mentioned is that someone who chooses to take antidepressants might have tried the alternatives before. If you’ve tried the exercise, mindfulness, therapy etc and none of them worked, it’s better to try an antidepressant than to give up on life, in my opinion. That has been my experience, I tried all the other stuff first, and I always roll my eyes when people talk about how effective exercise is for depression and how much better it is than to take SSRIs. If exercising fixes you, great!

[@cyndijohnson5473]

I got off antidepressants at the end of 2019. I had been on them over 10 years. It took a few years after that for sleep to begin to resemble normal, and another 2 to stop feeling emotionally blunted. Emotions are protective. Hiding from them or medicating them away is absolutely not a good solution.

[@BVEE-j3q]

Withdrawing from Xanax and effexor was the worst and I was cut cold turkey by my doctor.

[@Iliketurtlezz]

Its hell. I am in protracted withdrawal. Hope youre in a better place.

[@claireh.7605]

I was depressed because I kept avoiding buying a house; I took Lexapro and it made me go insane which got me evicted and sued, so once I was homeless, I was forced to buy a house which reduced the cause of my depression but now I have a broken brain with anger confusion and rage which I didn’t have before starting and stopping Lexapro cold turkey

[@Chizuru94]

For me, my depression - and I know that is not the case for everyone - usually does come back when my emotional needs are not met and my ADHD acts up worse again AND hormones. Hormones (and PMDD) play a massive role for me also. But dopamine as well (and less serotonin). My brother didn't even have any success with 5 antidepressants, those being SSRI's as well as SNRI's (?). But yeah, if we have a great time in life for a while (a few weeks to a month), the depression gets better, but as soon as smth bad happens or we get chronically stressed again, we become resistant to dopamine and feeling good and it goes to crap again. Not to mention all of us also have neurological disorders that also make us more prone to it, though, so yeah.

[@franjkav]

I wish there was more research on PMDD. I hate how much of my life is wasted on the most extreme agitation and severe increase in depression like clockwork every month. Most months my ADHD meds are basically not useful for up to those 3 days when that occurs. I’m completely dysfunctional and it takes an extreme amount of energy to not blow a gasket over the pettiest crap.

[@BOSSDONMAN]

Writing letters of complaints to the manufacturers (52:40), is he talking about his parents? Lol.

[@VioletEmerald]

I was thinking more a joke about a potential God.

[@therearenonameslefta]

SSRIs are extremely hard to come off of. It isn't that you can't. It's that coming off them (even if they aren't working) is going to fuck you up even worse than you already are.

[@FrostRare]

These manufacturers have blood on their hands. Hundreds of millions of ruined lives, shattered dreams, broken homes. This man is a beacon of hope.

[@Elephant_2024]

Thank you Dr Mark Horowitz and Dr K for your honesty.

[@susanmorgan4151]

Dr. Horowitz helped me so much in my journey to get off SSRI's. I have akathesia currently from Paxil withdrawal. Just verification that its real , was incredibly helpful!

[@MrMusashiMusashi]

Man, now I'm not sure if I should take the meds that were prescribed to me. The side effects freak me out, and I don't have the medical knowledge to figure it out on my own. The only people I can ask are the same people that would prescribe them in the first place.

[@brendan6778]

Starts at 7:11

[@Golgibaby]

Timestamp: 01:31:57 Therapeutic effect of psychotherapy in the prolonged and counterproductive use of a numbing therapeutic agent. You can't find the root nidus of psychological infection, drain the infection, and allow for proper healing.

[@kingfisher9553]

Had panic attacks (but didnt' know that's what it was at the time), depression and killer anxiety as a graduate student (full ride scholarship). I did no drugs (ever) and didn't drink alcohol (health choices/loved my mind and didn't want to fuck it up). But I was in bad shape emotionally/mentally at the time and needed some help. First drug prescribed was Lexapro, which was amazing for anxiety but within two weeks I knew I'd have to give it up (muscle tremors/nightmares). Next was fluoxetine and that was good enough and I never had withdrawal (quit cold turkey in the summer -- nobody mentioned seasonal affective disorder or vitamin D deficiency -- let alone the fact that graduate school was a waste of my time, didn't fit my goals, and put me in a culture that mirrored my worst experiences in childhood [among many other things, graduate advisor was sexually harassing me and threatening my scholarship]). Fast forward 20 years I'm diagnosed with CPTSD, ADHD and Epstein Barr -- all conditions I've had from childhood (Epstein Barr since 12). Well, that explains a lot. Also, can't absorb vitamin B9 from my diet well (that's a genetic issue many, many people have; see MTHFR Mutation - lucky I didn't have worse mental health conditions given that!). Antidepressants were never the right treatment. It was a lazy answer.

[@Kris-vb9uz]

I'm bad at responding to these forms of comments but good to hear of the improvements, I feel that society tells people that meds are a cure instead of just a tool to help manage the negative/taxing things.

[@Michael-jq5pf]

MTHFR gene mutations are often implicated in mental and physical health disorders but the science (and my own personal anecdotal experience) is very shaky around that. I only mention this because sometimes there are no good answers for people and they choose to use a tool like an SSRI or SNRI or DNRI or whatever. There's nothing wrong with that. That being said i agree fully the conventional medical system in the US (and I assume the rest of the western world to a good extent) is well adapted to giving lazy answers / "solutions" and avoiding the detective work involved in finding the underlying causes for issues, particularly mental health issues. Similarly patients also have trouble doing that, devoting the time and energy and money they likely don't have if they're working full time jobs they can't lose by attention to health, and are likely struggling to get by (aka most Americans) and can't afford appointment after appointment. Our medical and economic system does not facilitate healing for anyone but the upper class, period.

[@mrs.quills7061]

Seasonal affective disorder is real! I bought these glasses I wear in the morning as I live up north and it’s starting to be darker in the morning. I’d become a zombie for half the year and were expected to work and be on during a time that I feel is supposed to be a period of rest. Nature and everything else slows down, yet we can’t.

[@oahola237]

As someone who suffered from at least moderately severe depression for > 10 years (no meds), I have no doubt that it is just a series of indulgent and disempowering choices one makes about how to see the world and one's place in it. Because eventually as you bore of it and come out of it, you wake up and realize that the only escape is to once again make a choice, this time in a different direction. As you sober up you are confronted with the quality of your thinking and the consequences of your conclusions. Then you either decide to just let it go or not.

[@lisam2036]

Delays in withdrawal symptoms is a huge takeaway.

[@taylormann93]

Is there a way to book an online appointment with you dr. K. I live all the way down south and you are located in boston from my current understanding. Any info would be appreciated.

[@charlesminckler2978]

Therapy might be economically viable in UK and EU, but in the US, therapy is expensive. Even with insurance, copays add up fast.

[@anamembrives3411]

I don't know about the UK, but in Spain for example it's difficult to access a psychologist because it's quite expensive. We have "social security", but it's functioning well because you have to wait a lot to one appointment and they're so overworked that you don't receive good attention.

[@anamg3708]

I've lived in Spain, UK and Belgium and therapy is always expensive. I don't know if it's considerably more expensive in the US but here I could not call it affordable

[@Lenci_the_Nugget]

I've gotten to a better point in my life and am currently stopping my SSRI on a schedule my doctor gave me. Even with that medical advice, it sucks 🥴 The symptoms are pretty uncomfortable and I wasn't even on a high dose. You know that feeling you get if you start falling asleep on the couch and your head nods forward? I've got that same kind of weird dizzy/exhausted feeling in waves, all day long. Idk how people do this while doing normal life stuff like working or going to school. I'm lucky that I just graduated and had a good time to stop, because this and the other symptoms are exhausting!

[@Alex-js5lg]

I had "brain zaps" when I stopped venlafaxine. Each time I moved my eyes, my brain felt the way my tongue does when I touch it to a new 9V battery. This lasted for a few days, then faded over the course of a couple weeks. I couldn't imagine dealing with that for weeks or months.

[@nocando89]

Yeah that's not the best med but just saying that anecdotally...

[@ClassyJohn]

my psychotherapist keeps pushing me to take antidepressants because he thinks I have Major Depressive Disorder (MDD) but I’m too concerned about the side effects and withdrawal effects. I have C-PTSD as well so he thinks me taking antidepressants will greatly help his treatment. I will NEVER take antidepressants. I am doing other stuff like exercising more (I went from sedentary lifestyle to 3 times at the gym a week), eating healthier, obviously therapy, and I am trying to seek other alternative ways to improve.

[@lesleysears9808]

Try mediation like Dr. K suggests ❤

[@08ADLa]

No matter how hard he pushes it don’t take em man, they really fuck you up iv been on 3 different antidepressants and had terrible experiences with each one, my first one was lexapro then I was moved onto fleuxotine and then desvenlafaxine, everything this dr describes is spot fukin on, I was in the Australian mental health system for 2 years and it was the biggest waste of life and time, it ended up making me way worse actually because I had psychiatrists and therapists seriously pushing these drugs onto me, they put you into these systems and they tell you all these great things there gonna “help” you with but every session I had with my therapist was just a drag and everything they said they would do they didn’t but instead glorifying these drugs and making it sound like the sole solution to my problems, I had gone thru a lot and i knew what was right and wrong, fact is these government run clinics are scams to you’re mental health and they will seriously twist you’re mind, for love of god man please do not take any of these antidepressants, they are seriously bad news and cause alot of problems, take it from someone who has done these drugs and been thru the system, im not sure what country you’re based in but in Australia this kind of stuff is a serious serious issue!! Good luck to you my friend 🙏

[@Hemlocker]

@@lesleysears9808 There is one very important letter missing here... medication, or meditation? 😂

[@jameelhill9503]

Dose he agree with you that %50 of people nave negative side affects ot dose he just go off by what he had one class on in med school and what reps tell him.

[@ClassyJohn]

@@jameelhill9503 full transparency, i stopped seeing this therapist because it was clear that their therapy was not helping me. Regarding medication, he never mentioned the side effects or statistics around negative affects on people who take them. He kept saying “its like if you have diabetes and are taking insulin shots”. All he said to me after was that I should talk to a psychology about taking medication. He would bring up statistics on how patients who took a combination of therapy and medication saw a benefit (although the researched showed that it was marginally better than therapy alone). I talked to a psychologist and asked about the effects and they said that it depends on the dosage and how long the patient is on the meds. I go back to my therapist and honestly, this guy didn’t seem to care what I thought about putting medication in my body. He refrained from giving me medical advice because hes not qualified to speak on it.

[@saryl_]

I absolutely agree that depression requires much more than drugs to manage, but this conversation made me a little uncomfortable. I see Horowitz's study get shared *a lot* in antipsych circles to convince people to go off (or not start) their medications - I have concerns about broadcasting his work without including a lot of caveats. Anecdotally, many of us get put on SSRIs when our symptoms start, find they don't work, and end up on something later that does work - for me, I got diagnosed a couple decades after I got put on my first SSRI with bipolar disorder and finally ended up on a medication (not an SSRI) that changed my life. If I'd seen Horowitz's study back then when SSRIs weren't working for me, I never would've continued pursuing treatment. Less anecdotally, and as Dr. K mentioned, SSRIs do help some, even if they only stay on them temporarily. Plenty of people use SSRIs as they're going through therapy, reach a point where they've learned to manage whatever's happening to them, and go off the medication - and that's perfectly valid. Horowitz's research is important (although I encourage you to go read the opposing articles out there as well), but it needs to be approached and shared with a lot of nuance.

[@austinz9310]

I’m not sure why his work should be delivered with a million caveats when SSRIs have been given out like candy for decades with any nuance at all. The work pushing back against SSRIs should be pushed far and wide in my opinion. You and anyone interested should look into Irving Kirsch’s meta-analysis of all SSRI studies. It’s now been shown that perhaps ALL positive effects of SSRIs can be attributed to the placebo effect. The placebo effect makes people uncomfortable but it’s very real and very powerful. Because of this many clinicians and patients have seen SSRIs “work” but I truly believe that they do not work.

[@sabrinusglaucomys]

I think the better solution for this would be for doctors to stop prescribing SSRIs to everyone as a first-line treatment for practically any mental health condition? You wouldn't have been at risk of being turned off all psych treatment if you hadn't been prescribed a med with such poor evidence for its efficacy in the first place.

[@sabrinusglaucomys]

If I'm understanding correctly, it also seems like part of the problem in your case is that you didn't have an accurate diagnosis *before* they started prescribing you meds. I find it troubling that SSRIs are seen as a short-cut to skip actually understanding an individual's problems, instead just throwing something at them that might work (or might do more harm than good). Dr. K. talks about how that's only going to get worse with the increasing shortage of psychiatrists (though to him he doesn't think it's a bad thing but a reasonable way to try helping people).

[@syl59281]

@@austinz9310 Just because one person (or system) doesn't use nuance doesn't mean we shouldn't use nuance. Nuance is important regardless of how much nuance others have used in the past

[@sabrinusglaucomys]

Sorry for so many replies, but I think another important point here is about people being able to make their own choices--if you had decided that psych meds weren't for you based on your assessment of the risks and benefits, you might never have gotten on that life-changing medicine. But that would have been *your choice*, and it wouldn't have been due to lack of exposure to claims that psych meds are helpful. We shouldn't assume that maximizing the number of treatments that patients try, to hopefully help them hit on something with a clinically significant positive benefit and at most tolerable side effects, is the outcome we're striving for. It's more important that people have autonomy over their own lives, and that includes choosing to associate with anti-psych circles. (That said, your general call to share information with nuance and to share articles on both sides of the debate is certainly in line with patient autonomy.)

[@XCeazyX]

viewers, please view this for what it is, a discussion between two people involved/adjacent to the industry about less-than theories. do not take this as gospel that one side or the other is right "for sure."