Big Pharma's Trillion Dollar Deception on Mental Health | Joanna Moncrief

What I object to most [music] about What I object to most [music] about telling people that they've got a telling people that they've got a telling people that they've got a chemical imbalance is that that is a chemical imbalance is that that is a chemical imbalance is that that is a really depressing message. That's really depressing message. That's really depressing message. That's telling people there's something wrong telling people there's something wrong telling people there's something wrong with your brain. There's nothing [music] with your brain. There's nothing [music] with your brain. There's nothing [music] you can do about it. You've got to rely you can do about it. You've got to rely you can do about it. You've got to rely on, you know, someone giving you a drug. on, you know, someone giving you a drug. on, you know, someone giving you a drug. just correcting [music] that mistake and just correcting [music] that mistake and just correcting [music] that mistake and informing people that there isn't informing people that there isn't informing people that there isn't something wrong with their [music] something wrong with their [music] something wrong with their [music] brains and that they do have the brains and that they do have the brains and that they do have the capacity to improve, to recover, to capacity to improve, to recover, to capacity to improve, to recover, to change is is [music] actually a positive change is is [music] actually a positive change is is [music] actually a positive and a hopeful message. and a hopeful message. and a hopeful message. >> Before we begin, I'd like to note that >> Before we begin, I'd like to note that >> Before we begin, I'd like to note that today's conversation explores one today's conversation explores one today's conversation explores one perspective of an area of medicine that perspective of an area of medicine that perspective of an area of medicine that continues to be actively debated. And continues to be actively debated. And continues to be actively debated. And while we discussed emerging evidence and while we discussed emerging evidence and while we discussed emerging evidence and critiques of current psychiatric critiques of current psychiatric critiques of current psychiatric practice, treatment decisions, practice, treatment decisions, practice, treatment decisions, especially involving anti-depressants or especially involving anti-depressants or especially involving anti-depressants or other prescription medications, should other prescription medications, should other prescription medications, should always be made in consultation with your always be made in consultation with your always be made in consultation with your healthcare provider. The views expressed healthcare provider. The views expressed healthcare provider. The views expressed by my guest are her own and reflect her by my guest are her own and reflect her by my guest are her own and reflect her interpretation of the available interpretation of the available interpretation of the available evidence. My goal in hosting evidence. My goal in hosting evidence. My goal in hosting conversations like this is to explore conversations like this is to explore conversations like this is to explore different perspectives, to examine the different perspectives, to examine the different perspectives, to examine the science, to encourage thoughtful science, to encourage thoughtful science, to encourage thoughtful discussion, not to provide discussion, not to provide discussion, not to provide individualized medical advice. So, if individualized medical advice. So, if individualized medical advice. So, if you're currently taking medication, you're currently taking medication, you're currently taking medication, please don't stop or change your please don't stop or change your please don't stop or change your treatment based on this conversation treatment based on this conversation treatment based on this conversation alone. Instead, use this episode as a alone. Instead, use this episode as a alone. Instead, use this episode as a starting point for an informed starting point for an informed starting point for an informed conversation with your healthcare team. conversation with your healthcare team. conversation with your healthcare team. My hope is that these discussions My hope is that these discussions My hope is that these discussions encourage curiosity, critical thinking, encourage curiosity, critical thinking, encourage curiosity, critical thinking, and shared decision-m between patients and shared decision-m between patients and shared decision-m between patients and their clinicians. Well, Joan, it's and their clinicians. Well, Joan, it's and their clinicians. Well, Joan, it's great to have you on the podcast. great to have you on the podcast. great to have you on the podcast. [music] Thanks for joining us today. [music] Thanks for joining us today. [music] Thanks for joining us today. >> Thanks for inviting me, Mark. Really >> Thanks for inviting me, Mark. Really >> Thanks for inviting me, Mark. Really excited to talk to you. excited to talk to you. excited to talk to you. >> I'm excited to talk to you because I >> I'm excited to talk to you because I >> I'm excited to talk to you because I think our our intellectual history is think our our intellectual history is think our our intellectual history is very similar. We were just chatting very similar. We were just chatting very similar. We were just chatting before [music] the podcast and a lot of before [music] the podcast and a lot of before [music] the podcast and a lot of the seinal books in psychiatry we both the seinal books in psychiatry we both the seinal books in psychiatry we both read and they were really around read and they were really around read and they were really around challenging the orthodoxy and our way of challenging the orthodoxy and our way of challenging the orthodoxy and our way of thinking about mental illness and how we thinking about mental illness and how we thinking about mental illness and how we approach it and I think hopefully this approach it and I think hopefully this approach it and I think hopefully this conversation will sort of help us conversation will sort of help us conversation will sort of help us understand some of the challenges we're understand some of the challenges we're understand some of the challenges we're facing around our framing of mental facing around our framing of mental facing around our framing of mental illness our understanding of sort of illness our understanding of sort of illness our understanding of sort of some of the myths out there that are some of the myths out there that are some of the myths out there that are propagated that I think undermine uh propagated that I think undermine uh propagated that I think undermine uh people's public health and mental health people's public health and mental health people's public health and mental health the title of your book is is really the title of your book is is really the title of your book is is really really provocative chemical imbalance really provocative chemical imbalance really provocative chemical imbalance the making and unmaking of the serotonin the making and unmaking of the serotonin the making and unmaking of the serotonin myth which is going to probably strike myth which is going to probably strike myth which is going to probably strike people like wait a minute I thought people like wait a minute I thought people like wait a minute I thought depression was about a serotonin depression was about a serotonin depression was about a serotonin deficiency and Prozac was about actually deficiency and Prozac was about actually deficiency and Prozac was about actually helping fix that and my joke is that a helping fix that and my joke is that a helping fix that and my joke is that a depression is not a Prozac deficiency depression is not a Prozac deficiency depression is not a Prozac deficiency right [laughter] right [laughter] right [laughter] and so I think your your central and so I think your your central and so I think your your central argument is really this whole chemical argument is really this whole chemical argument is really this whole chemical imbalance theory is it doesn't actually imbalance theory is it doesn't actually imbalance theory is it doesn't actually hold up when you look at it objectively hold up when you look at it objectively hold up when you look at it objectively scientifically and you're research scientifically and you're research scientifically and you're research scientist and you look at these issues scientist and you look at these issues scientist and you look at these issues objectively, you look at them objectively, you look at them objectively, you look at them dispassionately and uh and you're not um dispassionately and uh and you're not um dispassionately and uh and you're not um sort of ideologically driven, you're sort of ideologically driven, you're sort of ideologically driven, you're just driven by the science. And I think just driven by the science. And I think just driven by the science. And I think I I find that very refreshing and also I I find that very refreshing and also I I find that very refreshing and also this is a big problem because when we this is a big problem because when we this is a big problem because when we look at anti-depressants as a class of look at anti-depressants as a class of look at anti-depressants as a class of drugs and depression is probably the drugs and depression is probably the drugs and depression is probably the most prevalent mental illness, it's $20 most prevalent mental illness, it's $20 most prevalent mental illness, it's $20 billion a year globally that's spent on billion a year globally that's spent on billion a year globally that's spent on this. and your your thesis is this. and your your thesis is this. and your your thesis is essentially that they don't really work essentially that they don't really work essentially that they don't really work [laughter] [laughter] [laughter] and in a few cases in some cases they and in a few cases in some cases they and in a few cases in some cases they can be helpful but that maybe it's can be helpful but that maybe it's can be helpful but that maybe it's mostly driven by placebo. I I kind of mostly driven by placebo. I I kind of mostly driven by placebo. I I kind of want to dive into this conversation with want to dive into this conversation with want to dive into this conversation with you because we really are um at at a you because we really are um at at a you because we really are um at at a crisis. I think we're seeing more and crisis. I think we're seeing more and crisis. I think we're seeing more and more mental illness. We're seeing less more mental illness. We're seeing less more mental illness. We're seeing less effective approaches to it. And uh you effective approaches to it. And uh you effective approaches to it. And uh you know, we keep trying to apply, you know, know, we keep trying to apply, you know, know, we keep trying to apply, you know, like we say, if all you have is a like we say, if all you have is a like we say, if all you have is a hammer, everything looks like a nail and hammer, everything looks like a nail and hammer, everything looks like a nail and and we're, you know, we we think and we're, you know, we we think and we're, you know, we we think someone's depressed, everybody needs a someone's depressed, everybody needs a someone's depressed, everybody needs a an SSRI or an antresscent. But you uh an SSRI or an antresscent. But you uh an SSRI or an antresscent. But you uh actually have sort of looked at this actually have sort of looked at this actually have sort of looked at this broken paradigm very carefully and and broken paradigm very carefully and and broken paradigm very carefully and and sort of have unmasked this myth of quote sort of have unmasked this myth of quote sort of have unmasked this myth of quote chemical imbalance as a root cause of chemical imbalance as a root cause of chemical imbalance as a root cause of mental illness and the serotonin myth. mental illness and the serotonin myth. mental illness and the serotonin myth. And you you did a 2022 review, a And you you did a 2022 review, a And you you did a 2022 review, a landmark review that looked at all the landmark review that looked at all the landmark review that looked at all the data and you found that there's no no data and you found that there's no no data and you found that there's no no consistent evidence that depression is consistent evidence that depression is consistent evidence that depression is caused by low serotonin. Like we now can caused by low serotonin. Like we now can caused by low serotonin. Like we now can study this there's there's ways of study this there's there's ways of study this there's there's ways of objectively scientifically measuring objectively scientifically measuring objectively scientifically measuring this. So I you know if if there's no this. So I you know if if there's no this. So I you know if if there's no evidence that this is true, how how did evidence that this is true, how how did evidence that this is true, how how did this idea get established in our psyche? this idea get established in our psyche? this idea get established in our psyche? I I I did the research because I was I I I did the research because I was I I I did the research because I was aware that the majority of people aware that the majority of people aware that the majority of people thought that the link between serotonin thought that the link between serotonin thought that the link between serotonin and depression was an established fact and depression was an established fact and depression was an established fact and yet I knew that probably the and yet I knew that probably the and yet I knew that probably the majority of psychiatrists and doctors majority of psychiatrists and doctors majority of psychiatrists and doctors knew that actually it was a theory and knew that actually it was a theory and knew that actually it was a theory and that there was maybe a bit of evidence that there was maybe a bit of evidence that there was maybe a bit of evidence for it but probably a bit of for it but probably a bit of for it but probably a bit of contradictory evidence too. And in fact, contradictory evidence too. And in fact, contradictory evidence too. And in fact, there hadd been people saying that the there hadd been people saying that the there hadd been people saying that the theory of that that depression is caused theory of that that depression is caused theory of that that depression is caused by low serotonin wasn't really supported by low serotonin wasn't really supported by low serotonin wasn't really supported by evidence for quite a few years. There by evidence for quite a few years. There by evidence for quite a few years. There was a paper published in 2005 suggesting was a paper published in 2005 suggesting was a paper published in 2005 suggesting that, but there was nowhere that you that, but there was nowhere that you that, but there was nowhere that you could really point to um to say, oh, you could really point to um to say, oh, you could really point to um to say, oh, you know, there's an overview of the know, there's an overview of the know, there's an overview of the evidence and it shows that really it evidence and it shows that really it evidence and it shows that really it doesn't stack up. So that's why we um doesn't stack up. So that's why we um doesn't stack up. So that's why we um you know that's that's why we did that you know that's that's why we did that you know that's that's why we did that review of the research on serotonin and review of the research on serotonin and review of the research on serotonin and depression that you mentioned that was depression that you mentioned that was depression that you mentioned that was published in 2022. So where does this published in 2022. So where does this published in 2022. So where does this idea come from? Um idea come from? Um idea come from? Um its origins are in the 1960s. its origins are in the 1960s. its origins are in the 1960s. It was first proposed by psychiatrists It was first proposed by psychiatrists It was first proposed by psychiatrists and and people doing research on drugs and and people doing research on drugs and and people doing research on drugs that they were proposing might be that they were proposing might be that they were proposing might be anti-depressants anti-depressants anti-depressants back then. um that depression might be back then. um that depression might be back then. um that depression might be caused by a lack of noradrenaline or caused by a lack of noradrenaline or caused by a lack of noradrenaline or serotonin. Serotonin and noradrenine are serotonin. Serotonin and noradrenine are serotonin. Serotonin and noradrenine are both chemicals that are found in the both chemicals that are found in the both chemicals that are found in the brain and transmit nervous impulses brain and transmit nervous impulses brain and transmit nervous impulses between nerve cells. They're what we between nerve cells. They're what we between nerve cells. They're what we call neurotransmitters. call neurotransmitters. call neurotransmitters. So it was proposed back then there might So it was proposed back then there might So it was proposed back then there might be an abn abnormality of one of those be an abn abnormality of one of those be an abn abnormality of one of those chemicals that might be involved in chemicals that might be involved in chemicals that might be involved in depression. But it it wasn't sort of depression. But it it wasn't sort of depression. But it it wasn't sort of widely popularized. It was you know it widely popularized. It was you know it widely popularized. It was you know it was a theory that was circulating within was a theory that was circulating within was a theory that was circulating within psychiatry and within you know aca ac psychiatry and within you know aca ac psychiatry and within you know aca ac academic research circles. There was a academic research circles. There was a academic research circles. There was a lot of research done to look into it in lot of research done to look into it in lot of research done to look into it in the 1970s sponsored by the US um the 1970s sponsored by the US um the 1970s sponsored by the US um national institute for mental health and national institute for mental health and national institute for mental health and that didn't report any findings and I that didn't report any findings and I that didn't report any findings and I would assume therefore didn't find would assume therefore didn't find would assume therefore didn't find evidence of any abnormalities. evidence of any abnormalities. evidence of any abnormalities. So it so it was sort of you know going So it so it was sort of you know going So it so it was sort of you know going into decline. The idea was going into into decline. The idea was going into into decline. The idea was going into decline in the 1980s and then the decline in the 1980s and then the decline in the 1980s and then the pharmaceutical industry recruited the pharmaceutical industry recruited the pharmaceutical industry recruited the idea to market their new range of drugs idea to market their new range of drugs idea to market their new range of drugs the SSRI anti-depressants which they the SSRI anti-depressants which they the SSRI anti-depressants which they brought out at the end of the 1980s. brought out at the end of the 1980s. brought out at the end of the 1980s. Prozac was the first one that you Prozac was the first one that you Prozac was the first one that you mentioned earlier and then there were a mentioned earlier and then there were a mentioned earlier and then there were a range of other others that were brought range of other others that were brought range of other others that were brought in in the 1990s in in the 1990s in in the 1990s and the industry wanted to persuade and the industry wanted to persuade and the industry wanted to persuade people that these drugs were different people that these drugs were different people that these drugs were different from the old benzoazipines. They weren't from the old benzoazipines. They weren't from the old benzoazipines. They weren't just numbing you or tranquilizing you. just numbing you or tranquilizing you. just numbing you or tranquilizing you. They were doing something really They were doing something really They were doing something really important. They were targeting that you important. They were targeting that you important. They were targeting that you had an abnormality in your brain and had an abnormality in your brain and had an abnormality in your brain and they were going to target that and put they were going to target that and put they were going to target that and put it right. And that bzzodazzipene is like it right. And that bzzodazzipene is like it right. And that bzzodazzipene is like a volume. And that was a big drug in the a volume. And that was a big drug in the a volume. And that was a big drug in the 60s that was used for almost every 60s that was used for almost every 60s that was used for almost every housewife in America as a way of just housewife in America as a way of just housewife in America as a way of just keeping them calm and subdued and keeping them calm and subdued and keeping them calm and subdued and sedated. But that's that that's that's sedated. But that's that that's that's sedated. But that's that that's that's that big class of drug. So that was that that big class of drug. So that was that that big class of drug. So that was that was the first psychiatric drug really. was the first psychiatric drug really. was the first psychiatric drug really. >> Yeah. Yeah. And that they they were >> Yeah. Yeah. And that they they were >> Yeah. Yeah. And that they they were enormously popular, very widely enormously popular, very widely enormously popular, very widely prescribed, but they'd got a very bad prescribed, but they'd got a very bad prescribed, but they'd got a very bad reputation by by the mid [clears throat] reputation by by the mid [clears throat] reputation by by the mid [clears throat] 1980s because it became clear that they 1980s because it became clear that they 1980s because it became clear that they were highly dependence inducing were highly dependence inducing were highly dependence inducing substances. So the pharmaceutical substances. So the pharmaceutical substances. So the pharmaceutical industry wanted to put clear water industry wanted to put clear water industry wanted to put clear water between the benzodioipines and their new between the benzodioipines and their new between the benzodioipines and their new drugs. And so they came up with this drugs. And so they came up with this drugs. And so they came up with this idea, persuade people they've got this idea, persuade people they've got this idea, persuade people they've got this chemical imbalance and they need to take chemical imbalance and they need to take chemical imbalance and they need to take the drug to rectify this. They need to the drug to rectify this. They need to the drug to rectify this. They need to take it in a medical sense to put take it in a medical sense to put take it in a medical sense to put something right in their uh in in their something right in their uh in in their something right in their uh in in their biology, in their brain biology. biology, in their brain biology. biology, in their brain biology. So that's where it came from. And you So that's where it came from. And you So that's where it came from. And you know they they they just put so much know they they they just put so much know they they they just put so much money into marketing these drugs. That money into marketing these drugs. That money into marketing these drugs. That message was said again and again and message was said again and again and message was said again and again and again in advertisements in on on online again in advertisements in on on online again in advertisements in on on online sites. It was supported by medical sites. It was supported by medical sites. It was supported by medical institutions who also told people that institutions who also told people that institutions who also told people that depression was caused by a chemical depression was caused by a chemical depression was caused by a chemical imbalance. And there was never really imbalance. And there was never really imbalance. And there was never really any good strong evidence to support it. any good strong evidence to support it. any good strong evidence to support it. And yet it, you know, it caught on And yet it, you know, it caught on And yet it, you know, it caught on because it was just so widely because it was just so widely because it was just so widely disseminated. It's true, you know, and I disseminated. It's true, you know, and I disseminated. It's true, you know, and I think, you know, when you're a busy think, you know, when you're a busy think, you know, when you're a busy doctor and these drug reps come in and doctor and these drug reps come in and doctor and these drug reps come in and they and I remember this [laughter] and they and I remember this [laughter] and they and I remember this [laughter] and I was in practice, you know, early on, I was in practice, you know, early on, I was in practice, you know, early on, they'd come in and they'd have their they'd come in and they'd have their they'd come in and they'd have their scientific papers and they'd have all scientific papers and they'd have all scientific papers and they'd have all their SL, you know, so there's their their SL, you know, so there's their their SL, you know, so there's their slides and their graphics and their slides and their graphics and their slides and their graphics and their impressive data and, you know, they and impressive data and, you know, they and impressive data and, you know, they and you're you don't always have time to you're you don't always have time to you're you don't always have time to read all the literature as a doctor. read all the literature as a doctor. read all the literature as a doctor. You're sort of going, "Okay, this makes You're sort of going, "Okay, this makes You're sort of going, "Okay, this makes sense. My patients are suffering. This sense. My patients are suffering. This sense. My patients are suffering. This sounds like a good idea." But it turned sounds like a good idea." But it turned sounds like a good idea." But it turned out there was just very little evidence out there was just very little evidence out there was just very little evidence that it actually worked. And when you that it actually worked. And when you that it actually worked. And when you look at the studies that they they kind look at the studies that they they kind look at the studies that they they kind of are rigged, I would say rigged in of are rigged, I would say rigged in of are rigged, I would say rigged in many ways. The way they design them, the many ways. The way they design them, the many ways. The way they design them, the way they do them, you know, that they way they do them, you know, that they way they do them, you know, that they the way they try to, you know, control the way they try to, you know, control the way they try to, you know, control the outcomes and write them up. And the, the outcomes and write them up. And the, the outcomes and write them up. And the, you know, when I started looking into you know, when I started looking into you know, when I started looking into this, when I wrote my book, The Ultra this, when I wrote my book, The Ultra this, when I wrote my book, The Ultra Mind Solution in in the mid 2000s, I I Mind Solution in in the mid 2000s, I I Mind Solution in in the mid 2000s, I I was shocked to find that, you know, the was shocked to find that, you know, the was shocked to find that, you know, the there was very little evidence that there was very little evidence that there was very little evidence that these actually worked and they didn't these actually worked and they didn't these actually worked and they didn't really work much more than placebo for really work much more than placebo for really work much more than placebo for mild to moderate depression. And and yet mild to moderate depression. And and yet mild to moderate depression. And and yet they were being prescribed like water. they were being prescribed like water. they were being prescribed like water. >> I think one of the reasons that idea >> I think one of the reasons that idea >> I think one of the reasons that idea about the chemical imbalance and the about the chemical imbalance and the about the chemical imbalance and the drugs correcting it caught on is because drugs correcting it caught on is because drugs correcting it caught on is because is because it's so simple. you know, it is because it's so simple. you know, it is because it's so simple. you know, it it it it's yeah, it seems to make sense it it it's yeah, it seems to make sense it it it's yeah, it seems to make sense and you can show it with these nice and you can show it with these nice and you can show it with these nice diagrams. And so, I think it was sort of diagrams. And so, I think it was sort of diagrams. And so, I think it was sort of really compelling both for doctors and really compelling both for doctors and really compelling both for doctors and for patients or potential patients. But for patients or potential patients. But for patients or potential patients. But you're right, the the actual trials that you're right, the the actual trials that you're right, the the actual trials that were set up to demonstrate that were set up to demonstrate that were set up to demonstrate that anti-depressants were effective really anti-depressants were effective really anti-depressants were effective really show that they have little benefit. They show that they have little benefit. They show that they have little benefit. They are minimally different from a placebo. are minimally different from a placebo. are minimally different from a placebo. um you know and that's that's just um you know and that's that's just um you know and that's that's just taking them as they are set up but then taking them as they are set up but then taking them as they are set up but then as you say they're actually rigged in as you say they're actually rigged in as you say they're actually rigged in various ways. They recruit people who various ways. They recruit people who various ways. They recruit people who often want some sort of drug treatment. often want some sort of drug treatment. often want some sort of drug treatment. So so they're they're hoping to get it. So so they're they're hoping to get it. So so they're they're hoping to get it. They're not completely double blind. They're not completely double blind. They're not completely double blind. That means that the people the people That means that the people the people That means that the people the people getting the the real drug and the people getting the the real drug and the people getting the the real drug and the people getting the placebo tablet are not meant getting the placebo tablet are not meant getting the placebo tablet are not meant to know what they're getting. Of course to know what they're getting. Of course to know what they're getting. Of course that's the whole point of these studies. that's the whole point of these studies. that's the whole point of these studies. But actually people can often tell But actually people can often tell But actually people can often tell because taking, you know, because taking, you know, because taking, you know, anti-depressants are active drugs. anti-depressants are active drugs. anti-depressants are active drugs. They're not just dummy tablets and they They're not just dummy tablets and they They're not just dummy tablets and they make people feel different, have side make people feel different, have side make people feel different, have side effects. They give you a dry mouth. They effects. They give you a dry mouth. They effects. They give you a dry mouth. They might make you feel a bit sick. Um, and might make you feel a bit sick. Um, and might make you feel a bit sick. Um, and they might make you feel, you know, they might make you feel, you know, they might make you feel, you know, mentally a little bit different or a lot mentally a little bit different or a lot mentally a little bit different or a lot different depending on on the drug. different depending on on the drug. different depending on on the drug. They're they're, you know, they have They're they're, you know, they have They're they're, you know, they have very varied effects, different very varied effects, different very varied effects, different anti-depressants. anti-depressants. anti-depressants. And so they're not properly blinded. And And so they're not properly blinded. And And so they're not properly blinded. And the people who get the real drug, get the people who get the real drug, get the people who get the real drug, get some side effects, think, "Wow, I've got some side effects, think, "Wow, I've got some side effects, think, "Wow, I've got the real thing. That's great." So, they the real thing. That's great." So, they the real thing. That's great." So, they probably get uh, you know, an additional probably get uh, you know, an additional probably get uh, you know, an additional placebo effect, what we might call an placebo effect, what we might call an placebo effect, what we might call an amplified placebo effect. Uh, and that amplified placebo effect. Uh, and that amplified placebo effect. Uh, and that in my view easily accounts for the very in my view easily accounts for the very in my view easily accounts for the very small difference that you're seeing small difference that you're seeing small difference that you're seeing between the drugs and the uh, placebo between the drugs and the uh, placebo between the drugs and the uh, placebo substances. substances. substances. So yeah, not really don't have many So yeah, not really don't have many So yeah, not really don't have many benefits. But but but I think it's benefits. But but but I think it's benefits. But but but I think it's important to say that's not that doesn't important to say that's not that doesn't important to say that's not that doesn't mean they are placeos. They are active mean they are placeos. They are active mean they are placeos. They are active drugs. They do have side effects. They drugs. They do have side effects. They drugs. They do have side effects. They do have effects. I mean they do affect do have effects. I mean they do affect do have effects. I mean they do affect people's emotions. Most anti-depressants people's emotions. Most anti-depressants people's emotions. Most anti-depressants seem to produce this sort of an seem to produce this sort of an seem to produce this sort of an emotional numbing state, state of emotional numbing state, state of emotional numbing state, state of emotional numbness. emotional numbness. emotional numbness. um which in theory might be helpful if um which in theory might be helpful if um which in theory might be helpful if someone's intensely sad or intensely someone's intensely sad or intensely someone's intensely sad or intensely stressed. stressed. stressed. On the other hand, lots of people don't On the other hand, lots of people don't On the other hand, lots of people don't like that feeling of numbness. And it's like that feeling of numbness. And it's like that feeling of numbness. And it's it doesn't seem likely that that's it doesn't seem likely that that's it doesn't seem likely that that's really going to be helpful to people in really going to be helpful to people in really going to be helpful to people in the long run to sort out their their the long run to sort out their their the long run to sort out their their problems if they can't feel anything, problems if they can't feel anything, problems if they can't feel anything, you know, they can't feel happiness or you know, they can't feel happiness or you know, they can't feel happiness or or um or joy anymore either. But but or um or joy anymore either. But but or um or joy anymore either. But but this the trials suggest that it it's not this the trials suggest that it it's not this the trials suggest that it it's not really that useful anyway because really that useful anyway because really that useful anyway because there's so little difference between the there's so little difference between the there's so little difference between the anti-depressants and the placebo. anti-depressants and the placebo. anti-depressants and the placebo. >> Have you ever climbed into bed exhausted >> Have you ever climbed into bed exhausted >> Have you ever climbed into bed exhausted but your body just won't switch off? but your body just won't switch off? but your body just won't switch off? Your mind keeps racing, your muscles Your mind keeps racing, your muscles Your mind keeps racing, your muscles feel tight, and you can't fully relax. feel tight, and you can't fully relax. feel tight, and you can't fully relax. 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Well, it seems even worse than that Well, it seems even worse than that Well, it seems even worse than that because here you're promising somebody a because here you're promising somebody a because here you're promising somebody a drug to correct something that this a drug to correct something that this a drug to correct something that this a myth that doesn't really work and comes myth that doesn't really work and comes myth that doesn't really work and comes with a whole host of problems which is with a whole host of problems which is with a whole host of problems which is you know anhidonia like you basically you know anhidonia like you basically you know anhidonia like you basically get these feelings of numbness and get these feelings of numbness and get these feelings of numbness and emotional numbing and also sexual emotional numbing and also sexual emotional numbing and also sexual dysfunction and low libido and how does dysfunction and low libido and how does dysfunction and low libido and how does that affect relationships and how does that affect relationships and how does that affect relationships and how does that cause even more depression? It's that cause even more depression? It's that cause even more depression? It's sort of like a vicious cycle. sort of like a vicious cycle. sort of like a vicious cycle. >> Yeah. It's just unbelievable, isn't it? >> Yeah. It's just unbelievable, isn't it? >> Yeah. It's just unbelievable, isn't it? that we're giving people things for that we're giving people things for that we're giving people things for depression that actually are going to, depression that actually are going to, depression that actually are going to, you know, numb numb your sex drive, you know, numb numb your sex drive, you know, numb numb your sex drive, interfere with your sexual functioning. interfere with your sexual functioning. interfere with your sexual functioning. They're going to make your life worse. They're going to make your life worse. They're going to make your life worse. In other words, In other words, In other words, >> and then they're and then they're really >> and then they're and then they're really >> and then they're and then they're really hard to get off of. They're not like you hard to get off of. They're not like you hard to get off of. They're not like you can just stop it like an antibiotic or can just stop it like an antibiotic or can just stop it like an antibiotic or any other many other drugs. You you have any other many other drugs. You you have any other many other drugs. You you have to taper off of them. It's complicated. to taper off of them. It's complicated. to taper off of them. It's complicated. There's often a rebound effect. You get There's often a rebound effect. You get There's often a rebound effect. You get serotonin syndrome. I mean, it's it's serotonin syndrome. I mean, it's it's serotonin syndrome. I mean, it's it's actually quite significant and can be actually quite significant and can be actually quite significant and can be very serious. So, can you talk about how very serious. So, can you talk about how very serious. So, can you talk about how in that in that way they're not in that in that way they're not in that in that way they're not completely benign and and that they we completely benign and and that they we completely benign and and that they we need to think about how do we help need to think about how do we help need to think about how do we help people um understand that? people um understand that? people um understand that? >> To start off with, I think presenting >> To start off with, I think presenting >> To start off with, I think presenting these drugs as drugs that have specific these drugs as drugs that have specific these drugs as drugs that have specific effects on underlying mechanisms like a effects on underlying mechanisms like a effects on underlying mechanisms like a chemical imbalance is is really chemical imbalance is is really chemical imbalance is is really dishonest and and and prevents people dishonest and and and prevents people dishonest and and and prevents people from fully understanding what they're from fully understanding what they're from fully understanding what they're doing when they take an anti-depressant. doing when they take an anti-depressant. doing when they take an anti-depressant. And that is they are taking a foreign And that is they are taking a foreign And that is they are taking a foreign chemical substance that alters the chemical substance that alters the chemical substance that alters the normal state of your brain chemistry and normal state of your brain chemistry and normal state of your brain chemistry and activity and in ways that we don't fully activity and in ways that we don't fully activity and in ways that we don't fully understand and whose consequences we understand and whose consequences we understand and whose consequences we haven't fully worked out either. So haven't fully worked out either. So haven't fully worked out either. So they're doing something risky. When you they're doing something risky. When you they're doing something risky. When you mess with the the state of your brain, mess with the the state of your brain, mess with the the state of your brain, you're doing something risky. Uh and and you're doing something risky. Uh and and you're doing something risky. Uh and and I think if we you know if we said that I think if we you know if we said that I think if we you know if we said that to people straight up, at least that to people straight up, at least that to people straight up, at least that would be more honest. you know, if we would be more honest. you know, if we would be more honest. you know, if we said we what what you're taking is is a said we what what you're taking is is a said we what what you're taking is is a drug that's going to, you know, modify drug that's going to, you know, modify drug that's going to, you know, modify your normal biology in a way that we your normal biology in a way that we your normal biology in a way that we don't properly understand. I think don't properly understand. I think don't properly understand. I think people would then understand people would then understand people would then understand better that what they're doing is better that what they're doing is better that what they're doing is something risky. something risky. something risky. And as you say, some of the risks are And as you say, some of the risks are And as you say, some of the risks are things like sexual dysfunction, uh, things like sexual dysfunction, uh, things like sexual dysfunction, uh, dependence problems, dependence problems, dependence problems, particularly for people who've taken particularly for people who've taken particularly for people who've taken anti-depressants for, you know, years on anti-depressants for, you know, years on anti-depressants for, you know, years on end, they may might well have difficulty end, they may might well have difficulty end, they may might well have difficulty coming off them. And sometimes they can coming off them. And sometimes they can coming off them. And sometimes they can um, especially, it seems, if people come um, especially, it seems, if people come um, especially, it seems, if people come off too quickly, can get into a really off too quickly, can get into a really off too quickly, can get into a really bad state and have really bad problems. bad state and have really bad problems. bad state and have really bad problems. So, it's very important to come off So, it's very important to come off So, it's very important to come off slowly. If anyone's thinking about doing slowly. If anyone's thinking about doing slowly. If anyone's thinking about doing that, the most important thing really is that, the most important thing really is that, the most important thing really is that we should should stop prescribing that we should should stop prescribing that we should should stop prescribing so many anti-depressants in the first so many anti-depressants in the first so many anti-depressants in the first place, particularly to young women to place, particularly to young women to place, particularly to young women to avoid these problems. avoid these problems. avoid these problems. >> Well, that sort of begs the question of >> Well, that sort of begs the question of >> Well, that sort of begs the question of like, you know, what is the right like, you know, what is the right like, you know, what is the right framing for mental illness and what are framing for mental illness and what are framing for mental illness and what are the root causes? And I if it's true that the root causes? And I if it's true that the root causes? And I if it's true that you know this we we've gone through this you know this we we've gone through this you know this we we've gone through this period of um you know massive period of um you know massive period of um you know massive pharmaceutical marketing to create a pharmaceutical marketing to create a pharmaceutical marketing to create a market literally they they made a market market literally they they made a market market literally they they made a market for these drugs. Uh they convinced for these drugs. Uh they convinced for these drugs. Uh they convinced everybody they need them that they everybody they need them that they everybody they need them that they convinced doctors to prescribe them and convinced doctors to prescribe them and convinced doctors to prescribe them and then people got on them and had a hard then people got on them and had a hard then people got on them and had a hard time getting off of them. And you know time getting off of them. And you know time getting off of them. And you know we're kind of in this pickle now where we're kind of in this pickle now where we're kind of in this pickle now where mental illness is on the rise and yet mental illness is on the rise and yet mental illness is on the rise and yet what are we going to do? like what what what are we going to do? like what what what are we going to do? like what what are we going to do and how do we address are we going to do and how do we address are we going to do and how do we address the root cause of these this crisis the root cause of these this crisis the root cause of these this crisis we're in we're in we're in >> as you were suggesting I think I think >> as you were suggesting I think I think >> as you were suggesting I think I think one of the one of the origins of this one of the one of the origins of this one of the one of the origins of this problem is that we've developed a problem is that we've developed a problem is that we've developed a wrongheaded way of thinking about mental wrongheaded way of thinking about mental wrongheaded way of thinking about mental health problems um so you know and it health problems um so you know and it health problems um so you know and it start it really sort of got going with start it really sort of got going with start it really sort of got going with this idea of the chemical imbalance it this idea of the chemical imbalance it this idea of the chemical imbalance it was very it was very interesting I when was very it was very interesting I when was very it was very interesting I when I was doing the research for the book I I was doing the research for the book I I was doing the research for the book I went and looked at the archives of one went and looked at the archives of one went and looked at the archives of one of these depression awareness campaigns of these depression awareness campaigns of these depression awareness campaigns that was run by the Royal College of that was run by the Royal College of that was run by the Royal College of Psychiatrists in the UK in the early Psychiatrists in the UK in the early Psychiatrists in the UK in the early 1990s 1990s 1990s and they did some market research before and they did some market research before and they did some market research before they started their campaign. Their they started their campaign. Their they started their campaign. Their campaign was to go and convince people campaign was to go and convince people campaign was to go and convince people that depression was a medical condition. that depression was a medical condition. that depression was a medical condition. Go and see your GP, get treatment. Of Go and see your GP, get treatment. Of Go and see your GP, get treatment. Of course, it was partly funded by Eli Liy course, it was partly funded by Eli Liy course, it was partly funded by Eli Liy who were the makers of Prozac. who were the makers of Prozac. who were the makers of Prozac. But the market research they did was But the market research they did was But the market research they did was really interesting. They they went out really interesting. They they went out really interesting. They they went out and they asked people, this is in in and they asked people, this is in in and they asked people, this is in in about 1991 probably, what do you think about 1991 probably, what do you think about 1991 probably, what do you think causes depression? And people didn't say causes depression? And people didn't say causes depression? And people didn't say um you know, I think it's a chemical um you know, I think it's a chemical um you know, I think it's a chemical imbalance or a brain problem or a imbalance or a brain problem or a imbalance or a brain problem or a genetic problem even. They said genetic problem even. They said genetic problem even. They said unemployment, divorce, child abuse. unemployment, divorce, child abuse. unemployment, divorce, child abuse. And they said that they didn't think And they said that they didn't think And they said that they didn't think that taking a drug to deal with that taking a drug to deal with that taking a drug to deal with emotional problems was a good idea emotional problems was a good idea emotional problems was a good idea because it would just numb the problem because it would just numb the problem because it would just numb the problem and there was a potential that people and there was a potential that people and there was a potential that people might get dependent. might get dependent. might get dependent. So people people had a different idea So people people had a different idea So people people had a different idea back then. Their idea back then was that back then. Their idea back then was that back then. Their idea back then was that depression is part of the range of our depression is part of the range of our depression is part of the range of our emotional reactions to the world. emotional reactions to the world. emotional reactions to the world. And And And and I think we need to go back to that and I think we need to go back to that and I think we need to go back to that understanding that we that got buried by understanding that we that got buried by understanding that we that got buried by this campaign to medicalize depression this campaign to medicalize depression this campaign to medicalize depression and to medicalize other mental health and to medicalize other mental health and to medicalize other mental health struggles and difficulties. struggles and difficulties. struggles and difficulties. >> I think that's an important point. I >> I think that's an important point. I >> I think that's an important point. I think you know that you know humans are think you know that you know humans are think you know that you know humans are these incredibly emotive beings and we these incredibly emotive beings and we these incredibly emotive beings and we have a whole range of emotions have a whole range of emotions have a whole range of emotions throughout our lifetime and they're throughout our lifetime and they're throughout our lifetime and they're often situation dependent. you know, often situation dependent. you know, often situation dependent. you know, someone dies, you break up with a someone dies, you break up with a someone dies, you break up with a partner, you know, something tragic partner, you know, something tragic partner, you know, something tragic happens, there's an illness, you know, happens, there's an illness, you know, happens, there's an illness, you know, I, you know, I I just had a very close I, you know, I I just had a very close I, you know, I I just had a very close friend who just died. I mean, I I friend who just died. I mean, I I friend who just died. I mean, I I understand, you know, when you start to understand, you know, when you start to understand, you know, when you start to feel these emotions and we just want to feel these emotions and we just want to feel these emotions and we just want to like plate them or subdue them or like plate them or subdue them or like plate them or subdue them or suppress them instead of actually suppress them instead of actually suppress them instead of actually feeling the full range of what it is to feeling the full range of what it is to feeling the full range of what it is to be a human being. And I think I think be a human being. And I think I think be a human being. And I think I think that's that's an important point. And that's that's an important point. And that's that's an important point. And often, you know, those those are often, you know, those those are often, you know, those those are temporary situations, but they're temporary situations, but they're temporary situations, but they're they're also, I think, um, they're also, they're also, I think, um, they're also, they're also, I think, um, they're also, you know, we live in a very stressful you know, we live in a very stressful you know, we live in a very stressful world right now geopolitically. Those world right now geopolitically. Those world right now geopolitically. Those those things are real and they're those things are real and they're those things are real and they're destabilizing. I think, you know, destabilizing. I think, you know, destabilizing. I think, you know, there's divisiveness never before. there's divisiveness never before. there's divisiveness never before. There's increasing, you know, inequities There's increasing, you know, inequities There's increasing, you know, inequities and economics. There's there's and economics. There's there's and economics. There's there's challenges with chronic stress from challenges with chronic stress from challenges with chronic stress from social media and everything else. So, social media and everything else. So, social media and everything else. So, we've got so many things that are making we've got so many things that are making we've got so many things that are making us mentally challenged. Um, but I also us mentally challenged. Um, but I also us mentally challenged. Um, but I also think that there's there's another part think that there's there's another part think that there's there's another part of this, which is that, you know, that of this, which is that, you know, that of this, which is that, you know, that there's there's just, you know, this there's there's just, you know, this there's there's just, you know, this there's a rise in the sort of um there's a rise in the sort of um there's a rise in the sort of um biological factors that I think are biological factors that I think are biological factors that I think are actually a more accurate description of actually a more accurate description of actually a more accurate description of what's causing mental illness than than what's causing mental illness than than what's causing mental illness than than a serotonin deficiency. Uh, and and this a serotonin deficiency. Uh, and and this a serotonin deficiency. Uh, and and this is more sort of the work that I've sort is more sort of the work that I've sort is more sort of the work that I've sort of focused on around functional of focused on around functional of focused on around functional medicine. And and you know there's been medicine. And and you know there's been medicine. And and you know there's been clinical trials for example called the clinical trials for example called the clinical trials for example called the Smiles trial where we looked at people Smiles trial where we looked at people Smiles trial where we looked at people who were eating processed food getting who were eating processed food getting who were eating processed food getting them on real food randomized control them on real food randomized control them on real food randomized control trial showed that just eating a trial showed that just eating a trial showed that just eating a healthier diet actually helped with healthier diet actually helped with healthier diet actually helped with depression. And I've seen this over and depression. And I've seen this over and depression. And I've seen this over and over in my practice when you when you over in my practice when you when you over in my practice when you when you treat nutritional deficiencies whether treat nutritional deficiencies whether treat nutritional deficiencies whether it's B12 or folate or vitamin D or it's B12 or folate or vitamin D or it's B12 or folate or vitamin D or omega-3 fats all of these have been omega-3 fats all of these have been omega-3 fats all of these have been linked to you know low mood or linked to you know low mood or linked to you know low mood or depression. So there's a lot of depression. So there's a lot of depression. So there's a lot of biological reasons, but I I think you biological reasons, but I I think you biological reasons, but I I think you you you you are when you say biological you you you are when you say biological you you you are when you say biological cause of depression, you're you're cause of depression, you're you're cause of depression, you're you're really focusing more the this sort of really focusing more the this sort of really focusing more the this sort of chemical imbalance framework and not chemical imbalance framework and not chemical imbalance framework and not these other aspects which I think are these other aspects which I think are these other aspects which I think are pretty well understood. Is that is that pretty well understood. Is that is that pretty well understood. Is that is that right? right? right? >> Yes. Um predominantly on these theories >> Yes. Um predominantly on these theories >> Yes. Um predominantly on these theories that uh depression is caused by specific that uh depression is caused by specific that uh depression is caused by specific by deficiencies of specific brain by deficiencies of specific brain by deficiencies of specific brain chemicals. chemicals. chemicals. Um Um Um but I uh but I uh but I uh I I I worry that any sort of specific I I I worry that any sort of specific I I I worry that any sort of specific biological mechanism biological mechanism biological mechanism might be used in the same way might be might be used in the same way might be might be used in the same way might be might be used as a sort of way of might be used as a sort of way of might be used as a sort of way of suggesting that depression is you know suggesting that depression is you know suggesting that depression is you know is a physical and bodily thing and is a physical and bodily thing and is a physical and bodily thing and forgetting about the elements that we forgetting about the elements that we forgetting about the elements that we bring to our feelings and emotions that bring to our feelings and emotions that bring to our feelings and emotions that are about us as people rather than us as are about us as people rather than us as are about us as people rather than us as bodies. But I completely agree with you bodies. But I completely agree with you bodies. But I completely agree with you that um one has to be physically healthy that um one has to be physically healthy that um one has to be physically healthy to to have a sense of well-being that to to have a sense of well-being that to to have a sense of well-being that it's very you know that if you are badly it's very you know that if you are badly it's very you know that if you are badly nourished or inactive nourished or inactive nourished or inactive uh you are much more likely to be you uh you are much more likely to be you uh you are much more likely to be you know to be depressed or anxious or know to be depressed or anxious or know to be depressed or anxious or stressed. I mean, we know that there's, stressed. I mean, we know that there's, stressed. I mean, we know that there's, you know, there's lots of literature on you know, there's lots of literature on you know, there's lots of literature on that. And we know that um doing exercise that. And we know that um doing exercise that. And we know that um doing exercise is really good for your for your mental is really good for your for your mental is really good for your for your mental well-being and also very good for well-being and also very good for well-being and also very good for depression. depression. depression. >> Yeah, exactly. Exercise is great for >> Yeah, exactly. Exercise is great for >> Yeah, exactly. Exercise is great for depression. Meditation is great for depression. Meditation is great for depression. Meditation is great for depression. Lowering stress levels is depression. Lowering stress levels is depression. Lowering stress levels is great for depression. Sleeping is great great for depression. Sleeping is great great for depression. Sleeping is great for depression. All all these common for depression. All all these common for depression. All all these common sense things that we kind of forget. And sense things that we kind of forget. And sense things that we kind of forget. And I think, you know, it got exciting to I think, you know, it got exciting to I think, you know, it got exciting to think, oh god, I don't need to spend 40 think, oh god, I don't need to spend 40 think, oh god, I don't need to spend 40 years, 5 days a week doing years, 5 days a week doing years, 5 days a week doing psychoanalysis for treating my mental psychoanalysis for treating my mental psychoanalysis for treating my mental health. I can take this pill once a day health. I can take this pill once a day health. I can take this pill once a day and then be done with it. But it's kind and then be done with it. But it's kind and then be done with it. But it's kind of been a it's it's been an unfortunate of been a it's it's been an unfortunate of been a it's it's been an unfortunate trajectory because it hasn't allowed us trajectory because it hasn't allowed us trajectory because it hasn't allowed us to to get to the real root causes. And to to get to the real root causes. And to to get to the real root causes. And you also talk about the sort of the the you also talk about the sort of the the you also talk about the sort of the the social factors, right? The poverty, the social factors, right? The poverty, the social factors, right? The poverty, the you know, housing instability, you know, housing instability, you know, housing instability, loneliness, childhood trauma. I mean, I loneliness, childhood trauma. I mean, I loneliness, childhood trauma. I mean, I think we've kind of distracted ourselves think we've kind of distracted ourselves think we've kind of distracted ourselves from some of this contextual stuff and from some of this contextual stuff and from some of this contextual stuff and are trying to sort of almost blame the are trying to sort of almost blame the are trying to sort of almost blame the individual rather than understand the individual rather than understand the individual rather than understand the social and political environmental social and political environmental social and political environmental causes. So, I'd love you to sort of causes. So, I'd love you to sort of causes. So, I'd love you to sort of speak about that because I think this is speak about that because I think this is speak about that because I think this is a really important framing. a really important framing. a really important framing. >> Well, yes. And and and and you were >> Well, yes. And and and and you were >> Well, yes. And and and and you were talking earlier about what's going on in talking earlier about what's going on in talking earlier about what's going on in the world and how frightening that is the world and how frightening that is the world and how frightening that is and how stressful that is. And you know, and how stressful that is. And you know, and how stressful that is. And you know, we can add to that all the sort of we can add to that all the sort of we can add to that all the sort of social and economic um chaos that we've social and economic um chaos that we've social and economic um chaos that we've seen over the last, you know, 15 years seen over the last, you know, 15 years seen over the last, you know, 15 years or so since the crash since the economic or so since the crash since the economic or so since the crash since the economic crash of 2008. And and I would add to crash of 2008. And and I would add to crash of 2008. And and I would add to that that I think there's a you know that that I think there's a you know that that I think there's a you know that a lot of people have this feeling that a lot of people have this feeling that a lot of people have this feeling that there's nothing they can do about that there's nothing they can do about that there's nothing they can do about these events, that there's no way to these events, that there's no way to these events, that there's no way to change them. And you know I think that's change them. And you know I think that's change them. And you know I think that's partly a consequence again of of partly a consequence again of of partly a consequence again of of changing social conditions of the you changing social conditions of the you changing social conditions of the you know loss of community people you know know loss of community people you know know loss of community people you know families and communities being much more families and communities being much more families and communities being much more fractured and dispersed than they were fractured and dispersed than they were fractured and dispersed than they were trade unions not being very powerful trade unions not being very powerful trade unions not being very powerful anymore anymore anymore uh organized religion having much less uh organized religion having much less uh organized religion having much less role in in society and in people's role in in society and in people's role in in society and in people's lives. So I think on top of all the lives. So I think on top of all the lives. So I think on top of all the stresses that we're dealing with there stresses that we're dealing with there stresses that we're dealing with there are people just can't see a way to are people just can't see a way to are people just can't see a way to change change the world change not only change change the world change not only change change the world change not only to change the world but just to change to change the world but just to change to change the world but just to change their world you know to change their their world you know to change their their world you know to change their environment and so I suppose there's a environment and so I suppose there's a environment and so I suppose there's a degree of learned helplessness that you degree of learned helplessness that you degree of learned helplessness that you know that that um that people are know that that um that people are know that that um that people are experiencing that feeds into mental experiencing that feeds into mental experiencing that feeds into mental health problems and I completely agree health problems and I completely agree health problems and I completely agree with you that the problem with this with you that the problem with this with you that the problem with this medical model that we've got and with medical model that we've got and with medical model that we've got and with encouraging encouraging encouraging you know, encouraging the idea that you you know, encouraging the idea that you you know, encouraging the idea that you can treat depression with with a with a can treat depression with with a with a can treat depression with with a with a pill is that it discourages people pill is that it discourages people pill is that it discourages people themselves from trying to work out what themselves from trying to work out what themselves from trying to work out what they might be able to change about their they might be able to change about their they might be able to change about their own lives, how they might be able to own lives, how they might be able to own lives, how they might be able to improve their own lives, how they might improve their own lives, how they might improve their own lives, how they might be able to, you know, take an active be able to, you know, take an active be able to, you know, take an active role in their recovery and discourages role in their recovery and discourages role in their recovery and discourages governments from asking why why so many governments from asking why why so many governments from asking why why so many people are depressed and unhappy. and people are depressed and unhappy. and people are depressed and unhappy. and introducing social policies that might introducing social policies that might introducing social policies that might improve people's, you know, living improve people's, you know, living improve people's, you know, living conditions. conditions. conditions. >> It's really interesting. I think I think >> It's really interesting. I think I think >> It's really interesting. I think I think those are all so essential things. I those are all so essential things. I those are all so essential things. I mean, we we have to deal with the the mean, we we have to deal with the the mean, we we have to deal with the the social determinance of health. Um, but, social determinance of health. Um, but, social determinance of health. Um, but, you know, there's also the commercial you know, there's also the commercial you know, there's also the commercial determinance of health. I don't know if determinance of health. I don't know if determinance of health. I don't know if you've ever heard that term, but it was you've ever heard that term, but it was you've ever heard that term, but it was sort of developed by the WHO as a way of sort of developed by the WHO as a way of sort of developed by the WHO as a way of understanding the way in which understanding the way in which understanding the way in which corporations corporations corporations are determining our health through their are determining our health through their are determining our health through their actions, whether it's the ultrarocessed actions, whether it's the ultrarocessed actions, whether it's the ultrarocessed food industry, tobacco, alcohol, food industry, tobacco, alcohol, food industry, tobacco, alcohol, pharmaceutical industry, all driving for pharmaceutical industry, all driving for pharmaceutical industry, all driving for profit and undermining public health. profit and undermining public health. profit and undermining public health. And I think the these promote this these And I think the these promote this these And I think the these promote this these ongoing social, political, and ongoing social, political, and ongoing social, political, and environmental causes. So it's it's just environmental causes. So it's it's just environmental causes. So it's it's just this really kind of almost uh disease um this really kind of almost uh disease um this really kind of almost uh disease um creating context we live in in the world creating context we live in in the world creating context we live in in the world today. And it's it's it's the individual today. And it's it's it's the individual today. And it's it's it's the individual is often at the effect of all this is often at the effect of all this is often at the effect of all this stuff. And unless you have some stuff. And unless you have some stuff. And unless you have some understanding of how to have agency and understanding of how to have agency and understanding of how to have agency and how all these things affect you, the how all these things affect you, the how all these things affect you, the average person has no clue that if average person has no clue that if average person has no clue that if they're eating ultrarocessed food, it's they're eating ultrarocessed food, it's they're eating ultrarocessed food, it's going to give them depression. Like you going to give them depression. Like you going to give them depression. Like you know, they they may know it's not the know, they they may know it's not the know, they they may know it's not the healthiest for them. They may know make healthiest for them. They may know make healthiest for them. They may know make make them gain a little weight but they make them gain a little weight but they make them gain a little weight but they don't understand the full impact of of don't understand the full impact of of don't understand the full impact of of these behaviors or things and I think these behaviors or things and I think these behaviors or things and I think you know empowering people with agency you know empowering people with agency you know empowering people with agency you talk a lot about this how do how do you talk a lot about this how do how do you talk a lot about this how do how do we have more agency and how how do you we have more agency and how how do you we have more agency and how how do you help people have more understanding of help people have more understanding of help people have more understanding of what they can actually do themselves to what they can actually do themselves to what they can actually do themselves to in some ways to protect themselves from in some ways to protect themselves from in some ways to protect themselves from the onslaught from the medical the onslaught from the medical the onslaught from the medical industrial complex and from the industrial complex and from the industrial complex and from the pharmaceutical you know industrial pharmaceutical you know industrial pharmaceutical you know industrial complex and the commercial interests complex and the commercial interests complex and the commercial interests that are driving towards towards people that are driving towards towards people that are driving towards towards people being unhealthy andre producing you know being unhealthy andre producing you know being unhealthy andre producing you know commercial benefit but really commercial benefit but really commercial benefit but really undermining public health. So h how do undermining public health. So h how do undermining public health. So h how do you help people think about that on an you help people think about that on an you help people think about that on an individual level? You're a psychiatrist. individual level? You're a psychiatrist. individual level? You're a psychiatrist. I mean this is kind of how you how you I mean this is kind of how you how you I mean this is kind of how you how you have to think about these things. have to think about these things. have to think about these things. >> So we have we have a food industry that >> So we have we have a food industry that >> So we have we have a food industry that you as you say is thrusting you as you say is thrusting you as you say is thrusting ultrarocessed food at people making ultrarocessed food at people making ultrarocessed food at people making people unhealthy and then we people unhealthy and then we people unhealthy and then we pharmaceutical industry that's coming up pharmaceutical industry that's coming up pharmaceutical industry that's coming up with drugs that you know anti-obesity with drugs that you know anti-obesity with drugs that you know anti-obesity drugs uh to to drugs uh to to drugs uh to to >> great business model >> great business model >> great business model >> weight. [laughter] Yeah. Exactly. As >> weight. [laughter] Yeah. Exactly. As >> weight. [laughter] Yeah. Exactly. As well as anti-depressants to deal with well as anti-depressants to deal with well as anti-depressants to deal with the fact that, you know, when you're the fact that, you know, when you're the fact that, you know, when you're unhealthy and overweight, you're much unhealthy and overweight, you're much unhealthy and overweight, you're much more likely to be unhappy as well. So, more likely to be unhappy as well. So, more likely to be unhappy as well. So, we've got all these, you know, different we've got all these, you know, different we've got all these, you know, different different huge commercial sectors different huge commercial sectors different huge commercial sectors working in synergy with each other working in synergy with each other working in synergy with each other almost. almost. almost. >> Maybe it's maybe going to be a new drug, >> Maybe it's maybe going to be a new drug, >> Maybe it's maybe going to be a new drug, ompic combined with Prozac. [laughter] ompic combined with Prozac. [laughter] ompic combined with Prozac. [laughter] >> Yeah. Yeah. Exactly. Yeah. Yeah. Yeah. >> Yeah. Yeah. Exactly. Yeah. Yeah. Yeah. >> Yeah. Yeah. Exactly. Yeah. Yeah. Yeah. Yeah. Don't even don't even put that out Yeah. Don't even don't even put that out Yeah. Don't even don't even put that out there. I'm still someone [laughter] >> I know. But this is how pharmaceutical >> I know. But this is how pharmaceutical industry thinks. They they're trying to industry thinks. They they're trying to industry thinks. They they're trying to manufacture illnesses and they've done manufacture illnesses and they've done manufacture illnesses and they've done this I've seen this happen throughout my this I've seen this happen throughout my this I've seen this happen throughout my career and we graduated medical school career and we graduated medical school career and we graduated medical school around the same time and it's like the around the same time and it's like the around the same time and it's like the sort of the the sort of medicalization sort of the the sort of medicalization sort of the the sort of medicalization of problems is sort of what you're of problems is sort of what you're of problems is sort of what you're talking about. Um and and this talking about. Um and and this talking about. Um and and this medicalization undermines our ability to medicalization undermines our ability to medicalization undermines our ability to really look at you know when one of what really look at you know when one of what really look at you know when one of what are the bigger context issues that we are the bigger context issues that we are the bigger context issues that we just talked about. You know, one of the just talked about. You know, one of the just talked about. You know, one of the things I I see emerging, I love your things I I see emerging, I love your things I I see emerging, I love your perspective on this because it it does perspective on this because it it does perspective on this because it it does kind of it is kind of nagging me in the kind of it is kind of nagging me in the kind of it is kind of nagging me in the back of my head because I don't quite back of my head because I don't quite back of my head because I don't quite understand it. And there's this sort of understand it. And there's this sort of understand it. And there's this sort of psychedelic revolution going on in psychedelic revolution going on in psychedelic revolution going on in psychiatry and there's a lot of work psychiatry and there's a lot of work psychiatry and there's a lot of work being done in the UK along the US and a being done in the UK along the US and a being done in the UK along the US and a lot of clinical trials and the orders of lot of clinical trials and the orders of lot of clinical trials and the orders of magnitude of improvement is so far magnitude of improvement is so far magnitude of improvement is so far greater uh than placebo and then greater uh than placebo and then greater uh than placebo and then anti-depressants and other psychiatric anti-depressants and other psychiatric anti-depressants and other psychiatric medications for PTSD, for anxiety, for medications for PTSD, for anxiety, for medications for PTSD, for anxiety, for depression, psilocybin, MDMA, uh even depression, psilocybin, MDMA, uh even depression, psilocybin, MDMA, uh even now Ibagane is being talked about more now Ibagane is being talked about more now Ibagane is being talked about more which is a root medicine from from which is a root medicine from from which is a root medicine from from Gabone in West Africa that has profound Gabone in West Africa that has profound Gabone in West Africa that has profound neurochemical effects. Uh and and I've neurochemical effects. Uh and and I've neurochemical effects. Uh and and I've actually even taken it myself and I I actually even taken it myself and I I actually even taken it myself and I I can tell you it is profoundly can tell you it is profoundly can tell you it is profoundly neurochemically altering not just in the neurochemically altering not just in the neurochemically altering not just in the moment but it seems to have lasting moment but it seems to have lasting moment but it seems to have lasting effects around you know trauma and brain effects around you know trauma and brain effects around you know trauma and brain repair and um brain trophic factors to repair and um brain trophic factors to repair and um brain trophic factors to get released. And I wonder how you think get released. And I wonder how you think get released. And I wonder how you think about that because in in some ways, you about that because in in some ways, you about that because in in some ways, you know, it is a it is a biological know, it is a it is a biological know, it is a it is a biological framework for understanding how to treat framework for understanding how to treat framework for understanding how to treat disease. And they and the interesting disease. And they and the interesting disease. And they and the interesting thing about these compounds is that it's thing about these compounds is that it's thing about these compounds is that it's not like an antress where you have to not like an antress where you have to not like an antress where you have to take one a day for the rest of your take one a day for the rest of your take one a day for the rest of your life. It's, you know, a couple of life. It's, you know, a couple of life. It's, you know, a couple of treatments or not that many that seem to treatments or not that many that seem to treatments or not that many that seem to have really profound long-lasting have really profound long-lasting have really profound long-lasting effects. So I'd love your perspective on effects. So I'd love your perspective on effects. So I'd love your perspective on that. I don't know if it's an area you that. I don't know if it's an area you that. I don't know if it's an area you think about, but it it just kind of as think about, but it it just kind of as think about, but it it just kind of as you're talking about the the biology of you're talking about the the biology of you're talking about the the biology of this, I'm think, oh wait, you know, this, I'm think, oh wait, you know, this, I'm think, oh wait, you know, maybe we should talk about this. maybe we should talk about this. maybe we should talk about this. >> No, no, absolutely. I do think about it >> No, no, absolutely. I do think about it >> No, no, absolutely. I do think about it because they're they're also they're because they're they're also they're because they're they're also they're also um very popular in or or becoming also um very popular in or or becoming also um very popular in or or becoming popular in the UK this whole area of popular in the UK this whole area of popular in the UK this whole area of psychedelic medicine. So this is how I psychedelic medicine. So this is how I psychedelic medicine. So this is how I think about it. I I think that we need think about it. I I think that we need think about it. I I think that we need to think about all the drugs we use to think about all the drugs we use to think about all the drugs we use that's whether we use them that's whether we use them that's whether we use them recreationally or whether they're recreationally or whether they're recreationally or whether they're prescribed if they're drugs that cross prescribed if they're drugs that cross prescribed if they're drugs that cross the bloodb brain barrier they're drugs the bloodb brain barrier they're drugs the bloodb brain barrier they're drugs that alter our mental states in one way that alter our mental states in one way that alter our mental states in one way or another. And that's how I think we or another. And that's how I think we or another. And that's how I think we should think about all drugs rather than should think about all drugs rather than should think about all drugs rather than as things that target underlying as things that target underlying as things that target underlying pathological mechanisms because no drug pathological mechanisms because no drug pathological mechanisms because no drug that we use for mental health whether that we use for mental health whether that we use for mental health whether that's anti-depressants or that's anti-depressants or that's anti-depressants or antiscychotics or Valium or mood antiscychotics or Valium or mood antiscychotics or Valium or mood stabilizers or anything else has been stabilizers or anything else has been stabilizers or anything else has been shown to actually do that to work in shown to actually do that to work in shown to actually do that to work in that way. Um so psychedelics are that way. Um so psychedelics are that way. Um so psychedelics are psychoactive substances. They are psychoactive substances. They are psychoactive substances. They are psychoactive substances that give people psychoactive substances that give people psychoactive substances that give people a very unusual experience. And some a very unusual experience. And some a very unusual experience. And some people find that experience to be people find that experience to be people find that experience to be enlightening and to give them insights enlightening and to give them insights enlightening and to give them insights into their lives and into their pasts into their lives and into their pasts into their lives and into their pasts that might help them going forward. And that might help them going forward. And that might help them going forward. And the original the original introduction the original the original introduction the original the original introduction of psychedelics into psychiatry or of psychedelics into psychiatry or of psychedelics into psychiatry or original it the they were sort of original it the they were sort of original it the they were sort of reintroduced maybe a decade or so ago um reintroduced maybe a decade or so ago um reintroduced maybe a decade or so ago um in the context of what was called in the context of what was called in the context of what was called psychedelic assisted psychotherapy. And psychedelic assisted psychotherapy. And psychedelic assisted psychotherapy. And the idea was that you'd have one or two the idea was that you'd have one or two the idea was that you'd have one or two psychedelic experiences and then you psychedelic experiences and then you psychedelic experiences and then you would pro on in a sort of clinical would pro on in a sort of clinical would pro on in a sort of clinical setting and then you would process what setting and then you would process what setting and then you would process what your experience what you might have your experience what you might have your experience what you might have learned from that with a therapist. And learned from that with a therapist. And learned from that with a therapist. And the idea was that for some people there the idea was that for some people there the idea was that for some people there would be insights that would help them would be insights that would help them would be insights that would help them to get over what they were suffering to get over what they were suffering to get over what they were suffering from and to move forward in their lives. from and to move forward in their lives. from and to move forward in their lives. The problem is that model isn't isn't The problem is that model isn't isn't The problem is that model isn't isn't great for people who want to sell great for people who want to sell great for people who want to sell psychedelics or psychedelic experiences psychedelics or psychedelic experiences psychedelics or psychedelic experiences because it's just once or twice that because it's just once or twice that because it's just once or twice that you're going to take the things and um you're going to take the things and um you're going to take the things and um you know if you're setting up a you know if you're setting up a you know if you're setting up a psychedelic clinic like with the psychedelic clinic like with the psychedelic clinic like with the ketamine clinics that have got going in ketamine clinics that have got going in ketamine clinics that have got going in the states you wanted people to keep the states you wanted people to keep the states you wanted people to keep coming back. coming back. coming back. >> You want an annuity but that's not how >> You want an annuity but that's not how >> You want an annuity but that's not how we should be practicing medicine. It's we should be practicing medicine. It's we should be practicing medicine. It's like it's like we give an antibiotic for like it's like we give an antibiotic for like it's like we give an antibiotic for an infection. we we know it's only for a an infection. we we know it's only for a an infection. we we know it's only for a week and that's great as long as you week and that's great as long as you week and that's great as long as you take antibiotics for the rest of your take antibiotics for the rest of your take antibiotics for the rest of your life. So I think you know I think most life. So I think you know I think most life. So I think you know I think most doctors probably do care about doing the doctors probably do care about doing the doctors probably do care about doing the right thing. It's just the system is set right thing. It's just the system is set right thing. It's just the system is set up not for that. And so what has up not for that. And so what has up not for that. And so what has happened with ketamine which which was happened with ketamine which which was happened with ketamine which which was set up with the same sort of model, same set up with the same sort of model, same set up with the same sort of model, same idea in mind is that the psychotherapy idea in mind is that the psychotherapy idea in mind is that the psychotherapy has gradually dropped away and people has gradually dropped away and people has gradually dropped away and people are in you know people are encouraged to are in you know people are encouraged to are in you know people are encouraged to and certainly have got into the habit of and certainly have got into the habit of and certainly have got into the habit of going back repeatedly for their shots of going back repeatedly for their shots of going back repeatedly for their shots of ketamine and so it becomes a long-term ketamine and so it becomes a long-term ketamine and so it becomes a long-term treatment. And we have no idea about the treatment. And we have no idea about the treatment. And we have no idea about the safety or well actually we do have some safety or well actually we do have some safety or well actually we do have some idea about the lack of safety of idea about the lack of safety of idea about the lack of safety of long-term ketamine use because we've got long-term ketamine use because we've got long-term ketamine use because we've got data from recreational drug users on how data from recreational drug users on how data from recreational drug users on how it damages your bladder and things. We it damages your bladder and things. We it damages your bladder and things. We don't have terribly good data on don't have terribly good data on don't have terribly good data on long-term repeated use of other long-term repeated use of other long-term repeated use of other psychedelics because because they're psychedelics because because they're psychedelics because because they're they're not so often used in that way. they're not so often used in that way. they're not so often used in that way. So that's my concern about about So that's my concern about about So that's my concern about about psychedelics. I think the idea that some psychedelics. I think the idea that some psychedelics. I think the idea that some people get insights from using them is people get insights from using them is people get insights from using them is fine, but I worry that we will end up fine, but I worry that we will end up fine, but I worry that we will end up with the same old model of people just with the same old model of people just with the same old model of people just going on to chronic long-term treatment going on to chronic long-term treatment going on to chronic long-term treatment because that's what makes organizations because that's what makes organizations because that's what makes organizations money without knowing very much about money without knowing very much about money without knowing very much about the possible negative consequences of the possible negative consequences of the possible negative consequences of doing that. doing that. doing that. >> Yeah. Although I don't you can go to >> Yeah. Although I don't you can go to >> Yeah. Although I don't you can go to work on Prozac. You can't go to work if work on Prozac. You can't go to work if work on Prozac. You can't go to work if you take a big dose of mushroom or MDMA. you take a big dose of mushroom or MDMA. you take a big dose of mushroom or MDMA. >> But [laughter] but of course this micro >> But [laughter] but of course this micro >> But [laughter] but of course this micro doing idea has come in hasn't it? doing idea has come in hasn't it? doing idea has come in hasn't it? >> What do you think about the micro doing? >> What do you think about the micro doing? >> What do you think about the micro doing? I mean I think you you look at the I mean I think you you look at the I mean I think you you look at the literature on the toxicity of these uh literature on the toxicity of these uh literature on the toxicity of these uh drugs like uh not intimate particularly drugs like uh not intimate particularly drugs like uh not intimate particularly but like psilocybin or LSD there there but like psilocybin or LSD there there but like psilocybin or LSD there there seems to be a very low toxicity and very seems to be a very low toxicity and very seems to be a very low toxicity and very high safety threshold for these drugs. high safety threshold for these drugs. high safety threshold for these drugs. So micro doing as a as a therapeutic So micro doing as a as a therapeutic So micro doing as a as a therapeutic option is something it's interesting and option is something it's interesting and option is something it's interesting and I've been talking to some scientists I've been talking to some scientists I've been talking to some scientists about it. And it seems there's some about it. And it seems there's some about it. And it seems there's some increasing, you know, both anecdotal and increasing, you know, both anecdotal and increasing, you know, both anecdotal and and clinical literature on this. and clinical literature on this. and clinical literature on this. >> There's a film, there's a Swedish film >> There's a film, there's a Swedish film >> There's a film, there's a Swedish film that's come out recently which is about that's come out recently which is about that's come out recently which is about I'll try and remember the name of it I'll try and remember the name of it I'll try and remember the name of it before I finish um which is about a before I finish um which is about a before I finish um which is about a group of teachers who decide to go to group of teachers who decide to go to group of teachers who decide to go to work um having had a a glass of wine or work um having had a a glass of wine or work um having had a a glass of wine or a small amount of beer or something like a small amount of beer or something like a small amount of beer or something like that, having had some alcohol. And they that, having had some alcohol. And they that, having had some alcohol. And they will they they their theory is that, you will they they their theory is that, you will they they their theory is that, you know, if they just have a small amount know, if they just have a small amount know, if they just have a small amount and maybe have to top it up a bit during and maybe have to top it up a bit during and maybe have to top it up a bit during the day, they'll be at that lovely sweet the day, they'll be at that lovely sweet the day, they'll be at that lovely sweet spot where they're, you know, confident spot where they're, you know, confident spot where they're, you know, confident and outgoing but not too drunk. And the and outgoing but not too drunk. And the and outgoing but not too drunk. And the film is about how that goes horribly film is about how that goes horribly film is about how that goes horribly wrong. Really, [laughter] wrong. Really, [laughter] wrong. Really, [laughter] >> micro doing alcohol, I don't think, is a >> micro doing alcohol, I don't think, is a >> micro doing alcohol, I don't think, is a good strategy because we know that's a good strategy because we know that's a good strategy because we know that's a lethal poison. [laughter] lethal poison. [laughter] lethal poison. [laughter] But but I but the point is that you know But but I but the point is that you know But but I but the point is that you know I think these ideas are fine but I think these ideas are fine but I think these ideas are fine but actually when you're dealing with you actually when you're dealing with you actually when you're dealing with you know psychoactive substances it's maybe know psychoactive substances it's maybe know psychoactive substances it's maybe not so easy to you know to control it in not so easy to you know to control it in not so easy to you know to control it in that way or to get the the sweet spot. that way or to get the the sweet spot. that way or to get the the sweet spot. Exactly. And we don't as I've said we Exactly. And we don't as I've said we Exactly. And we don't as I've said we you know we just don't have any good you know we just don't have any good you know we just don't have any good research on on the long-term effects of research on on the long-term effects of research on on the long-term effects of regular daily use of psychedelics which regular daily use of psychedelics which regular daily use of psychedelics which hasn't been how they've been used hasn't been how they've been used hasn't been how they've been used traditionally. traditionally. traditionally. This episode is brought to you by Row This episode is brought to you by Row This episode is brought to you by Row Nutrition's liposomaal dim. And here's Nutrition's liposomaal dim. And here's Nutrition's liposomaal dim. And here's the thing most women are never told. A the thing most women are never told. A the thing most women are never told. 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Keep protein simple and go to paleo valley.comheimman and go to paleo valley.comheimman and go to paleo valley.comheimman to save 15% off your first order today. to save 15% off your first order today. to save 15% off your first order today. >> It's true. I agree. I mean, but but it >> It's true. I agree. I mean, but but it >> It's true. I agree. I mean, but but it sort of lets me sort of wonder about the sort of lets me sort of wonder about the sort of lets me sort of wonder about the the the brain effects uh these compounds the the brain effects uh these compounds the the brain effects uh these compounds and and how they they are altering brain and and how they they are altering brain and and how they they are altering brain function. They're altering brain function. They're altering brain function. They're altering brain structure. They they increase structure. They they increase structure. They they increase neuroplasticity, neurogenesis, neuroplasticity, neurogenesis, neuroplasticity, neurogenesis, um and also neurochemistry in ways that um and also neurochemistry in ways that um and also neurochemistry in ways that seem to have like lasting effects. And I seem to have like lasting effects. And I seem to have like lasting effects. And I I don't um I don't know how to comport I don't um I don't know how to comport I don't um I don't know how to comport that with the sort of the what you're that with the sort of the what you're that with the sort of the what you're talking about, which is sort of this talking about, which is sort of this talking about, which is sort of this sort of failure of this chemical theory sort of failure of this chemical theory sort of failure of this chemical theory of of mental illness. Maybe we're just of of mental illness. Maybe we're just of of mental illness. Maybe we're just thinking about it wrong. I I don't know thinking about it wrong. I I don't know thinking about it wrong. I I don't know how to think about it. I love your sort how to think about it. I love your sort how to think about it. I love your sort of advice on that. [laughter] of advice on that. [laughter] of advice on that. [laughter] >> Well, well, I I I worry about all these >> Well, well, I I I worry about all these >> Well, well, I I I worry about all these um ideas that they're enhancing um ideas that they're enhancing um ideas that they're enhancing neuroplasticity. I don't think there's neuroplasticity. I don't think there's neuroplasticity. I don't think there's actually that much evidence that they actually that much evidence that they actually that much evidence that they are, but if they are, if there is are, but if they are, if there is are, but if they are, if there is research showing that, it's not research showing that, it's not research showing that, it's not necessarily a good thing because because necessarily a good thing because because necessarily a good thing because because often you're seeing neuroplasticity, often you're seeing neuroplasticity, often you're seeing neuroplasticity, neurogeneration when you're getting neurogeneration when you're getting neurogeneration when you're getting damage. damage. damage. There there was, you know, there there There there was, you know, there there There there was, you know, there there was um a suggestion that anti- was um a suggestion that anti- was um a suggestion that anti- psychotics and anti-depressants psychotics and anti-depressants psychotics and anti-depressants improve neuroplasticity, improve neuroplasticity, improve neuroplasticity, but we uh but we know and and and the but we uh but we know and and and the but we uh but we know and and and the evidence that was offered was that evidence that was offered was that evidence that was offered was that they're, you know, altering some some they're, you know, altering some some they're, you know, altering some some growth, some nerve growth factors, but growth, some nerve growth factors, but growth, some nerve growth factors, but actually we know those are altered in actually we know those are altered in actually we know those are altered in the same way by having a stroke or the same way by having a stroke or the same way by having a stroke or having a brain injury. So, it doesn't having a brain injury. So, it doesn't having a brain injury. So, it doesn't necessarily show that the drugs are necessarily show that the drugs are necessarily show that the drugs are doing, you know, something that's good. doing, you know, something that's good. doing, you know, something that's good. It may be that they're harming the It may be that they're harming the It may be that they're harming the brain. And what we're seeing is the brain. And what we're seeing is the brain. And what we're seeing is the brain's repairerative mechanism. brain's repairerative mechanism. brain's repairerative mechanism. >> No, that's interesting. That's one so >> No, that's interesting. That's one so >> No, that's interesting. That's one so complicated, isn't it? I mean, I want to complicated, isn't it? I mean, I want to complicated, isn't it? I mean, I want to pivot a little bit because you you talk pivot a little bit because you you talk pivot a little bit because you you talk about this sort of drug centered model about this sort of drug centered model about this sort of drug centered model versus a disease centered model. I'd versus a disease centered model. I'd versus a disease centered model. I'd love you to sort of unpack that. I I I love you to sort of unpack that. I I I love you to sort of unpack that. I I I don't quite um think most people are don't quite um think most people are don't quite um think most people are familiar with that. I'd love you to sort familiar with that. I'd love you to sort familiar with that. I'd love you to sort of explain your your view on this. The of explain your your view on this. The of explain your your view on this. The conventional way of thinking about drugs conventional way of thinking about drugs conventional way of thinking about drugs like anti-depressants is this idea that like anti-depressants is this idea that like anti-depressants is this idea that they are working by targeting some they are working by targeting some they are working by targeting some underlying biological mechanism that underlying biological mechanism that underlying biological mechanism that leads to the symptoms of depression leads to the symptoms of depression leads to the symptoms of depression that that's often been said to be you that that's often been said to be you that that's often been said to be you know a deficiency of serotonin but it know a deficiency of serotonin but it know a deficiency of serotonin but it could be some other some other could be some other some other could be some other some other abnormality. So people have, you know, abnormality. So people have, you know, abnormality. So people have, you know, recently proposed abnormalities in recently proposed abnormalities in recently proposed abnormalities in inflammation and they may be related inflammation and they may be related inflammation and they may be related somehow to how anti-depressants are somehow to how anti-depressants are somehow to how anti-depressants are having their effects. But it's it's that having their effects. But it's it's that having their effects. But it's it's that basic idea. And what I'm saying is that basic idea. And what I'm saying is that basic idea. And what I'm saying is that anti-depressants like alcohol, like anti-depressants like alcohol, like anti-depressants like alcohol, like cannabis, like psychedelics are cannabis, like psychedelics are cannabis, like psychedelics are mindaltering substances. They they mindaltering substances. They they mindaltering substances. They they change the normal state of our brain change the normal state of our brain change the normal state of our brain chemistry and our brain activity and chemistry and our brain activity and chemistry and our brain activity and they therefore change our underlying they therefore change our underlying they therefore change our underlying thoughts and thought processes, thoughts and thought processes, thoughts and thought processes, feelings, sensations, etc. in more or feelings, sensations, etc. in more or feelings, sensations, etc. in more or less subtle ways. So, I'm not saying less subtle ways. So, I'm not saying less subtle ways. So, I'm not saying anti-depressants are exactly the same as anti-depressants are exactly the same as anti-depressants are exactly the same as alcohol. Of course, they're not. They're alcohol. Of course, they're not. They're alcohol. Of course, they're not. They're different sorts of chemicals. They have different sorts of chemicals. They have different sorts of chemicals. They have different sorts of effects. Uh and some different sorts of effects. Uh and some different sorts of effects. Uh and some anti-depressants have quite noticeable anti-depressants have quite noticeable anti-depressants have quite noticeable effects, make people feel quite effects, make people feel quite effects, make people feel quite different, quite groggy, lethargic for different, quite groggy, lethargic for different, quite groggy, lethargic for example. And some of them have much more example. And some of them have much more example. And some of them have much more subtle effects. And one of the effects subtle effects. And one of the effects subtle effects. And one of the effects they have is this emotional numbing they have is this emotional numbing they have is this emotional numbing effect. Um but so so that's that's what effect. Um but so so that's that's what effect. Um but so so that's that's what I've called a drug centered model of I've called a drug centered model of I've called a drug centered model of drug action. at is understanding these drug action. at is understanding these drug action. at is understanding these drugs as drugs, as foreign chemical drugs as drugs, as foreign chemical drugs as drugs, as foreign chemical substances that induce mental substances that induce mental substances that induce mental alterations that are then superimposed alterations that are then superimposed alterations that are then superimposed onto people's underlying feelings in the onto people's underlying feelings in the onto people's underlying feelings in the same way that that the effects of same way that that the effects of same way that that the effects of alcohol are. So, you know, we know that alcohol are. So, you know, we know that alcohol are. So, you know, we know that if you might be feeling down, you go out if you might be feeling down, you go out if you might be feeling down, you go out and you have, you know, a few drinks and you have, you know, a few drinks and you have, you know, a few drinks temporarily, you might then feel better temporarily, you might then feel better temporarily, you might then feel better because of the effects of alcohol. because of the effects of alcohol. because of the effects of alcohol. That's not because it's, you know, That's not because it's, you know, That's not because it's, you know, rectified a chemical imbalance. rectified a chemical imbalance. rectified a chemical imbalance. And certainly not because it's rectified And certainly not because it's rectified And certainly not because it's rectified an alcohol deficiency. It's because it an alcohol deficiency. It's because it an alcohol deficiency. It's because it it's because the characteristic it's because the characteristic it's because the characteristic alterations induced by alcohol is alterations induced by alcohol is alterations induced by alcohol is temporarily superimposed onto your temporarily superimposed onto your temporarily superimposed onto your underlying feelings. underlying feelings. underlying feelings. >> And then and how does that sort of >> And then and how does that sort of >> And then and how does that sort of connect to the the drug centered versus connect to the the drug centered versus connect to the the drug centered versus disease- centered framing of of mental disease- centered framing of of mental disease- centered framing of of mental health? So what I'm saying is that drugs health? So what I'm saying is that drugs health? So what I'm saying is that drugs like anti-depressants have been like anti-depressants have been like anti-depressants have been misleadingly portrayed as having these misleadingly portrayed as having these misleadingly portrayed as having these disease centered or disease targeting disease centered or disease targeting disease centered or disease targeting effects whereas actually what the way we effects whereas actually what the way we effects whereas actually what the way we should understand them is having drug should understand them is having drug should understand them is having drug centered effects as being drugs that centered effects as being drugs that centered effects as being drugs that produce alterations to our normal or produce alterations to our normal or produce alterations to our normal or undrugged states undrugged states undrugged states >> which is which makes a lot it makes a >> which is which makes a lot it makes a >> which is which makes a lot it makes a lot of sense. So given all that um you lot of sense. So given all that um you lot of sense. So given all that um you know sort of what what's a more honest know sort of what what's a more honest know sort of what what's a more honest look at mental health today in terms of look at mental health today in terms of look at mental health today in terms of an evidence-based model of what mental an evidence-based model of what mental an evidence-based model of what mental health care and mental health approach health care and mental health approach health care and mental health approach to mental illness could be. to mental illness could be. to mental illness could be. >> The first thing to say about an honest >> The first thing to say about an honest >> The first thing to say about an honest approach is that we really don't have approach is that we really don't have approach is that we really don't have evidence to conclude that any sort of evidence to conclude that any sort of evidence to conclude that any sort of mental health condition but particularly mental health condition but particularly mental health condition but particularly things like depression or anxiety are things like depression or anxiety are things like depression or anxiety are biological diseases in the sense that biological diseases in the sense that biological diseases in the sense that Parkinson's disease is a biological Parkinson's disease is a biological Parkinson's disease is a biological disease. we haven't detected any disease. we haven't detected any disease. we haven't detected any underlying underlying underlying disease processes that might explain you disease processes that might explain you disease processes that might explain you know or count for the symptoms. Um and know or count for the symptoms. Um and know or count for the symptoms. Um and there are other ways as we've discussed there are other ways as we've discussed there are other ways as we've discussed of understanding uh the distress the of understanding uh the distress the of understanding uh the distress the sadness the unhappiness the despondency sadness the unhappiness the despondency sadness the unhappiness the despondency that people that people go through at that people that people go through at that people that people go through at different times in their lives. Um, so I different times in their lives. Um, so I different times in their lives. Um, so I think that's the first thing to say and think that's the first thing to say and think that's the first thing to say and then also that we have been misled about then also that we have been misled about then also that we have been misled about the nature of the drugs that we're that the nature of the drugs that we're that the nature of the drugs that we're that are prescribed for mental health are prescribed for mental health are prescribed for mental health problems into seeing them as these problems into seeing them as these problems into seeing them as these specific targeted sophisticated specific targeted sophisticated specific targeted sophisticated um substances. Whereas actually what um substances. Whereas actually what um substances. Whereas actually what they're doing like alcohol, like other they're doing like alcohol, like other they're doing like alcohol, like other recreational drugs, is inducing a an recreational drugs, is inducing a an recreational drugs, is inducing a an altered artificial mental state that may altered artificial mental state that may altered artificial mental state that may temporarily suppress underlying temporarily suppress underlying temporarily suppress underlying feelings, but it is not resolving feelings, but it is not resolving feelings, but it is not resolving anything anything anything >> like a band-aid. >> like a band-aid. >> like a band-aid. >> Yeah. Just just to emphasize this is not >> Yeah. Just just to emphasize this is not >> Yeah. Just just to emphasize this is not I'm not trying to because I think this I'm not trying to because I think this I'm not trying to because I think this fits in with some of your views as well. fits in with some of your views as well. fits in with some of your views as well. I'm not trying to suggest that the brain I'm not trying to suggest that the brain I'm not trying to suggest that the brain is irrelevant. We are biological is irrelevant. We are biological is irrelevant. We are biological creatures. We're embodied creatures and creatures. We're embodied creatures and creatures. We're embodied creatures and and and the reason that we have the and and the reason that we have the and and the reason that we have the range of sophisticated and refined range of sophisticated and refined range of sophisticated and refined emotions that we do is because we have emotions that we do is because we have emotions that we do is because we have our large such large brains, such large our large such large brains, such large our large such large brains, such large and complex brains. It's our large and complex brains. It's our large and complex brains. It's our large brains that enable us to interact with brains that enable us to interact with brains that enable us to interact with the environment in a super sensitive way the environment in a super sensitive way the environment in a super sensitive way and flexible way. and flexible way. and flexible way. >> That that kind of begs the question of >> That that kind of begs the question of >> That that kind of begs the question of what now? you know, how if if these what now? you know, how if if these what now? you know, how if if these drugs are not the answer, what is and drugs are not the answer, what is and drugs are not the answer, what is and and how do we support people with and how do we support people with and how do we support people with depression without necessarily depression without necessarily depression without necessarily defaulting to anti-depressant defaulting to anti-depressant defaulting to anti-depressant medication? medication? medication? >> I think we need a really radical change >> I think we need a really radical change >> I think we need a really radical change in how we approach mental health in how we approach mental health in how we approach mental health problems. This this medical model problems. This this medical model problems. This this medical model encourages us to encourages us to encourages us to see, you know, us in the health see, you know, us in the health see, you know, us in the health professions to see ourselves as treating professions to see ourselves as treating professions to see ourselves as treating diseases. But what we should be seeing diseases. But what we should be seeing diseases. But what we should be seeing ourselves as doing is helping people ourselves as doing is helping people ourselves as doing is helping people with their individual problems. I think with their individual problems. I think with their individual problems. I think if you if you see if if you get away if you if you see if if you get away if you if you see if if you get away from that disease model then you can from that disease model then you can from that disease model then you can understand that you know everyone who is understand that you know everyone who is understand that you know everyone who is depressed is depressed for different depressed is depressed for different depressed is depressed for different reasons. There are different causes for reasons. There are different causes for reasons. There are different causes for everyone. There are as many causes of everyone. There are as many causes of everyone. There are as many causes of depression as there are people with depression as there are people with depression as there are people with depression. And we need to help people depression. And we need to help people depression. And we need to help people with their individual situations to with their individual situations to with their individual situations to identify why they are feeling as they identify why they are feeling as they identify why they are feeling as they feel now and what can be done to change feel now and what can be done to change feel now and what can be done to change that. and and that's, you know, and that. and and that's, you know, and that. and and that's, you know, and that's it's not complicated to do that, that's it's not complicated to do that, that's it's not complicated to do that, but we're so entrenched in this medical but we're so entrenched in this medical but we're so entrenched in this medical framework that that sort of forces us framework that that sort of forces us framework that that sort of forces us down the route of thinking that we're down the route of thinking that we're down the route of thinking that we're treating some thing that is somehow the treating some thing that is somehow the treating some thing that is somehow the same, some condition that's somehow the same, some condition that's somehow the same, some condition that's somehow the same in everyone who has it. Uh that same in everyone who has it. Uh that same in everyone who has it. Uh that that we are failing to treat people as that we are failing to treat people as that we are failing to treat people as individuals often and to really identify individuals often and to really identify individuals often and to really identify what their problems are. I mean I think what their problems are. I mean I think what their problems are. I mean I think this happens you know this is happening this happens you know this is happening this happens you know this is happening out there in in the community as well out there in in the community as well out there in in the community as well because people I find and I'm sure you because people I find and I'm sure you because people I find and I'm sure you find the same you know will often come find the same you know will often come find the same you know will often come to me saying oh you know I think I've to me saying oh you know I think I've to me saying oh you know I think I've got depression I think I've got ADHD I got depression I think I've got ADHD I got depression I think I've got ADHD I think I've got this I think I've got think I've got this I think I've got think I've got this I think I've got that think I've got yeah you know a that think I've got yeah you know a that think I've got yeah you know a diagnosis that they they might have sort diagnosis that they they might have sort diagnosis that they they might have sort of spent quite a lot of time looking up of spent quite a lot of time looking up of spent quite a lot of time looking up and it can be quite difficult then to and it can be quite difficult then to and it can be quite difficult then to get underneath this label that people get underneath this label that people get underneath this label that people have decided they have to to find out have decided they have to to find out have decided they have to to find out what the actual problems are what are what the actual problems are what are what the actual problems are what are the difficulties that they're having the difficulties that they're having the difficulties that they're having with their dayto-day life. Just wanted with their dayto-day life. Just wanted with their dayto-day life. Just wanted to add something something more to that to add something something more to that to add something something more to that because because people people often say because because people people often say because because people people often say to me um well, you know, that that's all to me um well, you know, that that's all to me um well, you know, that that's all very well for, you know, for a lot of very well for, you know, for a lot of very well for, you know, for a lot of people, but but what about people who people, but but what about people who people, but but what about people who have really severe depression or have have really severe depression or have have really severe depression or have depression when there doesn't seem to be depression when there doesn't seem to be depression when there doesn't seem to be any obvious cause, any obvious reason any obvious cause, any obvious reason any obvious cause, any obvious reason for them to be depressed? So, just like for them to be depressed? So, just like for them to be depressed? So, just like to address that cuz I think that's to address that cuz I think that's to address that cuz I think that's important. That was going to be my next important. That was going to be my next important. That was going to be my next question. question. question. >> It's important to say that the that >> It's important to say that the that >> It's important to say that the that there is no evidence that severe there is no evidence that severe there is no evidence that severe depression is caused by any specific depression is caused by any specific depression is caused by any specific biological mechanism either. biological mechanism either. biological mechanism either. But of course, we're all different and But of course, we're all different and But of course, we're all different and some people will react to possibly quite some people will react to possibly quite some people will react to possibly quite trivial problems in their lives in a trivial problems in their lives in a trivial problems in their lives in a much more severe or intense way than much more severe or intense way than much more severe or intense way than other people will. other people will. other people will. >> Yeah. Um and so there are some people >> Yeah. Um and so there are some people >> Yeah. Um and so there are some people obviously who get into a really bad obviously who get into a really bad obviously who get into a really bad state um who you know take to bed. state um who you know take to bed. state um who you know take to bed. Sometimes they refuse to eat or drink. Sometimes they refuse to eat or drink. Sometimes they refuse to eat or drink. Some people you know get sort of Some people you know get sort of Some people you know get sort of depressive delusions and in that depressive delusions and in that depressive delusions and in that situation we need to make sure that we situation we need to make sure that we situation we need to make sure that we take care of people. The evidence that take care of people. The evidence that take care of people. The evidence that anti-depressants are any use in that anti-depressants are any use in that anti-depressants are any use in that situation is no better than than in any situation is no better than than in any situation is no better than than in any other situation. They're not they other situation. They're not they other situation. They're not they haven't been shown to have um you know haven't been shown to have um you know haven't been shown to have um you know clinically relevant substantial effects clinically relevant substantial effects clinically relevant substantial effects in people with really se severe in people with really se severe in people with really se severe depression anymore than they have for depression anymore than they have for depression anymore than they have for people with milder milder episodes of people with milder milder episodes of people with milder milder episodes of depression. But it certainly is depression. But it certainly is depression. But it certainly is important that we help and take care of important that we help and take care of important that we help and take care of people in that situation because they people in that situation because they people in that situation because they can well often they can't take care of can well often they can't take care of can well often they can't take care of themselves and you know sometimes people themselves and you know sometimes people themselves and you know sometimes people can try and commit suicide. So it is can try and commit suicide. So it is can try and commit suicide. So it is important to keep people safe and to important to keep people safe and to important to keep people safe and to remember that remember that remember that >> almost everyone will come out of it >> almost everyone will come out of it >> almost everyone will come out of it eventually. eventually. eventually. >> Most people will recover from depression >> Most people will recover from depression >> Most people will recover from depression eventually naturally in their own time. eventually naturally in their own time. eventually naturally in their own time. >> Hopefully helped by being cared for and >> Hopefully helped by being cared for and >> Hopefully helped by being cared for and as soon as they're able to do it, being as soon as they're able to do it, being as soon as they're able to do it, being helped to identify things that might helped to identify things that might helped to identify things that might improve their situation. Because even improve their situation. Because even improve their situation. Because even people with this very severe depressive people with this very severe depressive people with this very severe depressive reactions are often reacting to reactions are often reacting to reactions are often reacting to circumstances. So it's quite typical circumstances. So it's quite typical circumstances. So it's quite typical people who get into this severe state, people who get into this severe state, people who get into this severe state, it's quite typical that they're older it's quite typical that they're older it's quite typical that they're older people who have just been affected by a people who have just been affected by a people who have just been affected by a bereavement, loss of their spouse or or bereavement, loss of their spouse or or bereavement, loss of their spouse or or um other loved ones or or retirement is um other loved ones or or retirement is um other loved ones or or retirement is is another another thing that can is another another thing that can is another another thing that can trigger these sort of episodes. People trigger these sort of episodes. People trigger these sort of episodes. People listening are going, "Well, gosh, if listening are going, "Well, gosh, if listening are going, "Well, gosh, if these things don't work and you know, these things don't work and you know, these things don't work and you know, there's $20 million of these drugs there's $20 million of these drugs there's $20 million of these drugs prescribed a year globally. Millions and prescribed a year globally. Millions and prescribed a year globally. Millions and millions of people are taking them and millions of people are taking them and millions of people are taking them and they're listening. What do they do? And they're listening. What do they do? And they're listening. What do they do? And how do you responsibly how do you responsibly how do you responsibly deprescribe them? And how do you support deprescribe them? And how do you support deprescribe them? And how do you support them as they're getting off of them? And them as they're getting off of them? And them as they're getting off of them? And how do you direct them to resources that how do you direct them to resources that how do you direct them to resources that can actually help address those can actually help address those can actually help address those underlying causes? underlying causes? underlying causes? >> First of all, it's it's important that >> First of all, it's it's important that >> First of all, it's it's important that people take their time to think about people take their time to think about people take their time to think about it. think about it. think about it. think about how the drugs are affecting them, the how the drugs are affecting them, the how the drugs are affecting them, the pros and cons of those effects. pros and cons of those effects. pros and cons of those effects. And then if they decide that and read up And then if they decide that and read up And then if they decide that and read up about the side effects that they might about the side effects that they might about the side effects that they might be experiencing, because sometimes be experiencing, because sometimes be experiencing, because sometimes people are getting side effects and people are getting side effects and people are getting side effects and they're not aware that it's, you know, they're not aware that it's, you know, they're not aware that it's, you know, they're not aware that it's the drug they're not aware that it's the drug they're not aware that it's the drug that's making them feel sleepy or groggy that's making them feel sleepy or groggy that's making them feel sleepy or groggy or or maybe interfering with their or or maybe interfering with their or or maybe interfering with their sleep. sleep. sleep. And and then if people decide that they And and then if people decide that they And and then if people decide that they do want to come off the drug, I would do want to come off the drug, I would do want to come off the drug, I would suggest that people go and see their suggest that people go and see their suggest that people go and see their doctors. Hopefully the doctor will be doctors. Hopefully the doctor will be doctors. Hopefully the doctor will be sympathetic and will draw up a a plan sympathetic and will draw up a a plan sympathetic and will draw up a a plan with you to come off it slowly and sens. with you to come off it slowly and sens. with you to come off it slowly and sens. If your doctor tells you to come off in If your doctor tells you to come off in If your doctor tells you to come off in in, you know, 2 to 4 weeks, don't take in, you know, 2 to 4 weeks, don't take in, you know, 2 to 4 weeks, don't take their advice, particularly if you've their advice, particularly if you've their advice, particularly if you've been taking these drugs for years at a been taking these drugs for years at a been taking these drugs for years at a time, because you may end up in a in a time, because you may end up in a in a time, because you may end up in a in a really bad state. Um there is there's really bad state. Um there is there's really bad state. Um there is there's information for people out there now information for people out there now information for people out there now about how to come off anti-depressants about how to come off anti-depressants about how to come off anti-depressants safely. A colleague of mine wrote safely. A colleague of mine wrote safely. A colleague of mine wrote something called the Msley deprescribing something called the Msley deprescribing something called the Msley deprescribing guidelines that give that gives really guidelines that give that gives really guidelines that give that gives really detailed evidence on how to reduce doses detailed evidence on how to reduce doses detailed evidence on how to reduce doses gradually um if you're experiencing you gradually um if you're experiencing you gradually um if you're experiencing you know difficult significant withdrawal know difficult significant withdrawal know difficult significant withdrawal effects. So yes, so so the main evidence effects. So yes, so so the main evidence effects. So yes, so so the main evidence is um don't do anything in a hurry. Make is um don't do anything in a hurry. Make is um don't do anything in a hurry. Make a plan. Try and get support from your a plan. Try and get support from your a plan. Try and get support from your doctor or from some health professional doctor or from some health professional doctor or from some health professional and come off slowly, particularly if and come off slowly, particularly if and come off slowly, particularly if you've been taking the drugs for a long you've been taking the drugs for a long you've been taking the drugs for a long time. time. time. >> One of the questions I get all the time >> One of the questions I get all the time >> One of the questions I get all the time is what's the healthiest way to boost is what's the healthiest way to boost is what's the healthiest way to boost your energy? Here's the truth. Many your energy? Here's the truth. Many your energy? Here's the truth. Many people depend on coffee to get through people depend on coffee to get through people depend on coffee to get through the day. But for a lot of people, it can the day. But for a lot of people, it can the day. 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You drug, but I'm going to be depressed. You drug, but I'm going to be depressed. You know, what do I do? know, what do I do? know, what do I do? >> So, yeah, that's a really good question, >> So, yeah, that's a really good question, >> So, yeah, that's a really good question, too. And also during the process of too. And also during the process of too. And also during the process of withdrawal, people might feel um one of withdrawal, people might feel um one of withdrawal, people might feel um one of one of the withdrawal symptoms is to one of the withdrawal symptoms is to one of the withdrawal symptoms is to feel sort of really intense emotions, feel sort of really intense emotions, feel sort of really intense emotions, tearfulness, anxiety, all those things tearfulness, anxiety, all those things tearfulness, anxiety, all those things can happen during withdrawal. And often can happen during withdrawal. And often can happen during withdrawal. And often people will assume that they're having a people will assume that they're having a people will assume that they're having a relapse because of those emotional relapse because of those emotional relapse because of those emotional symptoms. Um but those those symptoms symptoms. Um but those those symptoms symptoms. Um but those those symptoms can be part of the withdrawals process can be part of the withdrawals process can be part of the withdrawals process and to the extent that they are part of and to the extent that they are part of and to the extent that they are part of the withdrawal process they will the withdrawal process they will the withdrawal process they will gradually fade as as the body gets used gradually fade as as the body gets used gradually fade as as the body gets used to having not having the drug in the to having not having the drug in the to having not having the drug in the system anymore. So that's the first system anymore. So that's the first system anymore. So that's the first thing. Then the second thing if people thing. Then the second thing if people thing. Then the second thing if people are still depressed is the same as is are still depressed is the same as is are still depressed is the same as is the same advice as as as I would give to the same advice as as as I would give to the same advice as as as I would give to people who are depressed for the first people who are depressed for the first people who are depressed for the first time and thinking about possibly going time and thinking about possibly going time and thinking about possibly going to see their doctors. The most important to see their doctors. The most important to see their doctors. The most important thing is to try and identify why you thing is to try and identify why you thing is to try and identify why you feel as you feel. What is it in your feel as you feel. What is it in your feel as you feel. What is it in your life? What what is this emotion life? What what is this emotion life? What what is this emotion signaling to you? What is it in your signaling to you? What is it in your signaling to you? What is it in your life that is getting you down and that life that is getting you down and that life that is getting you down and that you might be able to change uh to you might be able to change uh to you might be able to change uh to improve how you feel? That's the first improve how you feel? That's the first improve how you feel? That's the first thing. M thing. M thing. M >> the second thing is as we've been saying >> the second thing is as we've been saying >> the second thing is as we've been saying earlier earlier earlier take exercise, eat well, optimize your take exercise, eat well, optimize your take exercise, eat well, optimize your physical health because that will make physical health because that will make physical health because that will make you feel better mentally and you feel better mentally and you feel better mentally and emotionally. emotionally. emotionally. >> I think that's important is that you >> I think that's important is that you >> I think that's important is that you know we we have to lean in on the things know we we have to lean in on the things know we we have to lean in on the things we know have been scientifically proven we know have been scientifically proven we know have been scientifically proven to work. eating a whole real food diet, to work. eating a whole real food diet, to work. eating a whole real food diet, regular exercise, especially regular exercise, especially regular exercise, especially cardiovascular exercise, getting cardiovascular exercise, getting cardiovascular exercise, getting adequate sleep and circadian rhythm adequate sleep and circadian rhythm adequate sleep and circadian rhythm regulation, managing stress and and just regulation, managing stress and and just regulation, managing stress and and just learning how to regulate your nervous learning how to regulate your nervous learning how to regulate your nervous system. And then and then there are system. And then and then there are system. And then and then there are other things that are easily addressed, other things that are easily addressed, other things that are easily addressed, you know, whether they're nutritional you know, whether they're nutritional you know, whether they're nutritional deficiencies, which are extremely deficiencies, which are extremely deficiencies, which are extremely common, whether it's omega-3s or vitamin common, whether it's omega-3s or vitamin common, whether it's omega-3s or vitamin D or folate or B12, things we know from D or folate or B12, things we know from D or folate or B12, things we know from the scientific literature do actually the scientific literature do actually the scientific literature do actually impact you. And then there's, you know, impact you. And then there's, you know, impact you. And then there's, you know, the whole other layer of things that can the whole other layer of things that can the whole other layer of things that can cause depression that we know can can cause depression that we know can can cause depression that we know can can drive inflammation in the brain, whether drive inflammation in the brain, whether drive inflammation in the brain, whether it's the microbiome changes that we now it's the microbiome changes that we now it's the microbiome changes that we now are understanding or whether it's are understanding or whether it's are understanding or whether it's environmental toxins. So there's there's environmental toxins. So there's there's environmental toxins. So there's there's actually a pathway and I it's what I actually a pathway and I it's what I actually a pathway and I it's what I spent a lot of my life thinking about spent a lot of my life thinking about spent a lot of my life thinking about and and I think you know it it sort of and and I think you know it it sort of and and I think you know it it sort of speaks to sort of really reframing the speaks to sort of really reframing the speaks to sort of really reframing the narrative of mental health from this narrative of mental health from this narrative of mental health from this sort of idea of some chemical imbalance sort of idea of some chemical imbalance sort of idea of some chemical imbalance which was sort of the the framework of which was sort of the the framework of which was sort of the the framework of your book to really a more sort of your book to really a more sort of your book to really a more sort of holistic view of understanding of health holistic view of understanding of health holistic view of understanding of health both from the sociological political both from the sociological political both from the sociological political environmental aspects and some of the environmental aspects and some of the environmental aspects and some of the other biological factors around other biological factors around other biological factors around lifestyle that we're just ignoring and lifestyle that we're just ignoring and lifestyle that we're just ignoring and uh I think that's That's it's a really uh I think that's That's it's a really uh I think that's That's it's a really important moment I think in psychiatry. important moment I think in psychiatry. important moment I think in psychiatry. It feels like a it feels like a really It feels like a it feels like a really It feels like a it feels like a really historical moment where we're basically historical moment where we're basically historical moment where we're basically understanding one the the degree of understanding one the the degree of understanding one the the degree of which trauma affects us from our which trauma affects us from our which trauma affects us from our childhood and two I think the childhood and two I think the childhood and two I think the psychedelic revolution is also opening psychedelic revolution is also opening psychedelic revolution is also opening up a different perspective of how did up a different perspective of how did up a different perspective of how did these things work and I think we're sort these things work and I think we're sort these things work and I think we're sort of entering a new era of of of um of entering a new era of of of um of entering a new era of of of um psychiatry and mental health and psychiatry and mental health and psychiatry and mental health and hopefully it get not like just like okay hopefully it get not like just like okay hopefully it get not like just like okay well proac didn't work let's just stop well proac didn't work let's just stop well proac didn't work let's just stop it and then you're all like kind of left it and then you're all like kind of left it and then you're all like kind of left holding the bag. I think that's a holding the bag. I think that's a holding the bag. I think that's a depressing thought literally in itself. depressing thought literally in itself. depressing thought literally in itself. So I think I think it's kind of a So I think I think it's kind of a So I think I think it's kind of a hopeful moment. Do you do you feel hopeful moment. Do you do you feel hopeful moment. Do you do you feel hopeful about the future of psychiatry? hopeful about the future of psychiatry? hopeful about the future of psychiatry? >> Possibly. I'm not sure. [laughter] The >> Possibly. I'm not sure. [laughter] The >> Possibly. I'm not sure. [laughter] The backlash the backlash I've had to both backlash the backlash I've had to both backlash the backlash I've had to both the book and the FDA panel on pregnancy the book and the FDA panel on pregnancy the book and the FDA panel on pregnancy is is a bit depressing. But I I'm always is is a bit depressing. But I I'm always is is a bit depressing. But I I'm always hopeful at an individual level because I hopeful at an individual level because I hopeful at an individual level because I see people who sometimes have been been see people who sometimes have been been see people who sometimes have been been depressed for years who do nevertheless depressed for years who do nevertheless depressed for years who do nevertheless manage to recover the agency to overcome manage to recover the agency to overcome manage to recover the agency to overcome what they're feeling and to make changes what they're feeling and to make changes what they're feeling and to make changes and to feel better. I see that all the and to feel better. I see that all the and to feel better. I see that all the time. And I think time. And I think time. And I think I think you know this is what I object I think you know this is what I object I think you know this is what I object to. What I object to most about telling to. What I object to most about telling to. What I object to most about telling people that they've got a chemical people that they've got a chemical people that they've got a chemical imbalance is that that is a really imbalance is that that is a really imbalance is that that is a really depressing message. That's telling depressing message. That's telling depressing message. That's telling people there's something wrong with your people there's something wrong with your people there's something wrong with your brain. There's nothing you can do about brain. There's nothing you can do about brain. There's nothing you can do about it. You've got to rely on, you know, it. You've got to rely on, you know, it. You've got to rely on, you know, someone giving you a drug. And so I someone giving you a drug. And so I someone giving you a drug. And so I think just just um you know correcting think just just um you know correcting think just just um you know correcting that mistake and informing people that that mistake and informing people that that mistake and informing people that there isn't something wrong with their there isn't something wrong with their there isn't something wrong with their brains and that they do have the brains and that they do have the brains and that they do have the capacity to improve, to recover, to capacity to improve, to recover, to capacity to improve, to recover, to change is is actually a positive and a change is is actually a positive and a change is is actually a positive and a hopeful message. hopeful message. hopeful message. >> Amazing. Well, everybody definitely >> Amazing. Well, everybody definitely >> Amazing. Well, everybody definitely should should take that to heart and should should take that to heart and should should take that to heart and should check out your new book, should check out your new book, should check out your new book, Chemically Imbalanced, the Making and Chemically Imbalanced, the Making and Chemically Imbalanced, the Making and Unmaking of the Serotonin Myth. It was Unmaking of the Serotonin Myth. It was Unmaking of the Serotonin Myth. It was definitely a wrong left turn that we definitely a wrong left turn that we definitely a wrong left turn that we took. took. took. >> [laughter] >> [laughter] >> [laughter] >> in the '9s and I think thank you for >> in the '9s and I think thank you for >> in the '9s and I think thank you for helping us correct it and rethink our helping us correct it and rethink our helping us correct it and rethink our approach. I really appreciate you being approach. I really appreciate you being approach. I really appreciate you being on the podcast. Is there any final words on the podcast. Is there any final words on the podcast. Is there any final words or thoughts you'd like to share with our or thoughts you'd like to share with our or thoughts you'd like to share with our audience? I I suppose inform yourself audience? I I suppose inform yourself audience? I I suppose inform yourself because because you know especially with because because you know especially with because because you know especially with the backlash I got to the book I the backlash I got to the book I the backlash I got to the book I realized that there are elements of the realized that there are elements of the realized that there are elements of the medical profession that don't want medical profession that don't want medical profession that don't want people to think for themselves that want people to think for themselves that want people to think for themselves that want people just to go on you know believing people just to go on you know believing people just to go on you know believing expert pronouncements about things which expert pronouncements about things which expert pronouncements about things which are not always accurate. I know that's a are not always accurate. I know that's a are not always accurate. I know that's a scary message, but I think we need to we scary message, but I think we need to we scary message, but I think we need to we need to be informed as as as patients, need to be informed as as as patients, need to be informed as as as patients, as consumers nowadays. We need to to as consumers nowadays. We need to to as consumers nowadays. We need to to inform ourselves and not just take inform ourselves and not just take inform ourselves and not just take things on trust. We have been things on trust. We have been things on trust. We have been essentially lied to about the nature of essentially lied to about the nature of essentially lied to about the nature of depression for, you know, two and a half depression for, you know, two and a half depression for, you know, two and a half decades now. Um so, so yeah, people need decades now. Um so, so yeah, people need decades now. Um so, so yeah, people need to do their own research and and not to do their own research and and not to do their own research and and not just take things on trust as as we may just take things on trust as as we may just take things on trust as as we may be used to. I I think that I think we're be used to. I I think that I think we're be used to. I I think that I think we're in that moment in medicine where people in that moment in medicine where people in that moment in medicine where people are are wanting to have more agency are are are wanting to have more agency are are are wanting to have more agency are less u sort of idealizing the sort of less u sort of idealizing the sort of less u sort of idealizing the sort of medical profession as a know-it-all medical profession as a know-it-all medical profession as a know-it-all profession and and sort of the emperor profession and and sort of the emperor profession and and sort of the emperor has no closed a little bit here and I has no closed a little bit here and I has no closed a little bit here and I think I think it's important not that think I think it's important not that think I think it's important not that medicine doesn't have a lot of value and medicine doesn't have a lot of value and medicine doesn't have a lot of value and that and we've both been trained in that and we've both been trained in that and we've both been trained in traditional healthcare and medicine and traditional healthcare and medicine and traditional healthcare and medicine and it it it does have a lot of really good it it it does have a lot of really good it it it does have a lot of really good things about it and doctors are things about it and doctors are things about it and doctors are generally very compassionate kind good generally very compassionate kind good generally very compassionate kind good people who want to do well for their people who want to do well for their people who want to do well for their patients It's just that we even even our patients It's just that we even even our patients It's just that we even even our own profession has been hijacked in ways own profession has been hijacked in ways own profession has been hijacked in ways by commercial interests that that by commercial interests that that by commercial interests that that leaving leave leave us not knowing leaving leave leave us not knowing leaving leave leave us not knowing what's true sometimes. what's true sometimes. what's true sometimes. >> I think people need to realize there are >> I think people need to realize there are >> I think people need to realize there are areas of debate and discussion within areas of debate and discussion within areas of debate and discussion within medicine and and you know things aren't medicine and and you know things aren't medicine and and you know things aren't aren't necessarily as clear-cut as the aren't necessarily as clear-cut as the aren't necessarily as clear-cut as the media and um scientists themselves media and um scientists themselves media and um scientists themselves sometimes portray them. sometimes portray them. sometimes portray them. >> Absolutely true. and you know, thank you >> Absolutely true. and you know, thank you >> Absolutely true. and you know, thank you for having the courage to um take on for having the courage to um take on for having the courage to um take on something that's quite controversial and something that's quite controversial and something that's quite controversial and and and challenging the orthodoxy and and and challenging the orthodoxy and and and challenging the orthodoxy and and moving science forward. I really and moving science forward. I really and moving science forward. I really appreciate your [music] work and uh it appreciate your [music] work and uh it appreciate your [music] work and uh it kind of validates what I was even seeing kind of validates what I was even seeing kind of validates what I was even seeing almost 20 years ago that were early almost 20 years ago that were early almost 20 years ago that were early signs in the literature that you know signs in the literature that you know signs in the literature that you know even in the 2000s [music] there was like even in the 2000s [music] there was like even in the 2000s [music] there was like wait a minute this isn't quite what it wait a minute this isn't quite what it wait a minute this isn't quite what it was promised to be. So thank you for was promised to be. So thank you for was promised to be. So thank you for doing the hard work and [music] uh doing the hard work and [music] uh doing the hard work and [music] uh making people like me look smarter. making people like me look smarter. making people like me look smarter. >> Thank you. Thank you. It's been a real >> Thank you. Thank you. It's been a real >> Thank you. Thank you. It's been a real pleasure. pleasure. pleasure. >> If you loved that last video, you're >> If you loved that last video, you're >> If you loved that last video, you're going to love the next one. Check it out going to love the next one. Check it out going to love the next one. Check it out here.