29.1 A Radically Genuine Conversation with Roger McFillin, PsyD, ABPP

[00:00:00] So where does it go too far? The truth of the matter is that human suffering exists, behavioral problems exist, and what we identify to be severe mental illness is real, right? And within trying to understand and effectively treat those populations, this field is just ripe with theories, right? So because of the human experience, everyone thinks they can have some degree of expertise on what that means.

[00:00:29] Somebody get this guy some help!

[00:00:39] Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional, medical, or psychological advice, diagnosis, or treatment. All listeners should consult with a medical professional, licensed mental health provider, or other healthcare provider if seeking medical advice, diagnosis, or treatment. Or, put more simply, If you need help like this guy, call your own doctor.

[00:01:07] So today, I am pleased to welcome Dr. Roger McFillan, a licensed psychologist, board certified in behavioral and cognitive psychology, and diplomat of the Academy of Cognitive Therapy. He is the host of the internationally popular podcast, Radically Genuine, known for its widespread and scathing critiques of the U.S. healthcare system, and especially mental health.

[00:01:32] He obtained his doctorate in clinical psychology from the Philadelphia College of Osteopathic Medicine, and acts as the executive director at the Center for Integrated Behavioral Health in Pennsylvania.

[00:01:44] He recently started the Conscious Clinician Collective, an online community where individuals and families can find mental health specialists dedicated to ensuring informed consent and respect for personal autonomy in a system predicated on industry deception and regulatory corruption.

[00:02:05] Somehow, with all these other initiatives, Dr. McFillan still found the time to co-author a book, as well as numerous clinical book chapters, media appearances, and research. Roger, thanks for coming on to Renegade Psych. How are you doing today? Great. Dr. Short, it really is an honor to be with you today and have the conversation. Appreciate you coming on the Radically Genuine podcast. I feel like we could probably talk for hours on these subjects. Absolutely.

[00:02:31] I thoroughly enjoyed our conversation on Friday, and like I told you then, it really just lays the groundwork for a good day for me, just to have some of the same viewpoints reflected back onto me. Oftentimes, when you carry some of the views that you and I carry, you can get a lot of criticism from those who are maybe more party to the industry themselves or whether they realize it or not.

[00:03:00] I'm curious to hear more about your background. Tell us a little about first your upbringing and then your journey into clinical psychology. Yeah, it's fascinating. Often when I'm working with clients, I have patients ask me, why did you become a psychologist? You know, that's one of the more common questions that I have. And, you know, what's interesting is that was never my intention. Grew up in a middle class family. My mom was a nurse. My dad was in sales. You know, sports were a big part of our life.

[00:03:30] I ended up going on to play small college football. It really was a focus of mine. But, you know, internally, I struggled in school because I had a hard time, you know, like just sustaining attention in the typical classroom American public school system. You know, I was an active kid. Looking back on it, you know, just like growing up in the 80s and 90s, some of the food that I was eating before I was even going into school.

[00:03:57] You know, right now where there's a certainly like an attention on, you know, the poisoning of the American public. But I remember having these cereals before I'd go into school and experiencing the crash very early on, not really understanding the food that I was eating. Had so much sugars in it and dyes and chemicals. And I was an athlete. So I was, at least for some respect, focused on my health. So I was someone who struggled in school because I just couldn't be there under those fluorescent lighting. I wanted to be outside.

[00:04:27] My mind was always daydreaming. There's no doubt if I was born today, I would have been slapped with the label of ADHD. And that, to be honest with you, like that experience that I've had does influence how I think about human potential. I ended up going on getting a doctorate degree, finished top of my class, you know, earned awards. Co-authored books. You know, right now I can throw myself into a book for a long extended period of time.

[00:04:56] And I just know that there's ways that we can, you know, train our minds, become disciplined, change the way we eat and change the way our outlook is. So I know like human potential is much greater than what it's really provoked for us. Like there's so much fear provocation in the American healthcare system that people want to identify with quick labels. But to make a long story short, right after I graduated, I thought I was going to be a teacher and a football coach, maybe even become a college football coach.

[00:05:23] I really didn't know anything other than like sports. That was my life. And I thought I might be a history teacher and coach. I really did not have the passion for that. So I accepted a job as a high school football assistant football coach right after graduation and then accepted a position at a children's psychiatric hospital right out of undergrad. So I was 21 years old, actually, when I graduated college. And I worked on a unit with young kids between the ages of five and 10. So the year is 1998.

[00:05:52] So I was there from 1998 through 2000. And what I saw at that in that hospital experience, I think just had such a profound effect on me. These were kids, five, 10 years old. They were certainly coming from backgrounds that were abusive, violent and neglectful. You could see the trauma reactions and them entering into the system. And they acted in ways that you would think that kids who are in traumatic environments would act.

[00:06:20] There was aggressive behavior, acting out, emotion, dysregulation, fear, hypervigilance. And I saw what my first hand was what the mental health establishment, how they traded those kids. And it was right in the boom, really, of, hey, there's childhood bipolar disorder, childhood schizophrenia. Let's try this new drug that comes to market.

[00:06:42] Trying to identify mental health conditions as some underlying brain chemical imbalance that could be stabilized with drugs. Almost ignoring the environment in which they came from. So these kids would come into the hospital. I'd see horrific side effects, part of dyskinesia. I've seen kids become more hyperactive from the drugs they were provided or sedated. Somewhere on this spectrum of sedation and stimulation.

[00:07:10] I saw kids sleeping 16, 18 hours a day. We couldn't get them out of their room. And morally and ethically, you know, I had a problem with that. I had a difficult time sleeping, feeling I was a part of it. And at 21 years old, I was just someone who challenged the system. I really thought and believed and still do that we must challenge systems of authority. And that's our right as free people.

[00:07:38] And by doing that, I actually got promoted fairly quickly in that hospital system where I became what was called a head treatment counselor that got to participate in these treatment team meetings. And what I observed was the hierarchy that existed. There was the psychiatrist on the unit, then nurses, then social workers, then counselors. And everyone really didn't question the physician, didn't question the psychiatrist.

[00:08:04] Regardless if these kids were deteriorating or not, you just saw a fear. And we'd leave the meetings and then privately they would like share their concerns. But when they had the opportunity to voice their concerns about what's happening, they just deferred. And I just kind of made a commitment at that time that I have to do something about this. I began to feel passionate about, you know, how do people overcome challenges in life? And what are all the complex reasons why we suffer?

[00:08:32] And I just started on my path to go into graduate school. I got a master's degree first before I entered in my doctoral program. And I've had a range of experiences before I even became a clinical psychologist. I mean, when I got my master's degree, I ended up going in the homes of impoverished communities to work with families. I've worked in the juvenile justice system.

[00:08:55] I was a juvenile probation officer working with a specialized caseload of teenagers who committed crimes but also had major mental health diagnoses. I worked in public schools. Some of them were in schools that had, you know, like 99% poverty rate. So I've been on the front lines of the growing mental health crisis throughout the 21st century right now. And I've seen it worsening. We were at a place where a lot of people just blame the worsening adolescent mental health crisis on COVID.

[00:09:24] But for us who were involved in the system saw it, you know, from the moment we started mass prescribing psychiatric drugs where kids got access to smartphones and technology, we started to see the deteriorating health of our youngest generations. And so that in a lot of ways has inspired me to speak out as I am now running a center and doing some nonprofit work and do consultation work, international consultation work, as well as running the Radically Genuine podcast.

[00:09:52] And I feel from my deep dive into the scientific literature on so many aspects of this, being aware of industry corruption, the regulatory failures of the FDA and the power of marketing, how it's really shaped our culture and how we think about our lifespan, our well-being and our health. The statistic that always jumps out to me is that we were medicating 0.2% of Medicaid-insured youths in 1987.

[00:10:21] Mental health problems were essentially a post-pubertal issue, and it was very rare for children or adolescents to have a mental health problem serious enough to warrant medication treatment. Nowadays, we medicate close to 15% with almost 20% of teenage girls being medicated with typically antidepressants, but also a lot of kids being medicated with antipsychotics.

[00:10:48] I want to point out there are good child psychiatrists out there. I know some of them that understand the failures of the system.

[00:10:56] One of which I've worked with, David Lohr, he revealed to me this just absolutely brutal and heartbreaking statistic in my state of Kentucky that sometime in the mid-2010s, there were 2.5% of Kentucky Medicaid children under the age of six that were prescribed an antipsychotic.

[00:11:22] I had a similar experience in child psychiatry, and one of the reasons why I don't see children in my practice is simply I don't want to burn out from my field. And I thought it was absolutely atrocious that we would rely on, a lot of times, the abuser of the child to give collateral information and be a huge part of the decision of whether to medicate or not.

[00:11:49] Like you said, medication is not going to fix the root cause of the problem, which may be environmental. It might be abuse. It might be neglect. It might be not getting their daily needs met. So you know, based on our last conversation, that I'm also highly critical of the field of psychiatry and definitely child psychiatry. But I'm curious, where do you think the criticism of psychiatry as a field goes too far?

[00:12:19] So where does it go too far? The truth of the matter is, is that human suffering exists, behavioral problems exist, and what we identify to be severe mental illness is real, right? Right. And within trying to understand and effectively treat those populations, this field is just ripe with theories, right? So, you know, because of the human experience, everyone thinks they can have some degree of expertise on what that means, right?

[00:12:47] And there's what's called a trauma-informed approach to understanding mental health treatments. And what that is, it kind of relates that every human struggle that potentially exists can be traced back to a traumatic experience. And then what that has done, it has really just inflated the label of trauma to be anything that's painful. And that's just as harmful as criticisms of psychiatry. So where does it go too far?

[00:13:16] Is that, first of all, any time that you apply a label to all people, like anti-psychiatry, it's under the assumption that everyone who's become a psychiatrist is practicing in the same way, adheres to the same belief systems, and treats everyone the same way. Which is a big umbrella, because me as a psychologist, it'd be like saying every psychologist does what I do, or I practice in the same way as any therapist does, right? So it's not fair to marginalize a large group of people in that way.

[00:13:46] Now, we have some critical questions, and we have some real valid critiques of the mainstream psychiatric establishment, how psychiatrists are trained and their role in the healthcare system, okay? So where does it go too far? There are legitimate situations, crisis situations lead to a legitimate risk, valid risk to a person or their community. And in that regard, pharmaceuticals, I'm not going to call them medicines, they're drugs,

[00:14:16] and we induce drug effects, can protect someone in that moment against harm of themselves or somebody else, right? There's also greater moral and ethical questions to the degree of impairment that a person would experience. A great example of this is, you know, if you have an animal that is in a lot of pain and is suffering and struggling,

[00:14:43] we would see it as the humane thing to do in trying to relieve that suffering. Drugs can do the same thing for people who have, like, multiple presenting problems disconnected from reality, hyper-aggressive sleep problems. So these drugs have drug effects, and these drug effects can be utilized as tools for the ethical and conscious physician

[00:15:06] to try to ease suffering and create stabilization in a way that can improve suffering and quality of life for an individual. So that's why we can't be critical of every time a psychiatric drug is utilized, or even sometimes with the labels utilized to be able to kind of understand what may be going on.

[00:15:26] Where we don't go too far is that model, which should be reserved for what amounts to very rare circumstances, is then mass applied in a medicalized way of understanding human struggle, suffering, and disconnection from, you know, reality and crises. It's mass applied, and then people are misled. An entire culture is told that we have these medicines or, you know, this is a discrete medical illness.

[00:15:55] You take this drug, this is your medicine, and you will be stabilized and you will be improved. And it's led to a mass over-prescription, mass over-diagnosis, and a sick society. And the field of psychiatry has to take responsibility for that, as does my field, because we are all complicit in kind of working in a very similar way. The fact that you and I are stepping out and having these critical conversations, we're still the minority. You know, this type of conversation is not mainstream.

[00:16:24] And if you have this conversation in mainstream circles, we're going to be dismissed, unfortunately. This is not how people in my community are treated. I would say we're close to 20% of adults being prescribed at least one psychiatric drug. I've seen numbers of adolescent girls between, like, the ages of 14 to 25, you know, post 20% on an SSRI. Like, that makes no sense. That's ridiculous. It's harmful.

[00:16:53] And they're not receiving informed consent. You were talking historically a little bit before. A great book on these subjects, 1968 Epidemiology of Depression by Charlotte Silverman. Another one is a paper in 1964 by Dr. Jonathan Cole, Therapeutic Efficacy of Antidepressant Drugs. The truth of the matter is what we would label as severe depression was historically so rare

[00:17:17] that it was unheard of and unseen in children as suicide, too, was a very rare event in young people. Adults would, fewer than 1 in 1,000 adults would experience a clinical depression annually in community-based surveys. And it was almost always prompted by extreme stress. Hardships in life, loss of job, loss of a loved one, generally provoked and seen as stress-related conditions.

[00:17:47] So much so that Jonathan Cole in his therapeutic ethic to give antidepressant drugs said there's no market for it. Because what we see as depression will overwhelmingly resolve itself in time without intervention. And so what we've done is we've induced and created mental illness in our society to fit a model and to sell drugs, which is exactly what the pharmaceutical company's job is. They're beholden to their shareholders.

[00:18:11] So they need to increase the amount of people who identify with mental illness in order to increase the sale of their drugs. And you need to increase the amount of people who take drugs for life or close to life in order to maintain that profit margin. That's their job. But it is the independent community, the independent physicians, the critical thinkers, who were the ones who have to challenge such a notion. Our system is actually set up to support doctors.

[00:18:41] The FDA pushes drugs into the hands of doctors to be used as tools. We don't have long-term safety, right? So doctors have to be independent of industry. And once the psychiatric medical establishment aligned with the pharmaceutical industry, they lost their objectivity, their professional objectivity. And you took a profession that could have evolved with behavioral management, psychotherapies,

[00:19:09] the evolving understanding of gut microbiome, nutrition deficiencies, impact of trauma on brain, all these aspects, along with using drugs as tools. But to be a true physician and being able to understand the ideology of struggles and work hand-to-hand with other mental health professionals, it got completely distorted about what their job was going to be.

[00:19:34] And they became, and I'm going to say this, close to 95% are just now legalized drug dealers working on behalf of the pharmaceutical industrial complex. And it's such a point that there's such mass harm and such mass conditioning that so many psychiatrists have lost the ability to critically analyze, and all they are are parroting what has become a marketing narrative that's influenced the way they were trained in their residencies,

[00:19:58] in their textbooks, by the pharmaceutical industry's hiring of academic psychiatrists as thought leaders. It's such a sick care model and sick care system to support industry that the psychiatry profession has made themselves vulnerable. And now they're being really called out by harmed patients globally, and it's such a strong movement. I agree with a lot of what you said there. I think for me throughout my medical school and my residency training,

[00:20:28] I think that most doctors coming up in training, at least in my experience, they seem skeptical about the effectiveness of psychiatric meds. But I think many are still willing to prescribe them, I guess, because they were taught that they were unequivocally safe, which I think I absolutely do not agree with on the whole. And again, I've got to point out, you know, we're talking about psych meds

[00:20:55] in a way that is a little dichotomous here or polarizing, like they're all created equal. There are certainly, in my opinion, probably somewhere between 5 to 20 percent of psychiatric drugs that actually have a role in prescribing, and the other 80 to 90 plus percent don't have good enough effectiveness or safety data for us actually to prescribe them en masse. But I want to talk a little bit more about that training environment.

[00:21:25] Because I thought that was very fascinating in terms of, you know, leading so many doctors down this path of being willing to prescribe drugs that they may recognize are not that effective, or at least not significantly more effective than placebo in order to offset their side effect profiles. And so when I think about this, I come into medical school.

[00:21:50] In that first six months, it is the most academically competitive environment I've ever been in. You go into this environment that's highly competitive. You have national standardized exams that you have to pass. And if you don't pass those, you're out. Not only are you not able to pursue that MD or that DO, but you're also out financially, depending on how much you've invested in your undergraduate.

[00:22:18] And the cost of medical school is absolutely absurd, especially if you don't have either any individual financial backing or any help with the cost of living. So you're in a highly competitive atmosphere. You're taking tests that are make or break. And that's not even considering your medical school exams. You do that for four years. And then you come out in a boatload of debt, 200,000.

[00:22:48] There was one economist analysis of this that shot the number up to seven or 800,000 on average for those without any financial aid. When you take into account interest and overall cost of living, along with medical school and residency, in terms of opportunity costs versus the person who comes out of undergraduate and goes into whatever field they go into. And then you go into residency where you have to, in a sense, kind of obey the norm.

[00:23:19] For example, you are mandated to get certain medical things done to you as part of you graduating from your training program. And then you get out. And if you speak out on these issues, one of the things that has prevented me from maybe going a little bit further in my critiques, well, gosh, what if you can't find a job or you get deboarded by your medical licensing board?

[00:23:44] Ignoring all of the pharmaceutical funding of medical school and training programs and instituting the guidelines, what are your thoughts on the impact of clinical training on the more widespread problems that we see in U.S. health care? You brought up some important points regarding the systemic challenges that exist.

[00:24:06] I have gotten countless anonymous emails from psychiatry residents over the past five years who support what I'm speaking about and my podcast and my substack and report the exact challenges that you stated, where they are stuck, where they are riddled with debt, and they work in a system that requires them to follow those guidelines,

[00:24:34] whether they agree with them or not. We also have to acknowledge that I think the last statistic I saw, about 80% of psychiatric drugs are prescribed in primary care settings. So it's not like we're just talking about the specialty of psychiatry and neurology. We're talking about primary care docs on the front line and 10-minute meetings writing prescriptions. Well, why are they writing those prescriptions? The major medical organizations, the American Medical Association,

[00:25:03] American Academy of Pediatrics, they develop these treatment guidelines. These guidelines are passed off as if they're the best available evidence. And they are not the best available evidence. They are funded, and those major medical organizations are funded by the pharmaceutical industry or some of their nonprofit groups that they prop up in order to act on their behalf, biotech. It's all part of a system.

[00:25:31] As one pediatrician told me, and I really appreciate his candor, he said, what do I do in this situation, Roger? I have a teenager in front of me who is depressed and is at least saying they want to die or would rather die. And other than sending someone to a hospital for a short period of time, let's say even if they're not actively, intentionally suicidal but depressed, he has a guideline

[00:25:59] that erroneously states the safety of that SSRI for that age range based on limited data, cherry-picked studies. I went through the Academy of Pediatrics guidelines for depression. They lie. Call it what it is. They lie about the evidence. They don't speak to the totality or the dangers. So he says, if I choose not to follow those guidelines and something happens to that teenager who I can only spend like 10, 15 minutes with,

[00:26:29] my license is then liable. If I follow the guidelines, I'm protected. If I follow the standard of care, I'm protected. And I have $500,000 in debt and two young kids. That's the situation that I am facing. And so that speaks to the systemic problems that exist in the corruption. So then it steps back to, okay, and this is ultimately my statement to this gentleman because I can empathize with where he is

[00:26:59] and also at the same time say he has a higher ethical standard. He has to adhere to. First do no harm, number one, informed consent, medical freedom. There are other ones, right? That you are not beholden to a document from the American Academy of Pediatrics. It's that patient in front of you, their well-being. And yes, it is only through fear that you can be controlled. Fear of losing your license.

[00:27:28] Fear of not being able to take care of your family, right? It is that fear that leads people and has throughout human history to participate in atrocities. And so ultimately, it comes down to is that we need ethical physicians to act on the best behalf of clients with a critical eye and analysis and understanding of the literature. And then you have to call out your own profession when you see there's discrepancies. Yeah. You know, one situation

[00:27:57] that I run into regularly, ethically, morally, is taking on a patient that somebody else has already seen or that is hell-bent on being on a certain medication. It has worked or been helpful in their mind for their family member or for a friend of theirs. And of course, you try to educate the patient on unknown or lesser-known harms of any certain drug class as well as the effectiveness and what studies have shown. But societally,

[00:28:27] people are influenced to believe that these medications are absolutely safe and absolutely effective. And they come to me expecting to be on that medication. If they come in on day one and I shut them down completely, well, in my mind, they're just going to go find somebody else. We are operating in a world now where it's not just psychiatrists, it's not just doctors. There are more and more mid-level practitioners out there every day, nurse practitioners,

[00:28:57] physician assistants, and they are really flooding the corporate healthcare entities because you can have a couple of doctors overseeing several nurse practitioners who you don't pay as much but you get reimbursed very similarly. And I would add to that, patient can jump on the internet, go to a platform, fill out a screening measure, and supposedly that's reviewed by an online doctor who then writes out the prescription

[00:29:27] and that could range from meds for sexual health to psychiatric drugs, right? You can get ADHD diagnosis in five minutes to obtain stimulants. You can get a depression and anxiety diagnosis to get an SSRI or a benzo. This is part of a system to get as many drugs prescribed as possible. So patients can be absolutely incredulous that this is the way that we're going to do this coming to myself or another psychiatric prescriber.

[00:29:56] How would you recommend that you maintain the trust and you maintain the patient so that you can hopefully make a positive impact on their life in the long term? We've lost an information war where the industry-funded, medicalized aspect of American culture where there's a pill for every ill has reduced and changed everyone's understanding of what it means to struggle or go through life.

[00:30:26] I say that we've lost our language of suffering. People don't know necessarily what is normal anymore and they think that whenever they go through a very difficult period in their life that there's something inherently broken within them medically and there's a quick fix to it. When you have the opportunity to develop a relationship with somebody and spend some time listening to them and understanding their struggles and context, then you can also provide them

[00:30:55] more accurate information and this is where that greater umbrella of informed consent really matters. In a free society with a drug that's approved and with a medical professional as a license to prescribe them, those are options that are available to that person but at what cost? And often what they're doing and too many of the prescribers as well, they're overestimating the benefits while underestimating the harms. If there was something really quick, right, if there was just

[00:31:24] a quick fix to all of this, we would see different outcomes and not where we're saying that some people are in a lot of ways making a deal with the devil. They believe that there's some temporary escape from their pain and there may be depending on what that drug is and then what happens just what is the human body and the human brain is that's always seeking out homeostasis, right? Always adapting and so you're going to need more and more of a drug or another drug to yield

[00:31:54] the same result while never really dealing with what is underlying all of that. You create this horrible drug dependence and this seeking and escaping of, you know, intrusive thoughts or uncomfortable emotions and before you know it you're sick from the drugs but you're also sick from the idea that life without pain or without struggle somehow does exist and so the information war is like this opportunity to normalize, validate emotions to understand it's an entire

[00:32:24] science space that exists around facing and exposing ourselves to discomfort overcoming it and then feeling so much better on the other end that there's these natural inborn processes of emotional resilience that we've experienced through the beginning of the dawn of time of our species and we've lost that under this drug model and I think that's the way that you communicate it. One of the things that, you know, my struggle is the most common prescribed drug is an SSRI

[00:32:53] and I have a hard time being objective about the literature and using my own clinical experience to say, well, where, I don't see the value in SSRIs at all. I don't see the value. I don't see it from the science. I don't see it in understanding mechanisms of action. I can't make a case for it. I only see harms. The costs so far outweigh the benefits of that drug and I'm not convinced that the benefits of that drug aren't expectancy effects or placebo

[00:33:23] effects, an active placebo effect because it's an active drug effect working on the brain. Outside of emotional blunting, which I see emotional blunting as problematic, not something that's helpful, with the myriad of potential harms. That's a drug I don't see any potential benefit. Sometimes I get the question, should SSRIs even be on the market? I say, no, I don't see its potential value. I could see the value of a benzodiazepine.

[00:33:52] Even though benzodiazepines are very harmful, I can at least articulate to you a short-term benefit or a value in that in the healthcare system. Absolutely. I agree with you on the SSRIs. I could certainly come up with a situation in which I think it would be effective. Yeah, let's talk about that. I actually am asking that question to almost everybody who prescribes them, and they give me the packaged answer. So I'm open to

[00:34:21] if I can have the other side to that. So I got to preface this with saying that these are one of the banes of my existence in terms of prescribing drugs, because I am taught to prescribe them to anybody and everybody for 275 of the 300 conditions in the DSM. The group that tends to get prescribed these most often are adolescents and young adults, and the average onset of what I

[00:34:51] would consider to be a legitimate psychiatric condition in mood disorders with a genetic hereditary basis of suicides occurring in families. That average age of diagnosis or the average age that somebody would experience a first manic episode in men is somewhere around 21, 22, in females can be later than that because of the protective effects of estrogen. I'm supposed to prescribe this drug that can cause somebody to switch into a

[00:35:21] manic state when they never have before, and in that manic state, or mixed state, they can kill themselves. I mean, that is the absolute worst outcome that we have in all of psychiatry, is death, suicide, overdose. So, you know, I want to preface this by saying I agree with you that they are so overused, and in the population that we're using them in, it's a travesty, it's an absolute travesty when we lose somebody at the age of 21. And again,

[00:35:51] it's a travesty when you lose anybody, but somebody who's 75 and dies because of a drug effect, that's a difference of 50 plus years compared to the 21-year-old. Now, where I would say maybe there is an impact is in conditions like OCD or a really severe form of OCD where the person or their mind, they just care about too many things. They have anxiety that overwhelms their system and makes them more

[00:36:20] incapable of getting other tasks done that are important to them. Now, I will also say with that, we're in such a rush when we prescribe these drugs. You know, the clinical trials are based on six, eight, 12-week studies, and to say that that drug has reached its max effect or that you understand all of the impacts of that drug after 10 or 12 weeks is kind of absurd. You know, I've heard well-respected psychiatrists talk

[00:36:50] about using even half doses of the lowest dose and giving it time to have its impact so that you don't overshoot your target. Because, again, when I talk to patients, they tell me, I mean, it seems like more than 50% of the time, oh, yeah, that drug caused me to be a little bit emotionally blunted or numb. If we overshoot the target because we're trying to rush through and get to an effect too early, then you can have all of the potential

[00:37:20] side effects that go long-term like sexual side effects or post-SSRI sexual dysfunction, you know, other sensory disturbances. So, I can imagine a group or a situation same as, you know, electroconvulsive therapy. I've seen patients who are catatonic, aka immobilized, not eating, not drinking, not able to communicate, that are responsive to high doses of benzodiazepines or electroconvulsive therapy. So, there are

[00:37:50] roles for these things, but they're so overstated. Okay, so if your position around an SSRI, maybe the most impairing obsessive compulsive disorder, where some may be so overwhelmed by their own thoughts, that inducing an SSRI has this way of maybe quieting this overactive aspect of the brain, where thoughts and fears are kind of interrelated,

[00:38:20] right? And so, again, those situations are quite rare. My concern is like the serotonergic system is so complex, and we are using a chemical compound made in a factory to induce a reaction in this complex system, the brain, 90 billion different neurons that exist, in ways that we could not ever really fully understand what the consequences of that are.

[00:38:49] We can only use data on how we understand the dangers to this, but we really are altering a system, we're inducing a chemical imbalance in the system where there wasn't one, and serotonin is so complex that there's this bi-directional relationship with so many aspects of a person. This is why I think it's so concerning for young people because of the bi-directional relationship with sex hormones, for example, that we're fundamentally changing somebody

[00:39:19] in ways that we can't necessarily predict, and what we do is we see this rise in gender dysphoria, in suicides for adolescents, in school shootings, and violence that occur after the drug is prescribed. I don't know if I talked to the most prestigious world right now, and I'd say, hey, on a scale of 1 to 10, 10 being we know everything about the human brain, the most complex organ,

[00:39:49] 1 being actually we know quite little, they would say we probably only know like a 3, possibly, right? Like it's that mysterious and the way that the entire body works together in concert with each other, that once you start inducing a drug reaction in one aspect, it has all these downstream consequences, right? And you see this with the down regulation of serotonin receptors on the cell, like once you start inducing that drug, it's almost like, hey, we don't need to produce this

[00:40:19] in the same way we did because we are recognizing this artificial induction of it. And so if somebody is so incapacitated, this is back to like the humane aspects of this, then I could argue that any, I would try anything, right? If I have no life to begin with, then I'm willing to try to do anything just to be okay, even if it decreases my overall lifespan, if I have other health effects, they might be worth it. So I can understand it in that regard, but that is such a small

[00:40:49] percentage of the population. We're actually giving this drug to teenage girls who experience premenstrual mood changes. Ethan, this is so harmful, and this is in my community. We have OBGYNs who are saying, listen, you take this SSRI for these two weeks leading up to your period, then you stop it, and then two weeks off, two weeks back on. It's like they're inducing withdrawal.

[00:41:18] They have no idea what they are doing. And I didn't go to one day of medical school. I'm a clinical psychologist, but I have put enough work in to be able to understand these dangers that I could never do that. that would violate my code of ethics of protecting a vulnerable population. And that's where we've gotten to at this point. Doctors are not independent, nor are they thoroughly evaluating the

[00:41:47] cost-benefit analysis of this and understanding the research. They are just repeating what they're told. So in some respect, we are getting medical care from pharmaceutical salespeople. I think the biggest problem with the SSRIs is that they are indicated as first-line treatments for so many conditions. And they absolutely should not be first-line treatments. They should be kind of last-resort type of options in

[00:42:17] that sense of nothing is working and I'm making an informed decision that I don't want to live this life and I'm willing to try this medicine that may have some potentially severe side effects, especially long-term. but I'm still willing to do it. You know, based on our limited conversations that for most psychiatric conditions, I think that there is a role of a low dose of lithium, whether it's even just a supplemental

[00:42:47] dose, five milligrams, which is roughly doubling, maybe tripling the natural amount that you get out of your environment through water and food supply. Lithium works in a much more natural and long-term stabilizing way. It provides neurostability, but it doesn't give an effect to the person immediately. So you got to counsel the patient that you don't feel anything and that's a good thing because what you want is a long-term change that is so

[00:43:17] gradual, just like if you change your diet, just like if you start to exercise and you're normally sedentary, the change you'll notice is going to be very gradual over time as you continue with that habit. Thanks again for watching and or listening. If you're passionate about the subjects that I discuss on the channel, do me a favor and like, comment, subscribe, do whatever you can to make your voice heard

[00:43:46] that these are problems that must be addressed in our society. If you have any questions, comments, or concerns, I want to hear them. Feel free to reach out on social media or email us at renegadesyke at gmail.com and if you'd like to be a guest of the show or you have a connection to somebody that you think would be a good guest, let us know. Thanks again for listening.