Rethinking mental health and antidepressant prescribing

Thanks so much for a very important conversation. Antidepressants are routinely prescribed for people who are having typical normal responses to life's circumstances which could be helped more with counselling/psychotherapy,not ssris/antipsychotics

I'm seeing a very good psychotherapist who is helping me navigate tough life circumstances and difficult situations, and for me personally this beats any drug I've put into my brain to alter chemicals that don't need to be altered especially when they made me feel so much worse,of course they have their place and absolutely help so many people and please take them if you feel you need to,they lift so many people, but work better alongside therapy,, combine the two and it helps even more…

I would suggest that antihistamines, antidepressants, GLP-1 related medication and some others have one thing in common. They all decrease the possibilities to perceive the longing or the need for change. To physically or emotionally feel an itch, discomfort (like sadness) or hunger for something and the rest of your physiology is quite balanced, is often the first sign of our old ways no longer being functional. A sign that we need to get rid of something bad, find something new or simply move forward no matter what the futur holds. I realised that when I had taken antihistamines for some time, that I probably also closed off for essential and healthy 'itches'. Although I didn't look into it there actually are connections, I decided to be very restrictive with antihistamines. Antidepressants and GLP-1 related medications for sure decrease the healthy longings and hungers, not only the unhealthy ones.

Sorry for a long text. But this is important:
Mindfulness seems indeed to be helpful for many. But like anything that has the potency to help it most likely also has the potency to cause harm. Mindfulness like the body work I practice, The Rosen Method, which is also relying on the body's natural capability to readjust into a more relaxed and balanced state. Both mindfulness and the Rosen Method is gently poking a physical and mental habitual holding as a slight reminder that there might be things to let go of in order to relax etc. This poking is for most good in the way that the the body can check in with itself and decide whether to let go or hold on. But people who's body at the moment can't make that decision, are at risk to lose the protection the body is providing. Not being able to keep things on a distance, holding themselves upright or together can be very harmful. People with chemical addictions, being in a current crisis or having a mental health issue can all block people from being able to balance functionally balance themselves.
In my view also the setting where and the mind set in which mindfulness is taught is important.
I was happy to hear this brought up in Rusell Barkley's YT video 'Does Mindfulness Meditation Work for ADHD'. (At 14:50​ Discussion of the potential side effects (adverse events) from mindfulness practices for ADHD.)
A channel that I very much recommend listening to from the first to the last video.

Very important topic. Thank you!

It's good that this information is being put out there. Just hope people can get other support

Mark Horowitz is doing such a good job of educating the public. I worked in mental health for almost a decade and was shocked at the lack of informed consent for psych meds.

Great podcast. Quite challenging for someone who worked as a psychiatric nurse for nearly 40 years. However, there is a huge problem in terms of access to psychological therapies and often medication is the only option available to us in that moment (I was not a prescriber). Sadly due to the general decimation of healthcare services, and even more so in mental health, we lack staff and resources and often rely on charities to provide the therapeutic activities we used to be able to provide in psychiatry. Of course, this is not a reason to go down the medical model route necessarily. But it also has to be remembered that only the most unwell people will be in psychiatric services who will need a lot of support to instigate alternative approaches.
And in terms of menopause and perimenopause, it is astounding that women can walk out of an 8 minute appointment with a prescription for SSRI's when natural hormones were not even considered. I really don't understand the fear and scaremongering around natural hormones, especially when comparing them to some medications.

I expected more of this conversation. It is very narrow. I agree that antidepressants should be assessed more carefully for younger people or for short term disstress and those who haven't tried lifestyle changes and therapy. I also agree patients should be informed about side effects and how to get off these drugs. What about patients who have tried lifestyle changes, therapy and don't get better? What shall those who suffer from stressors outside of their control like chronic illness, bullying and financial struggles? I expected qualified experienced doctors to discuss the full picture and not just one side. What about combined therapy and holistic approach where patients take meds short-term and figure out their issues in the meantime to feel better long-term?

I wasnt suicidal until i was put on antidepressants

Im 5 years post menopause and currently not on HRT. I have agoraphbia and autophobia since I began perimenopause 9 years ago. I tried several different HRT formulas of Estrogen and Progesterone but they often made me feel worse and I did not have support from any medical proffessional to navigate which doses or method to apply, to reach optimal balance. I was mostly told 'it was all in my head'. Im now under a psychatrist and have a support worker. Im currently on Quetiapine 25mg for the last 3 months and I feel terrible. I have put on 17lbs in weight which I have found very upsetting. Im now trying 'very slowly' to taper off. I since discovered that Quetiapine lowers Estrogen and Testosterone. I long thought the post natel depression id experienced and short stint of agoraphobia thereafter, was caused by unbalanced hormones and particularly low testosrerone which also occurs after giving birth. Low Testosterone also causes digestive issues and this probably explains why the Quetiapine has been been extremely problematic in making my acid reflux worse. Im a little lost on what to do now.

I remember when you had to reside in the Asylum to get these pills. Now that they built all the big new drug stores everywhere people in the OR. ER, and HR are on them.
You don't even have to be a mental case yet to get them.
In some classrooms the teachers are and the students are on the same darn lucrative pills.
Psychiatwists and psychiatricks.
The basic reality of Pharmaceutical commerce.

Very informative discussion and Dr Mark Horowitz scientific research and evidence is invaluable, as it dispels the commonly held view that there’s something wrong with the patients brain i.e chemical unbalance! So pleased to hear you explain that the symptoms are normal human responses to life tragedies, the problem is not in our brains but in the flawed, poorly resourced and I sufficiently trained mental health systems.