Rethink Mental Illness GraphicWell, the pro-drug forces are at it yet again. The website just published an extremely biased and misleading article raving about the supposed benefits of anti-depressants (ADs) by a psychiatrist in Scotland.

There are so many problems with this article I can scarcely address them all,  but I’ll try. (I apologize for any errors, but I wanted to get this blog out quickly to counter the many errors in the article.)

Let’s start off by observing that this author clearly believes the myth that “mental disorders” are caused by imbalances in brain chemistry. This concept is completely unproven and this is widely known and acknowledged by numerous authors and researchers and even by the World Health Organization and the United Nations. If the false disease model is stripped away, this leaves labels such as depression, bi-polar, and ADHD as arbitrary and meaningless. Ignoring this fact is such a fundamental flaw with this article that I really don’t need to continue, but I will so that we can knock down each of the other false arguments made to debunk this nonsense. 

A main complaint is that the article is extremely biased to the pro-drug perspective, which is not surprising coming from a drug-dispensing doctor. The author presents absolutely no opposing views about ADs. It seems reasonable to expect that an article on such an important subject should at least attempt to offer a balanced, fair, factual presentation. 

Here are some concerns I have about the article and some rather significant facts about anti-depressants that the author conveniently failed to mention. 


The article states it is not to be taken as medical advice, yet in the next sentence it ADVISES people get “treatment” including antidepressants! 

It ignores or downplays positive studies that show people get better without drugs, with therapy and do worse with ADs. 

The article does admit that 30-40 percent of people are not helped by antidepressants — yet fails to mention that all of these millions of people ARE very likely harmed by side effects during the drug use and by withdrawal from the drugs. Consider the facts mentioned on this webpage (with footnotes):

    • 55% of people have withdrawal symptoms
    • 60% of people on ADs feel emotionally numb
    • ADs increase suicide risk in young people by 2 times
    • 82% of benefit of antidepressants is due to placebo effect
    • 2-4x greater risk of developing mania if on antidepressants
    • 54% of depressive symptoms remain after taking antidepressants
    • 60% of people on ADs experience sexual dysfunction
  • The author ignores the fact that most people with “depression” spontaneously get better without drugs. In an NIMH study of “untreated depression,” 23% of the non-medicated patients recovered in one month; 67% in six months; and 85% within a year. “If as many as 85% of depressed individuals who go without treatments spontaneously recover within one year, it would be extremely difficult for any intervention to demonstrate a superior result to this,” the investigators wrote. (The naturalistic course of major depression in the absence of somatic therapy. Posternak, M., Journal of Nervous and Mental Disease 194 (2006):324-9.)
  • In contrast, in a large NIMH trial of 4,041 “real-world” outpatients, known as the STAR*D study, only 108 patients given antidepressants stayed well and in the trial during the one-year followup, a stay-well rate of 3%. (Efficacy and Effectiveness of Antidepressants. Pigott, H., Psychotherapy and Psychosomatics 79 (2010):267-279.) Makes me wonder: Would you take a drug with a 3% effectiveness rate?
  • In an 18-month NIMH study that compared four types of treatment (two forms of psychotherapy, an antidepressant, and placebo), the group that was initially treated with the antidepressant had the lowest stay-well rate by the end of the study. (Course of depressive symptoms over followup. Shea, M., Archives of General Psychiatry 49 (1992):782-87.)


The article assumes the biomedical or disease model of mental health, which is completely unproven. The article states there is a “widely held, ill-informed belief that depression is ‘just some sort of sadness, and that it is ‘mental’ rather than physical and therefore not a ‘real” medical condition that requires treatment.” Depression is NOT a medical condition. There has never been a scientific study that identified a “medical” or biological cause of depression, such as the “serotonin deficit” that many falsely state.

Many authors have written about this, including Robert Whitaker: “The low-serotonin hypothesis of depression and the high-dopamine hypothesis of schizophrenia had always been the twin pillars of the chemical-imbalance theory of mental disorders, and by the late 1980s, both had been found wanting. Other mental disorders have also been touted to the public as diseases caused by chemical imbalances, but there was never any evidence to support those claims. Parents were told that children diagnosed with attention deficit hyperactivity disorder suffered from low dopamine levels, but the only reason they were told that was because Ritalin stirred neurons to release extra dopamine. This became the storytelling formula that was relied upon by pharmaceutical companies again and again. Researchers would identify the mechanism of action for a class of drugs, how the drugs either lowered or raised levels of a brain neurotransmitter, and soon the public would be told that people treated with those medications suffered from the opposite problem.” (Anatomy of an Epidemic, Robert Whitaker, p. 77-8) 

Also: “‘The evidence does not support any of the biochemical theories of mental illness,’ concluded Elliot Valenstein, a professor of neuroscience at the University of Michigan, in his 1998 book Blaming the Brain. Even U.S. surgeon general David Satcher, in his 1999 report Mental Health, confessed that ‘the precise causes of mental disorders are not known.’ In Prozac Backlash, Joseph Glenmullen, an instructor of psychiatry at Harvard Medical School, noted that ‘in every instance where such an imbalance was thought to be found, it was later proved to be false.’ Finally, in 2005, Kenneth Kendler, coeditor in chief of Psychological Medicine, penned an “admirably succinct epitaph for this whole story: ‘We have hunted for big, simple neurochemical explanations for psychiatric disorders and have not found them.’” (Anatomy of an Epidemic, Robert Whitaker, p 78-9)

And: A recent study found that the “serotonin theory” for depression is completely wrong and anti-depressants are useless.- Brain scans show no difference between those “with depression” and those without.

The problem is that these false neurobiological explanations aren’t without harm. The disease model forecloses self-understanding and personal growth, notably about environmental factors which may cause the stress leading to anxiety and depression. By emphasizing false causes, it limits awareness of things such as abusive relationships, childhood trauma, toxic parenting, poverty, racism, gender discrimination, immigrant status, etc that can cause feelings of disconnection that are actually at the root of anxiety and depression. 

  • The article states “when the stress of life circumstances feels overwhelming, antidepressants can still offer valuable help by providing you with much-needed relief from depression-related symptoms such as insomnia and fatigue.” This implies that stressors might be a factor in depression, which, while true, is in direct opposition to the belief stated that depression is caused by a biological “chemical imbalance” in the brain. Drugs are also privileged as a solution, while addressing environmental stressors is downplayed as a solution — yet it is a cause? So very confusing!


shame, parenting, attachment, attachment theory, shaming, blamingThe disease model advocated by this article completely ignores the fact that EMOTIONS — aka human experience — might impact EMOTIONAL SUFFERING! The fact that the entire psychiatric profession seems to have gotten amnesia regarding emotions seems important. As humans we are social creatures that need love. In fact, evolution favors social animals that love, bond, cooperate and share. And when we don’t feel those experiences, we feel social threat, leading to “fight-or-flight” experiences. 

This feeling of social exclusion naturally triggers fear and feelings of shame, which should lead to the pro-social response of correcting our errant antisocial behaviors so that we can get in good with our tribe again. The fact that the disease model ignores this obvious, common-sense and well-researched fact is astounding. Yet this is repeatedly ignored in favor of drugs as the only solution to this normal emotional response of shame and fear of social exclusion. 

In those who research the emotion of shame, it is clear that this pro-social emotion which triggers fears of social exclusion can trigger the threat response. Neuroscientists now know that the same parts of the brain that evaluate physical pain are used to judge the emotional pain of social rejection [Ochsner, K.N., Zaki, J., Hanelin, J., Ludlow, D.H., Knierim, K., Ramachandran, T., et al. Your pain or mine? Common and distinct neural systems supporting the perception of pain in self and other. Soc Cogn and Affect Neurosci. 2008; 3(2): 144-160].

The neurobiological connection is clear with studies that show that feeling alone and excluded triggers feelings of fear, hostility, and shame that may result in physical symptoms, such as high blood pressure and heart disease. [Hawkley, L.C., & Cacioppo, J.T. Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals Behav Med; 2010; 40 (2): 218–27. doi:10.1007/s12160-010-9210-8]

Those of us who work in mental health know that most psychotherapy clients have feelings of unworthiness that make them hyper-vigilant to being judged as inadequate and rejected. This rejection sensitivity is the tendency to “anxiously expect, readily perceive, and overreact” to negative social comparisons [Downey, G., & Feldman, S.I. Implications of rejection sensitivity for intimate relationships. J Pers Soc Psychol; 1996; 70(6):1327–43. doi:10.1037/0022-3514.70.6.1327]

Considerable research has been done on the power of social affiliation or rejection sensitivity and its links to social anxiety, depression, anger and blame of self or other. However, the DSM never mentions this major influence on human behavior or uses it in its diagnostic criteria. By not acknowledging the importance of social affiliation needs, the DSM is based on an insurmountable deficit that limits its usefulness in explaining human behavior.[Citations: Baumeister, R.F., & Tice, D.M. Point-counterpoints: Anxiety and social exclusion. Journ Soc Clin Psychol: 1990; 9(2): 165-195. doi: 10.1521/jscp.1990.9.2.165; Baumeister, R.F., & Leary, M.R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychol Bull, 1995; 117 (3): 497–529. doi:10.1037/0033-2909.117.3.497; Gilbert, P., & Miles, J.N.V. Sensitivity to social put-down: It’s relationship to perceptions of social rank, shame, social anxiety, depression, anger and self-other blame. Per & Indiv Differences, 2000; 29:757-774

Yes depression is awful. Because it is the experience of feeling excluded, shamed and unworthy. Think about how painful it would be if your thought is: “Not only do others not love me, but I don’t love me.” This level of social and personal rejection and unworthiness is deeply distressing and goes against our very nature to crave love, acceptance and belonging. THIS is the cause of depression, not a chemical imbalance in the brain. 

Fear of social exclusion is a natural human condition. Therefore, loneliness and the need for human relationship (“depression”) should never be considered a mental disorder. 


  • DSM-5, mental disorders, anti-psychatryBy failing to mention that the list of “symptoms” in the DSM are arbitrarily decided by vote of a committee of people, it misleads readers. Might also be important to note that 60% of DSM committee members are paid directly or indirectly by Big Pharma (and 100% of those on the psychosis committee).
  • The article states: “It is a pain that the DSM-5 and ICD-11 definitions differ…” Umm, shouldn’t that alert the consumer that these definitions are arbitrary and meaningless? Do physicians disagree on the symptoms of a broken leg and arbitrarily change those symptoms whenever a new diagnostic manual is published?
  • Anxiety and depression are co-morbid… yes any clinician can tell you that, but why is that? If these were distinct “disorders” why would they almost always co-occur? That is because this article and the DSM/ICD ignore any mention of basic neurobiology. Actual science shows us that when humans, who are a social species, feel emotionally or physically or socially disconnected from others, they experience stress or the threat response. When it perceives threat, the nervous system goes from the ventral vagal (“safe and soothed”) state to sympathetic response (“fight or flight”) and if there is enough fear, into the dorsal vagal state (“freeze”) The sympathetic state looks like “generalized anxiety disorder” per the DSM (as well as OCD, ADHD, and other activation or mobilization responses) and the “freeze” response looks like “depression” or other immobilization or de-activation responses. Bipolar disorder is the switching between these two states with “mania” or mobilization and “depression” or immobilization. Notice there is no mention of neurochemical imbalances in this description! Yet this article, the DSM/ICD and the disease model propagated by Big Pharma conveniently ignore this well-known neurobiology as an explanation for “mental illness.” Probably because there are no drugs to “treat” the normal threat response.  
  • If you are responding to drugs, then he advises reconsidering the diagnosis. What? I thought this was a “disease” with X, Y and Z symptoms. Now suddenly the doc can just reconsider and change the diagnosis? Ohhh… now this is an admission that perhaps an ongoing stressor or unaddressed psychosocial issue might be the cause. So the drugs are fabulous, until they are not, then you can blame the external factors — but don’t ever blame the fact that the drugs might not be effective! 


The author states that depression pills are literally a lifesaver when, in fact, the opposite is true as they increase suicidality by 2-4 times in those younger than 25. He states: “There are no known adverse physical effects of staying on antidepressants in the long term.” This is a shockingly ignorant statement. 

ADs do not “fix” some supposed abnormal functioning of the brain, but DO alter normal functioning of the brain, leading to permanent changes in the function of neurons and withdrawal effects.  From ISEPP’s website: “Psychiatric drugs sedate or excite brain activity by increasing or decreasing the availability of certain neurochemicals. In doing so, they “work” by reducing or increasing emotional sensations and cognitive functions. As a result of this artificial change in brain chemistry, the brain attempts to compensate for the drug’s effect by working in the opposite direction. For instance, if a psychiatric drug increases the brain chemical serotonin, the brain interprets this as an excess in serotonin so it tries to reduce its production and sensitivity to serotonin. It is this compensatory process that leads to dependence on the drug and withdrawal symptoms if the drug is stopped. When multiple psychiatric drugs are prescribed, the withdrawal effect is more problematic.”

Also consider the way ADs work causes compensations in the brain. Prozac (fluoxetine) was an early anti-depressant and called a “selective serotonin reuptake inhibitor.” It blocks the pickup of serotonin by neurons in the brain, leaving excess amounts. This signals the presynaptic neurons to stop sending serotonin. But research shows the brain adjusts, reducing the serotonin receptors so that postsynaptic neurons become desensitized to serotonin. The brain has adapted to the drug and become altered by the use of the SSRI in a harmful way. The same effect occurs with dopamine and anti-psychotic drugs.

“Antipsychotics, antidepressants, and other psychotropic drugs, [Steve Hyman, director of the NIMH] wrote, ‘create perturbations in neurotransmitter functions.’ In response, the brain goes through a series of compensatory adaptations…However, after a period of time, these compensatory mechanisms break down. ‘The ‘chronic administration’ of the drug then causes ‘substantial and long-lasting alterations in neural function,’ Hyman wrote. As part of this longterm adaptation process, there are changes in intracellular signaling pathways and gene expression. After a few weeks, he concluded, the person’s brain is functioning in a manner that is ‘qualitatively as well as quantitatively different from the normal state.”’ (p. 83)Anatomy


It is absolutely false that depressant drugs “promote recovery from depression.” The author fails to explain the science behind this magical statement. This is also illogical — he states ADs “cure” but also you should take them forever. A cure means that the treatment was successful and you no longer need the treatment. Just because someone is on medications for high blood pressure and their blood pressure reads normal, it doesn’t mean their high blood pressure is “cured.”

At best ADs are temporary bandaids that suppress ALL emotions, even the positive emotions and when use is ceased, the depression “symptoms come back.” That is because the causes of depression are NOT chemical imbalances in the brain but feelings of loneliness, unworthiness and disconnection that prompt people to go into the threat response system because they feel socially rejected, unworthy and isolated. Depression is the dorsal vagal response of collapse or hopelessness in the face of this experience. In fact, this dorsal collapse is so powerful it can even cause people to “think” themselves to death: 



As a clinician, I frequently see antidepressants cause such a severely constricted emotional bandwidth, or emotional blunting or numbing, that patients are then labeled as “treatment resistant” by psychiatrists and PCPs. Instead, this is exactly what the drugs do! They limit emotional functioning, taking the joy, positivity and optimism out of peoples lives — exactly the emotional experiences they need to counter the depression!  Seems counter-intuitive, doesn’t it, to give people drugs that hinder their recovery. 

An FAQ at the end of the article asks: “Will anti-depressants interfere with therapy?” In my experience, yes. I have seen it numerous times when people’s personalities literally change by becoming more emotional restricted and withdrawn on ADs and conversely open up becoming more relaxed, self-aware and emotionally expressive off ADs. Emotional blunting is a well-known effect of ADs. Good therapists work with emotions by heightening them so people can experience them, learn to tolerate them, develop coping skills, and learn to self-soothe in the face of emotions. Blunting emotions does not allow this type of therapeutic work to occur, severely restricting the effectiveness of therapy. I prefer not to work with people on ADs for this reason. 


The good doctor appears to have conveniently cited only positive studies of ADs, but it is widely known that there is widespread evidence of publication bias: “Studies that find positive effects of drugs are more likely to be published than studies that find they have no benefits or cause harm[8]. In addition, published reports of studies often emphasize the measures that show the drug in the best light.[8] Measures that show no benefit or that indicate harmful effects may not be published or may be concealed in the small print of the article. Some pharmaceutical companies have been shown to withhold data that do not show their drug in a favorable light.[9] But doctors, researchers and editors have also played a part in focusing on research that highlights the positive and plays down the negative effects of drugs. There are extensive financial relationships between these groups, that have been shown to bias the undertaking, interpretation and reporting of research. [From: Guidance for psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. (2019) Citations: [8] Pies, R. (2012). Are antidepressants effective in the acute and long-term treatment of depression? Sic et Non. Innovations in Clinical Neuroscience, 9(5–6), 31. [9]. NHS (2019). Overview: antidepressants. conditions/antidepressants/.]


The good doctors states, almost as a throwaway at the end of the article after raving at length about how wonderful ADs are, that therapy should be a “first choice for addressing mild to moderate depression.” This can only be seen as a very biased presentation that makes readers conclude antidepressants are the best solution. 

The Psyche article suggests CBT and “interpersonal therapy” (I’m not even sure if this is a evidence-based protocol) as the only talk therapy options. He ignores many other interventions, especially compassion-focused therapy, which is well researched and effective as a direct treatment for the those with depression who have high levels of shame and self-criticism.  Compassion-based treatments can lead to permanent change in the way people relate to themselves, taking them out of the shame/fear cycle and leading to reductions in anxiety and depression. The article states psychotherapy does not get at the root of the problem, when, in fact, it can and does and I see this every day in my practice and experienced it myself before I was a therapist. 

The dismissive language about psychotherapy continues by asserting that psychotherapy does not cure childhood sexual or physical abuse. No, it doesn’t cure them and that is a straw man argument. Psychotherapy provides a way to process trauma, reframe it, and with CFT, decrease the self-blaming and shaming that so often accompanies those experiences of childhood rejection and unworthiness. 

While CBT is more insight oriented, not all psychotherapy is “top down” as asserted. Many, like CFT, work on embodied techniques, because we know that patients need to learn to manage their somatic experiences and re-engage their ventral vagal system of soothing.  


The good doctor does vaguely and off-handedly admit there are “many potential side-effects” but only lists a couple and immediately says most are rare. Not in my experience or in the research:

  • 60% of people on ADs feel emotionally numb
  • ADs increase suicide risk in young people by 2 times
  • 2-4x greater risk of developing mania if on antidepressants
  • 54% of depressive symptoms remain after taking antidepressants
  • 60% of people on ADs experience sexual dysfunction

He states that withdrawal symptoms are mild and last only a few days. Again wrong — just ask millions who have withdrawn and still face significant symptoms months and even years later. I just had a person withdraw very rapidly in just one month from her anti-depressants and went through a week of such severe discomfort that she likened it to the most painful medical treatment she ever experienced. And the doctor had not warned her, so she thought maybe she was having some strange and unknown disease and became anxious about that, which worsened her emotional functioning significantly. 

The author states there is no dependence with ADs. Yet we know that chronic treatment with an SSRI may lead to a 50% reduction in serotonin receptors in the brain. At that point, the brain has become “desensitized” to serotonin. This leads to dependence, so doses may have to be increased to get the same effect. See the statistics at the start of the article as well as the following.

  • Withdrawal symptoms are very common: In 2018 researchers who analyzed 17 withdrawal studies concluded that 56% of antidepressant users experience withdrawal symptoms, half of whom described the symptoms as “moderate or severe.” Additionally, 40% of individuals who experienced withdrawal had effects lasting at least six weeks, and 25% had effects lasting 12 weeks or more. 
  • The article completely ignores research on long-term disability due to ADs. A Canadian study found that use of antidepressants doubled the likelihood that a person will go on long-term disability. In a similar vein, an NIMH-funded study of depressed patients found that the “treated” group were seven time more likely to become “incapacitated” than those who did not get treatment.  And in country after country that has adopted widespread use of antidepressants, the number of people on disability due to mood disorders has dramatically increased as well. Psychoactive drugs often make mental health and functioning worse, as noted by many authors, including Robert Whitaker in “Anatomy of an Epidemic.” All classes of psychiatric drugs produce chronic brain impairment, frequently prevent recovery, and can cause chronic or permanent disability.
  • The Mad In America website has an excellent summary of the research on SSRI effectiveness, including this statement: “The scientific literature tells a story that stretches over the span of fifty years. When the antidepressants are introduced, at least a few psychiatrists worry that the drug treatment is causing a chronification of the disorder. Over the next two decades, researchers find that patients treated with antidepressants are relapsing more frequently than before. Studies in the 1990s and early 2000s do indeed find that the majority of depressed patients do not achieve a sustained recovery. Medicated depression is found to run a more chronic course than it had in the pre-antidepressant era. Numerous studies since 1995 tell of how patients treated with antidepressants are more likely than unmedicated patients to remain symptomatic over longer periods of time. Studies find that antidepressants increase the risk that a person suffering from an episode of depression will become disabled by the disorder. In country after country, the increased prescribing of antidepressants has been accompanied by an increase in disability due to mood disorders.”


Solid research shows that ADs are essentially no different than placebo: Irving Kirsch and collaborators, in their meta-analyses of industry-funded clinical trials, have reported that the difference in symptom reduction between the medicated and placebo groups is less than two points on the Hamilton Rating Scale of Depression (HAM-D). The National Institute of Clinical Excellence in the UK has stated that there needs to be at least a 3-point difference on this scale to be clinically relevant, and Kirsch found that it was only in a subset of patients, those severely depressed, that SSRIs met this standard. Kirsch and others have calculated “effect sizes” of around .30 for antidepressants based on symptom scores. This means that there is an 88% overlap in the distribution of outcomes for the drug-treated and placebo patients. Thus, the risk benefit equation from this symptom-reduction data can be summed up in this manner: Is exposure to the adverse effects of drug treatment worth the 12% chance of a better outcome? Or to put it another way: 12% of patients will benefit from the treatment, while the remaining 88% will suffer the adverse effects of treatment without any additional therapeutic benefit beyond placebo. Those are the odds that a person contemplating taking an antidepressant drug might want to know.

The author also misrepresents the immediacy of effect by stating that people will get better quickly with depression drugs and implies this will prevent suicides — yet package inserts state it takes 4-6 weeks before effects are felt. 


  • The article admits that ADs are used for anxiety — yet why should the same drugs work if these are “different” diseases? I find many people take ADs for anxiety, yet their PCP or psychiatrist never explained to them why this might be. 
  • Apparently we should get medication advice from celebrities who write books. 
  • He provides not one resource offering alternative views of depression or medication or the DSM. One is described as: “An impassioned personal and scientific defense of the effectiveness of antidepressants.” Not too biased, huh?!

Below are some resources that offer a very different perspective on psychiatric drugs: 


Mad In America has information on antidepressants and antipsychotics, as well as continuing education courses on drug withdrawal for clinicians and users.

How to Avoid Severe SSRI Withdrawal Symptoms

International Society for Ethical Psychology & Psychiatry (ISEPP) offers withdrawal resources.

Surviving Antidepressants is a forum with info on tapering, symptoms, self-care, success stories, and journal sources.

Psychiatric Medication Awareness Group offers withdrawal resources:

Guidance for Psychological Therapists on Psychiatric Medications has understandable information for everyone:

International Institute of Psychiatric Drug Withdrawal

Inner Compass Initiative for alternative perspectives on mental health and drug withdrawal:

Chaya Grossberg is a survivor of psychiatric drugs and offers consultations, books, and resources.

Icarus Project and Freedom Center’s Harm Reduction Guide to Coming Off Psychiatric Drugs

More at

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