Episode 135: Betty Bites – The Dark Truth On Anti-Depressants with Dr. Kelly Brogan
Welcome to Betty Bites. In this episode, we welcome Dr. Kelly Brogan. Kelly is a holistic psychiatrist, author of the NY Times Bestselling book, A Mind of Your Own, Own Yourself. She specializes in a root-cause resolution approach to psychiatric syndromes and symptoms. In this short episode, we discuss the misuse and lack of understanding of the effects of antidepressants and as well as the potential chemical dependency from them. Join The Better! Community On Facebook. Get the show notes here.
If you would like to tune in to the full episode with Dr. Carrie Jones- click here. In the full episode together, we focused on illuminating our dark emotions and turning them into potent fuel for personal growth and shares her deep insights around processing difficult emotions and how we can shift the way we see depression.
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Kelly Brogan (00:49):
Yeah, so the sorted history of psychiatry's clamoring to be accepted and acknowledged as a valid medical discipline is probably more elaborate. Um, then we can get into now, but suffice it to say that, you know, in around the 1950s, there were a number of factors that, uh, sort of came together to give birth to this theory. One of them was observations around the way that patients behaved after they were treated for tuberculosis, with medications that impacted at least theoretically what's called the monoamine, um, pathway in the brain. And there was an observation that there was like transient euphoria and these individuals and that plus a theoretical paper by a gentleman named shelled crowd, um, plus minus some potential, um, CIA cooperative research on psychedelics, uh, gave birth to this opportunity for the pharmaceutical industry to leverage a really poorly baked, uh, biological concept and physiological mechanism around, uh, what might be driving different States of behavior, mood, and cognition.
Kelly Brogan (02:28):
But in this case specifically depression, and, you know, uh, what follows is the multi-billion dollar industry of antidepressant drugs. And what happens is that in many cases, uh, pharmaceutical science, reverse engineers, the theory, right? So it would be like, as my colleague, David Healy says when he uses the metaphor around alcohol as, um, you know, uh, another representation of a consciousness altering substance, right? So what if we were to do a trial of, you know, two shots of vodka for social anxiety, and then we would have the participants take either that or water. Uh, you know, you could imagine that in an eight week trial, there would be an effect so that the participants might come out of that trial and say, you know, it really helped. I actually felt way calmer. And I didn't struggle with the social anxiety that cripples me every single day.
Kelly Brogan (03:24):
Um, but of course we know logically that it would, it would be an error to deduce from that, that those individuals have some sort of an alcohol imbalance or some sort of an ethanol deficiency. Right. And we certainly know that if they were to repeatedly expose themselves to that kind of an intervention, that biochemically they'd be in a bit of a tough place if they wanted to discontinue said intervention a couple of decades later, right? So there have been many Renegade, uh, psychiatrists before me like Peter Breggin and joining Moncrief who have been shouting from the rooftops, uh, about the fact that we can not call these medications, um, by their mechanism. Right? So the suggestion that this is an antidepressant in any way, uh, that it is resolving a baseline known state of imbalance is a fallacy. We can alternatively make the argument that there is a drug based effect.
Kelly Brogan (04:26):
Okay. So not unlike alcohol, right? Yes. Or it's a drug based effect. Now that is stacked, maybe very adaptive, right? So if you start Paxil and it's sedative and you've been wired for, you know, six months, that may be exactly what you need, or you have some of the stimulating effects of, of something like, you know, effects or Prozac that may be a perfect fit for you. Um, what they have in common seemingly is a certain kind of, um, blunting, right? Affective blunting kind of emotional blunting. And for many to your original question who do not have, I would argue this is all of us, but the experience to know how to sit with certain emotional States and to work with certain kinds of symptoms that are emerging, that could be highly preferable. Right? So, so no one is suggesting that there isn't an effect.
Kelly Brogan (05:22):
What many before me, and you know, what I've kind of collected data to support is that this effect is not resolving a problem. It's creating a new normal. And if you happen to like that, that would be great. If there weren't public, in my opinion, public health con consequences to the freedom to choose this medical intervention, uh, while I am a huge believer in informed consent. And I, and I, I would like to empower all people to make the best choice for them. And if you know, you know, the literature that suggests that the, the effect of antidepressants when you control for the side effects, right. And all of the beliefs that are enacted because of our direct to consumer advertising culture, where we've been literally brainwashed to understand our own biology through big corporations who stand to profit from that understanding. Right? So, so when we engage a medication, we imagine might help us and we start to have side effects.
Kelly Brogan (06:24):
Something happens that's called the active placebo effect. This has been exquisitely researched by Irvin Kirsch, who was arguably the placebo effect expert in what he has suggested through very rigorous statistical analysis, including the invocation of unpublished literature, conveniently texts in the file drawer, right. That he accessed through the foil, uh, process. Uh, he found that 88% of what we are calling the, the effectiveness of medication is actually reduplicated by placebo. So what that means is that 12% of people are getting a benefit that they couldn't otherwise get from placebo. And all 88% are getting only risk. So this is something to consider because we might say, okay, so what are the risks? What's the big deal who cares whether it's placebo or not, if it helps, it helps, right. Uh, it's a pragmatist perspective, but the risks that I have come upon to, to, you know, this is not the laundry list of like, you know, interference with libido and menstrual cycles and GI bleeding and hair loss and rashes, and all of that, the two that I want to shine a spotlight on, because I know too many people who wish that they knew about these before they, you know, waltz their first prescription to CVS.
Kelly Brogan (07:40):
One is the, um, um, propensity for these medications to seemingly randomly. Although it's just that we don't know how yet to properly risk stratify yet, um, induce States of impulsive violence, right? So whether this is a school shooting, or whether it's a pilot taking down an airplane, or whether it's hanging yourself from the rafters in your garage, when you've never felt a moment of suicidality before you started taking that medication, the trouble is that you just don't know if you are going to be one of those people. And I have many citizen activists who have contacted me over the years, including, um, David Carmichael, who, uh, had the experience of murdering his own 11 year old, old son on a routine dose of Paxil for work-related stress. And he's not alone. This is not random. It's not rare event. So that Russian roulette is a pretty big one, right?
Kelly Brogan (08:35):
Because in the state of intoxication, essentially, you actually can appear completely calm and normal to those around you. And meanwhile, you know, you're in this, um, agitated, uh, impulsive state of Agatha often what's called, is a neurological term for the kind of state that that can be induced. We think it has to do with the way certain people metabolize these medications that can lead to this intoxication state. But trust me, your, your primary care doctor is not screening you, um, for those liver based polymorphisms. Right? So, so that's one. And the other is the potential for, um, these medications to, I would say it's more than a potential. It's a likelihood, uh, for these medications to induce a state of chemical dependency, this is not to speak to the psychospiritual dependency. Uh, you know, that emerges from an experience of understanding yourself as fundamentally sick and broken and understanding your emotional States as wrong, right?
Kelly Brogan (09:37):
That is a whole nother topic. This is literally just biochemical, right? And these medications I've made the statement many times. I still stand by it for 10 years. I have had a practice devoted to taking women off of these medications. And I believe that they are the most habit forming chemicals on the planet that make cigarettes and Oxycontin and crack cocaine and alcohol look like a walk in the park to detox from, right? So I have never heard of a chemical that requires sometimes a thousandth of a milligram detriment per month in order to medically stabilize withdraw from, and there are literally hundreds of thousands of people on the internet right now telling their tales. And if that is a risk worth taking, at least you should know about the possibility because the many, many, many patients that I started on medication in my tenure as a conventional prescribing psychiatrist, I never told a single one of them about this because I didn't.