There has been a sharp increase in the prescription of drugs for depression and anxiety in recent years, as well as mood altering medication for children. What s really going on here and what are the consequences of this alarming trend? Today s guest, clinical psychologist Dr. Roger McFillan, has the fascinating answer. This is part one of our two-part conversation on the truth about mental health and the powerful industry behind it. This episode is brought to you by GoodRanchers.
00:00:00.000There has been a sharp increase in the prescription of drugs for depression and anxiety in recent years, as well as mood-altering medication for children.
00:00:09.620What's really going on here, and what are the consequences of this alarming trend?
00:00:13.960Today's guest, clinical psychologist Dr. Roger McFillan, has the fascinating answer.
00:00:19.360This is part one of our two-part conversation on the truth about mental health and the powerful industry behind it.
00:00:26.940This episode is brought to you by our friends at Good Ranchers.
00:00:55.620I'm also the co-host of the podcast, Radically Genuine.
00:00:59.720I run a large group practice in Bethlehem, Pennsylvania, which is about an hour north of Philly.
00:01:06.260And I think a lot of what's brought me onto various podcasts and here today is what I'm being vocal about on social media and through the podcast, which is, to be honest with you, it's really just being critical of my field in general.
00:01:19.960From the overprescription of psychiatric drugs, what typical therapy has become, the ideology that's influencing it.
00:01:29.420In fact, I make pretty controversial statements that I believe that entering into the system, the mental health system, does create harm and could create harm.
00:01:39.820And I've tried to provide information, science-based information, to help people make informed decisions, as well as just try to communicate to parents who have children and adolescents who are struggling about what might be the safest, most effective course.
00:01:54.440So you became a psychologist, but you were critical kind of of psychology, the industry.
00:02:40.280So these are relatively very young kids who came from very abusive and traumatic backgrounds.
00:02:45.380So these children would react as you would expect anybody would who was under a trauma response, abuse in homes, very difficult upbringings and violence in their homes.
00:02:56.840And I just observed how the mental health system worked with these kids.
00:03:00.440There was a psychiatrist on the unit who would basically ask basic questions.
00:03:19.680It was my first observation of what mental health care was.
00:03:24.940In a lot of ways, it was the sedation of behavior.
00:03:29.100And they viewed at that time, and I think still today, that an effective mental health treatment is when somebody numbs their own emotional states or they become sedative.
00:03:41.100And we'd see kids who were sleeping 16 hours a day.
00:03:52.640And so if you're going into a psychiatric hospital, obviously you are acting out aggressively generally or even at that age kind of talking about suicide.
00:04:02.800And so they would view the treatment as if they became less aggressive.
00:04:09.360So it was often creating, you know, lethargy and, you know, just sedation.
00:04:14.980And so that was upsetting and disturbing for me because it was in contrast with everything that I was taught growing up or everything that I believed about what it takes to be able to overcome challenges.
00:04:25.440For if you're going through an adverse period in your life, and I grew up in a Catholic family, and I was always taught that our life has purpose and meaning, and the struggles that exist in our lives are something that we can expect.
00:04:43.540And so observing how children were taken care of in that environment did inspire me to take steps with my education and do a lot of training.
00:04:53.960Before I became a clinical psychologist, I also worked with youth in the juvenile justice system who were also prescribed multiple psychiatric drugs as a way of managing behavior.
00:05:05.400And I just witnessed the cultural shift.
00:05:08.060And I was, I'm 46 years old, so I saw the cultural shift from the 80s into the 90s that really started when Prozac was brought to market.
00:05:18.700And the United States is one of only two countries where direct-to-consumer marketing exists from pharmaceutical companies.
00:05:26.360So in a lot of ways, we are mass conditioned to believe that our emotional states are something that may be outside of our control, that they are genetic or related to some imbalance of specific brain chemicals.
00:05:39.060In fact, that was advertised to us, mass advertising throughout the 90s into the 2000s.
00:05:44.600So when I had this exposure to the mental health system at that time early on, it was really at the height of all this.
00:05:50.220The truth of the matter is, and many of your viewers probably are not aware, that there's never such a thing as a chemical imbalance.
00:05:59.360That it was a theory that was initially identified by scientists back in the 50s or 60s to try to understand why some people might be depressed in comparison to others.
00:06:11.460And the drug companies, they really took off with this, this idea that like depression, for example, is related to deficiencies in serotonin.
00:06:22.100And if you can take this pill, you can correct these deficiencies in serotonin and almost like a happy pill.
00:06:28.680And it was, it really was marketed in that way.
00:06:31.760And it shifted an entire culture of how we think about our own mental health.
00:06:41.460Okay, there's so much in there that I want to ask about before we get to what I think is going to be one of the most interesting parts of this conversation, the whole chemical imbalance debate.
00:07:22.660And what was it about Prozac that kind of shifted things in your mind?
00:07:28.000Well, I think the pharmaceutical companies are incredibly powerful, as we all know.
00:07:33.880And on my podcast, I've said, I think they are the most lucrative criminal organization that exists globally.
00:07:41.140And I don't think that's an outrageous statement.
00:07:43.700All you have to do is look at the fines, the lawsuits.
00:07:47.080And the marketing is very distorted, right?
00:07:51.040It began to be pushed through major television networks.
00:07:55.700Even if you watch a movie, they started talking about taking your meds or I'm in balance.
00:08:00.680These little words are just like, they're placed in front of us and we become conditioned.
00:08:05.140And of course, there's the magazine covers where mental health is a brain disorder.
00:08:12.900And there was a ton of money that was dumped into this through the NIMH, the National Institute of Mental Health, throughout the 90s, billions in trying to identify some brain-related source of our own distress.
00:08:26.500And, you know, as we all know, what we experience and what we feel is very complicated, right?
00:08:31.640There is biological, social, relational, spiritual complexities to what we feel and to what we experience.
00:08:41.000And often our emotions are directly related to what's happening in our environment or internally in our own minds.
00:08:48.200And so they're definitely kind of biologically ingrained.
00:08:52.620I talk about emotions as being gifts because if we learn to utilize our emotions, that they're for a reason.
00:08:59.380They're there for us to either indicate potential threat or danger or there's something amiss in our life, solve problems that exist.
00:09:06.880These emotions are powerful indicators and the education around that matters.
00:09:12.140Like when you raise your children, when they experience some emotional reaction or response to something, my guess is you're not going to believe that it's something outside of their control and they have a medical illness that would require a pharmaceutical.
00:09:26.020Instead, you're probably going to teach them some emotional literacy, that your emotions make sense based on what you're thinking about or what's happening.
00:09:34.440And you're going to help them be able to manage their emotions in order to be able to be productive and effective in life, whether that's in relationships or academically or in sports or whatever they're doing.
00:09:46.740We need to be able to be able to manage our emotions.
00:09:49.120If I'm going to come on to this podcast and feel anxious, I'm not going to judge that emotion of anxiety as something that is wrong or that is something that I shouldn't feel.
00:10:00.800It makes sense given the environment that I'm in.
00:10:22.940And something that you said that I thought was interesting that I don't think many Americans consider because we're so used to this is that it's only here that you said that pharmaceutical companies sell directly to the consumer.
00:10:35.860So that's why we see like a commercial for Prozac or whatever it is.
00:10:43.380So we're supposed to go to our doctor and say, oh, I think I need Prozac because the 60 second commercial, it listed my symptoms and said it can make me feel better.
00:10:55.460Is that kind of is that what you're talking about, that that's unique here in America and not in other places?
00:11:01.520United States and New Zealand, I think, are the only two countries.
00:11:04.400So the idea that an individual can go to their doctor in order to get a pharmaceutical without having the background knowledge or the understanding of what that drug actually does is that we're all kind of victims to what the marketing is.
00:11:18.300What is really concerning to me, Ali, is that currently 80 percent of all psychiatric drugs are prescribed in primary care settings.
00:11:26.060So I just got done reading the American Academy of Pediatrics guidelines because I was trying to make sense of how are we seeing this dramatic increase in mind and mood altering psychiatric drugs for children and adolescents.
00:11:40.100And in popular media and culture, they speak about it as if the COVID-19 lockdowns and the isolation are what fueled a mental health crisis.
00:11:53.620And I think that was a primary factor.
00:11:56.440But we were seeing the statistics leading up to this of how many kids were going to their doctors and saying, I just don't feel well or I feel sad.
00:12:06.980Now, teens don't even use the word sad anymore.
00:12:28.000In teenage life, it can also provide you a certain disability status and a connection with others.
00:12:36.340So imagine being a vulnerable teenager who's struggling emotionally and you feel like you're just on the outside, that you're struggling relationally.
00:12:44.220It's another group that you can adopt to.
00:12:49.860Like, oh, I'm depressed or I'm mentally ill.
00:12:53.560The word is really, really being thrown around.
00:12:55.580In fact, I think I was most shocked a couple of years ago when a young girl said, called herself a Lexaho.
00:13:02.180Lexaho for the teenage girls who take the antidepressant Lexapro.
00:13:19.100The FDA wouldn't even approve them if they weren't safe and effective.
00:13:21.640And to be honest, you know, there was a time where I thought that had to be true.
00:13:25.640I live in the United States of America.
00:13:27.140Of course, our government protects us until I took the time to really do the research because I had to resolve the conflict between what I'm being told and what I'm seeing in front of me.
00:13:39.900And what I was seeing in front of me was a lot of young people, mostly under the age of 25, just doing poorly with the diagnosis of being mentally ill, of the drugs that they were taking.
00:13:53.860And what that leads to is going right back to your doctor, who's going to either up the dose or prescribe you another one.
00:14:00.760And now I think we're looking at close to one in five Americans are taking some form of a psychiatric drugs.
00:14:06.860And I think the outcomes are absolutely horrific in what it's doing to the physical and mental health.
00:14:13.260But also, it's that profound shift in how you think about your experience.
00:14:18.640So as a psychologist, my passion is around helping people create a life of value and one that's worth living.
00:14:27.040And I'm not going to sell an idea to them that you're going to go through life without pain or you're going to go through life without some sort of struggle or hardship.
00:14:37.160Or that you're entitled to that kind of life.
00:14:41.500And I did read your book, by the way, on the flight in here.
00:14:44.440And so a lot of those messages really resonated with me because it's the difference between what is sold to us in popular culture and its influence.
00:14:53.440I talk about it in terms of almost like a brainwashing, that young people believe that they should feel good all the time.
00:15:03.080And if they don't feel good, then there's something wrong with them.
00:15:06.540And my message is if you don't feel good, you're normal.
00:15:47.500And still they find themselves almost being like pulled down into the state of like of sadness or depression.
00:15:54.080Or they always feel a simmering sadness or anxiety underneath them.
00:15:59.040I think that we are told that, okay, that kind of person does have, though, some kind of chemical imbalance.
00:16:05.300We can't look at any of the factors in their life.
00:16:07.440So it must be that they need this SSRI or something like that.
00:16:11.400So with someone who has kind of what we might call inexplicable depression or depressive episodes, like is there ever to you a need or justification for those SSRIs?
00:17:11.480Is there anybody who could benefit from, let's say, an antidepressant?
00:17:16.580And so I just want to be science-based on this.
00:17:19.440So when I look at the data and the research study, this research study is over 40 years.
00:17:26.980What becomes really clear to me is this, is it's very difficult to distinguish the drug group from a placebo group in a lot of these trials.
00:17:36.720So what that means is a lot of people get better from a placebo, which is an inert substance.
00:17:48.260And that's important because there's a mind-body connection and experience that I don't know if we've really tapped into and how powerful that is.
00:17:59.440However, I do want to say this, is that there are a small group of people who will say they've benefited from antidepressants that are related to something that I think happens from taking the drug with a specific group of people.
00:18:47.380My concern with the drugs are the risks of taking the drugs are minimized.
00:18:52.460So there is a group of harmed patients globally who are in quite a movement right now to try to bring this information to the attention of the global public.
00:19:03.260One of them is a group who talks about post-SSRI sexual dysfunction.
00:19:08.700So that emotional numbing can also numb the genitals even permanently.
00:19:12.940And I would say as a psychologist that the ultimate recovery from anyone who's really struggling, if they're depressed, is going to go way beyond emotional numbing.
00:19:23.420Emotional numbing can happen when you drink alcohol.
00:19:27.060Emotional numbing can, from smoking marijuana, you can turn to many drugs to emotionally numb out.
00:19:33.420In my opinion, that's not antidepressant.
00:19:36.500That is a way that you're responding to how you're feeling.
00:19:40.020And that's the drug companies set up these trials that way, that they're short term, six to eight weeks, yet people are taking antidepressants for decades.
00:19:50.820We don't have any data on their safety, on their efficacy long term.
00:19:56.640But to view emotional health as a decrease of emotions, I think is problematic.
00:20:02.080So if you can create a symptom checklist of various feelings around depression, and depression is a concept too.
00:20:08.720It's not like you go to your doctor and get a medical test or a brain scan and they say, well, Ali, we see that you are suffering from major depressive disorder.
00:20:19.080And so we are relying upon a person's ability to communicate what they're going through, which can also be challenging too, because, you know, when you meet somebody, especially when you do the work that I do, you realize that you don't really know somebody until, you know, weeks, months down the line, because a relationship has to be built.
00:20:38.720So you go into a doctor and in 15 minutes, you start describing your experience, it can be easily misunderstood and misrepresented, it can be taken out of context, and you can be assigned a label.
00:20:49.000And now you're seeing your life through that lens.
00:20:52.680And so taking a pill and in measuring in a very short amount of time, and viewing those symptoms decreasing as emotional health or well being, I think is problematic.
00:21:03.880The problem with a lot of these trials is blind was broken.
00:21:06.360So we have to do randomized clinical control trials as a way to determine whether the drug has any sort of effect over a placebo group.
00:21:14.020But almost everyone who took the SSRI, including the doctors, knew that they were on an SSRI.
00:21:19.180It's a mood and mind altering substance.
00:21:36.360Towards overcoming what you're going through.
00:21:38.540But for, you know, people who are looking for kind of a quick fix or some relief from what they're going through,
00:21:43.740I can understand that that could be interpreted, at least in the short term, as it's helping them.
00:21:49.560I think the majority of that's a placebo response.
00:21:51.660We call it an active placebo response because you know that you're taking the substance.
00:21:56.060Even then, there's not that much of a difference between the drug group and the placebo group.
00:22:02.040So for those young people, probably mostly, I'm guessing young men that you saw like in the 90s in the hospital who were basically just numbed.
00:22:24.040What you were describing actually reminds me a lot of what they thought or actually kind of what lobotomies did accomplish and what they thought lobotomies could accomplish.
00:22:32.720Just kind of like taking out part of your brain, injuring part of your brain so that you're no longer really functioning at all.
00:22:39.600And so it kind of seems like in a way that's what was happening or what is happening to a lot of these young, maybe aggressive, maybe they would say, I don't know if they would say psychotic young people.
00:22:51.360Is that, okay, taking away their brain function entirely is preferable to the harmful behavior that they are doing right now.
00:23:02.080So you said it could be a quote unquote, maybe quick fix if your goal is just kind of short term numbing.
00:23:09.700So like in those kinds of situations where it seems like harm is imminent either to themselves or other people.
00:23:15.900I mean, how do you navigate that without those quick fixes?
00:23:19.740Yeah, this is a great question because when I say quick fix, it is short term.
00:23:29.100So that idea of like staying lethargic is only going to be for a period of time until you require more and more drugs or you add on another drug or you add on another drug.
00:23:39.520And now you're really experimenting with a developing brain.
00:23:44.780And it's interesting because when you look at, and this is clear, when you look at the data, the FDA has also provided this warning.
00:23:54.340For people under 25, just one SSRI can more than double the risk of a suicide event.
00:24:01.360When you go to the drug websites, they very clearly state that this drug can induce violence, self-harm or suicidality.
00:24:09.920So we have this notion that if we take this drug, it can numb some people out and that could decrease the likelihood that they act out aggressively.
00:24:22.260But the truth of the matter is everyone responds differently.
00:24:25.240I had a gentleman on my podcast, 40 years old, and this is where these drugs are prescribed outside the bounds of what they've ever really been studied to do.
00:24:33.540He was going through a very difficult time, a loss of a job, work-related stress.
00:24:40.200No history of any mental health issues.
00:24:42.740So he goes to his primary care physician, says, Doc, I'm having trouble sleeping.
00:24:49.740And so they give him a, I believe it was either Zoloft or Paxil.
00:24:54.780They give him a subscription for, hey, this is going to help you with your own anxiety.
00:24:59.980And what ended up happening is he began to develop psychotic beliefs that his own son was going to harm a bunch of people and he needed to protect society and kill his young son.
00:25:17.460And it turns out he had, he's one of about 10% of the population approximately who cannot metabolize these drugs due to a genetic variant of a metabolizing gene.
00:25:32.080So he, he was able to, through a lot of medical examination and testimony, he was able to, his sentence was actually decreased and now he's a promoter and he talks about his story and has a website called Know Your Drugs.
00:25:54.040So, I mean, his purpose and his mission right now is to communicate to the general public that these drugs do induce violence and have negative adverse reactions in a percentage of, of people.
00:26:06.240And when you, when you look into the science around this, it looks like we could probably identify those who could have that specific genetic variant of a metabolizing gene through, through gene testing.
00:26:37.320Because so much of the information that is provided is directly from the pharmaceutical companies and the pharmaceutical salespeople are brilliant.
00:26:48.260It's the marketing programs and they're, you know, they're in our doctor's offices and the allopathic medical establishment within the United States, which is drugs is healthcare.
00:26:57.760It's, it's, it's, it's, it's a system that kind of maintains that this, this simplified way of viewing our mental health and this story or this fantasy that we have drugs that can cure people.
00:27:11.000To put it in kind of my terms for anyone who is in like the communications world.
00:27:28.000If you want to know about a person, really their history and what they're about, you don't read the press release that was written by their publicist because that can tell you some of the great parts about them.
00:27:38.200It might even lie a little bit or twist the truth or kind of try to exaggerate or amplify the good things they've done.
00:27:44.580But you won't really learn about the person.
00:27:46.840You won't really know anything about the person.
00:27:48.500You'll just know about their accomplishments.
00:27:51.760Like if you're writing a biography about someone or you're, I don't know, trying to place someone in a job, you're not going to just read their press release.
00:27:59.240But we are prescribing, you're saying these medications, basically just reading the marketing and sales materials for them without really looking at the potential side effects.
00:28:08.860So true. And I think it goes even a little bit deeper because as I mentioned, I just published a podcast episode today, the Radically Genuine Podcast, where I was reviewing the American Academy of Pediatric Guidelines that are promoting drugs as frontline health care for young people who are experiencing mood related problems.
00:28:29.900And I was appalled by the entire publication because it was cherry picking science.
00:28:35.940I've spent the last five, six, seven years going through all this various research.
00:28:41.160And when we look at science, we have to look at the totality of all the research.
00:28:45.000And they really cherry picked only a few studies to suggest that these drugs are safe and effective and they help more people than they harm.
00:28:54.120And when you're talking about pediatricians or primary care physicians, this is not their area of specialty.
00:28:59.400They are not trained to assess, understand, diagnose and treat mental health conditions.
00:29:04.500In fact, the average amount of time for a primary care appointment in the United States is no more than eight minutes.
00:29:11.760We have a health care system that's kind of fast food mentality.
00:29:16.820So they're pushing everybody, everyone through and they're handing out these checklists.
00:29:21.760One thing that is really, really important that and this is new, this is new in my area.
00:29:26.780But in our primary care centers and pediatric centers, they're giving depression screening measures.
00:29:31.940These depression screening measures are really poor assessors of what actually clinical depression would look like.
00:29:41.400It's like this really quick 10 questions.
00:29:44.660That number of the questions can be applied to anyone at any given time.
00:29:50.260Like I guarantee you if you're a young mother and you're a bit sleep deprived and you're dealing the stress of multiple kids in a career, that a number of the questions on there would just be considered normal.
00:30:21.860The adults in their lives and the parents consent for them.
00:30:25.320And so parents, they've been trained in this United States medical culture, right?
00:30:32.680The medical authority, we trust them that they have our best interest in mind.
00:30:36.120And I think if anything that we've learned from COVID is that there needs to be an awakening for all of us to understand that what's happening in our health care centers is not always the best available evidence.