20 Brutally Honest Truths About Psychiatry

Here are 20 brutally honest truths about psychiatry in about 20 minutes that could save you from wasting decades of your life on medications. I’m Dr. Josef Witt-Doerring, and I run the world’s largest practice dedicated to helping people come off psychiatric medications, and these are the things my patients wish they had known before they even started psych meds.

1. To start with, psychiatric diagnoses, these are labels. These are not explanations. What that means is that there is no unified biological understanding for why these conditions occur. There’s, there’s nothing, there’s no lesion on a brain scan or chemical imbalance. This is why no diagnostic tests are used in psychiatry. How these conditions were created was essentially by a bunch of people voting on what symptoms they thought represented these conditions, so this has nothing to do with biology.

2. Number two, most people with psychiatric diagnoses, they do not have anything wrong with their brain. They’re simply suffering from life hardship issues or health issues. They’re, they’re struggling with things like loneliness, job dissatisfaction, financial stress, struggling to see a path for themself in the world. They also have problems with poor health driven by diet or substance abuse or lack of exercise. I think many people get kind of pulled into the psychiatric narrative where, you know, it’s a brain illness because it’s easier that way. It can simply be easier to say, you know, “I’ve got something wrong with my brain,” rather than contend with these much more complicated problems that people are facing.

3. Number three, psychiatric medications, these are not a cure. They do not fix any kind of chemical imbalance. This is just, uh, marketing slogans, not scientific fact. In fact, the way these drugs work, every single one of them, is by masking the symptoms that the person is, is experiencing. They’re not fixing or reversing any abnormality because we can’t find them, ’cause if (laughs) we could find that abnormality, we would test for it and show it to people. And so, that’s how the drugs work, not by fixing anything, but by papering over the symptoms.

4. Number four, most people who take psychiatric drugs long-term will run into the tolerance problem. What this means is that as you take these drugs over time, our body pushes against the effects of them and they wear off. And what this means is that if you’re gonna continue to use this as a solution, you will need to increase your dose over time. You may get maxed out on one medication and need to start another medication, and this is the way that we see someone who starts on, like, you know, a low dose of an antidepressant. After 10 or 20 years, they end up on, like, five different medications because they’re constantly trying to get that new drug effect as their body is fighting against it.

5. Number five, psychiatric drugs can actually worsen some people in the long term. This is the rule rather than the exception, and we see this across all of the drug classes. Antipsychotic medications, they can cause a permanent movement disorder called tardive dyskinesia. It’s highly correlated with cognitive decline. Benzodiazepines over time will make some people more anxious. It’s called benzodiazepine-induced neurological dysfunction. Sometimes they’ll even develop, uh, neuropathy, like tingling in their hands and feet or even, like, ringing in their ears or light sensitivity. That, that is a toxicity that happens long term with benzos. When we go into the mood stabilizers and we look at things like lithium, lithium can cause a condition called silent syndrome. Uh, this, this looks like dementia, and, and you have, like, tremors as well, and it can be irreversible in some people, and there’s no difference with antidepressants. S- particularly the serotonin antidepressants, like the SSRIs and the SNRIs, they, they can cause a condition called tardive dysphoria, where long term people will start to develop this feeling of being very blunted, having low motivation, um, some cognitive impairment, and high background anxiety, and it’s always there. You know, they try and increase the dose, it doesn’t really go away, they never feel quite themselves again, and unfortunately, what I see with many of these people who have these drug-induced worsenings is that it’s misdiagnosed and the doctors will tell them they’re treatment-resistant, and then they end up on ketamine or TMS or end up with, like, 60 treatments of ECT, and the docs never realize that it’s actually the drugs that were making people worse.

6. Number six, long-term users of psychiatric medications are essentially guinea pigs. Despite claims that these drugs are safe and effective, none of them have been studied in a placebo-controlled trial that lasted longer than a year. Uh, this is obviously really important because 50% of Americans are taking these drugs for five years or longer, and so we really don’t know what’s going on after a year. Are they still effective? Now, it doesn’t make sense to me that we’ve never done this study and that the NIMH has never extended these beyond a year to kind of match how long the people use these drugs for. You can do it, it’s not too expensive, and it would seem especially relevant given that the drugs wear off over time, they cause tolerance, and in some people they make them worse. We really should be seeing what these drugs are doing long term. So yes, the, the long-term users, um, we don’t really know what’s gonna happen to them. Yes, some people, they don’t develop a lot of tolerance, they use them long term and they’re fine. Other people, the drugs just wear off, they end up on multiple of them, and some people, they’re worse. Right now, because we haven’t done any clinical studies, we cannot predict who is gonna have what outcome and so your doctor doesn’t know the odds of that and you don’t know the odds of that, and so long-term use of these medications can really be a dice roll. People don’t understand that.

7. Number seven, coming off psychiatric medications, and this is especially true for antidepressants and benzodiazepines, can be one of the hardest things a person ever does in his life. Drop it in the comments below if that’s you so people can read about that. Um, this process can take years and it can be excruciating. This does not happen in everyone. Like, I have lots of people who come to my practice, I just talked to a mom the other day who was like, “Oh, I stopped my antidepressant, you know, essentially cold turkey during my first two pregnancies and it was fine,” but then the third time that she did it-… the bottom fell out and she completely fell apart. And so this is one of those nuanced things where some people, for reasons I don’t understand, even after using the drugs for several years, they can come off quickly, but eventually it breaks and then, and if they try that again, it doesn’t work. I’ve had some people on the first time they’ve tried to come off, they’ve had a really hard time, and so I think it’s something genetic. Some brains just seem to be more elastic, better able to adapt off the drug than others, but it can be a huge risk. Right now, we don’t know h- how to predict who is gonna be one of those people who will have a challenging withdrawal.

8. Number eight, withdrawing from antidepressants and benzodiazepines can cause severe neurological damage known as protracted withdrawal. Yeah, this is true, so for some people when they come off these medications, they go into severe withdrawal, they go, “Oh my God, I’m gonna hang on, I’m just gonna grit and I’m gonna bear it, I don’t wanna slide backwards, I’m just gonna deal with the withdrawal ’cause it’s going to go away.” That doesn’t happen for everyone, and some people will do this and then when they try and get back on the medication, the symptoms don’t go away, and I mean, I’m talking really bad symptoms, some people develop a condition called akathisia, where they pace a lot and they have severe anxiety and cognitive impairment and it stays for a really long time. This is, like, so disabling, people stop work, they go on disability and they are, uh, you know, essentially sick for several years when this happens. We have completely ignored these people within the medical community and if you, if you’ve never heard of this before, go onto Benzo Buddies or Surviving Antidepressants, like those two websites. There are hundreds of thousands of people out there in these groups who are supporting each other through it, and I think millions of people worldwide are suffering from this, um, condition right now, and we do a terrible job, um, educating doctors about this.

9. Number nine, cannabis is a major gateway drug for, um, bipolar and schizophrenia diagnoses, especially when it’s used in young adults and teens. Um, a lot of this is driven by big cannabis and the high potency THC products which are no- now out there, and also some chemical THC products, and essentially the cannabis industry has con- convinced people that these drugs are medicine, and that they’re harmless. That’s not true, you are much more likely to have a manic or psychotic episode if you’re using cannabis regularly, and many doctors will not think cannabis is that big of a deal, they will overlook it as something that can cause, um, bipolar or schizophrenia, and then people miss it, they’ll, they’ll get on any psychotic medications, they think they have these conditions and they keep on smoking cannabis and they could essentially avoid a lifetime of any psychotic and mood-stabilizing medication if they just cut the cannabis out.

10. Number 10, caffeine, nicotine, and inactivity are some of the biggest gateway drugs to anxiety disorders and ending up on SSRI antidepressants. Without a doubt, caffeine, especially if you’re having more than, like, a small cup per day or you’re s- drinking it after 10:00 AM, it will impact sleep, it will cause problems with anxiety. Nicotine does the same thing. People always tell me, “No, I smoke because it relieves stress,” you are relieving withdrawal, uh, you’re addicted to it, you’re going into withdrawal in between, um, cigarettes, and that’s what it’s getting rid of. When, when they’ve done controlled trials with caffeine and with nicotine, they increase anxiety and they decrease sleep for both groups. Inactivity is also another important thing, some people spend their whole days sitting behind computers, you know, nicotine products, drinking coffee, they don’t move their bodies. This, guys, this was me, I used to do this when I was at the FDA and I felt terrible, I started taking Xanax. I mean, that’s essentially the story. I know I’m not the only one, I see this all the time. If you’re having high anxiety, if you’re having difficulty sleeping, 5,000 steps a day, it’s not that much, you know, 30 to 40 minutes a day, cut out the stimulants and just see how you sleep and see how your focus and your energy is throughout the day. It might take five weeks or so, um, but it makes a huge difference.

11. Number 11 is that psychiatric research has been corrupted by the pharmaceutical industry. Guys, these industries will pour billions of dollars into crafting journal articles that appear neutral, but a lot of the times they’re ghostwritten, they get academics who are friendly to them and they put them on the authorship line and, and really, they’re created to persuade people. They do everything they possibly can in these articles to make the drug look better than it is. This isn’t really objective science, it’s really marketing disguised as science, and this is one of the main reasons why doctors have s- such a poor understanding of actually the benefits and the risks of these drugs, because they’re just consuming marketing material.

Number 12, pharmaceutical companies have corrupted academics. Listen, the people who are in charge of, uh, Ivy League institutions and, you know, who sit at the top of these departments, if you look at them, almost all of them have pharmaceutical ties, and now there’s a reason for this. The reason is that there’s huge career advantages if you’re an academic and you want to become a professor if you work with the drug companies. It’s way easier to get funding to run clinical trials for them than to apply for government funding or some kind of independent funding, and also when you work with these drug companies, they give you research staff, they give you the protocol, they kind of set the whole thing up for you, they put you on multiple publications, they fly you around the world to talk at conferences. All of this stuff pads your CV and makes you look like you’re a world expert, which is what you need to become a professor. And because of this, um, many academics will not say negative things about the drugs because they do not want to jeopardize their careers, and so what this means is, like, when we’re looking at these institutions saying, “Oh, at least we have these independent academics who are gonna push back against the marketing and that sort of narrative,” that’s not true, these people have been completely compromised.

13. And that leads into number 13 which is why we have such a problem, um, with doctors these days, and that is that these academics who have been corrupted, they are really training the next generation of psychiatrists. So they are passing on this biological-centric view of psychiatry where everything needs to be fixed by the drugs, they say, “Drugs are super effective, they’re a lot safer than they are,” and because doctors are learning from these compromised academics, they really aren’t aware of the risks and benefits of these drugs and that’s why they end up practicing, uh, bad medicine and that’s why we have so many people on psychiatric drugs these days.

14. Number 14 is that doctors really don’t have the time to actually understand the root causes of psychiatric distress in your life. Most doctors see people in 20-minute visits. Sometimes even less. If you’re seeing a family medicine doctor, I think it’s like seven minutes of face time. So essentially what happens is that people end up just talking about their symptoms and they get on a medication. Doctors like doing this because it’s faster to just prescribe a med than do all the digging into the history and then the motivational work to help them with their lifestyle. Uh, these doctors also feel, like, very justified and safe prescribing these meds ’cause they can point to the super biased, like, medical literature that the pharmaceutical companies have made to say, “Oh, but you see, you know, I’m doing what, you know, is in this literature.” And it’s got, like, the names of the people from, like, Harvard and Yale on there and they say, “Well, you know, look at these ex- esteemed academics.” And so not only is it faster, but it also feels very defensible because you can kind of point to all- all this research that’s out there, but guys, it- it’s just- it’s- it’s simply bad medicine.

15. Number fifteen is that good psychiatric care, unfortunately, is nearly impossible to get with insurance. Um, insurance-driven care will push doctors to do shorter and shorter visits. This is gonna lead them to focus on symptoms and to manage through medication instead of tackling life issues. It will lead to them focusing on symptom management through medications instead of helping people with root causes. Um, I also feel like when you go and see doctors in the insurance system, they don’t want to really take the time to help people do a taper if it’s a little bit more complicated. They’re just like, “Ah, that’s crazy. You know, that- that’s taking too long, I’m not gonna send this compounded script.” You really need to find someone who’s gonna take time with you if you want to get a good, uh, result. At the end of this video, I’m gonna share a resource for how to find someone to help you with tapering if you’re looking for that. But unfortunately, guys, the- the insurance system is just busted. Um, people do not spend time- uh, these doctors do not spend enough time with people to actually help them.

16. Number sixteen, American psychiatry, and this (laughs) may be true in the rest of the world, isn’t really designed to help people. I mean, if you just look at the system, it’s not set up in a way to treat root causes, to get people off the medications. Between the pharmaceutical industry and the academics and the insurance company, this is really is a system that’s just designed to medicate people. If this was truly patient-centered, we’d be helping people a lot more with life hardship and general, like, physical health. And so it is essentially a system that is busted. And people will say to me, they go, “You know, Josef, you know, you’ve spoken out about, um, like, screening for depression, saying it’s a really bad thing. But isn’t that a good thing if- if- if there’s more screening and people feel that there’s less stigma and they get help?” It would be a good thing if we actually had a mental healthcare system that was designed to help people. Instead, we have a conveyor belt that’s designed to put people onto drugs and then gaslight them when problems happen. This system needs a full overhaul.

17. Number seventeen, the NIMH, which is the world’s leading mental health institution, has essentially betrayed the public, especially the American public. Because rather than funding research into non-drug alternatives that could help people with anxiety and depression and other psychiatric conditions, um, for the last 10 years, they’ve been solely focused on biological driven studies which essentially support the pharmaceutical agenda. I mean, these guys are doing research into RDoC. Um, they’re trying to find targets for new drug therapies to treat things. They’re not looking at all of the obvious problems out there that are making Americans sick such as the lifestyle issues, you know, the poor food, things like that. On top of that, this is the group that should’ve said a long time ago, “Hey, maybe we should do, um, drug studies that last, you know, longer than a year. Uh, we should do them for two years, three years, four years, ’cause this is actually gonna match how long people are taking these in the real world.” They’ve completely shied away from some of the most important clinical questions that would’ve guided us to actually practice better medicine. And so I really think the NIMH has not fulfilled their public duty to actually better mental health. I- I think they’re on the sidelines potentially making things worse. I think they need a lot more leadership and they need to stand up and they need to steer this institution in a better direction.

18. Number eighteen, there is a massive over-prescription problem in the US. 14% of the population is on antidepressants and over 20% of people take psychiatric drugs. This is a glaring indictment of our public health system. I mean, how have our public health officials allowed this to happen? You know, 20% of the US population don’t have brain disorders, um, why are they taking psychiatric drugs on a daily basis to simply deal with life? Things have gotten completely out of hand and we really need to look at things closely. This is why I love RFK Jr., I know people hate me for saying that, but seriously, guys, no one else is doing it. He’s someone getting in there, he wants to make the country healthier, he’s looking at the psychiatric meds, he’s the best thing to happen, you know, with respect to, like, public health and psychiatry in a long time.

19. Number nineteen, in rare cases, psychiatric drugs can trigger mania, psychosis or aggression. And when this happens, people can m- be misdiagnosed. Y- a depression can all of a sudden turn into a bipolar disorder, and this person can end up for years on unnecessary medications, completely confused about their identity and who they are.

20 And finally, number twenty, in even rarer cases, psychiatric meds can precipitate violence, unpredictable behavior, and sometimes even mass shooting or mass violent events. We’ve had numerous court cases which have linked antidepressants to homicide in some cases where several homicides have occurred, and suicides. And I think we seriously need to be asking a question, what is the impact of putting 20% of the American population on these drugs that can contribute to violence and suicide even in very rare instances? Listen, guys, if this happens in one in two million people, like super rare, that’s still enough to lead to a mass shooting or something like that. Just, like, last month, we had that man plow into the Filipino street festival. He was on leave from a locked psychiatric facility. Typically, that means he’s on antipsychotic medications, maybe even under a med commitment. I think more of this stuff is gonna come out. Yeah, sure, you know, these people can do these for other motives, it may- it could’ve just been a criminal motive, I mean, the person could’ve been on dru- some other drugs, but could this have been akathisia? I mean, could this have been emotional blunting if someone is totally juiced up on psychiatric meds? These are the questions that we need to be asking. Thankfully, governor of Tennessee has just put it into the state law that at least in that state when one of these mass shootings happens, they will be investigating the role of psychiatric meds. And so it’s nice to see some leadership there, that people are actually asking these questions now. Okay, so that’s a wrap for today. If I missed anything that you wish you would have known about psychiatry before you got on these drugs, please post it in the comments below so I can read it. And if you need help getting off psychiatric medication, please watch these two videos. One is a beginner’s guide to coming off medications, and the other one is how to find a doctor to help you taper off psychiatric meds. Thanks.

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