It’s unnerving when you hear someone with whom you usually agree speak on an issue which they seem ill-informed, and you suddenly find yourself on the other side of the argument. That’s the case with Tucker Carlson discussing antidepressants. Even as a Tucker Carlson fan, I want to push back on some of the claims and the reasoning in his podcast with a psychiatrist who holds a very anti-antidepressants view, if you will.

First, Tucker and Dr. Josef Witt-Doerring attacked the concept of chemical imbalances– which is an admittedly vague concept to understand why some people might benefit from antidepressants. Apparently there’s no kind of tangible proof of a chemical imbalance per se. You can’t see it in the brain; at least we haven’t found it yet.  On the other hand, if some people benefit from antidepressants, and antidepressants are known to increase the presence of certain chemicals in the brain, that would suggest a some kind of deficiency of these chemicals, wouldn’t it? Is it not a logical inference?

The psychiatrist explained to Tucker his view that antidepressants “mask” symptoms of a deeper problem:

“Do you want to take a drug that’s going to mask those symptoms? Most people would say no, I'd rather get to the root cause of that.  Usually sweeping things under the rug doesn't work that well.”

But that’s assuming that antidepressants are masking symptoms of something else. If indeed there is a biochemical issue which causes people to feel depressed, anxious, bipolar, etc.; then an antidepressant is not masking the problem, it’s directly treating the problem. And we know that mental illness is heritable, so wouldn’t that point to a physical, biological issue?  

Witt-Doering mocks the view that antidepressants fix a chemical imbalance:

"People said, 'Maybe they just had low serotonin and now they're feeling better because we've fixed the chemical balance.'" 

Yes, literally yes. You’ve fixed the chemical balance. Witt-Doering uses the term “drugged” to refer to the effects of antidepressants, which is a loaded term, with the connotation of illegal drugs or people taking drugs to get high. But that’s not what antidepressants are and that’s not what they do.  There are psychiatric drugs which might fall into that camp, like stimulants and Xanax-like depressants.  But that’s not antidepressants. 

So could there be a financial motive in prescribing antidepressants? Witt-Doering refers to the billion dollar marketing spend for Prozac. That could certainly explain why Prozac was pushed; certainly people are not above trying to make a profit. But Prozac has been available in generic form for a long time now. So is just about every other every other antidepressant. If you’re going to explain why people are taking them and why doctors are prescribing them, making money is not necessarily the answer. You can get a 30-day supply of antidepressants for next to nothing if you have insurance, or maybe five dollars.

The tenor of the conversation between Tucker and the psychiatrist is that what we refer to as depression or mental illness is not actually distinct from normal sadness and the usual problems and challenges which people face. But in fact depression is not just normal sadness. If you’re a person without any mental issues, you might get sad at setbacks and sometimes feel tired or cranky. So you look at a person who has a problem functioning in life due to depression or anxiety and is taking antidepressants and you say, ‘Hey I get sad too, but I don’t take antidepressants.’ In other words, rather than looking at the issue of objectively, you’re taking your own experience in which you can solve your problems yourself and your extrapolating that to everybody else. This leads to thinking like depression is not real because basically you don’t have it and based on that you assume that everyone else is just making it up.

Well, I think people with diabetes are just exaggerating.  Because for me, there’s no problem.  So why do they need all that insulin or whatever they take? That’ s the logic.  

Witt-Doering continues on the theme of challenging the theory of a ‘chemical imbalance’:

"People have looked at the chemical imbalance, and there's a clear way to do it. You can look at the brains of depressed people on autopsy, and you can look at receptor levels, and you can say is there any changes in receptor levels[...] you can look at depressed people and undepressed people and say,'Is there any difference in the amount of serotonin floating around in the brain?' Every time they've done this, they have not found that there is any difference." 

Ok, there’s no biological way to confirm a mental illness. That is interesting, but think of how complex the brain is. Maybe it’s not a matter of simply measuring serotonin or looking at a brain in an autopsy. Maybe it’s just the complex interaction of different chemicals and neurons. I’m not a scientist. But I will say that just evidently if people take drugs that target these chemicals, such as serotonin and dopamine, and they were previously having difficulty just functioning in their life, and then they feel better; it would seem that the resolution had something to do with those chemicals which antidepressants target. Or am I missing something?

After all, Witt-Doerring himself said that anti-depressants work by “increasing the amount of serotonin between the neurons.”  Ok, so that’s biologically what’s happening.  That’s not pseudo science; it’s not all people’s heads– no pun intended. 

Now with all that said, it’s a perfectly legitimate thing to discuss whether antidepressants are overprescribed, what they do, and what they don’t do. We can debate if teenagers are too young to start on these drugs. There’s plenty of gray area. It is a great subject for a podcast with experts. However, I just find that the views expressed on this particular discussion tend to deny the lived experience of people who suffer from all varieties of mental-illness, and who might benefit from antidepressants. 

Even thought Tucker seems to be categorically opposed to these medications, the psychiatrist himself admitted that some people benefit from antidepressants.  Obviously they do. 

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