Are Antidepressants Treating Depression—or Just the Symptoms? | The Brief

So on another concerning note, according to the American Enterprise Institute, 30 years ago, the majority of men, this is close to 60%, they reported having at least six friends. Today, the number has been cut in half. Only 25% have close friends. 15% of adult men in America have no friends at all. That's a five-fold increase from 1990. Amongst my generation, Gen Z, 30%, 30% of Gen Z men have zero friends at all. What is happening? and i know we've alluded to the medical and scientific problems with suicidality with depression with anxiety but just from a friendship perspective this is this is insane i mean i can speak i'm a millennial and i can kind of speak speak to how this has impacted me i i feel like i've right now my whole life has been dominated by work i mean that is the cultural values going on and you know i often get up and leave and i leave my friends behind and then i often find myself socially isolated from others um i also think you know the there's a lot of political polarization going on right now there's a lot of canceling going on online and i also think it kind of scares people to open up and just be themselves and that can create barriers but i'm gonna push this back on you and you don't have to be an answer but i'm just i'm just so curious i was like what do you think is going on as you know someone down in the the gen z trenches what do you see happening? As the token Gen Z representative for this conversation, I would say it's social media. I mean, why do you need to have a physical relationship when you have pornography in your basement? I would say it's also a fear of cancel culture and a blowback to me too. I'm scared of asking that pretty girl out because I don't want to have any type of professional blowback or social isolation as a result. I do think to get a little political, men have been stigmatized and told that they are inherently due to their gender, due to their race, are bad or racist or misogynistic. And when you keep telling young people that thing, they're actually going to believe you. So I think the solution is not just medical or scientific. It's also cultural and political. I think, yeah, I mean, we're coming out of a period where for the last 10 years we've been told, you know, if you're if you're a man, especially if you're a white man, you're privileged and you're kind of racist. And you better watch out, buddy, because, you know, if you say something that could even be perceived in a negative way, you know, we're going to come after your job. So you made this point that psychiatric medication does have potential side effects. We know that this includes sexual dysfunction. We know this includes emotional blunting. We know that this includes dependence and other long term complications. But I sort of want you to preempt the nasty comments on YouTube who say, hang on a second, are you really telling me that someone who is depressed or someone who is anxious should not be on any medication at all? Like, how do you know to draw the line between when someone needs to just go on a walk, needs to solidify relationships versus no, this person really has a chemical imbalance. We really do need to treat them with medication. Yeah, we need to move back to a common sense approach to using the drugs. No drugs are bad. I mean, they're essentially tools that you have in a toolkit to use. But if you OK, so if if you come to me and you are saying, hey, I'm depressed and I just put you on Prozac, did I did I really help you if I don't understand your life? Because let's say I dig a little deeper and I find out that you walk 4,000 steps a day, that you don't move your body, that you, you know, rarely get out of the house before 11 a.m. in the morning. You kind of wake up and you flip open your laptop and, you know, you go to work. You know, you also drink several cups of coffee a day. You're using nicotine products. You drink a couple of drinks to go to bed at night. and and and yes i could say well you know technically you meet criteria for major depressive disorder because you feel terrible and you're eating bad food and put you on the Prozac is that really good medical care it's not that's crap i mean that's you you wouldn't want anyone to have that and that's pretty much what most people in our country are getting today they are getting care from uninvested doctors who do not understand their lives because all of that stuff getting that fixed you know moving your body more cleaning up your diet exercising getting out into nature early in the morning to set up your circadian rhythm properly spending time outside all of those things are the things that actually make people feel better and when we just paper over them with drugs that don't address those problems they just fester and people get worse now if you come to me and you say hey dr yosef i've done all those things i'm super invested in my healthcare. My relationships are good. I've got meaning and purpose in my life and I'm healthy. I'm still feeling bad. I'll say, you know what? Let's use some Lexapro. Let's use some Prozac. You've done all the non-drug alternatives. You've really tried to get to the root cause. We can't find them. Now let's treat this more like a genetic depression and just, you know, we'll talk about the risks and benefits and we'll use it in that way. But that's like, that doesn't happen to anyone right now. Like most people, you know, they just, they come and say I'm depressed and they get a drug. And so that's, that's my problem with the current system. You know, Dr. Midd, I shouldn't say this, but the real reason we booked you is I essentially wanted a free consultation because I'll just say that, you know, post October 7th, I was diagnosed with anxiety. I was diagnosed with depression and I was given medication, a heavy dosage, I would say. And I gained a tremendous amount of weight. It didn't really make me feel better. And I would just add that anecdotally, what you're saying really resonates because what did in fact help was going on walks, was making friends, was solidifying, you know, previous relationships. It was things like that. So obviously, every individual is different, but I very much relate to what you're saying. But I do have to ask, when you talk about these doctors who are overprescribing or they're treating an algorithm rather than a patient, I mean, most individuals watching this would say, well, you know, I know my doctor. My doctor, for the most part, has my best interests at heart. So where is this coming from? Is this really because of the pharmaceutical companies? Is this because of bad policies or politics? Like, why are they doing this? These are not bad people. Yeah, Shabbos, it's two things. The first thing is the pharmaceutical industry. Now, when it comes to antidepressants, I mean, these are some of the most successful drugs of all time. I mean, they made Eli Lilly a billion-dollar company, and they've done the same for many others. When you essentially have like five or six different companies selling these drugs, you have billions of marketing spend, which are trying to control the narrative about these medications. And the most effective thing that they ever did was convince the public that depression is a genetic problem. It's medical in origin, and it needs to be treated by drugs. That is not true at all. It is not backed up by the medical literature. And depression is much more broad and should be addressed in more holistic ways. So that's the first thing they did. They convinced the public and the doctors to look at depression in that way. The second major player is simply an economic one. Back in the 90s, health insurance companies conglomerated and they negotiated with doctors on how much they were going to get paid per visit. That number was so low that doctors now have to see people with seven minutes of face time to essentially make the medical practices economically viable. and so you have these lovely people these are doctors in our families these are our friends these are our parents who essentially are trying to do a job with a hand tied behind their back now if you're seeing if you have to see like four or five people an hour you have a patient panel of 2,000 people how well can you understand their lives you can't it's effectively impossible and so these good people they do what they can in their limited time which is essentially oh you filled out this questionnaire you're depressed and i know that there's an FDA approved drug for this. Let me just prescribe that. And so that's, that's essentially what's happening. These aren't bad people. They are just, you know, they just don't have the time to do the job properly. Hey, if you enjoyed that clip, make sure you click the link below to watch the full episode of this week's The Brief.