← Culture Apothecary with Alex Clark
Culture Apothecary with Alex Clark
Step-by-Step Guide to Getting Off Antidepressants 💊 | Dr. Josef Witt-Doerring, MD
01:14:43
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- [00:00]
Dr. Joseph Whit Doring
There have been no clinical trials with SIBO controls, active controls of any sort, where you can see what these drugs are doing past a year.
- [00:09]
Alex Clark
There is widespread belief that SSRIs cure depression.
- [00:14]
Dr. Joseph Whit Doring
We've had like three decades of marketing tell us that anxiety and depression are due to chemical imbalances. We have never found that.
- [00:22]
Alex Clark
How do you feel as a psychiatrist about primary care physicians being some of the main people prescribing, you know, antidepressants to people?
- [00:29]
Dr. Joseph Whit Doring
I think it's malpractice.
- [00:54]
Alex Clark
Are you currently on an antidepressant and wondering what the risks really are? Or maybe you're struggling to taper off and finding it almost impossible due to brain zaps, physical discomfort or emotional turmoil. If you're feeling stuck in the cycle of medication, this is an episode you absolutely can't miss. Today we're joined by Dr. Joseph Whit Doring, a board certified psychiatrist, drug safety expert and the co founder of Taper Clinic, the largest psychiatric deprescribing practice in the United States. With a background As a former FDA medical officer and a consultant to the pharmaceutical industry, Dr. Joseph has an unmatched understanding of psychiatric medication safety, the risks involved with withdrawal and the often overlooked issues in conventional mental health treatment. His mission is to help people safely and effectively taper off psychiatric medications, all while improving their overall health through functional medicine and holistic therapies. In this episode we dive deep into the science behind antidepressants, the realities of withdrawal, and explore how you can regain control of your mental health. Whether you're trying to get off medication or just want to better understand its effects, watch this episode on the Culture Apothecary, Spotify or Real Alex Clark on YouTube. And don't forget we are completely donor funded. So if you love this show and you want to see its continued success, consider gifting a tax deductible donation through the link in the show notes. Or as always, you can leave a five star review for free, find new friends and continue the discussion after the episodes in the Cute servatives Facebook group or Culture Apothecary on Instagram. Please welcome psychiatry piatrist Joseph Whit Doring, co founder of the Taper Clinic. To culture apothecary. You call yourself a psychiatric d prescriber? What is that?
- [02:36]
Dr. Joseph Whit Doring
So I'm someone who specializes in helping people come off psychiatric medications.
- [02:40]
Alex Clark
How unpopular is that in psychiatric circles?
- [02:43]
Dr. Joseph Whit Doring
I would say massively needed for the people on the medications. But for the doctors out there who aren't doing this, it makes them uncomfortable and so it becomes Unpopular.
- [02:56]
Alex Clark
Why would that make a doctor uncomfortable? People getting off medications.
- [02:59]
Dr. Joseph Whit Doring
Wow. So I think it goes to the heart of what a big problem is in psychiatry these days. And it is that we have a very transactional way of helping people with mental health problems, which is obviously broken. And I think a lot of people, doctors included, have started to pick up on that. I mean, the common experience for many people out there is they'll go in and see a family doctor or psychiatrist. They'll see them for maybe half an hour, they'll get diagnosed sometimes with just a checklist of symptoms and they'll get started on a medication. The doctor seldomly spends much time talking about non drug approaches to helping people, whether it's, you know, dietary interventions, exercise, targeted therapies for things like relational problems or problems with, you know, work. And they just put them on medications. And that's really how the mental health system functions these ways. A lot of doctors out there have kind of just sort of rationalized to themselves that hey, this is just how we do things these days. It's an insurance based practice. We don't have a lot of time. This is just the way we have to treat people. But I don't accept that. And you know, a lot of people that you've spoken to on your show, like Kim and Roger and other people, they think the system's broken and so do I. And so I think when someone like me comes out and is talking about over prescription problems, that we need to be doing much better in mental health. It makes people uncomfortable because they say, I don't want to change. You know, I've already sort of rationalized to myself that this is just the way that we need to do things. And so I cop a lot of flack for that. People feel, feel very uncomfortable.
- [04:41]
Alex Clark
Have people tried to shut down your ability to practice?
- [04:43]
Dr. Joseph Whit Doring
Yeah, yeah. So we get comments on our, on our social media and it's just like if anyone else here is unhappy about what he's saying, here is the email address for the Utah Medical Licensing Board. You know, go ahead, file a complaint against Dr. With During. And so we got a lot of that. I guess that's, you know, that's, that's just the way it is when you're out there talking about inconvenient truths.
- [05:09]
Alex Clark
As a psychiatrist, which drugs do you believe are responsible for an uptick in anxiety and depression?
- [05:16]
Dr. Joseph Whit Doring
What I've been seeing a lot of is actually non prescription drugs. And so even so things like caffeine, I mean, we have situations these days where, because we live a much more sedentary lifestyle. You know, people will sit behind the computer and work all day, and they'll drink three cups of coffee, or they'll be dipping or using, like, Zen pouches or something like that, and they're not moving their body, and then they start to feel really anxious. And so I think that's a big problem. I feel like we feel like we always need to be so on that we can sort of work ourselves up into these big sort of anxious states. So that's one part of it, which I think is really concerning. The other is cannabis use. Cannabis is way stronger than what it used to be. You know, at least when I was experimenting with cannabis, smoking some cannabis when I was growing up, I see that get people really sick and not just anxious, like sometimes psychotic. And so I'd say those. Those drugs definitely make people more anxious.
- [06:16]
Alex Clark
Well, the marijuana conversation is a fascinating one to me because we hear that a lot, especially from a lot older generations. They say, like, man, the stuff you guys are smoking is so different than what I smoked, you know, when I was in college or whatever, and feel like it has something to do with, like, we've totally commercialized that business by legalizing it, and they're growing it cheaper. They're spraying it with all sorts of chemicals. Like, the stuff that we're spraying on weed today is different than what they were using before as well. And so you're really just smoking a ton of chemicals. I don't think people realize that. They think it's just a plant. So it's just a plant, but it isn't. Today's weed is not the same. It's. It's basically like what we've done to marijuana is like what we did to ultra processed food.
- [06:59]
Dr. Joseph Whit Doring
Yeah. Yeah. And I mean, the. I mean, cannabis is a big industry. I mean, over the last 10 years or so, it's just been becoming, you know, either medically legal or fully recreationally legal in different states in the U.S. and so we have a big cannabis industry right now that does what we see in pharma, where the messaging is essentially to kind of overhype the positive aspects of it. Oh, it's great for ptsd. It's great for pain, you know. You know, it's safer. And they don't. And they don't talk about the risks of it either. And so I also think that the perception of cannabis being this really harmless thing has been completely skewed now, where people don't recognize that there's actually a lot of Harm to it. And I mean, get stronger and stronger and stronger. I think usual like weed used to be like 1 to 2% THC. You have like dabs and shatter and these different like ultra concentrated forms of it that are like 40%.
- [07:54]
Alex Clark
Holy smokes.
- [07:55]
Dr. Joseph Whit Doring
Yeah, yeah. So much more. And there's even synthetic types of THC and different chemical compounds like spice or K2 which go even higher than that. This is actually one of the ways that I see people enter the psychiatric industry and become a permanent mental health patient.
- [08:13]
Alex Clark
You're kidding me. Well, you know, everybody is so adamant who smokes weed. They're like, it's not addictive. But the first time you post anything that's, you know, at least that's even minimally critical about marijuana on X, for example, get mobbed. All of your replies are all these people like freaks in this marijuana cult being like, oh, it's not addictive. Like there's like, I'm like, who reacts this way? Like, you only see that when you talk about pot. You know, these people, it's like they have to, they have to take a hit, you know, every so often throughout the day. You know, I can't wake up without it. I can't go to sleep without it. I'm like, that is literally addiction.
- [08:47]
Dr. Joseph Whit Doring
Yeah, it is addiction. But I think a lot of people lie to themselves and say, it's my medicine, you know, it's my medicine for anxiety, it's my medicine for pain. But then they're smoking like ultra high potency THC and then they get stuck on it and they can't come off. And I want to, you know, I'll be a little sensitive here because I know that a lot of people really campaigned for the legalization of this and maybe, you know, there are some use case scenarios, like if someone is smoking pot and they're not taking oxycodone or something like that, hey, that's okay. You know, if someone's using pot for, you know, terminal cancer, that's okay. And we shouldn't be putting up barriers for these people. We have to just realize that, that it's gone too far. And we, we need to be aware of just how risky this is. And it's not that big of a deal. If you are someone who is like 30 and your, your central nervous system has fully matured, you're much less likely to have serious problems. But we have like, I mean, the group that picks it up the Most are like 16 to 25. I mean, these are young people. They're way More susceptible to the harms of it, they're more likely to get addicted, they're more likely to have cognitive problems and actually to develop like a psychosis from it. And oftentimes I will see people who I take off anti psychotics, you know, who've been diagnosed with bipolar or schizophrenia. And when you take the history, you know, they started smoking a lot of pot when they were in their late teens or early 20s to have a psychotic disorder, they become psychotic. And people don't understand. The cannabis is so strong these days that like even two weeks after this and when the drug is out of your system, you can still be reeling from a cannabis induced psychosis. Because it's not just the drug that's like in there that's making the person psychotic. It's almost like they've had like a concussion from it, like they've had an injury. You can have paradoxical bad reactions to all sorts of drugs. So sort of cannabis or psychiatric ones. A lot of people have seen this, you know, you have like 10 sitting around, nine of them are giggling from the cannabis. And one person's like very self conscious.
- [10:50]
Alex Clark
I'm the one person, let me tell you right now. Yeah, I like, I was somebody that would like do that occasionally. If somebody had it at like a, at a social get together, whatever in my like early to mid-20s. And it was never fun for me. And I finally in like my late 20s, I was like, you know what, I don't like this. I don't know why I accept it, I don't have to. And I was like, I just made a decision one day. I was like, I'm never doing this again. I've never enjoyed it. I always felt extremely paranoid, like just, it wasn't fun.
- [11:18]
Dr. Joseph Whit Doring
So you, you would have been the type of person that if you were exposed to like super high strength cannabis, if someone's like, hey Alex, let's do some dabs, something like that, you might have had a psychotic, psychotic reaction to it, which would have, I think there, it's actually neurotoxicity. And so when someone who is sensitive to it gets exposed to this really high potency thc. I've seen people have a psychosis and not feel like themselves for like months afterwards, sometimes up to a year. And doctors will miss this, they'll say, no, you know, you've smoked cannabis, you're still having some psychosis. But you know, really we expected this to go away within one to two weeks of stopping the drug. And if it's still there, instead of Them seeing it like, you know, you took a hit to the nervous system because you're susceptible. They'll, they'll say you have schizophrenia and then they end up putting someone on antipsychotics.
- [12:09]
Alex Clark
If you actually are somebody who doesn't truly have schizophrenia and you were put on schizophrenia medication, what can that do to the brain?
- [12:16]
Dr. Joseph Whit Doring
It can do a whole, a whole range of things. I mean, anti psychotics are some of the most toxic psychiatric meds from a safety perspective. I mean, there's always a use case scenario for some of these things. But in general, the things we worry about with antipsychotics is they can cause permanent movement disorder, cortative dyskinesia that occurs at an incidence of like 5% per year. So the longer you're on it for, the more likely you are to, to experience that. Most people are familiar with this from the Batman movies with the Joker. And, and if you sort of remember what he looks like, his, his tongue is like popping out of his mouth, his lips are moving. And that's because he spent so much time in like Arkham Asylum where he's been given antipsychotics. And so they, they start to look like the Joker. They have involuntary mouth movements and that does not go away.
- [13:08]
Alex Clark
Oh my gosh.
- [13:09]
Dr. Joseph Whit Doring
And so you have, that cognitive decline correlates with that as well. So people will, they won't be as sharp. And it actually causes brain shrinkage as well. I mean, they've done terrifying animal studies where they would grab macaw monkeys and they would put them on Haloperidol and olanzapine, which are antipsychotic medications, and it shrinks their brains. You know, when they, when they look at the size of the, the monkey brain afterwards, it's like 15% smaller. And so I, I mean these things are sort of terrifying. So you really want to get the diagnosis right if you're going to use a medication like this. I mean, we're, we're missing things like cannabis induced psychosis and, and needlessly putting, putting folks on these drugs. We, we, we put people on Seroquel to help them sleep. That's like another sedating antipsychotic. And there's heaps of people out there that take Seroquel for sleep, not being aware that they're on an antipsychotic that has all of those side effects that I was just telling you about.
- [14:11]
Alex Clark
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- [16:20]
Dr. Joseph Whit Doring
I think we've had like three decades of marketing tell us that anxiety and depression are due to chemical imbalances or genetic problems in our brain. We have never found that. This was just a marketing spin that was put out there and researchers have gone and they've collected all of the data together and there's no chemical imbalance there. So there's no unifying cause of. Of depression. That's why we don't use tests in psychiatry. That's why when you go and see a doctor, even if you go to, like, Harvard or Yale or, you know, one of these big tertiary medical centers, no, no one's scanning your brain or measuring like, the neurotransmitter metabolites because it just doesn't correlate to anything. So, and that's important because when we think about what an antidepressant does is they disrupt your neurotransmitter systems. So like SSRIs, they block serotonin reuptake to increase the amount of serotonin between the neurons. That's not actually fixing any underlying problem because an underlying problem like that has never been found for anyone.
- [17:25]
Alex Clark
Well, one of my favorite things, every single time I talk about, you know, SSRIs and antidepressants and how they're basically placebos and they don't do anything, you know, people in my replies are like, how dare you, an antidepressant, save my life? I have a chemical imbalance in my brain. And my response to them always is, oh, really? How did. How did they tell. Test for that? What was the test like to test for your chemical imbalance? They don't ever reply. There was no test. This is fake. We're just told that.
- [17:48]
Dr. Joseph Whit Doring
I mean, this is how the whole thing fits together, right? Because the drugs do work. I mean, I've taken them, my wife has taken them, and we've experienced their effects firsthand. I know you've taken them as well, and you might have experienced a drug effect. They generally tend to do a few things. I mean, things like Lexapro, SSRIs generally tend to be cause emotional constriction or blunting or numbing or something along that range. You know, things like Wellbutrin can be stimulating. Things like Remeron can make people sort of blunted and kind of tired. But that can be experienced as therapeutic. Like, if you're a nervous Nelly and there's a lot of stuff going on in your life and you take a drug to sort of mask that, something that knocks out the highs, something that knocks out the lows, your experience may be, this is better than what I was feeling before, I feel more in control under this drug effect. And, and yes, sure, it's not fixing, like, the underlying problem that you had, but it is making you feel better from the drug effect. However, when you look at it like that, it also becomes really concerning from like, a moral perspective because effectively what we're doing is we're giving someone drugs to mask how they feel. And there's all these sort of ramifications because we're emotional beings, right? You know, we care about our relationships with others and our friends. You know, we care about the work that we do and finding purpose and meaning in our lives. If there are genuine things happening in our life that need to be addressed for us to feel happy, we don't. We don't want to numb those things. We don't want to put a damper on those messages that are saying, hey, you know, something's not quite right. And it doesn't have to just be emotional. I mean, there's problems in our food at the moment that's making us sick, that's making us inflamed, and that's also going to make people feel unwell. The real issue is, I mean, we aren't. We have a mental health system that doesn't really care about getting to the root causes and helping people. We just sort of like, paper over symptoms. And so that person in the comments who's just like, it really helped me. Sure, it's helped you now. But where I sort of come into this is I see what happens, like 10 years down the line, 20 years down the line when people want to come off. That's like a moment of time. And masking your sort of like your smoke detector in your brain that's telling you like, something's not right. You know, feel anxious, get curious. You mask that for several decades, you can end up in a very bad place later on.
- [20:23]
Alex Clark
What are the side effects and risks that we're not told about whenever we get a prescription for an antidepressant?
- [20:29]
Dr. Joseph Whit Doring
The main ones that everyone should know and that unfortunately aren't mentioned is. So some of these are quite uncommon, but. But they're serious when they happen. So the first one would be post SSRI sexual dysfunction. And essentially this is a neurological injury that can occur when you're on the medication. And typically what happens is someone will take the drug, they'll experience sexual dysfunction. That's a very common side effect for many antidepressants. I think like. Like 70 to 90% of people will experience a decrease in libido. Men will have things like erectile dysfunction because of it. But when they start to come off the medication, either that doesn't get better or it gets worse. There's actually something about coming off the drug that damages the. The nervous system even more. And so these people will. They'll be on the drug, they'll have sexual dysfunction. They'll come off, it will get worse, and they start to experience genital numbness. And so they lose all. I guess it's. I mean, it's called erogenous sensation, but it's just, you know, your private parts, they feel differently than the skin on the rest of your body. And they'll say it either feels numb, like it's had anesthesia, or it feels like the sensation on, like, the back of your hand. There's no erogenous sensation down there. That feels good. The men will have a lot of erectile dysfunction as well. They'll be less interested in sex. But the thing that these folks complain about even more than the sexual problems is that they feel emotionally blunted and they have some mild cognitive impairment sometimes. Actually, it's not mild all the time. Sometimes it can be bad. And they feel like it's almost like their sensory system has been, like, totally turned down from this. And. And they'll describe things like they're watching their life through a tv, you know, and they'll lose things, like when their favorite song comes on, on the radio that they used to listen to growing up. And, you know, you'd have this, like, prickle on the back of your neck with just, like, nostalgia and joy. They'll lose that, you know, when they hug their children or when they hug someone that they love, like a family member. They don't feel those. Those warm emotions anymore. And they describe just walking around, you know, they have sexual dysfunction and they're super numb. And for many people, this doesn't go away. This actually has quite a bad prognosis. A lot of the other things that we may talk about, the prognosis is kind of better, like the withdrawal injuries. But for many people with pssd, yes, some will get better, you know, in a couple of years. But there are people that have been suffering from this for. For years. And particularly in the United States, people are not told about that. And it's in vast contrast to the rest of the world, where this is in the drug labels and doctors are warning them about it.
- [23:18]
Alex Clark
Wait, PSSD is not in the drug labels for these in the United States.
- [23:22]
Dr. Joseph Whit Doring
PSSD is not in the drug labels.
- [23:25]
Alex Clark
I. I am shocked to hear that. I did not know that.
- [23:28]
Dr. Joseph Whit Doring
Yeah.
- [23:28]
Alex Clark
How is that possible? Why?
- [23:31]
Dr. Joseph Whit Doring
I mean, this is going to almost feel like, you know, like that. The Matrix scene, you know, where it's like, do you want the red pill or do you want the blue pill? You want the red pill, you want the red pill? Okay, so I, I used to work in the pharmaceutical industry and I used to work at the fda, as in the, in the division of psychiatry, as a drug regulator. So I've kind of seen what happens behind the scenes there. The whole PSSD thing. I mean, it's, it's been in the literature for like 20 years, but around 2015, 2016. David Healey is a psychiatrist in the UK. Really great drug safety researcher. He got like 100 people plus who had PSSD. He interviewed them, he collected their stories. He asked permission from their doctors to say, hey, you know, were there any other explanations other than the drugs? The doctor said there weren't. And he said, hey, can I include your name in this dossier? And then he sent it out to all of the medical agencies saying, I think I found a new side effect. It's called pssd. It's very serious. And so there's these hundreds of patients and these doctors saying that it's real. So it goes to the eu, EU approves it, goes to Australia, Australia approves it, Hong Kong does, Canada does. And so we have all these major drug regulators around the world doing it. And then it comes to the FDA and the FDA puts it on ice. It went in there in 2018 and no one picked it up at all. It just, it just sort of sat there on the back burner. Now, the reason for this is that psychiatrists in the us and this includes psychiatrists in the fda, they are so captured by the pharmaceutical industry that they act more like advocates for the drug than actual scientists. They don't want to find problems with them because it's very uncomfortable and inconvenient for them. And so they've just, they sort of just like let it sit on the side and they haven't addressed it, which is insane if you think about it. They, they haven't even given a response. They got sued recently, but the lawsuit got dismissed. People from the PSSD Network, along with another nonprofit, was just like, you guys need to respond to this and you need to do it now. And so they're looking into it, but we, they haven't updated the labels yet because I think it's just going to be embarrassing and it's going to make them look very, very bad.
- [25:49]
Alex Clark
Well, who cares? People are freaking suffering. Does Dr. Marty McCary, head of the FDA, have you ever spoken to him? Do you, do you know he knows about this?
- [25:58]
Dr. Joseph Whit Doring
No, but I, I don't know if he knows about this.
- [26:01]
Alex Clark
Okay, yeah, well, I, I'll start the ball rolling. I'm Gonna make sure people tell him. Could you explain how the biochemical mechanisms behind SSRIs work in the brain? And are these mechanisms fully understood the.
- [26:14]
Dr. Joseph Whit Doring
Way SSRIs work is? So they, they, they block serotonin reuptake and so it increases the amount of serotonin between the neurons. And that sounds like very circumscribed and well defined. But then there's a whole like, you know, serotonin isn't functioning like an island on its own in the brain. I mean, it's affecting all of our other neurotransmitters. Norepinephrine, dopamine, estrogen, hormones. I mean, we're essentially changing the way the brain functions. We don't actually know fully what these drugs are doing. We don't, we don't.
- [26:48]
Alex Clark
I would think, like, these have been around for so long. We've done a lot of scientific research on these drugs.
- [26:53]
Dr. Joseph Whit Doring
It's hard to know. I mean, the, the, the part that I think is a lot more concerning in terms of like, what we don't know about the drugs is actually what they do long term, because when we look at the studies that we have supporting the long term use of them is actually very poor because we've got 50% of Americans on antidepressants have been on them for five years. And they've often been told by their doctors that these drugs are safe and effective. 20% of women, nearly 20% of women are taking antidepressants these days. So. And then people are always shocked when I tell them there's been no clinical trials that lasted longer than a year looking at what these drugs do long term.
- [27:37]
Alex Clark
Now say that again.
- [27:40]
Dr. Joseph Whit Doring
There have been no clinical trials with placebo controls, active controls of any sort, where you can see what these drugs are doing past a year. And so when doctors are telling people, hey, these drugs are safe and effective, the part that they're leaving out is for the year that we studied them.
- [27:59]
Alex Clark
Oh my gosh. And do SSRIs affect different people differently?
- [28:05]
Dr. Joseph Whit Doring
Yes. Yeah, absolutely. So, you know, much like we were talking about before with, with cannabis, you know, you can have paradoxical reactions. So, you know, some person is going to have the expected therapeutic effect, which is one of emotional constriction or numbing, you know, but then some people can get more aggressive on them. And that's why there's, and then some people can become suicidal. And then there's this whole part of it where they talk about SSRIs and antidepressants potentially being linked to school shootings because we've had so many cases of people becoming unexpectedly suicidal and aggressive when exposed to it.
- [28:43]
Alex Clark
Okay, so you brought up, when it comes to side effects that people don't know about with SSRIs, you brought up PSSD. What are some other side effects that people don't realize when they're taking antidepressants they're at risk for?
- [28:53]
Dr. Joseph Whit Doring
I think it's interesting to talk about the most common side effect, which is actually the drug effect. There are some other ones. You know, we definitely should talk about how hard they are to come off later on. But one of the problems with antidepressants is they, they're emotionally numbing to people. And so, you know, you're turning off that sensor in your brain that's saying, hey, you know, there's something not working right in your life, whether it's a relationship or a job. And to me, I think that is the biggest risk. It's, it's being cut off from your intuition and then not realizing that you need to make changes in your life.
- [29:30]
Alex Clark
And what are we seeing when it comes to increases of anxiety and depression on an antidepressant?
- [29:36]
Dr. Joseph Whit Doring
The antidepressants can sometimes make people more anxious and more depressed in the long run. And, and so this is mainly an issue for long term users. Most chemicals, when you take them long term, are harmful to the brain, especially ones that act on your neurotransmitters. I mean, if we think of like drugs of abuse, alcohol can cause something called Wernicke Korsakoff, which is a type of dementia. You know, methamphetamine and cannabis, when used long enough, they also show neurological changes in the brain. But then even shifting over to psychiatric meds, you know, we talked about the antipsychotics. You know, they cause permanent movement disorders. Benzodiazepines cause a condition called bind, which is potentially for some people, irreversible neurological problems. Lithium, when you take it long term, causes some irreversible cognitive problems. It's called silent syndrome. And so the same thing is happening with antidepressants. And the term for that is tardive dysphoria. And here's what it looks like. So when I see patients who have been on antidepressants for a long time, when they do develop this, how they describe feeling is they start to feel really numb. They say they feel emotionally disconnected. They start to have anxiety that doesn't even seem to be like linked to anything anymore. It's just this constant background anxiety. They have some cognitive problems and Then they also have some cognitive impairment. Frequently what happens is that these folks will get diagnosed with a condition called treatment resistant depression, which really isn't like it sounds like it's this more severe form of depression, but essentially just means you haven't responded to two different antidepressants. It's not recognized that they're actually having a toxic reaction to being on the drug long term, where the right thing to do for them would be to say, hey, this isn't working for you anymore. In fact, it's putting you in this sort of blunted, dissociated, anxious state where you have no motivation and you just don't feel like doing anything anymore. You'd want to bring them off the drug. And I've done that several times. And the people do get better. That's often missed. It's called treatment resistant depression. They start putting them on higher and higher doses, they add new medications, they, they give them ketamine, tms, and sometimes even ect. And essentially what they're doing is, is blaming the person. They're not recognizing that the drug is actually made that individual worse. And things just go off the rails for them. They, they never quite feel like themselves again and they're just, they just feel bad.
- [32:14]
Alex Clark
My dog Mochi isn't really a dog. He's more like a stuffed animal rabbit, cat thing. So he doesn't do anything except lay next to me and squeak his toys. But my best friend's pup chased rabbit last week and came back limping a scratched paw, whining the whole thing. Neosporin tempted her because it's what we grew up with. But it can be toxic if pets ingest it, causing nausea or worse and wounds. Medical Journal warns of contact dermatitis risks plus antibiotics. Breed superbugs over time, I told her about active skin repair instead. Active Skin repair uses hypochlorous acid or H, a natural antimicrobial your body already produces to cleanse wounds and soothe irritation. You can get it as a light spray or a thicker hydrogel. Heals cuts, diaper rashes, even burns with no harsh chemicals. It's safe for pets, kids, rosacea prone skin and Beyond. With over 500,000 users raving about active skin repair for virtually every issue under the sun, Active Skin Repair is HSA eligible, pregnancy safe and National Eczema association approved. It's a first aid kit. Must skip the toxic ointments. Go to ActiveSkinrepair.com use code ALEX for 20% off. This is going to be like the new thing to get everyone at their baby shower and give your furry friends and not so furry friends pure science backed healing. That's activeskinrepair.com code Alex for 20 off. You ever lay in bed and feel like your sheets are conspiring against you? Like you're just trying to sleep and then bam, you wake up drenched in sweat, your body feeling like it's been trapped in a plastic bag with a hair dryer on full blast. You could be in Dateline right now. Oh, wait, no, I'm just talking about polyester sheets. Yeah, I bought into the well, it's cheap nonsense and ended up living in a personal sauna. Hell, here's the thing. I already live in a sauna. I live in Phoenix, so I need a break at night. I'm a human who deserves better than a trash bag to sleep in. Thank God I discovered Cozy Earth. Let me tell you about the Cozy Earth bamboo sheet set. These are made from 100% premium viscose bamboo, which basically means they're soft and breathable, not a plastic puddle of misery. I can now sleep without waking up feeling like I'm about to melt into a puddle of regret. The best part, they actually get gets softer every time you wash them, which I really love. So it's like my sheets are giving me a hug every night saying, you deserve this and you're welcome. Oh, and if you really want to be living like royalty, the women's stretch knit bamboo pajama set feels like it's made of fairy dust. Cool, breathable, luxurious. Basically what you wish your life could be. Do yourself a favor, stop sleeping in a swamp of polyester. Go to cozyearth.com Alex that's cozyearth.com Alex with code Alex for 40% off your order, that's cozyearth.Com with code with code Alex for 40% off. A better year starts with better sleep. Wrap yourself in Cozy Earth. How do you feel as a psychiatrist about primary care physicians being some of the main people prescribing, you know, antidepressants to people?
- [35:08]
Dr. Joseph Whit Doring
I think it's malpractice. I mean, if we think about antidepressants, right? You know, the. Here is a pill that will turn off the smoke detector in your brain to the problems in your life. I mean, there's just so much in that. I mean, you would need to know about their relationships, you would need to know about their work, you'd need to know about their health. You'd need to be spending so much time with that person to make sure you're not actually making them worse. People who are on these drugs as well frequently don't even realize when they're affecting them negatively because they're affecting their mind. And they have less insight when their brain is sort of in that chemical spell, if you will. So you have to go and talk to their spouse as well or people who know them.
- [35:50]
Alex Clark
So is that what you do?
- [35:51]
Dr. Joseph Whit Doring
Yeah, yeah. If you're doing psychiatry right, and you're prescribing subscribing mind altering drugs which change people's personalities and behaviors where the person can't even realize if it's helping them or hindering them. Sometimes you have to talk to family members as well. Now, family medicine doctor, they have like 15 minutes with some people. Maybe it's like six, seven minutes of FaceTime. Maybe half of that they're talking about like some other issue, like a cardiovascular thing. And then it's just like, oh, you're depressed. Have this. Yeah, there's no way, I mean, there's absolutely no way you could use those medications in a safe way when you actually think about what they do and the consequences it could have for a person.
- [36:38]
Alex Clark
So that's basically my story. Yeah, I had a 10 minute wellness checkup with my primary care physician a couple of years ago. I had just casually mentioned, you know, oh my gosh, I'm so stressed out right now at work or whatever, like just, I had stuff going on and she just was like, oh, well, you know, that's no big deal. Like, it just sounds like you're a little bit anxious. I'll just prescribe you Lexapro. And I was like, oh, what's that? She's like, oh, it's just like an anti anxiety medication. I'll put you on a low dose. So that's all that happened. I was not told anything about potential risks, side effects, whatever. I didn't know any better. This is way before I had my awakening on pharma. So I just said, okay. I got on that. I remember accidentally, and it was a very low dose. I think I was only on 5 milligrams, but I had like ran out or something and didn't go fill my prescription. And I think I missed like two days. And I remember driving like, I want, I want to, I want to crash into the median. Yeah, it was just very like, like I want to do it. And I was like resisting, like, I just, I don't want to be here anymore. And I was like, something's not right. I got to fill my prescription now. What's Interesting is like now what I know is that it's not depression or anxiety coming back. Like, it's like part of the withdrawal. Right. Of like not being on these drugs starting to kick in.
- [37:49]
Dr. Joseph Whit Doring
Yeah.
- [37:49]
Alex Clark
So then I got back on and then anyway, I myself started, which you probably don't do this, but I started kind of tapering off and I just started like cutting like a third of it off. And then eventually, like after several months, went down to a half. And then, you know, so I tapered myself off and I fully got off Lex probably in about six months, which may be too fast. I don't know. I didn't have any issues getting off, but I was also in a very low dose and I didn't even notice. Besides, when I didn't take it that time where I felt like I had ideations happening, I didn't ever notice like a big difference in that I was feeling better or less anxious at all while being on the drug. Thank God. But that's, that's my story on it.
- [38:28]
Dr. Joseph Whit Doring
How long were you on it for, Alex?
- [38:30]
Alex Clark
I think probably like two years. Now.
- [38:33]
Dr. Joseph Whit Doring
What I want to ask you is in your follow up appointments with your family doctor, how much did they talk to you about how long are you going to be on the med for?
- [38:43]
Alex Clark
Never.
- [38:44]
Dr. Joseph Whit Doring
What was the discussion? Was it just like kind of they just kept refilling it or was this.
- [38:49]
Alex Clark
So then it's like. And you're still on the Lex Pro?
- [38:51]
Dr. Joseph Whit Doring
Yep.
- [38:51]
Alex Clark
Okay. That's it?
- [38:53]
Dr. Joseph Whit Doring
Yeah.
- [38:53]
Alex Clark
There's no discussion.
- [38:55]
Dr. Joseph Whit Doring
It wasn't like, hey, has your job gotten better or anything like that, or have things changed in your life? Are you sure you want to be on this?
- [39:01]
Alex Clark
Never.
- [39:02]
Dr. Joseph Whit Doring
I don't think that's that uncommon for many people. I. I talk to people and they're like, hey, I was anxious because I moved away for college and they just get put on an antidepressant and then like 15 years later, they're just like, oh, you just kept refilling it. Mm. And it's like you feel like made your brain dependent on this drug. Like, like cemented this, this thing together for like 15 years now.
- [39:26]
Alex Clark
Yeah.
- [39:26]
Dr. Joseph Whit Doring
And they just like, just like let it go.
- [39:29]
Alex Clark
So what is the correct tapering process for getting off SSRIs or antidepressants?
- [39:34]
Dr. Joseph Whit Doring
So yeah, so this is, this is really my specialty and what I do. And so it's, it's symptom LED tapering. And so I'm going to provide some parameters here. There's variability in how people respond to coming off these meds Some people, their brains are super elastic and they could survive a rapid taper. You know, they can come off after, you know, two months. You know, some family medicine doctors will do it that quickly and they'll feel poor, but, you know, maybe a month later, you know, six weeks later, they're. They're okay. There are a lot of people out there where that's way too fast and they become really symptomatic and they become suicidal, they become anxious like that they've never imagined. They have cognitive problems as well. And to get them off the medications, you have to do it much, much slower. So generally, I think if someone has been on antidepressants for over a year, they should do one of these, these slower tapers. I typically recommend people knock the dose down by 5 to 10% per month, and then they just adjust it as they go. You know, if you do that and you're feeling fine, just knock another 10% off. But as you get lower, you generally need to slow down. And this is actually the, the part of it where most people fail their tapers or they'll end up just on, like, a small dose at the very bottom. And I'll try not to get too scientific here, but I do think it's helpful to imagine this at the higher doses of antidepressants. You know, there's a space between two neurons and it's just flooded with the drug. And so let's say it's like 60 of Prozac, which is. Would be one of the higher doses. You could drop that down by half and really not change receptor occupancy at the neurons because there's still so much drug, like, floating around. So you're on half the dose and it's still like pretty much the same. But once you get down to the lower dose range of a drug, as you remove more and more, there's less of the, the excess just like, floating around in that space. And then you start to disengage the receptors much more. And so many people will feel like, oh, you know, I. I knocked, you know, 10 off the Prozac and I went to 50 and it was fine. And I knocked another 10 off and I got to 40 and it was fine. And then they get all the way down to like, let's say 20, and then they knock another 10% off, and then they feel it and they go, oh, no, you know, what's happening? I'm never going to be able to get off this drug.
- [42:04]
Alex Clark
And what are they feeling?
- [42:06]
Dr. Joseph Whit Doring
So what they're feeling is that they've reached this tipping point where there's no longer this big saturation of leftover drug, you know, sitting between the neurons, and now there's not that much left, so they're really feeling each reduction. So, and this is the part where people fail. When you get to the lower doses of the drug, you have to understand that you have to move much slower. So eventually, when someone will hit this, this, this withdrawal is usually when I tell them to go and get a liquid formulation of the drug, because it's really hard to just break the tablets in half at that point. You don't really have the level of precision that you need. And so let's say you had 10 of Prozac, you would just get 10 milligrams and put it into 10 milliliters of the drug. And then because a syringe has so many, like, fine gradations on the side, you can actually lower it down with much greater precision than if you were to be, you know, breaking up a tablet. And so from that point onwards, you might just have someone remove 1 milligram, you know, every. Every two to three weeks, and then they can go down like that. The key point here is do not panic. If you go into withdrawal at the end, you probably need to go onto a liquid formulation and then use a syringe to sort of steadily bring it down, and that's the way you can safely get someone off.
- [43:30]
Alex Clark
And what's the typical timeline for how long it takes someone to fully get off an ssri? Like, are we talking about a year, two years? What is it?
- [43:38]
Dr. Joseph Whit Doring
I would say it's one to two years if someone's been on them for, like, you know, more than a couple of years.
- [43:44]
Alex Clark
If somebody is experiencing brain zaps as they're trying to taper off, like, what's your recommendation for how to deal with that?
- [43:50]
Dr. Joseph Whit Doring
Go up.
- [43:51]
Alex Clark
Okay, so you need to go back up on the.
- [43:53]
Dr. Joseph Whit Doring
Yeah, go. Go back up. And this sort of links into one of the problems with antidepressant withdrawal, which most people aren't aware of. And it's a condition called protracted withdrawal. Now, this doesn't happen to everyone, but it's going to sound really scary. This. Actually, most people are okay when they go through abrupt withdrawals, but there is a fraction of people out there that if they come off the medications and they go into one of these bad withdrawals and syndromes like you mentioned, with, like, brain zaps, or they have, like, really high anxiety that can almost be experienced, like a concussion or like a Neurological injury. And so for some people, when they have a lot of these withdrawal symptoms, it doesn't get better even when they reinstate the drug. And this can be a completely devastating condition that can go on for years. And that's what I try and do with these slow tapers, because it's not harmless to just stop the drug in, in two months. It can actually, you know, it can cause really devastating problems. And, and if you give me a bit of leeway, I'll kind of tell you a story about sort of how this happens. You have someone, they go and see a family medicine doctor. They say, oh, you can come off in two months. And then they go into withdrawal and they start to have brain zaps and high anxiety. And they're sitting there and they go, I'm just going to white knuckle through it. I'm just going to tough it out. I don't want to lose my gains because I know it's just going to get better. And they're having really, really bad anxiety and brain zaps. Now what happens is, and for reasons I don't understand, somewhere around like the, you know, the one month mark, two month mark, three month marks, sometimes it's even further out than that. The bottom falls out and they stop just having brain zaps. They start to develop like, severe anxiety, cognitive impairment, ringing in their ears, light sensitivity, gastrointestinal problems. Like they develop ibs, this, you know, tingling in their hands and feet. And then they panic and they go, oh, my God, what is happening to me? This is terrible. And so they think I must be in withdrawal. The withdrawal is getting worse. And then they try and take the drug to make it go away, but it doesn't go away. Oh, and that's because they're not in withdrawal anymore. They've, because they've been sitting in that acute withdrawal. It's sort of built up to a point. It's actually damaged their brain. And that condition, that, that one does get better for the vast majority of people. But sometimes it can take, you know, 18 months, two years, sometimes even longer for, for it to fully resolve because it's not a withdrawal. It's. It's almost like you've had a concussion. It's like you've had a neurological insult.
- [46:32]
Alex Clark
Holy smokes.
- [46:34]
Dr. Joseph Whit Doring
And there's hundreds of thousands of these people online who have been neglected. They, they hang out on places like, if you ever want to see a dark corner of the Internet, you can go to surviving antidepressants Dot com. It's like hundreds of thousands of these people who have had these antidepressant injuries and they've just been completely forgotten by people.
- [46:55]
Alex Clark
Had a date night with my boyfriend, Stephen. He's the type that orders the guac at restaurants like it's his last meal. But this time I showed up prepared. I pulled out my own bag of masa chips because I'm a snack ninja. I'm not going to eat those greasy seed oil laden chips at the restaurant when I know that I have better options that I could bring in my purse. So Steve thought I was being a little extra, but hey, I was just being smart. And also, he secretly loves how I've leveled up his life when it comes to healthier food. So he didn't actually care. Masa chips are the real deal. Thick, crunchy, made with no seed oil, really salty, which means no nasties like chemicals or fake ingredients. You get organic corn, grass fed beef, tallow, and sea salt. That's it. No weirdness. Just a chip that doesn't break in your guac, which I think we can all agree is a game changer. You want to impress your date? Or maybe just snack smarter? Use code real Alex Clark for 20% off your first purchase@masa chips.com. when you taste Masa chips, you are going to understand the hype. Do not wait for the restaurant guac. Bring the real deal with you. That's real alex clark@masachips.com for 20% off your first order. All right, let's talk about allergies. I know you love the idea of flowers blooming and the sun shining, but you're also getting a lovely free dose of pollen in the air, making you feel like someone is attacking your sinuses with a sledgehammer. And then, of course, there's the wonderful world of over the counter allergy meds, where you get to choose between I can't breathe at all and I'm so drugged out I might fall asleep standing up. But guess what, folks, There's a better way. It's called Alertica. And this stuff actually does something. It doesn't just block histamine like those lazy pills over the counter at the drugstore you're taking. It actually helps your body deal with it naturally. So I'm not sure about you, but I would like my body to process stuff instead of just slapping a band aid on it like those useless drugs. And they're really expensive. So here's the deal. Alera uses natural ingredients like stinging nettle and rosemary to support your body's ability to deal with histamine the right way. No drowsiness, no foggy brain, no need to take a nap every time you need to breathe. Just clear sinuses and easy breathing. You're tired of feeling like a zombie every spring, right? You could be an extra. Could we do Zombie Island? Well, head to utsy.comutzy Use my code Alex to save 20% off on Alera. It's the natural solution that doesn't make you feel like you're being poisoned. Trust me, it's time for a real change when it comes to allergies. That's utsy.comutzy.com code Alex to save 20% off on Alertica, a natural allergy medicine that works. Lexa Pro was recently. Recently approved for kids as young as seven. What are your thoughts on prescribing SSRI to children?
- [49:39]
Dr. Joseph Whit Doring
To me, it just. It. It does not make sense unless someone has tried absolutely everything else. Because there's a boxed warning on antidepressants for suicidal behavior. And this is especially a problem in people under age 20, under age 25, that the younger you are, the more likely you are to experience it. It's due to these paradoxical reactions. And the younger you are, the less mature your nervous system is and the more likely you are to have a bad response to it. And when they looked at the clinical trials, Alex, there were more suicide attempts on the people who got the drug than the people who were just given placebo. When we're talking about giving these drugs to children, you're essentially giving a kid a drug where they're more likely to have a suicide attempt than if you were to do nothing. And so, for me, I really struggle to think about why we. We give these medications to people under age 25 at all. Because, yes, you know, it lowers the symptoms on the depression rating scale, but the outcome you really care about is really suicidal behavior with something like depression. And when you look at it in that way, you're more likely to have a suicide attempt on the drug than if you were just given placebo. So for me, it's like, don't do it.
- [50:59]
Alex Clark
How do you predict children who start taking SSRIs at such a young age will fare in adulthood, particularly if they remain on the medication for decades?
- [51:09]
Dr. Joseph Whit Doring
I think it's. For me, it's scary. Like, I'm a drug safety guy. And so I'll talk about some animal studies, which I've seen. And so when we. When we look at what happens to mice who are exposed to antidepressants in utero, you know, like in the mom's belly or to baby mice who are exposed, growing up and maturing. Their behavior is different from, from the other mice. I mean, it has an effect on how the nervous system develops. They engage in less mating behavior and, and they're stopped. You know, they're just exposed during that time and then they're not given antidepressants anymore. And so there's, there's an effect on the nervous system that just changes how they function socially. There's also concerns that in humans that antidepressant exposure when the, you know, in utero, you know, when they're, when the mother is pregnant leads to an increased risk of autism as well. And so there's these behavioral things that I worry about, like just simply from interfering with the maturation of the central nervous system. But then there's the. Oh, so the. What I see to be like a clear, like, emotional issue, and that is that you're going to suppress someone's emotional development because part of growing up is, you know, getting rejected by a crush, feeling like, excluded sometimes, getting upset, you know, feeling uncertainty about your life and your job and all of these things. And when you turn the volume off on that, you can have people who are emotionally stunted. I've taken people off, you know, cocktails of meds, which they've been on for 20 years, and they tell me that when they come off, it's like all of their emotions are back and it's, and they're learning how to deal with them for the first time when they're like 40, when everyone else has sort of worked through all of these messy emotions which are a normal part of development. And you sort of rob someone of that. You rob them of the opportunity to really work through their emotions. And you can get into relationships that, that you wouldn't have gotten into while you're on the medications. You can, you can settle for jobs that you wouldn't have settled for while you're on, while you're on these things. And, and so, I mean, there's just so many ways essentially drugging your brain can have all of these different effects as you're growing up and trying to figure out who you are.
- [53:35]
Alex Clark
And so I'm guessing there's no long term research on the effects of SSRIs on children, like being on it forever?
- [53:42]
Dr. Joseph Whit Doring
No, no, there's, there's this not. And I mean, we didn't even talk about the fact that you, you're like this massive sexual dysfunction from these drugs. And so you're also Going to rob a teen. That's what I'm scared about, of going through, you know, normal, being excited about being, you know, sexually active. And if you just blunt all of that as well, it's kind of like a very special experience for. For young. For a teen and a young person to go through. And if you take that away, I mean, that's.
- [54:12]
Alex Clark
I mean, in a way, and, I mean, this is a whole nother debate, and I don't know your thoughts on it, but, like, you know, there's this debate about, you know, the trans movement and. And allowing minors to transition and putting them on hormones and, you know, basically castrating them medically and what that will do to them in a way. If you were putting a child on an antidepressant for years and years and years, I mean, couldn't we. That also be another form castration?
- [54:37]
Dr. Joseph Whit Doring
Yes, it can be. And I mean, the thing, you know, I'll say the quiet part out loud because this is something that I worry about, and long ago, I sort of got over not just speaking my mind on things. I. I actually, I do worry that the increased use of antidepressants in young people and I. So in pregnant mothers may contribute to people having gender dysphoria. You know, like. Like we saw in the animal studies, this less mating behavior in the kids who grow up exposed to antidepressants. I've spoken to several people with PSSD who tell me when they developed it, they were used to being attracted to. You know, I spoke to two men, and they. They normally, they have normal sexual attraction towards, like, a woman. And when that went away because they developed pssd, they started to think that they were gay, essentially. I do think it can lead to gender dysphoria, confusion about your sexual identity if you. If your brain sort of matures going through this. If you blunt someone's normal sexual functioning. And there's actually, and this is the scariest thing here, there's actually some data about this. A researcher, Yazi Priyani and Travis, they did a study. It was published, it was commented on in the New York Times a few years ago. They went out and they. They. They did a survey of people identifying as LGBTQ, and I think 30 of them were taking antidepressants. And when they asked them, you know, what percentage of you had enduring sexual dysfunction when you came off the antidepressant? It was 13 of them. To me, it's like, well, what came like, could that be a reason why you're identifying as lgbtq? If you got on an antidepressant. And then you experienced enduring sexual dysfunction. And now you have gender dysphoria and.
- [56:29]
Alex Clark
Identity confusion because they're attributing like, oh, I can't, like, keep an erection because maybe I'm not attracted to the sex. Yeah, it's really just a side effect of the drug.
- [56:38]
Dr. Joseph Whit Doring
Yeah, yeah. And, and, and how you're not feeling. You're looking around and everyone else is having kind of normal sort of sexual connections with each other and you don't feel. Feel that.
- [56:49]
Alex Clark
Wow. I think you're on to something there. Yeah.
- [56:51]
Dr. Joseph Whit Doring
If that happens to you and then you're in sort of one of these places where people, like, just, you know, they say they do these evaluations to make sure you're really, you know, you really need the surgery. But it's just a bunch of, like, psychologists, like, cheerleading people, like, to the finish line. Like, I mean, you can pretty much ruin their life and their family's life forever, like, if that was not what was going on. And that's, that's kind of. That's like evil when I think about it. I mean, it's probably one of the sickest things that you could do is to. Is to miss that 100.
- [57:20]
Alex Clark
Now, do you have similar concerns about kids on ADHD medication?
- [57:24]
Dr. Joseph Whit Doring
ADHD medications, generally, they tend to be safer in terms of, like, horrific. Like, Like, I think PSSD is horrific. I think protracted withdrawal is horrific. People coming off ADHD meds aren't having those problems. They're not having neurological injuries. The thing that I worry about the most with ADHD meds is really, like, addiction. You know, ADHD is sort of like an. It's as a disease, it's like an interesting concept. Right. Because when you go to societies where, you know, it's. You sit down and you work and you need to be, like, disciplined, and it's like, really, like, you're almost your worth as, as a person is, like, how much you contribute and how successful you are. You're going to see a lot of ADHD there. Because anyone that doesn't fit that mold, who isn't able to sort of achieve in that way, they're going to be like, oh, I feel like something's wrong with me. And so that's why in places like the US which are really like that, we're going to have sky high ADHD rates. When you go to places like France or other places, they're like, no, there's more variability in how people are. You know, not everyone is meant to be sitting down and studying at a desk. What I really worry about in the US Is because we have this culture that's so. That valorizes like success and, you know, doing all of these things that people, they put themselves on, on these medications. And one, they can get into jobs that they really shouldn't be doing because then they, to actually do the job, they need to be on the stimulants. But they also get sort of like lulled into this, this, this state of mind that really does lead to addiction. And that is when my mind isn't working the way that I want it to work, I can just take something to fix it. Like if you're like a young person, oh, my diet's crap and, you know, I can't concentrate because of that. I'll just take some Adderall. I went out drinking last night with my friends and now I have to get up and go to college and, you know, I have to focus. I'll just take some Adderall. It's so ubiquitous now that I think people feel like that's really normal. And so what I see with ADHD meds is people get on that, they'll start that they'll have a crash in the evening, they'll start to drink more beers to kind of deal with that. And then again, just hacking their neurology or they'll start taking benzodiazepines. And when they start to eventually get more anxious because they're on Xanax and it does that long term, then eventually they start getting on an antidepressant and it just starts this like this spiral where it just started with an ADHD medication. And now someone's like using all of these different medications to sort of like hack their neurochemistry rather than just being like, hey, you were okay the way you were, and maybe there needed to be. You needed to find a different thing that you could do to be okay.
- [60:00]
Alex Clark
So now I've heard somebody describe ADHD medication before as legal meth, essentially. Do you think that that's a fair description or do you think that's kind of disingenuous?
- [60:09]
Dr. Joseph Whit Doring
I think it's just completely fair to get distinction. I mean, there's a drug called Desoxin that, that is methamphetamine. Like, it's actually methamphetamine, the active ingredient. It is an ADHD medication that you can take. It's, it's a third line therapy for it, you know, after you try Ritalin and Adderall. But meth, like methamphetamine like the methamphetamine people smoke. You can get that in a tablet. In a tablet from, like, you know, your big box pharmacies for adhd.
- [60:37]
Alex Clark
And can kids take this?
- [60:38]
Dr. Joseph Whit Doring
Yeah, if they have treatment resistant adhd.
- [60:40]
Alex Clark
Oh, my gosh.
- [60:41]
Dr. Joseph Whit Doring
Like, we draw this, like, distinction that, like, no, those are the street drugs and, and, and these are our safe medications. But no, they, they're just, they're all stimulants.
- [60:50]
Alex Clark
Wow. How quickly can post SSRI sexual dysfunction develop once you start taking it? Like, is it like, oh, you got to be on it for like six months or more for develop. It could be like you took it one time. It could be after only, you know, decades on the pill.
- [61:05]
Dr. Joseph Whit Doring
Oh, we've seen, we've seen it all. So I think, I mean, that's, I've spoken to several people where it's developed within one to two pills of it, and then some people where it's happened over a much longer period of time. I, I think it's very unlikely, very, very unlikely that it happens after a couple pills. But, yeah, that, that can happen.
- [61:25]
Alex Clark
I was recently interviewed by Glenn Beck and he's kind of like, learning because of the Maha movement, he's kind of learning for the first time about all this, like, big pharma, big food stuff. So he doesn't know that much. And people that are fans of Glenn, they know his story is that his whole family, like his mother and all and everybody in his immediate family struggled with severe depression. And Glenn was basically suicidal and then got on antidepressants. And he says, like, that saved my life. So his question for me was about, like, how do you explain an entire family all having severe depression? 2. How do you explain if it is a placebo, how, like, immediately I took it and I felt like, okay, like, I'm better.
- [62:08]
Dr. Joseph Whit Doring
I don't really buy it. I don't think antidepressants or placebo at all. I think they have a very obvious drug effect. Like, if you're paying attention. I mean, when, when I was, when I took Zoloft, like, it was just like, it was like a pane of glass separated me from the world. And I felt serene and like I was disconnected. And my wife would be, you know, complaining about the state of the home, and I'd just be like, I don't care, you know? You know, it's just like, oh, everybody's.
- [62:33]
Alex Clark
Gonna want their husbands to be on that.
- [62:34]
Dr. Joseph Whit Doring
Then, no, she's like, I hate you on Zoloft. And I was like, oh, I'm just Experimenting with. I'm just trying it so and so, yeah, there's this idea that if you take it, you know, you're going to have this expectation it'll make you better and then you'll just feel well. And that's what they do. It's just placebo. It's just a psychological trick from a sugar pill. No way. You know, there's a, there's. There is an obvious drug effect from being on them that, that is kind of numbing and disconnecting. So it's not placebo. Glenn, how do we describe why his family is, is depressed? And, you know, this is where nuance is needed. So there can be, you know, what, what makes people depressed? I mean, for me as a psychiatrist, I think about, you know, like, medical problems. You know, are there medical problems? You know, is there mold in the house? You know, is it, is there dietary issues going on? You know, is there substance, Substance, substance use, misuse? But if you rule out all of those things, I mean, the other thing is, is there trauma in the family? You know, are there stressful things happening around them? So you kind of go through all of these, these, these causes for depressed mood. If you can't find any of them, there's no problem with sort of falling back on. Maybe this is depression that is arising from more of a biological cause. Because there are some people who generally tend to be more neurotic. You know, they're, they're, they're worriers and they, they slip into depression more. And so I do think there are some people that are kind of tilted that way, and that's just.
- [64:00]
Alex Clark
But it's not a chemical imbalance.
- [64:02]
Dr. Joseph Whit Doring
Well, it's, it's, it's not like a well defined chemical imbalance where it's like you could point to it in a brain and just say, this is the actual problem. We're really just talking about, you know, variations in, in how people are. And, and truthfully, Alex, I mean, maybe one day there, there will be something that they find. I, I think they'll probably find something for schizophrenia. I'm not that convinced they're going to find something for like, anxiety and depression. I think it's way too complicated, and it's probably like polygenic, meaning that there's multiple different genes involved. It's not going to be this, like, neat little solution that we can like, fire a drug add. And so there's no issue with someone like Glenn or someone like, taking a medication. If they've done everything else, you know, done the therapy, you look, you look, you looked at your diet, your lifestyle, you're not smoking lots of pot. If you're still feeling really bad, you can take an antidepressant. I mean, if someone's informed you about the risks and you're just like, I really need this to function, there should be no shame in that. And so there are going to be some people out there, you know, maybe like Glenn, who's done everything and he's taken it and it's been helpful for him. He should be able to, he can do that. And I, and I would, I have no problem with that. And I think that's reasonable. The issue is, is that we rob people of that, the way we practice it these days, because we, we do these transactional visits. No one tries to motivate anyone or help them do these other things.
- [65:27]
Alex Clark
Yeah.
- [65:27]
Dr. Joseph Whit Doring
And so, yeah, they're robbed of the opportunity of trying something that's less harmful and they're not told about the risks.
- [65:32]
Alex Clark
What do you think causes schizophrenia?
- [65:34]
Dr. Joseph Whit Doring
I don't think it can be described explained away by, by trauma or stresses in someone's life. There's a lot of things that look like schizophrenia. I mean, the main thing I think is cannabis induced psychosis. Like that looks like a psychotic disorder. But for someone who hasn't had that, I don't know what it's caused by. Researchers don't. But I do think they'll probably find something eventually because, you know, the way it presents is you have someone who's, you know, in their late teens, early 20s and they just, and they just tank. You know, their cognition goes down so they start to experience delusions and paranoia and they never quite recover. And then they sort of live at this lower level of functioning, sort of drifting in and out of psychosis throughout their life. I don't think there's a trauma that's severe enough. I don't think there's life stresses that that could be so bad that it would kind of tilt someone into that level of, of dysfunction. And so the cause of it, I, I, I lean more on like a genetic biological side for that one which we haven't quite found.
- [66:37]
Alex Clark
Do you see any connection between the over prescription of antidepressants and the rise in mental health issues like depression and anxiety in recent generations?
- [66:47]
Dr. Joseph Whit Doring
I think these drugs are making a lot of people worse. I mean, for multiple reasons. I think for some people they're harmful to the brain long term. I mean, we talked about tardive dysphoria and I also think that we've sold people on a lie, you know, that the solution to their problems is, you know, in their brain to be fixed with a chemical. And I think anytime you don't actually fix something at the root cause, it just festers and it gets worse.
- [67:13]
Alex Clark
So if not SSRIs, what are the most effective treatments for depression?
- [67:17]
Dr. Joseph Whit Doring
So I think it's. It's the things that are really intuitive to a lot of us. I mean, we're emotional beings. I mean, so we, our relationships are really important, you know, finding meaning in what we do. You know, having work, that we enjoy, having freedom as well. I think those things are all essential from an emotional standpoint. You know, financial insecurity, although that's harder to treat for some people. I mean, you can't really treat. It's not really in the domain of a doctor to treat poverty and things like that. It's more of a societal thing. So, so there's that. And then we have like, your, your physical health. I mean, the food that you put into your body. I mean, our brains are connected to our body by our neck. You know, if. If we, if we don't look after our body, we're going to feel unwell. We're designed to move as well. Like, if you're someone who's just like, anxious and just like, what's going on? It's like, are you moving your body? Are you exercising? We're not. We're also not designed to be, you know, smashing cups of coffee and like, you know, using nicotine products all day and like hacking, you know, hacking our biology. I mean, so you got to cut all of those, all of those things out. I mean, that's where I would start with helping people with depression. I mean, and these things aren't quick fixes. You know, finding the love of your life or a friendship group that you like, that's like, can take decades. You know, finding work that you find meaningful and that is fulfilling, that this is like life cultivation. This is, this is things that people will spend decades.
- [68:44]
Alex Clark
Right.
- [68:45]
Dr. Joseph Whit Doring
Working on. So it's not a quick fix. So do those things first. And we don't want to say no to antidepressants completely. It's just like, you want to do the things that are much safer before you go and lean on a drug that can, you know, in rare cases, cause things like PSSD that can be really hard to come off and, and so use the antidepressant. But, but don't, don't just like, jump on it because family doctor tells you to do in like a seven Minute visit.
- [69:15]
Alex Clark
Is there evidence to support that certain lifestyle changes or nutritional interventions are as effective as taking an antidepressant?
- [69:22]
Dr. Joseph Whit Doring
There's heaps of evidence for that. You know, when they look at long term outcomes for antidepressants versus psychotherapy, you know, for the studies that go over a year, you know, psychotherapy does better than the antidepressant. When they look at exercise, that does really well. When they do observational studies and they look at dietary interventions, people that do anti inflammatory or Mediterranean diets do better. And there's all of these studies out there, even in severe mental illness that are coming out of places like Stanford recently showing ketogenic diets can actually reverse bipolar disorder and schizophrenia for some people.
- [70:00]
Alex Clark
Well, and Dr. Chris Palmer is who's doing a lot of the work on that and he's phenomenal. I'm hoping to get him on the show soon to talk about all of that and the gut brain connection and everything. But yeah, it's, it's fascinating the stuff that they're finding out. Do you think that the public is becoming more aware of the risks associated with long term use of SSRIs or is the conversation still very one sided?
- [70:21]
Dr. Joseph Whit Doring
So I think, I mean we're, we're breaking through. I mean there's, there's, there's me and there's a lot of people like me who are just, you know, we're talking about this all the time on social media, trying to just get the word out through earned media. But yeah, we're, I mean we're competing against essentially an industry that has unlimited funds and has infiltrated academia by, you know, take, you know, essentially all of the academics in there get funding from the drug companies. They're not going to say anything negative about them. And so we're constantly battling this group of people with a war chest of resources that, you know, the message is essentially, you know, these drugs are super safe and they're really effective. But I mean we're breaking through.
- [71:03]
Alex Clark
Tell us about the Taper Clinic. What is it?
- [71:05]
Dr. Joseph Whit Doring
So, so the Taper Clinic is a business my wife and I started back in about five years ago and as I mentioned, I was in the FDA and in the pharmaceutical industry. And when I left I was just so disgusted by how we were not practicing in alignment with what the evidence showed. So we decided to make a clinic to help people safely come off these meds. That's all we do. You know, we, we take people off psychiatric meds, we help them find non drug approaches to deal with their mental Health problems. We're in the 10 most populous states in the US and a couple more, you know, it's all available on our website and we hire a lot of people who have been drug injured. I'd say about more than half of the people that work in the clinic as clinicians have been on psychiatric meds.
- [71:49]
Alex Clark
They've come off so they can relate to the patients.
- [71:52]
Dr. Joseph Whit Doring
They can relate to them. Yeah. You know, a clinic run by people have been personally affected by, you know, over drugging and withdrawal injuries. And that's what we do. It's sort of structured like a rehab. So it's, you know, people that come, they work with us long term. We do slow, safe, tapers.
- [72:10]
Alex Clark
What advice would you give somebody who is just beginning their antidepressant treatment journey and you know, they feel a little stuck in the cycle of prescription medication?
- [72:20]
Dr. Joseph Whit Doring
I mean, you need to trust your intuition would be, would be the first thing. I mean, really think about it. You know, other things in my life that need to be getting addressed. You know, you never want to end up just on the medication. And that's like the treatment, you know, it's, if you're going to use it, it needs to be done in conjunction with fixing my relationship, my job, my health and my exercising. Getting off cannabis and like other drugs. Am I using too much like coffee and nicotine? You, you want to do it with all of these other things that are really well known to, to help improve your health. And there should always be an exit plan. I mean the, you should be thinking about this medication, like how am I going to get off this? You know, what's the fastest way to get to a place where I don't need this anymore? I think if you're thinking about it in that way, you'll be safe and then obviously get educated on how to come off it safely eventually because you don't want to get hurt on the way off.
- [73:15]
Alex Clark
Are people able to work specifically with you if they want to?
- [73:18]
Dr. Joseph Whit Doring
I'm the medical director, so right now I'm overseeing all of the cases in the clinic.
- [73:22]
Alex Clark
Okay. And how can people get in touch?
- [73:24]
Dr. Joseph Whit Doring
Best way to get in touch is just to come to our website, which is, you know, www.taper t a P E R clinic dot com.
- [73:33]
Alex Clark
If you could offer one remedy to heal a sick culture and that could be physically, emotionally or spiritually, what would it be?
- [73:40]
Dr. Joseph Whit Doring
Purpose. I, I think that's, I think that is the driving force for many people. It's, it's finding something that you believe in and that you can go after and you can build your life around it. I think when people have purpose, a lot of things fall into place for them.
- [73:54]
Alex Clark
Thank you for coming on Culture Apothecary.
- [73:56]
Dr. Joseph Whit Doring
Dr. Joseph thanks for having me Alex.
- [74:01]
Alex Clark
If you enjoyed this episode, make sure you go back and listen to my interview with Dr. Roger McFillan on the same subject from a few years ago. Please leave a five star review. Tell others why you love to listen to Culture Apothecary. My expert guests bring their own unique remedy to helicit culture twice a week, Mondays and Thursdays at 6pm Pacific 9pm Eastern. Subscribe to Real Alex Clark on YouTube for extra content beyond just the episodes and you can follow me personally on Instagram at real Alexander Clark. TPUSAmerch.com will get you a bunch of show merch. If you really want to rep the show out in the wild, use code Alex Clark. That'll get you 10% off. I'm Alex Clark and this is Culture Apothecary.