Presenting: P.E. Moskowitz on Whether Your Mind is Broken or the World Is (with Depresh Mode)

Summary

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Proxy with Yowei Shaw

Presenting: P.E. Moskowitz on Whether Your Mind is Broken or the World Is (with Depresh Mode)

Date: March 10, 2026
Host: John Moe (Depresh Mode)
Guest: P.E. Moskowitz (journalist, author of Breaking: A Reporter’s Search for a New Life and a New World Through Drugs)
Summary Prepared By: Expert Podcast Summarizer

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Episode Overview

This episode revolves around a central, deeply resonant question: When your mind struggles, is something wrong with you — or is the world fundamentally broken?
Host John Moe welcomes journalist P.E. Moskowitz for a raw, searching conversation about trauma, healing, the history and social context of mental health diagnoses, and whether individual treatments can truly address collective distress. Drawing on their own story—including surviving Charlottesville and 9/11—Moskowitz explores the messy boundaries between personal pain and societal dysfunction. The episode also critiques the limitations of psychiatric labels and talks candidly about the role of both pharmaceutical and recreational drugs in managing (and making sense of) mental health.

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Key Discussion Points & Insights

1. Is It Me or Is It the World?

• Mental health as a signal vs. an illness:
  Moe opens with a question: Are depression and anxiety distortions, or are they highly rational responses to a traumatic, unjust world?
  • “Are these problems a distortion of reality… or is this the real life? Do we get immobilized by depression and anxiety because we see the truth about how the world is?” (John Moe, [03:23])

2. The Impact and Aftermath of Trauma

• Charlottesville as a breaking point:
  • Moskowitz recalls witnessing the deadly 2017 neo-Nazi attack in Charlottesville, which triggered a massive breakdown a month later.
  • “At the peak moment of this kind of ecstatic feeling that we’d won... a neo-Nazi drove his Dodge Challenger into the crowd. I saw bodies flying and I lost my friends in the crowd and dropped my phone and had other people’s blood on me… my entire psyche was kind of wrecked.” (P.E. Moskowitz, [07:20])
  • For weeks, Moskowitz suppressed their trauma until a total breakdown struck suddenly in a hotel room.
• 9/11 and cumulative trauma:
  • Moskowitz also survived 9/11 as a 13-year-old at a school near the World Trade Center, experiencing direct terror and displacement ([13:11]).
  • Both incidents triggered not just acute stress but reactivated “boxed away” family and generational trauma.

3. Healing Is Not the Same as Curing

• The Myth of Going Back:
  • Many want to believe healing equals a “return to normal,” but for survivors, there is no return.
  • “There’s no going back to this kind of pre-traumatized state... It was really painful to try for years in therapy, I just wanted to be fixed… The more I accepted that this had to transform me in some way, the easier the healing got.” (P.E. Moskowitz, [18:26])
  • Healing is not linear or complete; instead, trauma transforms us—sometimes even opening space for new vulnerability, empathy, or love.

4. The Language and Politics of Psychiatric Diagnosis

• Diagnosis as description, not destiny:
  • Diagnoses (ADHD, depression, PTSD, etc.) are “clusters of symptoms,” not immutable facts.
  • “Even the most mainstream psychiatrist acknowledges that these things are clusters of symptoms… diagnosis is not a material fact. It’s a way of describing behaviors and reactions to things.” (P.E. Moskowitz, [48:41])
• Individualization vs. structural critique:
  • The danger is pathologizing what might be reasonable responses to “a horrible world,” thus internalizing social failures as personal flaws.

5. Drugs: Tool, Cure, or Coping Mechanism?

• On medications vs. “drugs”:
  • There’s a long history—rooted in racism and classism—of distinguishing “medications” (respectable, prescribed) from “drugs” (illicit, stigmatized) ([23:04]).
• Personal experiences with drugs (Klonopin, SSRIs, Adderall, ketamine):
  • Tools, not panaceas. Drugs help manage symptoms but cannot (and shouldn’t be expected to) fix a sick society.
  • “I view drugs, medications… all as just tools. Tools can be used in productive and negative ways.” (P.E. Moskowitz, [38:53])
  • SSRIs for example, may dull both lows and highs; the decision to use them can be highly individual, contingent on access and context ([28:28–32:26]).
• Recreational drugs and altered states:
  • Moskowitz describes using ketamine and LSD to access new perspectives—sometimes more meaningful in community or raves than in clinical settings ([38:53–43:59]).

6. The Limits of Clinical Approaches

• A “polluted lake” metaphor:
  • Treating mental health only on the individual level is like “picking a fish out of a polluted lake, giving it medicine, then throwing it back into the same toxic water.”
  • “No matter how many drugs you legalize, how many medications you give people, we have to stop making people sick in the first place. There is never going to be a pill or anything that does that.” (P.E. Moskowitz, [47:47])

7. Collective Trauma and Solidarity

• Loneliness and connection:
  • Traumatic events isolated Moskowitz, but deep reflection revealed that “most people are going through similar things... just less obvious forms.”
  • “All of us are going through the same thing… in a way, even though that’s a depressing fact, it’s felt incredibly… it’s made me feel love for the world and less lonely.” ([53:30])

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Notable Quotes & Memorable Moments

• On suppressing trauma:
  “I was extremely good at suppression and repression of my feelings... Without even being aware that’s what I was doing.” (P.E. Moskowitz, [09:24])

• On “success” in therapy:
  “For years in therapy, I just wanted to be fixed… The more I accepted that this had to transform me in some way, the easier the healing got.” (P.E. Moskowitz, [18:26])

• On medication’s double-edged effect:
  “SSRIs... helped me have fewer panic attacks. The problem is that it also calmed down everything else. The ecstasy and joy one is capable of feeling… felt muted on that drug.” ([29:04])

• On diagnosis and gaslighting:
  “It almost becomes a form of gaslighting oneself, because you start to believe that everything you’re experiencing is within your own individuality… as opposed to legitimate reactions to the world.” ([48:41])

• On collective suffering and solidarity:
  “Everyone is having the violence of capitalism, of police violence, of racism… imparted into their psyches on a day to day basis. And that really breaks people.” ([53:30])

• On the ultimate futility of individual “cures”:
  “No matter how many drugs you legalize, how many medications you give people, we have to stop making people sick in the first place.” ([47:47])

• Closing optimism:
  “Let’s expose ourselves to a huge variety of personal experiences and stories of what works and what doesn’t… Imagine if we did that with mental health. That drive, that purpose, that exploration, that innovation, that celebration. What would our mental health moon landing be?” (John Moe, [55:37])

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Timestamps for Essential Segments

• Introduction & framing the big question: [02:51–06:42]
• Charlottesville and immediate aftermath: [07:16–12:55]
• 9/11 experience and cumulative trauma: [13:11–16:15]
• Healing vs. being ‘fixed’: [18:26–20:42]
• Politics and history of “drugs” vs. “medication”: [22:15–25:58]
• SSRIs, Adderall, and the medicalization dilemma: [28:15–34:01]
• “Polluted lake” metaphor, individual vs. systemic causes: [34:01–37:12]
• Drugs as tools; context of use: [38:53–43:59]
• On diagnosis, DSM, and internalized blame: [48:16–52:58]
• Solidarity in collective trauma, mutual understanding: [53:30–55:25]

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Tone & Style

The conversation is frank, personal, and compassionate, marked by empathy for those struggling and a healthy skepticism toward systems that medicalize or individualize collective distress. Both speakers invoke humor and self-awareness, but the primary mood is one of searching honesty and vulnerability.

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Final Thoughts

This episode offers a nuanced, critical take on mental health: fully respecting personal suffering while passionately insisting that much misery is a function of structural cruelty, not individual brokenness. It’s a call to compassion, solidarity, and humility—in how we respond to our own pain and in what we demand of the systems that shape us.

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Transcript

[Yowei Shaw]

All right, Proxy listeners, who discovered Diane Keaton and put her in Annie Hall? Who found Dustin Hoffman and made sure he played Razzo Rizzo in Midnight Cowboy? Who saw Jason Schwartzman and was like Wes Anderson? You need to have this person in Rushmore Casting Directors of course when the 98th Oscar ceremony airs on March 15, the first Academy Award for Achievement in Casting will be given. In nearly 100 years of Academy history, five films laden with stars and fascinating new discoveries are nominated. One battle after another. Marty Supreme, Hamnet, the Secret Agent and Sinners in their latest series, the Kitchen Sisters take us behind the scenes and into the lives and work of the first ever batch of nominees and into the mysterious world of casting. Fun fact along with being a Kitchen Sister, Divya was a casting director for over a decade. The Kitchen Sisters present Everyone's a casting director with four time Academy Award winner Frances [e-mail] or wherever you get your podcasts. Hello everyone, it's Yowei. If you're new to the show, welcome on Proxy people bring me very specific emotional conundrums, the kinds of problems that make them feel alone, and I go looking for a stranger who's lived something close enough to help them get a little less stuck. If you want to try a classic proxy case, a great place to start is our episode Bisexual Wife Guy. And if you haven't already, follow the show. We got a new season of cases coming mid April. In the meantime, I have been sharing episodes from shows that I think Proxy listeners will appreciate. Shows that make space for honest, real, raw conversations about the emotional parts of being human. Today's episode comes from Depress Mode, hosted by the comedian John Moe. Besides having a great name for a podcast, Proxy engineer Kyle laughed for I think a full 15 seconds when I told him about the show. Depressed Mode is a show where John talks with artists, writers, comedians, and all kinds of thoughtful people about mental health. The messy, complicated reality of it. What I love about this show is how much room it gives to people to be open about the things we usually keep quiet. If you have ever found yourself stuck in your head trying to make sense of your feelings, I think you'll enjoy it. Today's episode is an interview with journalist P.E. moskowitz about a big question when your mind feels broken, is it you or is it the world? Here's John Moe from depressionode.

[John Moe]

We won't play the whole song, it's super long. But we will play the very, very beginning.

[P.E. Moskowitz]

Is this the real life? Is this just fantasy caught In a landslide. No escape from reality. Open your eyes, look up to the skies and see.

[John Moe]

Cut it there. Not doing the Scaramouche or Mama parts, just that first part. It's what I've thought for a while about mental health issues, depression, anxiety, panic attacks. Thought about it even more after this week's interview. Are these problems a distortion of reality, a distortion of the truth, a work of imagination, just fantasy? Or is this the real life? Do we get immobilized by depression and anxiety because we see the truth about how the world is? We see the truth of the traumas we've been through. In short, is it me or is it the world? Me or them? It's an important question to at least consider, even if it's not easily answered, because it applies to how we address these interesting minds that many of us seem to be stuck with. If it's fantasy, if these conditions cause us to see a distortion of the world, we try to treat our minds by jolting ourselves back to a healthy and pleasant normal. If that exists. If we allow that we're having a rational response to the world and our personal trauma, then we're saying we are the normal ones. And treatment becomes a way of dealing with that reality, grim as it may be, and managing ourselves so we're equipped for that landscape. A lot of mental health medicine and treatment operates on option one that that we're getting it distorted. An effort to help you live in the peaceful, normal world, which is different than the one you're currently in. Maybe we need to explore the help being a way to cope with the grim reality. Maybe we need to look more at option two. It's depression mode. I'm John Moe. I'm glad you're here. PE Moskowitz is an author and journalist. They're the author of how to Kill a City in 2017 and 2020's the case against Free Speech. Their new book is Breaking A Reporter's Search for a New Life and a New World Through Drugs. They also run Mental Health, a newsletter about psychology, psychiatry and society. PE Is a survivor of a few things. Being within inches of a protester being murdered in Charlottesville. Being within blocks of the World Trade center on 9 11. They've experienced and survived a mental breakdown. They don't want to be defined by diagnostic terms. They see their mental state as part of being in the world as it is. They've been through extensive therapy and they've tried a lot of drugs of the pharmaceutical and street recreational varieties in order to feel better. Neither they nor I Want to tell you how to manage your own mental health, but I think it's good to think about some different perspectives. Welcome to depression mode.

[P.E. Moskowitz]

Thanks for having me.

[John Moe]

You know, in thinking about your story, I wonder, should we begin with Charlottesville or begin with 911 to kind of get at, get at your personal story as your story informs the other things we're also going to talk about?

[P.E. Moskowitz]

Yeah, I mean, I think Charlottesville, even though it happened after 9 11, kind of, kind of started the whole breakdown of my life and then 911 appeared in there. So maybe we can start with Charlottesville.

[John Moe]

Yeah. Tell me what happened to you in Charlottesville.

[P.E. Moskowitz]

Yeah, so I was a 27 year old reporter reporting for a now defunct news site and also a kind of leftist anti racist activist. So I was, I was there both for this lefty publication in Virginia and also as a counter protester. Charlottesville was this huge neo Nazi far right rally. They were trying to, to save a Confederate statue that was being taken down in this public square there. And I went down from Philadelphia, where I lived at the time with two friends, in a way was having a great time being a counter protester, feeling like we were on the right side of history, contributing towards the fight or whatever. And then kind of at the peak moment of this kind of ecstatic feeling that we'd won, that we'd kicked the Nazis out of the town, that, you know, the statue would come down and that, you know, that we were just fighting for, for a good cause. James Alex Fields, a neo Nazi, drove his Dodge Challenger into the crowd of protesters and I was a few feet away and he killed an anti racist activist, Heather Heyer. And I saw bodies flying and I lost my friends in the crowd and dropped my phone and had other people's blood on me. And you know, the whole, the whole scenario, I guess lasted maybe five minutes. And in that time, I think my entire nervous system, my entire psyche was kind of wrecked. But it took me, it took me a while to realize that that's what had happened.

[John Moe]

Yeah, you write about how you didn't fall apart right there on the spot. You went and finished your article and you made phone calls and sent emails. How long after that did things start to fall apart?

[P.E. Moskowitz]

About a month. And very suddenly, I think what I realized with hindsight was that I was extremely good at suppression and repression of my feelings at that point in my life without even being aware that that's what I was doing. But the month after Charlottesville, I just kind of kept my head down. I kept ignoring this Kind of anxious, bubbling feeling I was having. And then I was on a work trip to Oakland, California to give a talk on my first book and was in a hotel room and woke up one morning feeling like I was in a completely different universe. I, my hands were shaking. I felt like I was being chased by a pack of wild animals. Basically, I couldn't stop moving. If I did sit down, it felt like all the energy coursing through me would shoot up into my brain and then cause me to have a panic attack. I basically just had a mental breakdown. And it, it was terrifying in and of itself, but it was also just terrifying not understanding what was happening to me, not understanding how I could feel so out of control of my, my brain and body.

[John Moe]

Had you had panic attacks previously?

[P.E. Moskowitz]

I had a few kind of like normal run of the mill panic attacks where during a big move from one city to another, kind of getting overwhelmed and feeling like, oh no, am I having a heart attack? Or, you know, am I going crazy or something? I'd had a few of those and then they would subside after an hour or something and I could recognize them as panic attacks. So when this happened, it felt much more intense and then also just didn't stop. So I kept thinking, oh, this is just a panic attack, except every hour, every day, and then every week it just kept going.

[John Moe]

So what, what did you do? It, it kept compounding over the course of several weeks. What did you do about it?

[P.E. Moskowitz]

In, in the immediate term, I called my therapist who, who told. Calmed me down a little bit, just enough to make me realize I could survive and get back to, to Philadelphia. And he told me to take a, a Klonopin, which I thankfully had carried on me since I had had a few panic attacks. And the Klonopin really, really, really, really, really helped. It just helped me not feel like I was about to die at any given moment and eventually got back to. I went to New York, where I'm from, where my parents live, to stay with them because I was not capable of, of living a normal, adult, independent life at that point. And they're both psychoanalysts actually. And they helped me, they helped explain to me that, you know, this kind of made sense, that people go through periods like this sometimes where, you know, there's this perfect storm of things that happen and your brain is overwhelmed and it takes a while, but you have to sort through it. And then after a few weeks, went back to Philadelphia, started going to therapy three times a week, and then the next, essentially year two Years of my life were just healing from that, trying to get back to a stable baseline where my nervous system was not a wreck.

[John Moe]

And I feel compelled to ask about your experiences as a child during 911 because that was another trauma that certainly informs your history. Tell me about what happened to you then.

[P.E. Moskowitz]

Yeah, so When I was 13, my middle school was two blocks from the World Trade center and I was in school when the first plane hit in Spanish class and the building shook and my notebook dropped to the floor and we were all ushered down to the cafeteria and that's when the second plane hit. And then my. A friend's mom took him and me and about eight other kids out of the school because she was convinced that the building was going to collapse and we all thought she was crazy. And then as we were crossing the street on the west side highway, you know, seeing people falling out of the building, seeing, seeing people with blood and dust on their faces walking towards our, my friend's house, the tower, in fact did collapse and we had to run away from the, from the kind of plume that was chasing after us. And then when we got back to my friend's house, the second tower collapsed and we thought our whole school had died because it fell kind of in the direction of our school. Thankfully, everyone was fine, but we were out of school for about six months and I was a teen. I didn't know really what trauma was. It's not that I, I don't think I was purposely trying to suppress it, but I just, I just think it's too much for any 13 year old to handle something like that. And so even though I, I went to therapy, I just didn't understand how it affected me. And I think that kind of just went in another box in my brain and to never be opened again. And Obviously Charlottesville and 911 aren't like directly related, but Charlottesville was the proverbial straw that broke the camel's back. I just had too much pent up behind this wall in my brain and all of a sudden this event opened it all. So when Charlottesville happened and when my nervous breakdown happened after Charlottesville, it turned out that I didn't only have to sort through Charlottesville, I had to sort through the terror I felt during 911 and sort through my, my family's history. You know, I come from a family of Holocaust survivors. There's always this kind of feeling within my family of like, the next terrible thing is, is going to happen. Right?

[John Moe]

Yeah. Sudden, terrible violence can happen when you least expect it is sort of the. The theme.

[P.E. Moskowitz]

Yeah. Yeah. And then in a way, it's like these two events prove that that was very true. And I think that that triggered this kind of ancestral trauma or, like, things I just. That had been imparted to me subconsciously by my parents and grandparents. And that, in a way, was one of the hardest things to get over. I'm not sure I am over it, but just this idea that even if you're safe any given moment, that who knows what the next. What the next thing might be.

[John Moe]

Has that made you hyper vigilant your whole life? Like, just expecting something terrible is going to happen?

[P.E. Moskowitz]

Yeah, I mean, I think I've worked on it a lot. A lot, a lot, a lot in the past seven years, but it's still something I struggle with as I write in the book. Like, one of the biggest things I work through in therapy is this feeling of happiness or feeling like free or untethered to anything. I. E. Not hyper vigilant. That. That almost in itself is a trigger because when. When my subconscious, when my nervous system realizes that I'm. I'm not on guard, that I've let myself be vulnerable, that I've let myself, you know, have a fun night with friends or. Or, you know, hung out with a guy and had good sex, if I'm allowed to talk about that on this podcast. But you know, just any, you know, anything. Anything that provides a kind of joy but is vulnerable, all of a sudden, the. The other part of my brain says, hold on, you've let your guard down. And then I. That's. That can trigger a panic attack. And so working through that has been really hard because it feels like this kind of catch 22 of, like, I'm trying to become happier and freer and less. Less, you know, beholden to my kind of ptsd. But then when I do that, it. It triggers the ptsd.

[John Moe]

Yeah. Well, I want to ask about. About drugs here in a minute, but I want to ask you also about if somebody hears, oh, P. Moskowitz had a mental breakdown in Oakland. This is when it happened. And then it was a long journey from that. I think the natural human instinct is to say, oh, well, when did they get over it? How long did it last? When was it finally done? And it's sort of part of the thesis of what you write about, as I understand it, that it's not something to be solved and walked away from, but is it fair to say it becomes an evolution of who you are?

[P.E. Moskowitz]

Yeah, I think it transforms you. And there's no way for it not to. And I think one of the most painful parts of the process of healing is that there is no going back to this kind of like, pre. Pre traumatized state. And it was really painful to try for. For years in therapy, I just wanted to be fixed, that I wanted to. To not have the brain I had now. I wanted to have the brain I had before Charlottesville, you know, And. And the more I accepted that this had to transform me in some way, the easier the healing got. But. But I think in our culture, in the way we usually talk about mental health, it is so much about cure, right? We give ourselves this narrative of, like, you know, you were sick or anxious or traumatized, and then you took the right pill or you went to the right kind of therapy or whatever, and then you're fixed. And I think that not only does that not work for everyone, it also kind of disenables the positive aspects of this kind of transformation. Not that there's any kind of silver lining to trauma, because no one should have to go through any of that kind of stuff. But I feel like a different and in many ways better version of myself than I did before my mental breakdown because it allowed me to explore what I really wanted, what was really important to me. My own identity, my own. My own relation to my work and the world. And I now feel more open to the world. I now feel more open to a kind of hippie, dippy, love thy neighbor, like, everyone, zen it together, kind of, you know, I just have a lot more love in my heart now, frankly, than I did before. And I feel more vulnerable. I feel less, like, capable of living life in a kind of normative, capitalist, productive sense. But I feel. I feel like I've changed, and I kind of wouldn't trade that for anything in the world.

[John Moe]

More with P.E. moskowitz in a moment. Hey, I wanted to quickly tell you about another podcast. This is one that I'm not hosting, but I am producing. It's called in this Family. And it's all about the connections between mental health and families. The families we're born into, the ones we create, what mental health issues we inherit from genes or environment and what we do or don't pass on. We have guests like Gary Gulman, Dr. Joseph Lee from Hazelden, Betty Ford Foundation, Maria Bamford is coming up. It gets really fascinating. Look for in this Family, wherever you get your podcasts,

[Yowei Shaw]

I just spent the weekend with some friends, and they're extremely cute toddlers, and so I'm excited to let them and you know about a great podcast called the Longest Shortest Time. The show is hosted by OG Hilary Frank and she covers all aspects of parenthood and reproductive health. She's got an episode about sex ed at her daughter's school. There's one about birth control and the FAA and another that follows the journey of a single trans dad. But she also talks to plenty of non parents, so you don't have to be a parent to listen. The stories are surprising, fun, edgy, poignant. They'll give you all the feels. The show was on hiatus for five years and I'm so excited that it's back now with new episodes. Find the Longest, Shortest Time in all podcast apps [e-mail].

[John Moe]

We're back talking with P.E. moskowitz, author of Breaking Awake. A Reporter's search for a New Life and a new world through Drugs. Well, let's, it's funny, I was going to ask in my notes, I was going to ask what guided your experience through the use of, and I paused to say medication or drugs, which of course mean the same thing. But as you point out, they have a different, they carry different meanings in our society having to do with class and race and caste and all these other things. Let's talk about that a little bit first. Why do we use different names for the same thing here?

[P.E. Moskowitz]

Right? I mean, I think so. Probably, unsurprisingly, as with everything in America, it comes down to like a history of racism. You know, back in the 1800s, early 1900s, when there was a lot of immigration to America, there was this idea that there were Chinese men who were like capturing white women and bringing them to opium dens and corrupting them. And so this idea that opium, the illegal, bad drug, was harmful was what everyone thought, what the New York Times and every other media institution would write about this kind of menace that's plaguing white society, that's the fault of, of immigrants, right? And then at the same time, white people were being prescribed opiates from their doctors at higher rates than people were doing opioids. So like, everyone was kind of high on, on opiates in this moment in history, but it allowed for this kind of sheen of, of respectability to a drug to see it as a medication. So it's like, you know, bad illegal drug for, for, for the, and good regulated medication for me. And, and I think we still see that history playing, playing out today where, you know, Adderall and other ADHD drugs are extremely, extremely similar chemically to, to street speed and if you ask someone who, who does illegal speed, if you take enough Adderall, it feels like speed, because it is speed. And that doesn't mean it's bad, but it means that these are essentially the same drugs. But people without privilege who, you know, through no fault of their own, just were born with less money, born in the wrong location, whatever, don't have access to the doctors, the system by which your speed comes to you, regulated, tested in normal, small doses. You don't get to go to a psychiatrist or, or any kind of psychopharmacologist or whatever for every week or month or whatever and. And check in. So instead, you're trying to solve many of the same issues that someone like me. I take Adderall almost every day, and it helps a lot. But the people who are taking illegal drugs are in many ways trying to do the same thing. They're trying to ameliorate their pains. They're trying to feel less anxious or more focused or like they can make it through the day. We just. We've relegated them to this dark underbelly world where they're using drugs and we're using medications.

[John Moe]

You mentioned Klonopin. Is that, Is that a med that you. Is that as far back as you go, I guess, with meds? And how long were you on that? And what does it do?

[P.E. Moskowitz]

Yeah, so Klonopin is a benzodiazepine, like Xanax is probably its more popular cousin. And I was prescribed it for occasional panic attacks. It's not something that's great to take on a daily basis because your brain adjusts to it pretty quickly, and then without it, you go through withdrawal and probably become more anxious. But basically what it does is just, like, calm down the receptors in your brain that are responsible for your nervous system telling you to be anxious. And so it works like a charm. And it's very similar to drugs that have been around for 75 years at this point, Very similar to the ones like Mother's Little Helper. The Rolling Stone song was about housewives taking Valium, which is essentially the same thing as. As Klonopin. And I found it extremely helpful. I, you know, if I had a panic attack every time I would wake up in the morning after my. My breakdown and feel like I was being chased by a pack of wolves or whatever. Klonopin didn't solve any of that because I still needed to, like, rework my nervous system, explore my trauma and therapy, do all of that healing. But Klonopin1 gave me a break from. From that so that I didn't feel like I couldn't do it. Like, without that, I think I just would have been too stressed and feeling too crazy all the time. I needed a mental break. But I think more importantly, what it did is show my brain that there was a future that didn't feel as horrible as the present. Because once I took Aclonopin, I was like, oh, that version of me is still in there. The version of me that can sit on a couch and look at my phone without having a panic attack still exists. And so it gave me, in a way, something to fight for. And that's how I feel about a lot of drugs, is it's less about their effect and more about the kind of lesson you can take from them, that through an altered state, you. You can see a different version of yourself or the world or life or just a different perspective and then take that with you when you're not on the drug.

[John Moe]

I wanted to ask about SSRIs or antidepressants in general. How did your thinking on that substance, how has that evolved through the years? Because that's taken so commonly by so many people.

[P.E. Moskowitz]

Right. I've been on various antidepressants for years, throughout my life, and again, they were helpful. When I was maybe a year out of. Of my mental breakdown and still really struggling, but not in such a crisis state anymore, but still near crisis state, I began taking this drug, Effexor, which is an snri, which is basically the same thing as an ssri. But I won't get into all the, you know, slight mechanical differences or whatever.

[John Moe]

Slightly different, but, yeah, it's from the same. Same idea, basically.

[P.E. Moskowitz]

And it really helps. Calmed down my anxiety, helped me have fewer panic attacks. The problem is that it also calmed down everything else. So the kind of ecstasy and joy one is capable of feeling in life to me, felt very muted on that drug. There was this moment where I, you know, was with my boyfriend and realized that, like, I couldn't feel the joy of sex. Right. And then there was another moment where I was with my parents in the. The bayou in Louisiana where I was living in New Orleans at the time. And we were in this beautiful kind of alien landscape that, you know, just should have made me feel this kind of, like, awe and wonder. And instead, I just felt kind of nothing. And then the last straw for me was driving, which I love driving, and I love cars. I'm just like a car nerd. And driving and listening to Core and the heavy metal band and Like, I knew that I should be kind of having goosebumps and feeling exhilarated. And again, instead, I felt nothing. And I realized that I couldn't live my. My life like that, especially as a writer. Like, I need to be able to feel things in order to. To understand them and. And to write about them effectively. And I'm not against any drug. I think SSRIs are great for many people. I think the difference between something like an SSRI and Klonopin, let's say, is that SSRIs are often viewed not as tools but as cures. They're not seen as modifiers of behavior or thoughts or feelings. They're seen as kind of like you have a chemical imbalance and this fixes it. And I think that that disenables people from understanding their uses and their drawbacks. I think it's very different to prescribe someone an SSRI and say, okay, for the next year, while you're going through a particularly hard time, you'll take this, and then also in combination with that, go to therapy, do other things that help you figure out what's causing all the anxiety and depression instead. What usually happens is the vast majority of people who are prescribed SSRIs get them from their primary care doctor. They don't even get to see a mental health specialist, and they're put on them for years and years and years and often entire lifetimes. And so, again, I'm not against any drug, but I'm against a system that completely individualizes our mental health and a system that sees drugs as the end all, be all, only solution, and basically just says, put you on a pill, fix you, goodbye.

[John Moe]

Right? A lot of people, including people I've talked to on the show, I've asked directly about this, have said, I will take that bargain. I will give up my highs, my super highs. I'll give up transcendent joy if it means that these crashing loads that I don't have to deal with, you know, are. Are gone. Like, which can, you know, lead to suicidality in many cases, right? That. That level of despair, you know, I'll trade. I'll trade the high and low in order, in order to establish a middle totally.

[P.E. Moskowitz]

And if that's what one wants to do, then go for it. But. But I think the thing. I think the thing that pisses me off is that we're not given many other options in an ideal world. I mean, I'm in an incredibly privileged position for several reasons. Like, one, just like monetarily, I can Afford years of therapy. I can afford to explore things like bodywork and, you know, acupuncture and yoga and all these things, other modalities of healing. And then I'm privileged in the sense of, like, this is my job is to figure out what's going on with my brain and like, what modifiers of my brain work best. Um, so a lot of people that, that is their only option is to kind of take that, that compromise of, you know, maybe this makes me feel a little numb or a little less creative or whatever, but at least I don't feel despondent all the time. And that's fine. I just wish that people were given the, the myriad other tools that are available. But those tools take time, they're more expensive. Insurance doesn't cover things like somatic therapy and, and bodywork and stuff like that usually. So, so I think it's. We're given this kind of false choice where it's like either you take this and you feel numb but okay, or you don't take it and you want to kill yourself all the time, but we're thinking way too small. Like there's such a larger world out there of healing and possibility. And I just, instead of faulting any one person for taking any one drug, I just want everyone to have that many options.

[John Moe]

I mean, I've been doing this show and another one very much like it since 2016. I've done tons and tons of interviews and there's a handful of questions that I keep coming back to because I don't feel like I can ever answer them. And one of them is, especially with depression, with major depressive disorder, is this a warping of reality or is this a rational response to the world that we live in, to the politics that we live in, through the social climate we live in, through the environmental climate that we live in. And you write in your book. So perhaps asking whether antidepressants or any other mental health medication is effective is too small a question. Perhaps a better one would be one. Why are we all so depressed in the first place? Do you think that what we're all calling depression is just clear eyed reality of the horror of the truth?

[P.E. Moskowitz]

I think it's both. To vastly oversimplify Freud, he basically believed that depression was a kind of form of anger turned inwards, that, you know, there are these, these energetic flows of like, you feel abused or mistreated or you feel angry at a person or whatever it may be, and you internalize that. You don't have enough release of that and it turns into, you know, depression, anxiety, or whatever other neuroses, because that, that kind of anger is still trapped within you. So I think. I think in a way, there's no way to feel normally healthy, period, at all within our society currently. I think that, that that is the wrong goal, that we should. We shouldn't be going for that. Because, you know, the metaphor I often give is like, if you go to therapy or you take a medication or whatever it may be, I feel like often what we're doing is like, there's this polluted lake with a bunch of fish in it where all the fish, right, and, and the pollution, the polluted lake is making all the fish sick by taking an antidepressant, by going to therapy. Whatever individualist solution one has to feeling depressed. It's like we're picking the fish up out of the water and giving it medicine and then throwing it right back into the polluted lake. Right? And so that's. That's how I feel in terms of. In terms of depression is like, yes, it is kind of impossible to cure in any kind of societal level or any kind of individual level when it's what society is doing to so many of us. But that being said, that doesn't mean you shouldn't give the fish medicine, right? Like. Like there are ways to feel better at an individual level. There are ways to feel like even if you. Even if you end up right back in that same pond, you still deserve to be out of it, getting the medicine for. For a bit. Maybe this is a bad metaphor. I don't know. But.

[John Moe]

No, that's working, I think.

[P.E. Moskowitz]

But, but yeah, I mean, I think. I think that, you know, just it's. It's both like, there's no way to. To. To feel 100% normal or cured in this society. That being said, like, you deserve to be able to try. You deserve to have these opportunities to get that kind of anger that's been imparted into you by society out to have to have places and spaces to mourn, to grieve, to feel your pain and not feel like it's all within you.

[John Moe]

More with author P.E. moskowitz in a moment.

[P.E. Moskowitz]

Kids are different today. I hear every mother say, mother needs something today to calm her down. And though she's not really ill, there's a little yellow pill she. She goes running for the shelter of her mother.

[John Moe]

Talking with P.E. moskowitz about mental health and drugs. You've taken a variety of substances, some prescription things you pick up at a pharmacy, other things you Know that you pick up at a party or you pick up from a friend. Is there a difference between one group and the other group in terms of how they've made you feel? Or does it just depend on the substance and the context in which you're consuming it to determine how helpful it is?

[P.E. Moskowitz]

The ones you pick up at a party are more fun. But, no, I mean, I think I. You know, I've started to just view drugs, medications, which are drugs all, as just tools. And tools can be used in productive and negative ways. I am on Adderall, as I said now, and it's tremendously helpful at keeping me able to do my work and not feel like my life is falling apart. But I have been on Adderall when I was, like, 15 and was a drug addict and was, like, abusing it. And that is no different than, you know, basically doing speed from the street. So. So it can be helpful, it can be harmful. And same with. Same thing with illegal drugs. You know, Ketamine helped me envision a life in which I was no longer so traumatized. I tell the story in the book of. Of laying down in my house in New Orleans with my best friend, who also was in Charlottesville with me when we were kind of PTSD buddies together, and doing ketamine and listening to a Lady Gaga album and just feeling this feeling of floating above my body and seeing my life from a bird's eye view, and that helping me realize that I did indeed have a future. And so I just think, at the end of the day, they're all tools. And I think the context with which you take those tools is really important, too. If you're doing ketamine treatments at a infusion center, for example, that can be really helpful. But I think one of the things, One of the healing potentials of drugs is through their context. Like when I've taken Ketamine or LSD and I've been at a rave surrounded by a thousand sweaty people and feeling like to, you know, to butcher the quote of Eric from a psychoanalyst from the 60s, like to feel like but a drop of water on the crest of a wave in the ocean or whatever of your fellow men, right? Like that. That feeling of community, that feeling of deep ecstasy and possibility, of what it can mean to all come together and feel free from the bounds of normative society like that. That's enabled by both being with people, but also being on certain kinds of drugs. Right? And I think, unfortunately, what's happened is we have destigmatized a Lot of these drugs, which is good. Like, we've destigmatized ketamine. We've seen it as a legitimate treatment of depression. We're doing studies on MDMA and LSD and psilocybin and seeing how well they affect PTSD or depression. That's all great, but at the same time, I think it decontextualizes these things so that we don't realize that part of the reason they're so helpful is because they enable certain, certain ways of being in the real world. And so I just. I just worry that we kind of neuter the efficacy of these drugs when we try to turn them into quote,

[John Moe]

unquote, medications, because people are seeing the drugs as the solution as opposed to the state of mind, as opposed to. As a tool, like you said, to the state of mind. That would be, for lack of a better term, better mental health.

[P.E. Moskowitz]

Yeah. I mean, I think when I am at a underground rave in Bushwick or whatever, and I'm on ketamine and I'm dancing with someone and feeling, feeling like, wow, maybe a better future is possible. Maybe this feeling of togetherness and this feeling of joy is something that it can bring into my life more. Or that if we abolished capitalism, that it would be more common to have these moments of togetherness and joy. Right. That is enabled by this drug. But if I am in a ketamine infusion clinic, I just don't think you get the same. The answer your brain gives you is a different answer. And so that doesn't mean that it's bad, But I think drugs can be modifiers of your psyche and your emotions so that you fit back into the current system better so that you can concentrate on work better. Silicon Valley tech bros are obsessed with microdosing all forms of drugs to heighten their productivity and so they can code better. And that, to me, is not the highest and best use of any of these substances. So to me, it's less about whether the substance is good or bad. It's about how are you using the tool, what context are you operating in? And is that to envision a better future for yourself or the world? Or is that to optimize yourself to fit into our current shitty world?

[John Moe]

Now, not all of us listening to the show are going to be at an underground rave in Bushwick.

[P.E. Moskowitz]

Why not?

[John Moe]

Most of us rarely get invited. I'm more likely to be at the trader Joe's in St. Paul, which gets me to the question about the availability of some of these substances, legalization of some of These substances. I mean, I write a newsletter for our show every week. And just today, the day that we're taping this interview, there was a story about the massive relief for generalized anxiety disorder that comes with a single larger dosage of lsd. They tried it on a smaller dosage, no different than placebo. They tried it on a larger dosage. Huge relief for months and months at a time from a single dosage. And I thought, well, that, that's fascinating, but I'm not going to be able to get that at Walgreens anytime soon. And so do you see that narrowing to a point where, I mean, you write about it in the book, like when Prozac became available, it was heralded as this new change. Milltown or Valium, all these things. Do you think that is coming for some of these other substances so that somebody who goes to Trader Joe's in St. Paul can have the same experience as somebody in an underground Raven Bushwick?

[P.E. Moskowitz]

I think that we'll probably never reach a point where you can like get

[John Moe]

plus, you gotta go to our Trader Joe's. It's just amazing. Sorry,

[P.E. Moskowitz]

I'm more of a Aldi shopper, I think.

[John Moe]

Okay, all right, fair enough.

[P.E. Moskowitz]

But I think that we'll never reach a point where pharmacies are dispensing mind altering medication that makes you trip so that you can go to a rave. I don't think our medical system would ever allow for that. But what I do think is very possible is that these drugs will be formulated into less intense versions of themselves that are more patentable and that cause less kind of mind altering behavior, but can be extremely effective for things like depression. And I think that that's a great thing. I think the problem as you were mentioning is this is what we always do with every drug like Milltown, this tranquilizer. In the 1950s, everyone and their mother literally was on it. And then after 10 years of all of America being tranquilized, we were like, wait, whoops, this is addictive. It has a lot of side effects. We probably shouldn't be taking this. And then so the prescription drug industry came back with benzodiazepines like Valium and Klonopin. And same process repeated. We were like, ah, finally we have the cure to the blues or the cure to anxiety, right? And then turns out those were addictive and had a lot of side effects. And then in the 1980s, they came out with a new class of drugs, antidepressants, SSRIs, where they were like, finally we figured out what you know how to make a non addictive mental health med that cures everyone's problems. And it turns out that one, they have a lot of side effects, but two, they're, they're not working like they might be working for some people on an individual level. But check any, any chart of anxiety, depression, suicide in the United States. It's going up and up and up. The drugs simply aren't enough. And then so I think what I'm worried about with the kind of destigmatization and pharmaceuticalization of things like Ketamine and lsd is that we're going to see again these things as cures in the same way we viewed SSRIs as cures as opposed to tools. And meanwhile we're ignoring that proverbial polluted lake that no matter how many drugs you legalize, how many medications you give people, that we have to stop making people sick in the first place. And there is never going to be a pill or anything that, that, that does, that.

[John Moe]

You write in the book. I refuse to call my inability to sit still for 10 hours without medication ADHD, and I refuse to call my overwhelmed depression or bipolar disorder or psychosis or anything else. My problems are based in the real world, you, not in my brain. Do you believe in the acronyms in the DSM diagnoses as real things or not?

[P.E. Moskowitz]

There's a large misconception amongst the general public with the DSM and diagnosis in general, as I see it talked about online. These are immovable categories that are, are completely scientific and almost chemical in nature. If you have adhd, it's because, you know, a brain scan showed you have adhd. And first of all, that's not really true. But second of all, like, even the most mainstream psychiatrist acknowledges that these things are clusters of symptoms. They're not like immovable, immovable. Like it's not like the same thing as like you have a broken leg because your bone is like this. ADHD is a cluster of symptoms. And that's why the DSM changes every few years to change the cluster of symptoms and call it something new. I don't think it should be a controversial opinion to say diagnosis is not a material fact. It's a way of description of certain behaviors and reactions to things. And if you look at me, I have many of those symptoms and clusters that, that are labeled adhd. I think the thing that, that angers me and the thing that I'm scared of in relying too much on diagnosis is that it almost becomes a form of, of gaslighting oneself because you start to believe that everything you're experiencing is within your own individuality, within your own head, within your own chemical makeup, as opposed to legitimate reactions to the world. And the world is horrible. So, like, maybe. Maybe the reason you feel inattentive is because you hate your job. Maybe the reason you feel inattentive is because life makes us so anxious that we have energy coursing through our nervous system that it makes it really hard to sit fucking still. Um, and that doesn't mean that you shouldn't get an ADHD diagnosis and you shouldn't get prescribed a drug, if that would. That would help. But I do think it means we should stop individualizing and internalizing what are material, external problems. We should stop essentially convincing ourselves that the world is not at fault, that we are at fault, because that completely disenables us from. From seeing what should be obvious to everyone, which is that, you know, I have adhd. You, the person down the street, have bipolar. You, the person next to me, has depression. But we're all in the same boat. We're all dealing with the same thing. We're having varied responses to the exact same inputs.

[John Moe]

I had a conversation with my therapist one time early on when we were meeting, and I said, well, you know, I think this might be general gad, Generalized anxiety disorder, might be PTSD from this incident. And she said, john, stop it. She's like, let me tell you, those terms are for insurance purposes around here. This is how we get someone else to help pay for some of your treatment. Let's talk about life instead.

[P.E. Moskowitz]

Yeah, exactly. And I think that. Yeah, I think one of the most helpful parts of therapy for me hasn't been in kind of diagnosing me with anything. It's been in just acknowledging and feeling validated that it makes sense that I feel the ways I do. You know, I remember this one session with my therapist a few years ago where I, like, kind of took stock of everything that had happened to me in life and, like, everything that was happening in the world and. And then being like, you know, why am I so depressed? And my therapist was like, I mean, he didn't use these words, but he was kind of just like, what the fuck are you talking about? Like, of course you're depressed. Like, you. You almost died. You have trauma twice. You have lots of trauma. The world is really bad. Like, what. What do you expect to feel? And that it felt like such a revelation because I was like, oh, right, this isn't my fault, and this isn't Something I can purely control in my brain. It is a legitimate reaction to, to what's happening around me.

[John Moe]

How you were feet away from two deadly terrorist attacks, these huge major traumas in your life after the work that you've put in on those things and the work you've put in on your brain and on your happiness and congratulations on doing all that work. Where do those things live with you today? How are they present in your mind today?

[P.E. Moskowitz]

I think in a way they've helped me feel less alone and the healing work I've done has helped me feel less alone because I think, you know, Charlottesville, for example, is like a very direct form of, you know, the violence of fascism and how that kind of like affects people. That, you know, the kind of violence and energy of a neo Nazi was in many ways, like literally put into my body and then left for, for me to deal with and figure out. But what's become obvious to me through my healing and through my writing and, you know, reporting in this book is like most people are going through similar things. It's just less obvious forms of it, right? It's like not everyone is having a neo Nazi try to murder them, but everyone is having the violence of capitalism, of police violence, of racism, of classism, of sexism imparted into their psyches on a day to day basis. And that really breaks people. It really, you know, shuts them down, makes them feel lonely and despondent and they're, you know, and then meanwhile, we have very, very few outlets for any of that that, you know, people are, are often physically separated from each other down, you know, suburban roads and, you know, like there's no community center or parks or whatever. It's like that I've realized that all of us are going through the same thing. And that's, in a way, even though that's a depressing fact that we're all dealing with so much psychic violence. In a way, it's felt incredibly like, I don't know, it's made me feel love for the world and it's made me feel like less lonely. I feel like I'm in it together with everyone because even though all of our experiences are different, we're all kind of dealing with the same thing.

[John Moe]

The book is breaking a reporter's search for new life and a new world through drugs. P.E. moskowitz, thank you so much.

[P.E. Moskowitz]

Thank you.

[John Moe]

Thank you to P.E. moskowitz for that conversation. Look, here's my philosophy. Let's learn what we can. Let's hear from a brief bunch of different perspectives. Let's expose ourselves to a huge variety of personal experiences and stories of what works and what doesn't. Because really we're behind on this one. On mental health. Our society for centuries has shamed mental illness, made it something embarrassing to talk about. People with interesting minds like me and maybe you have been discouraged from. I'm learning about stuff that will help. There's a hole. I think we gotta plant trees in that hole. Crops, flowers, maybe stuff that will grow and contribute. Like imagine if we were encouraged to figure out mental health at the same speed and with the same acclaim and support and drive that we provided aviation a century ago. You know, there were just 66 years between the Wright brothers and the moon landing. 23,953 days. That's it. Imagine if we did that with mental health. That drive, that purpose, that exploration, that innovation, that celebration. What would our mental health moon landing be? So our show is not funded like the space program, a bit smaller. But we'll do our part here to give you ideas and points of view and stories and encouragement, see what you can learn. We'll do what we can. Speaking of funding, we don't ask for NASA grants, but we would love you to be a member of the show. That's the only way that we're able to make the show and bring those stories to you. We really appreciate those of you who donate and support the show. It is how I can keep making the show, how we can all keep making the show. And it's easy to to do. Just go to maximumfun.org join, find a level that works for you and then pick Depress Mode from the list of shows. Be sure to hit subscribe, give us five stars, write rave reviews. That helps get the show out into the world where it can help folks. It's just nice to help folks. It feels good to help folks. We need your help doing that. The 988 Suicide and Crisis Lifeline can be reached in the US and Canada by calling or texting. 988 free available 24. 7. We're on blue sky at depression mode. Our Instagram is depresspod. Our depression mode newsletter is on substack. Search that up. Search for Depression Mode or John Mo. I'm on bluesky and Instagram onmo. Our precious group is on Facebook. A lot of people hanging out there, talking about mental health, supporting each other, giving each other some ideas. I'm there hanging out too. I'll see you over there. People sometimes just having a laugh. Our electric mail address is depressionmodemaximumfun.org hi credits listeners. The Trader Joe's in St. Paul that I mention has two stuffed bunnies hidden somewhere in the store. If you tell the cashier where you get a free sucker. The offer is intended for children, but I imagine it holds for adults who aren't self conscious and really want a suck sucker. Depression Mode is made possible by your contributions. Our production team includes Raghu Manavalan, Kevin Ferguson and me. We get booking help from Mara Davis. Rhett Miller wrote and performed our theme song, Building Wings. Depressed Mode is a production of Maximum Fun and Papuchik. I'm John Moe Bye now.

[P.E. Moskowitz]

I'm always falling off of cliffs now building wings on the way down I am figuring things out Building wings, building wings building wings no one knows a reason maybe there's no reason I just

[John Moe]

keep believing

[P.E. Moskowitz]

no one knows the answer maybe there's no dancer I I just keep on dancing. Hi, it's Bill Radke in Seattle.

[John Moe]

You're not doing it wrong. Just begin again.

[P.E. Moskowitz]

Maximum Fun A worker owned network of artist owned shows supported directly by you. Radiotopia from prx. It.