Episode Summary: "Is America on Too Many Psychiatric Drugs?"

Podcast: The Journal.
Hosts: Jessica Mendoza & Ryan Knutson
Guests/reporters: Betsy McKay, Shalini Ramachandran
Date: December 3, 2025

Episode Overview

This episode explores America’s growing dependence on psychiatric medications—specifically antidepressants and anti-anxiety drugs (benzodiazepines). Through interviews, firsthand testimonials, and investigative reporting, Jessica Mendoza, along with Wall Street Journal reporters Betsy McKay and Shalini Ramachandran, investigates the widespread use (and overuse) of these drugs, the lack of long-term studies, significant withdrawal and side effects, as well as the cultural normalization of psychiatric drug use. The episode asks: Is the U.S. “overmedicated,” and what are the true costs—personal and societal—of prolonged psychiatric drug use?

Key Topics & Discussion Points

1. The Social Media "Antidepressant Boom"

• Antidepressants in Pop Culture: On platforms like TikTok, there are thriving communities destigmatizing, normalizing, and even celebrating psychiatric medication use through hashtags (e.g. #lexaprogirly, #lexahoe).
  • [00:18] Lexapro User playfully rallies "Lexapro baddies" and "Prozac girlies."
• Positive Testimonials: Young users share how drugs like Lexapro and Zoloft have transformed their lives:
  • Quote: “One thing that Lexapro has, like, indirectly done for me is allow me to see a different perspective of, like, life isn’t just all pain.” – Lexapro User [01:27]
  • Quote: “When I tell you my brain is quiet, it is quiet.” – Lexapro User [01:49]
• Growing Popularity: Hashtag #antidepressants has over 1.3 billion views on TikTok.
  • Implication: Antidepressant use is not only commonplace but culturally embraced among many demographics, especially youth.

2. Investigating the "Dark Side" of Psych Meds

• Overlooked Risks: Despite online positivity, prolonged use can have serious side effects, a reality often omitted from public discussion.
  • Quote: “If you were just to look at the most glamorous videos, the most positive ones, you really wouldn’t come away thinking these drugs can have serious side effects.” – Betsy McKay [02:09]
• Withdrawal Challenges: Users report extreme difficulties when stopping medication, with little prior warning from providers.
  • Quote: “Absolutely nobody told me, not even my psychiatrist, how bad it is to wean off an antidepressant. I feel crazy.” – Shalini Ramachandran [02:32]

3. Benzodiazepines: The Hidden Epidemic

• Roots of the Investigation: The team’s reporting began with benzodiazepines (benzos) like Ativan and Xanax, not just antidepressants.
  • Benzo withdrawal can be life-derailing; one executive's personal story prompted deeper inquiry. [04:56]
    • Quote: “The worst years of my life was when I was on benzodiazepine withdrawal.” – Executive testimonial relayed by Shalini [04:56]
• Medical Guidelines vs. Reality:
  • Guideline: Benzos should typically be used for “no more than two to four weeks.” – Shalini [07:33]
  • Reality: “Anything between two weeks and like 20+ years.” – Betsy [07:43]
• Side Effects & Mismanagement:
  • Chronic use linked to akathisia (restlessness), agoraphobia, memory loss, panic, and severe withdrawal.
  • Doctors often respond to side effects by increasing doses rather than reassessing use.
    • Quote: “Often they would go to the doctor and describe their symptoms and their doctor would say, you sound more anxious, you probably need a higher dose.” – Shalini [08:40]
• Withdrawal Hell:
  • Some users experience “chemical anxiety," "brain zaps," and even suicidality while tapering.
  • Shalini recounts a patient whose withdrawal experience drove her to the brink:
    • Quote: “She wrote her daughter a note because she thought she might die amid her journey to get off the drug.” – Shalini [10:11]
  • Suicide linked with enduring post-withdrawal symptoms.
    • Read from a victim’s suicide note: “My body has been completely destroyed. I would never leave my family and beautiful daughter if I had another option.” [10:32]
• Understudied Issues and Lack of Awareness:
  • Most users “had no idea” about long-term risks; minimal to no warnings from their healthcare providers. [11:17]
  • Quote: “The side effects and the problems that, you know, we’ve documented are really from lived real world experience... they’re not being studied enough.” – Betsy McKay [11:36]
• Advocacy & Regulatory Response:
  • Recent FDA warnings (since 2020) now acknowledge withdrawal and dependence but prescriptions remain sky-high—over 86 million written annually in the U.S. [12:23]

4. Antidepressants: America's Living Experiment

• Massive Numbers: 347 million antidepressant prescriptions in the U.S. in the last year; polypharmacy is common. [15:59]
• Telehealth’s Role: Prescription access is easier and more frictionless thanks to virtual clinics (ex: Hims & Hers), per company statement. [15:59]
• Duration Problem: Most antidepressant studies run ~8 weeks, but Americans average 5 years on these drugs. [16:34]
  • Quote: “Nobody really knows. We’re kind of a living experiment in that sense.” – Betsy [16:53]
• Social Media Pushback: After initial destigmatization, more users are posting about negative long-term effects:
  • Quote: “Zoloft has completely removed me from my identity.” – Testimonial [17:47]
  • Quote: “My Lexapro, girlies, do we have a sex drive? Because I don’t.” – Lexapro User [17:52]
  • Withdrawal can be intense—even after tapering, users report emotional volatility and other hardships.
• Cycle of Prescription:
  • Side effects or withdrawal often lead to dose increases or new/additional drugs—“a pill for every ill” mentality.
    • “With antidepressants, patients experience side effects. So their doctor raises their dose or switches to a new pill or layers on more meds...” [18:42]
  • Quote: "So after going viral for weaning off my Lexapro, guess whose doctors told them they need to go back on it? Me." – Lexapro User [19:02]

5. Knowledge Gaps, Informed Consent, and a Pill-First Culture

• Lack of Long-Term Data: The extended impact of years-long antidepressant/benzo use is still largely unknown.
• Inadequate Patient Education:
  • Patients often aren’t informed about addiction risk, withdrawal, or alternative treatments.
    • Quote: “One thing that a lot of people talk about is informed consent, which is making sure that when a prescriber is about to prescribe you a benzodiazepine or antidepressant, they tell you, hey, like, these kind of things could happen…” – Shalini [19:32]
• Cultural Forces:
  • Psychiatry is now deeply woven into U.S. culture—across all generations and socioeconomic groups.
  • Quote: “...these meds are embedded in American culture and that the US has yet to reckon with what it means to use these drugs for far longer than intended or ever studied.” – Jessica [20:14]
• System Critique & Reflective Closing:
  • "There are too few guardrails around these medications, which do help a lot of people. And it’s been sort of this underrecognized, untalked about problem for many years.” – Betsy [20:38]
  • “We live in a pill-first culture and it’s one that’s really deeply baked into our medical system. There are other ways to address the problems that we all struggle with…that doesn’t always have to be in the form of a pill.” – Shalini [20:57]

Notable Quotes & Memorable Moments (w/ Timestamps)

• "When I tell you my brain is quiet, it is quiet." – Lexapro User [01:49]
• "Absolutely nobody told me, not even my psychiatrist, how bad it is to wean off an antidepressant. I feel crazy." – Shalini Ramachandran [02:32]
• "The worst years of my life was when I was on benzodiazepine withdrawal." – Paraphrased, Shalini reports [04:56]
• "No more than like two to four weeks." – Shalini (on benzo prescribing guidelines) [07:33]
• "Often...their doctor would say, you sound more anxious, you probably need a higher dose." – Shalini [08:40]
• "She wrote her daughter...a note because she thought she might die amid her journey to get off the drug." – Shalini [10:11]
• “My body has been completely destroyed....” – From a suicide note, read by Jessica [10:32]
• “It’s a similar picture to benzos. Most antidepressants have not been studied for long...average time is five years.” – Betsy [16:34]
• “We’re kind of a living experiment, in that sense.” – Betsy [16:53]
• “Zoloft has completely removed me from my identity.” – TikTok testimonial [17:47]
• “My Lexapro, girlies, do we have a sex drive? Because I don’t.” – Lexapro User [17:52]
• “So after going viral for weaning off my Lexapro, guess whose doctors told them they need to go back on it? Me.” – Lexapro User [19:02]
• “There are too few guardrails around these medications.” – Betsy [20:38]
• “We live in a pill-first culture and it’s really baked into our medical system.” – Shalini [20:57]

Segment Timestamps

• 00:00–01:59 — Social media and cultural embrace of antidepressants
• 02:00–03:14 — The hidden downsides and the question of overmedication
• 04:46–12:23 — Benzodiazepines: history, danger, and the underreported withdrawal crisis
• 12:23–13:34 — Regulatory responses and continued high prescription rates
• 13:34–16:53 — The antidepressant boom; comparison with benzos
• 16:53–20:14 — Living experiment, social media shifting narratives, and withdrawal struggles
• 20:14–21:33 — Reflections on U.S. pill culture, missing guardrails, and policy implications

Takeaways

• America’s relationship with psychiatric medications is at a crossroads—driven by cultural acceptance, ease of access, and lack of long-term research, millions are prescribed drugs never studied for years-long use.
• Benzos and antidepressants can be life-saving, but carry real risks, especially with chronic use; users and even doctors often lack full risk awareness.
• Withdrawal syndromes are intense, under-discussed, and can be life-threatening, with a significant minority experiencing lasting aftereffects.
• As the U.S. continues to embrace a “pill-first” approach, experts warn of a need for more education, informed consent, robust long-term studies, and non-pharmaceutical strategies in treating mental health disorders.

For those who may be struggling, the podcast reminds listeners of the suicide and crisis lifeline: dial or text 988.