← The Michael Knowles Show
The Michael Knowles Show
Your Brain's REACTION To SSRI's, Adderall, & Depression LIES: Michael & The Good Doctor | Dr. Josef
01:51:35
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- [00:00]
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- [01:31]
Michael Knowles
Today.
- [01:35]
Dr. Youssef
We'Ve done spinal taps, we've done functional MRI scans, which are real time scans of the human brain kind of firing. Are there any differences between a depressed person and a non depressed person? No.
- [01:47]
Michael Knowles
What about the relation of these kinds of drugs to violent acts and to aberrant ideologies? I've noticed a major uptick in violence from the left, notably associated with transgenderism. And in the lion's share of these cases, they're on SSRIs.
- [02:09]
Dr. Youssef
Is it safe for 15 to 20% of our population to be on these drugs? The FDA is sitting on this because they are trying to cover up one of the biggest scandals in modern medical history.
- [02:20]
Michael Knowles
That's horrifying. About one in five women in the United States is hooked on depression pills, powerful psych drugs that we don't really know all that much about. And in my experience, the women remain crazy as ever. So I have brought on an expert to tell me what these drugs really do. That is Dr. Josef Wit Dohring. Have I pronounced that very Germanic name correctly?
- [02:57]
Dr. Youssef
You have.
- [02:57]
Michael Knowles
You have, Dr. Youssef thank you so much for coming on the show.
- [03:00]
Dr. Youssef
Thank you for having me, Michael.
- [03:02]
Michael Knowles
So you have gone really viral recently for discussing a lot of medical misconceptions, but especially SSRI drugs. I have known a lot of people on these drugs. I'm sure the entire audience knows a lot of people on these drugs. Some of them might be on the drugs themselves. I read a statistic that it's 1 in 5American women are hooked on these kinds of drugs.
- [03:26]
Dr. Youssef
Yes. So it's actually one in five Americans. And so one in five Americans, including men. Including men, are on psychiatric medications right now. Specifically, if we talk about antidepressants, which most commonly are SSRIs, that's around 14% of the population and about 18% of women on SSRIs. And if you go up in age range to around. When women are 60 and older, it's one in three are on psychiatric medications at that point. It's. It's a huge amount. I mean, it's so big that people are either taking them or they know someone in their immediate family who's on them. Everyone knows someone who is on one of these medications now.
- [04:07]
Michael Knowles
Okay, before we get to the other types of psych drugs, I want to focus in on SSRIs. What. Forgive my ignorance. What is an SSRI?
- [04:18]
Dr. Youssef
So it's a selective serotonin reuptake inhibitor, and it's a type of drug that was designed to block the reuptake of serotonin between the neurons. So, effectively, serotonin is a chemical messenger that allows neurons to communicate with one another. And if you block the reuptake, it builds up in the synaptic cleft, which is the space between the neurons. And that has a drug effect. So what that drug effect typically does is it is a numbing effect or an emotionally constricting effect, and that's what leads to that therapeutic benefit where people will feel less emotions.
- [04:57]
Michael Knowles
This is what I've heard about SSRIs, and also what I've observed is that it's not that it fixes people's emotions or corrects their emotions. It just blunts their emotions. Right?
- [05:10]
Dr. Youssef
Yeah. And that is kind of the. You know, one thing that people. That is really important for people to understand is that that is actually what they're doing, because for the last three decades, we've been lying to people about how these medications work. We've been telling them that they fix a chemical imbalance. And it's something that I want to lay out because it's really important, because there is A distinction between saying, hey, there's something wrong with your brain. You have low serotonin. I'm going to give you a drug to kind of bring it up to the normal level. You know, case closed, everything's fine. It's like Giving a type 1 diabetic insulin, we've essentially just corrected and a biological problem and all the things that flow from that should be fine. That was the story sold to Americans through the chemical imbalance.
- [05:59]
Michael Knowles
I remember the TV commercials that say, depression is caused by a chemical imbalance in the brain. So take this drug and it'll fix it.
- [06:06]
Dr. Youssef
Exactly. Yeah. And the thing is, a lot of people, it really is quite an evil lie, because many people, they're okay with that. They're okay with taking a medicine for. For a biological medical problem. But if you were to say to someone, the way these drugs actually work is by numbing you and constricting your emotional range, all of a sudden you start thinking about your grandma who says, you really shouldn't sweep problems under the rug. You know, you should deal with them, you should address them. And intuitively, a lot of Americans, they know that's not a great solution for problems, to kind of just numb them with something else. And so we've been selling this lie that they're not really drugs that numb things. They are drugs that fix a medical problem in your brain.
- [06:56]
Michael Knowles
So, okay, so the synapses are communicating, and the SSRIs block the serotonin. So the serotonin gets stuck in the middle and numbs up your brain. And serotonin is what? Serotonin is just like a happy chemical?
- [07:11]
Dr. Youssef
Yeah, it's one of the main neurotransmitters in the brain that control your mood, your personality, your emotions.
- [07:19]
Michael Knowles
Okay, so when did this all start? I remember when the commercials first came on in the 90s or 2000s or whenever. When were SSRIs first discovered, prescribed, popularized?
- [07:33]
Dr. Youssef
So we've had antidepressants since the 50s. But a lot of those older types, they were lethal in overdose. They were kind of complicated to use, and so they were used really sparingly. But then Prozac came out in 1987. That's when it entered the US market. And Prozac wasn't. You know, you couldn't overdose on that medication, so it had a much safer. A much safer safety profile as well. And so that drug became very successful in the early 90s. It was the drug that made Eli Lilly. Eli Lilly was not a big company before Prozac. I mean, it's the biggest pharmaceutical company now with the GLP1s. But Prozac came onto the market. Eli Lilly becomes a billion dollar company within a couple of years and we get flooded with a lot of they're called me too drugs. So after Prozac comes out, you get Paxil, you get Lexapro, you get Zoloft. All of these different SSRIs kind of follow Prozac's success. And the effect of that has, has essentially been brainwashing or propaganda where the commercial interests of all of these billion dollar companies has changed how we think about these drugs. I mean, because they have been pushing this narrative that depression is a chemical imbalance, that, and, and we have drugs to essentially fix it. And so that's, that's how they've kind of wrestled control of this narrative. Where before, you know, if you're anxious or depressed, like in the 80s, people would say, hey, let's look at your relationships, let's look at your purpose, let's look at your physical health. You know, are you dealing with problems of loneliness? The 90s comes along and there's this huge commercial interest and they take control of the narrative. Depression is now a medical problem that needs a medical solution. And if you say anything otherwise, you're dangerous, you're unscientific, you're kind of like a Neanderthal, like in terms of your understanding, you're in the past. And they've essentially been silencing these other views ever since then.
- [09:37]
Michael Knowles
So between the modern liberal advice of just ply yourself with heavy psych drugs and the kind of traditional old advice of take stock of your life and try to fix things that are able to be fixed and you know, keep your eyes up to God and have a stiff upper lip. There are the hippies in the middle who say that if you, I don't know, do a rain dance around the root of turmeric or something and like eat a few herbs, then that will fix your depression symptoms. I'm being only slightly hyperbolic here, but what do you make of the so called natural remedies?
- [10:10]
Dr. Youssef
It's bull.
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Michael Knowles
Okay, good.
- [10:13]
Dr. Youssef
And they're actually much closer to the liberals who are saying ply yourself with medications because there's this whole thing of like nutraceuticals. I don't know if you've ever heard that term.
- [10:24]
Michael Knowles
No, I like that word, but I don't, I've never heard of it.
- [10:27]
Dr. Youssef
So they, you know, adaptog, nutraceuticals supplements and so, and so these natural, you know, these natural Hippie types, they'll say, you know, take Ashwagandha, take St. John's St. John's Ward. Take Lion's Mane. Take really high doses of.
- [10:41]
Michael Knowles
What's the one that turns people blue? Colloidal silver.
- [10:44]
Dr. Youssef
Colloidal silver. Colloidal silver.
- [10:46]
Michael Knowles
Yeah.
- [10:46]
Dr. Youssef
And so. And then they. And then they. Or it could even be cannabis. You know, they'll say, these are natural things. They are safe. You know, don't worry about them. They're not like those nasty pharmaceuticals. Yeah, yeah, but they are. I mean, the only difference is that they're not coming from a pharmaceutical company. People use supplements, like psychiatric drugs, because they're actually quite powerful. I mean, these chemicals, they have real neurological changes. They can sedate you, they can energize you, they can numb you. Wow.
- [11:13]
Michael Knowles
I thought you were gonna say it's BS because it's, you know, you're just chewing on a piece of mint or something. No, no, no. You're saying, no, it actually. It is powerful and you should treat it like a drug.
- [11:22]
Dr. Youssef
You should treat it like a drug, but you shouldn't lie to yourself and say, oh, this is a natural thing. I'm not going to be dealing with the problems of tolerance. I'm not going to be where it wears off over time. I'm not going to have to worry about the fact that I'm sweeping legitimate problems under the rug. And I think they kind of delude themselves into thinking it's safe because it's not coming from a pharmaceutical company. Right. Yeah.
- [11:42]
Michael Knowles
I heard one time someone argue that anything that's natural has to be good for you. I thought, like, many poisons are natural. What are you talking about?
- [11:52]
Dr. Youssef
Look at what's happening with cannabis now. I mean, I feel like. I mean, we've been legalizing cannabis. We have high potent. And this is not the ditch weed that people used to smoke a long time ago. It's like 40 times more potent. And cannabis is one of the biggest gateway drugs into psychiatry. Like, if you're using high potency cannabis products and you have a psychotic. A bad trip, you know, a psychotic break on it. Cannabis, more so than meth, lsd, cocaine, is more toxic to the brain, that you are more likely to convert to an ongoing psychotic state.
- [12:27]
Michael Knowles
I knew that marijuana was related to psychosis, and I've just noticed that most of my pothead friends, I'm gonna get so much pushback for this. But most of my pothead friends insist they have no problem. No addiction. It's all. It's totally great for you. But they increasingly get problems. But I've never heard that it's worse for the brain than LSD when it.
- [12:47]
Dr. Youssef
Comes to trans, when it comes to someone who's had a bad trip transitioning to a bipolar or a schizophrenia diagnosis. And so essentially what that is with marijuana is that bad trip for some people, that's not a temporary thing, like it actually hurts them. Think about it as a serious toxic reaction that can actually lead to enduring problems over time. And I know this cause I've seen many of these patients, they'll have a psychotic episode on cannabis and it takes them sometimes a year, even two years to feel fully back to themselves. Now, during that year to two year period where their brain is recovering and they're still having periods of paranoia and mood instability, doctors will diagnose them with bipolar and schizophrenia and put them on psychiatric medications and tell them that they have like a brain disease when they've actually just had a neurological injury from the high potency cannabis products that they're consuming. And yes, it is more dangerous in that respect. It is more dangerous than meth and LSD and cocaine.
- [13:46]
Michael Knowles
So, okay, there are two views on depression. One being that it's basically just kind of made up. And it's people who are engaging in aberrant behavior who have suffered a lot of misfortune and haven't been able to pull themselves out of it. And so they've got these lifestyle problems that they're pretending is neurological or chemical or something, and then they pop the pills. The other side says, no, no, it's just hardwired into your brain and your lifestyle has absolutely nothing to do with it. And you might be making all sorts of bad choices, but that, you know, your choices don't affect anything. And is one of those views correct or is there. Is the answer necessarily in the middle?
- [14:27]
Dr. Youssef
So, well, let's start with the biological one. So we've been looking for this chemical imbalance for decades now. And I want to talk about some of the ways we've done this because I think there may be some people listening to this who are just like, are you sure it's not a chemical imbalance? They've heard it so much. We've done spinal taps where we sample the fluid around the brain and we look for differences in the serotonin metabolites. You can directly measure that. You get a group of depressed patients and non depressed patients. Are there any difference? No, we've done autopsies of the brains of people who have taken their lives, depressed patients, and compared them to non depressed people. Are there any changes in receptor density in those brains under pathology slides? No difference. We've done functional MRI scans, which are real time scans of the human brain kind of firing and showing all of the metabolic changes in the brain. Are there any differences between a depressed person and a non depressed person? No, there has never been any biological signature to differentiate depressed from non depressed.
- [15:39]
Michael Knowles
So are you therefore saying that this phrase, clinical depression does not signify a real thing?
- [15:46]
Dr. Youssef
It does not signify a biological problem? Usually people say clinical depression when they I'm very depressed. You know, that's, it's, it's just a, I think a way to say, hey, this is really serious, you know, take this seriously. But I want to have a little bit of nuance here because I'm not trying to say that there's no genetic loading for anxiety and depression. I mean, we probably know some people who are worry wards. I mean, they were just born that way. You know, they're a bit more neurotic, they have a tendency to be more depressed. That is just normal human personality. We exist on a bell curve and a spectrum. We're going to have more extroverts, we're going to have more worry warts. But that's hardly a disease. Imagine telling these worry warts, you have a diseased brain, there's something wrong with you. This is just normal human variation. And so I think that is possible. And yes, maybe there is some medical problem that we haven't found out about depression, but we, we essentially, we haven't found it yet. And so I think to go around and tell people that we really know depression is this biological problem is just a complete lie right now. Where we actually have a lot of evidence that shows that, you know, depression is correlated with loneliness, it's correlated with, you know, life dissatisfaction, work dissatisfaction, and a lot of the things that are very intuitive.
- [17:11]
Michael Knowles
Okay, so if that's the case, then if someone is depressed, and there are plenty of people around today who say they're depressed or clinically depressed, meaning just very, very depressed. They should not go seek a chemical is what you're saying. They should just seek behavioral therapy.
- [17:30]
Dr. Youssef
Yeah.
- [17:30]
Michael Knowles
Talk therapy.
- [17:31]
Dr. Youssef
Yeah. And one of the big injustices that I really worry about is that we actually rob people of that opportunity because, you know, you're upset, you're depressed, you go online and you're gonna see messages. You have a chemical imbalance or someone on TikTok or, you know, a celebrity influencer talking about how, you know, SSRIs saved their lives. You go, okay, maybe that could be something that's wrong with me. And sort of recasts how you view your problems. You go and see a doctor, you see a family medicine doctor. This is where 80% of the drugs come from. Not psychiatrists, just family medicine doctors. You have a 15 minute visit where you get five to seven minutes of FaceTime and they tell you, hey, you might have depression and we think it might be biological and take this medication. And so you take the medication and while you take it, you sort of, you ingesting along with the drug that numbs your emotions, a whole ideology about where the problems come from. And it robs you of the opportunity to, to fix other parts of your life. Because if you think about depression and anxiety as essentially signals, like a smoke detector in your brain that's saying, hey, maybe you need to look at your health, you know, maybe you need to cut down on your drug use or your cannabis use, you know, relationships work, all that kind of stuff. Instead of listening to that signal from the smoke alarm, when you take that drug, you're essentially numbing it. And you can go years or sometimes even decades, decades, not addressing real legitimate problems in your life that simply fester there in the background while you're on the drug.
- [19:07]
Michael Knowles
Do you think there is any circumstance in which doctors should prescribe SSRI specifically or antidepressant drugs more broadly?
- [19:17]
Dr. Youssef
Yes, yeah, I do. I think there are cases for that. But they should be, and this is, I mean, it's common sense. They should only be used after you've exhausted all of the non drug approaches. And so if someone comes in and they're anxious and depressed and you go through relationships, purpose, meaning your physical health, you get them off drugs and alcohol and you really take the time to get to know them and understand their life. This never happens, by the way.
- [19:47]
Michael Knowles
No doctors. Hold on. There is one exception. I know women, especially women of a certain age, have been going to their therapist for 30 years. They only ever seem to get crazier and they're. Now, I'm sure the therapist hasn't actually gotten to know them very well. Obviously not. They haven't worked on the symptoms. But yes, in modern medicine, as you say, you go in, you get five minutes with the doctor, maybe you say, okay, here's a script, see you later, bye.
- [20:14]
Dr. Youssef
Yeah, yeah. And so it doesn't happen. But let's say hypothetically you did that and they had great relationships and they're actually working a job that provides purpose and meaning. They're not using drugs. You Know, they're moving their body, they're getting out in the sun, they're eating a nice clean diet. If you have someone in front of you that's still suffering after that, I, I think you should use a medication. Why not use a medication in that point? Because you've exhausted all of the other non drug means. You want that person to function, you want them to be able, you know, you know, to live a productive life. And so I have no problem with the use of the drugs after you've exhausted the common sense, non drug approaches to treating anxiety.
- [20:57]
Michael Knowles
Now, what about the people who are currently on them? This huge percentage of Americans who are currently on SSRIs. One, other than restraining the range of emotion, are there other nasty side effects that come about as a result of this, other than just sweeping the problems under the rugs, which is a big enough negative side effect? And two, would you advise them or many of them or all of them to get off the SSRIs?
- [21:25]
Dr. Youssef
So that's a complicated question. So let's, let's, if it's okay, let's talk about some of the side effects first. And you know, there's a lot of them. One of the things that I worry about the most with these medications is they can actually make some people worse in the long run. Our brains, our brains are not designed to be exposed to drugs on a daily basis for years at a time. And I'll take a little aside here just to say most people aren't aware that these medications are studied for 12 weeks to get approval. There's never been a study that's gone any longer than a year. And these are drugs which clearly wear off over time. Our brain is not static. It doesn't like that you're taking a drug that disturbs neurotransmitter function, which doesn't just control your mood, it controls your heart, your digestion, your immune system. And so homeostasis kicks in, the body pushes it back against the drug and the effect wears. The effect diminishes over time. And so one, I think it's kind of very bad that we only studied these drugs for 12 weeks, 12 weeks to a year, and then we put people on them for multiple years when they clearly wear off over time. So that's the first thing. Not only when do they wear off over time. What I see in many patients after they've been on them for several years is they'll develop a trifecta of symptoms. Specifically with the SSRIs, people start to have low energy they start to get brain fog and they start to feel very flat. And that is just the effect of being on these drugs long term. Now, unfortunately, they will go and see their doctor at this time, and the doctor will say, well, they won't say, oh, you know, this is a side effect from chronic SSRI use and you're kind of getting worse, you're numbed out, you've got cognitive fog now. They'll say your depression is evolving, you've got treatment resistant depression. You know, these are mysterious mental illnesses and we need to put you on another drug. And so it starts this prescribing cascade where the drugs, when taken long term, cause side effects that make the person worse. And then they take another drug and all of a sudden you start accumulating psychiatric diagnoses and you end up on five or six different drugs. I think that's one of, like, the biggest risks and why we've seen the use of these medications balloon over time, because I do think they're making some people worse.
- [23:50]
Michael Knowles
What are some of the other drugs that the doctors will put you on then?
- [23:55]
Dr. Youssef
So if you take an SSRI and it triggers a manic episode where you become disinhibited, you know, hypersexual, you start gambling, maybe you become hostile or aggressive, they'll say you have bipolar disorder and they put you on antipsychotic medications. And so, and those are, those are heavy drugs. I mean, they have a lot of stopping power. They're really sedating. And your life really goes in a different direction once you've, once you're put on that, you can gain like £100 on some of these antipsychotics. It can be completely disfiguring for some people. And so it can get out of hand really, really quickly.
- [24:32]
Michael Knowles
So if you're telling them, you know, not to be doing this, you know, because of all these side effects, then for the people who are currently on them, do you, would you give a blanket recommendation, get off?
- [24:46]
Dr. Youssef
I think you need to check in with yourself and you need to look at your life and just say, so the drugs do work, so they do have this numbing effect, right? But if you pull that drug away, you can throw someone into a very anxious state. Let's say they have a lot of issues going on in their life already. What do you have in place of that? And so before just coming off these medications, you know, you need to think about, you know, why did I get on it in the first place? And so if you, I think if you let, let, let's say you just got on it cause you went through a divorce or a job loss, or you moved and you were lonely. Some kind of stressor at one moment of time, which you've recovered from, you don't need to be on that drug anymore. Like come off it, do a gradual, slow, safe taper. But if you had, I mean, I don't know, maybe you're in a relationship that's having a lot of problems. Maybe you're. Maybe you really don't like what you're doing at work. Maybe you have a whole bunch of physical health problems or you're using drugs and alcohol and it's leading to this anxious state. You need to address that first. Because if you just pull that drug off, you're also gonna send your life into a tailspin. So I recommend that kind of practical approach, just thinking about what can you replace it with. But for the majority of Americans, for the majority of people on these medications, and just from my clinical experience and doing this for over 10 years now, I think that 95% of people on these medications shouldn't have been put on them in the first place. And they don't actually need them.
- [26:20]
Michael Knowles
So it's dangerous to quickly come off these types of drugs. How are you supposed to do it? If you want to get off these kinds of drugs, what's the safest way to do it?
- [26:29]
Dr. Youssef
Sure. So there's a. The safest way to come off these drugs is without exposing yourself to severe withdrawal. Now, one of the big problems is many doctors have been telling patients for years that the withdrawal is mild and it goes away in a couple of weeks. And because of this, they'll get people who've been on these drugs for years, sometimes decades, and they'll taper them off over a couple of months. And that can be really dangerous. Now, for some people, they can do it. Their brains are very elastic and they come off quickly. And you know, it's very difficult for a month or two and then they're fine. But you may have, may recall I mentioned the issue of protracted withdrawal with benzos and antidepressants. There is a fairly large group of people that if you expose them to these severe withdrawal symptoms, they actually end up developing this neurological damage. And so the way to actually avoid the risk of that is to taper off slowly. Now, what I generally recommend for people is to start with a 5 to 10% reduction. And then every month just assess how you're going. You know, if that was a good reduction for you, you could do the same One. Or you could increase it. You could say, now I'm going to do 10%, now I'm going to do 15%. And go down. In these very gradual steps, many people, when they get to the very end of the taper, they struggle greatly. This is because at that point you've removed so much of the drug, it's like you don't have a lot of residual drug floating around in the brain. And so when you take another bit out, you actually disconnect a lot of the receptors. And so when people get to the very end of the taper, if they're struggling, I would just want them to know that that is normal and they should go up to the previous dose before they had the withdrawal symptoms and ask their doctor if they can give them a liquid version of the medication. And the reason I asked them to do that is you can draw up the drug in a syringe. And the great thing about syringes is you can get like a 1mL syringe and there's like 100 spaces on the side. It allows you to lower down that last amount with a lot of precision. And so I think finishing a taper with liquid is also a really great thing to do if someone's struggling to come off. As for the time frame, for many patients, it can take them a year, sometimes up to two years to come off these medications if they've been on them for a really long time. And so I always tell people not to rush it, take your time. You should be able to come off without having severe withdrawal, and that's the way to do it.
- [29:04]
Michael Knowles
What about the relation of these kinds of drugs to violent acts and to aberrant ideologies? I guess I'll put my cards on the table. I've noticed a major uptick in violence from the left, notably associated with transgenderism, a very serious psychiatric condition. And in the lion's share of these cases, basically every time it seems that we learn the information, they're on SSRIs.
- [29:35]
Dr. Youssef
Yeah, yeah.
- [29:36]
Michael Knowles
Is there a relationship?
- [29:38]
Dr. Youssef
Yes. So I believe there is. Now, this has been shut down in the media for a really long time, and sometimes people don't believe me when I say this. You can look at the drug labels from the FDA right now, and they already list these side effects in there. If you look at Adderall, for instance, there's a whole section in the Warnings and Precautions, which is the highlighted section of important risks in the drug label, that the drug can cause hostility because they see it a lot in kids. If you look at Abilify, it's an antipsychotic. Homicidal ideation is listed in the drug label. If you look at the SSRIs, the drug label already says they can cause suicidal ideation, suicidal behavior, aggression and violence. These are already recognized risks that the FDA has ratified and the pharmaceutical companies have put in their labels. But then when it comes to the issue of mass violence, we all of a sudden, I feel like the media pretends that these drugs, you know, there's no way that these drugs could do it. And if you bring it up, they try and intimidate you. They say you're stigmatizing the mentally ill. You are, you know, you're trying to make an excuse. You're trying to scare people away from it. They try and shut you down. But when we look at legal cases as well, this has been used as a defense in the court of law, and it has been found reasonable by judges and juries that it reduces culpability.
- [31:11]
Michael Knowles
Because they're on the psych drugs that were supposed to help them but actually made it worse. And you're not even allowed to acknowledge that the drugs made it worse.
- [31:19]
Dr. Youssef
Yeah. Well, let me talk about some of these cases because they are shocking because most people are thinking about school shootings when they're worried about these medications. So one of the cases was with a gentleman called Donald Shell in wyoming in the 90s. He had previously taken Prozac, an SSRI, and become agitated on it. Another doctor put him on a different SSRI later on called Paxil. This never should have happened because it's the same drug class. If you got worse on Prozac, you shouldn't have been put on Paxil. But the doctor didn't know he had that prior history. Within a week of going on Paxil, Don killed his wife, he killed his daughter, and he killed his granddaughter. He shot all three of them and then he killed himself. Now, the surviving son in law, Tobin, took out a claim against SmithKline. This was before they became GlaxoSmithKline. And he sued them. And they were found 80% liable for what had happened due to failure to warn about the fact that it could cause homicidal and suicidal behavior. They appealed it, but the appeal did not work. And it stood. And this has happened not just in this case. There have been several other cases where judges and juries have found that if not for the person taking the psychiatric medication, this act of violence would not have happened.
- [32:46]
Michael Knowles
I had actually never heard of that.
- [32:48]
Dr. Youssef
Yeah.
- [32:49]
Michael Knowles
Are There more recent examples of courts finding this, or have the courts started to turn on it, too?
- [32:57]
Dr. Youssef
The most recent one that comes to mind. And some of this stuff is pretty gruesome, so, you know. Yeah, but there was a gentleman, David Carmichael, who, again, very similar story, was put on Paxil, I believe, and he actually killed his son. And while he was in a psychosis because of it, now, he ended up spending some time in a psychiatric hospital afterwards for, I think it was two to three years, something like that. But the prosecutor did not press charges because they looked at him and they were just like, there's no, you know, judging from your history, from your wife and, you know, being an upstanding, great person, good citizen, there's no way we could explain this happening if not for the drug. And so they didn't pursue it, to kind of send him, you know, send him to prison and jail and all of that.
- [33:47]
Michael Knowles
But one objection I've heard, even if you tell your friends or family, if they're on it, you say, you should really get off this. They'll give you the same excuse that you'd hear if you raised an objection to the COVID vaccine. Remember the COVID vaccine? They said, if you take the vaccine, you won't get the virus. Then it turned out that wasn't true. And so they said, well, if you get the vaccine, you'll get the virus, but you won't transmit the virus. And it turned out that wasn't true. And they said, well, okay, you'll get it and you'll transmit it, but it would be much worse, the symptoms would be much worse if you didn't take the vaccine, which was unfalsifiable. Well, I've heard the same thing with the SSRIs, where you say, hey, you know, you've been taking these drugs forever, and you haven't gotten less crazy. And in some ways, you've gotten more crazy, it seems to me. So you should probably get off the drugs, Right? And a lot of the time they'll tell you, oh, well, no, you don't. You don't know how bad it was before. If you think this is bad. Oh, trust me, it would be much worse without the drug. What do you say to those people?
- [34:43]
Dr. Youssef
I say to them that on a population level, from the FDA's own clinical trials, taking these medications is associated with a greater risk of suicidal thoughts and behaviors. And I want to just let that sink in for a second because this should sound absolutely batshit crazy.
- [34:59]
Michael Knowles
How do they control. You're saying people who have depression or. Yeah, like, it's the same kind of people. Is it just normal people or people on. Because if it were just normal people and people on SSRIs, you say, well, those are the guys who are suicidal anyway. Or are you saying people.
- [35:14]
Dr. Youssef
People on depression with depression, People with.
- [35:16]
Michael Knowles
Depression who don't take the SSRIs, people with depression who do take the SSRIs. It's the ones who take the SSRIs who are more likely to kill themselves.
- [35:23]
Dr. Youssef
Yes.
- [35:24]
Michael Knowles
Crazy.
- [35:25]
Dr. Youssef
And your reaction is exactly the reaction that I want everyone listening to have right now. It is in the drug labels. So if you look at the drug labels right now for SSRIs, it says for populations under age 25, taking SSRIs is associated at a population level with a higher chance of suicidal behavior. And so I don't think there is any good justification for every. For really using these medications in younger people. Yes, it will reduce their symptoms. Their symptoms on the depression scale, which, by the way, is how they measure it. How many symptoms are you reporting? They're not measuring it by life satisfaction, relationships, rates of divorce, any of the things.
- [36:08]
Michael Knowles
So what are the symptoms?
- [36:09]
Dr. Youssef
You know, you know, anxiety, low mood, sleep. And if you just give someone a drug that kind of numbs them out, those symptoms are going to go down. But you could also see how being in a kind of numbed out state may not be the best state to be connected in your relationships, feel motivated at work, feel the drive to go and change things in your life. And so it decreases your symptoms. And so people kind of feel better, but then they're also kind of spellbound because they're in a drugged state that they may feel better, but their life really isn't getting that much better. And so when you think about it that way, you go, well, okay, so you're taking a drug that's masking problems. For many people, their problems aren't getting better. And you can also have these paradoxical reactions where people can become unexpectedly more suicidal. It makes sense that taking them actually on a population level, like you said, group on placebo, group on drug, the group on the drug is having more suicidal behavior and suicidal thoughts. And when further analyses were done, it was shown that it was not just in the group that was under age 25 that it actually extended to all adults. And so when someone says to me, hey, if I don't take this medication, it's going to lead to, you know, if people stop taking them, it's gonna lead to more suicidal behavior.
- [37:31]
Michael Knowles
That's what it comes down to, because people don't make the argument, oh, if they stop taking this medication, they're gonna be more eccentric or they're gonna be more annoying, or they're gonna be a little more. It's always, if you tell people not to take these drugs, they're gonna kill themselves and you're gonna have blood on your hands.
- [37:45]
Dr. Youssef
And the opposite is true. Wow. Yeah. Yeah.
- [37:50]
Michael Knowles
What about some of the other drugs? Because we focused on this one class of antidepressants. Is that basically just what people mean by antidepressant?
- [37:58]
Dr. Youssef
Or pretty much the SSRIs that constitutes the lion's share of that Antidepressant pot. Yeah.
- [38:04]
Michael Knowles
What are the other. Because what are the other ones? I've heard of Benzos. Is a benzo an ssri?
- [38:08]
Dr. Youssef
No, benzo. A benzo is a very popular type of sedative. Okay. And. Like Xanax or Klonopin. Yeah, that. That kind of stuff.
- [38:18]
Michael Knowles
So that's different. I'm confessing my ignorance to the entire audience, but. So that's different.
- [38:22]
Dr. Youssef
Yeah.
- [38:22]
Michael Knowles
Are those. Are those also bad for you?
- [38:24]
Dr. Youssef
They're incredibly bad for you. And I don't like SSRIs, but I think benzos are worse. So, I mean, the issue with the benzodiazepines kind of similar to the SSRIs, is they just. They simply make people worse over the long run.
- [38:41]
Michael Knowles
That's a pretty blunt characterization.
- [38:44]
Dr. Youssef
It is. And so you get. And here's what it looks like. If you're a benzo user, try and see if this is happening to you right now. They become more agoraphobic. They stop wanting to leave their house, and they start to have very anxious, ruminative, and obsessive thoughts over time, and they start to have mood instability. So, I mean, this is what I see in my practice all the time. We. Half of my practice is getting people off benzos. So they get worse over time, more anxious, more withdrawn, and then they're really hard to stop. And some people, when they come off these medications too fast, this is the benzos and the antidepressants. They can actually have a neurological brain injury called protracted withdrawal that can be completely disabling. And it's almost like you've had a severe concussion, like someone has pushed you out of a window and you've hit your head. And people can be disabled for several years after they come off these medications.
- [39:42]
Michael Knowles
If they come off too quickly.
- [39:44]
Dr. Youssef
If they come off too quickly. And this is, like, another thing when I say this people goes. They go, this is crazy. My doctor would have told me if coming off this medication could cause a brain injury that could last for several years. And to them I would say pick up the drug label, look in the warnings and precaution, and read the section that says protracted withdrawal. These are recognized risks in the drug labels, which doctors are not telling patients about. And so, I mean, I've had people take their lives because they've been so disabled they're not able to support their families. And yeah, essentially it's like you've had a brain injury and it can take them years to recover from. And this happens with the SSRIs as well.
- [40:25]
Michael Knowles
Are these the kind of drugs that people take on airplanes?
- [40:28]
Dr. Youssef
Yeah, yeah.
- [40:29]
Michael Knowles
That's the only time I really encounter them is I'll be flying with someone and say, oh, I popped. What's the popular one?
- [40:36]
Dr. Youssef
Xanax.
- [40:36]
Michael Knowles
Xanax. I'm popping a Xanax for the airplane. I said, just get a whiskey. I don't know. That's what I get on an airplane.
- [40:42]
Dr. Youssef
Well, the sad thing is I actually see a lot of perimenopausal women who are entering menopause get put on these drugs and end up getting a lot worse because of them. Menopause is one of the highest risk periods for women when it comes to psychiatrists, like. Cause they have mood instability, they have insomnia. And I have so many patients right now who are just going through menopause who end up kind of hooked in this, like, psychiatric hell, you know.
- [41:11]
Michael Knowles
So the idea being they start to go crazy during menopause, they can't take it anymore, they go get some drug. But if they had just gone through menopause on the other side of it, they would have been basically fine.
- [41:21]
Dr. Youssef
Again, going through menopause, started hormonal therapy. That could be really beneficial for some women. But. Yes, exactly. You know, that's a really high risk period for them.
- [41:34]
Michael Knowles
So then what is the alternative? You know, we're in a period where people really like the idea of alternative medicine, where it used to be all the left wingers were the hippies, and now the right wingers are kind of the hippies. And now Bobby Kennedy, who used to be a left wing kook, is now the Republican Health and Human Services Secretary. And it's all. My very traditional wife is reading all about, I don't know, granola and seed oils and everything.
- [42:00]
Dr. Youssef
That's a good wife.
- [42:01]
Michael Knowles
Yes. Yeah, we're kind of totally upside down at this point. So what do you tell people to do. I mean, the answer is just deal with it. Stiff upper lip, talk it out, fix your relationships. I don't mean that derisively. That's like good advice sometimes.
- [42:20]
Dr. Youssef
Well, it depends. I mean, when we're looking at anxiety and depression, we have to respect it as a very complicated problem. I mean, like, what are the things that make people anxious and depressed? I mean, there's a whole range of things from the fairly benign to, you know, quite bad childhood trauma where you develop maladaptive personality traits and it's very hard to relate to people and you have low self esteem. Like that kind of issue requires. That might require a lot more work. That might require actually working with a professional to gain insight into how, you know, terrible things that happened to you in the past are playing out in your current life and relationships. But then we can also have people that just have really terrible physical health. I mean, they're sitting behind their computer all day, you know, just typing away. They're not getting any sunlight, they're not moving their body, they're eating just lots of refined carbohydrates. They have insulin resistance. Their brain is starved of energy because they're completely metabolically destroyed. For that person, it's like, let's get you healthy, let's get nutritious food back into you. Let's decrease the amount of carbohydrates. And so your physical health is kind of improving. That might be a solution for one person. You could have someone who's in an abusive relationship and then it's like, well, how do you navigate that? Oh, gosh, you have kids as well. Well, that's a big problem. How do we navigate this abusive relationship where there's children going on? Like, some of these things are like, I don't want to diminish anxiety and depression. I mean, some of the things like, like, it's like, it's like a gut punch. It's really complicated, messy problems. Yeah, you could be in a job that you hate, but then you have a family to support as well. And it's like, how do you find peace with that? And so, no, I, I, you know, I have friends.
- [44:06]
Michael Knowles
I'm being a little tough on the ladies and calling them crazy and stuff. But I do have friends where I think, well, you know, if I had that lady's husband, I'd probably be a little anxious and depressed too.
- [44:15]
Dr. Youssef
Yeah.
- [44:16]
Michael Knowles
Be a little down in the dumps, you know, or if I had to do such and such job, that might get to me a little bit. Too. So look, it's. This is why I'm unsatisfied with the advice of just, you know, buck up, kid. Though I sometimes dispense that very advice is at the level of the US population, the fact that you have 20% of people or whatever it is, feeling the need to go on these very heavy psych drugs tells you that something has gone wrong. Maybe at the personal level, maybe they need to pull themselves up by their bootstraps. Maybe at the systemic level, maybe political level.
- [44:49]
Dr. Youssef
I think we should talk about that. And the thing that has kind of dawned on me the longer that I've been doing this for is that a lot of these problems actually start young. I mean, like relationships. I mean, this is one of the core pillars of your well being. If you marry the wrong person, like if you don't have the right kind of guidance to understand, hey, how do I pick a partner that shares my same views about having kids or values or religion or anything like that? That can be really hard. I've seen that turn up in a lot of relationships, you know, if you don't have parents that kind of encourage you to find the thing that energizes you and that you're going to naturally be interested in. And they say, no, you need to become a lawyer, you need to become an engineer, and okay, you're not interested. Take the Adderall so you can sit down and focus. Because success is just doing these jobs and you end up doing a job that you need to be essentially drugged to do. This is really common. Like, I don't want to.
- [45:46]
Michael Knowles
Great point.
- [45:46]
Dr. Youssef
There's so many people who get kind of driven into these careers. They white collar job, you know, big, big firm. That is success, you know, because.
- [45:55]
Michael Knowles
Wow. I considered for a while in my twenties, I considered going to law school. So should I, should I sit for the lsat? Should I go to law school? I thought, I really don't want to be a lawyer. On paper I could be. You know, I write, I read, I make arguments, but I just don't want to be a lawyer. It would be so depressing. And today, whatever it is that I do, I don't even really have a real job. I work 20 hours a day or something, but I don't feel like I have a real job. And it really jazzes me up. Whereas I think if I worked half the amount of time that I do, even in a prestigious career like a lawyer or a doctor, I would probably be severely depressed, would be my guess.
- [46:33]
Dr. Youssef
Yeah, yeah. And, and so I think we need to help, we need to help kids when they're, when they are young, actually challenge, you know, go figure out some really important things. Like most people aren't thinking about that at that stage in their life. And so, you know, I think, I mean, if we talk about. I think church going has, has gone down. And if we look at the decrease in churchgoing, I mean, that is something where people. There is an emphasis on marriage, There is an emphasis on values, core values, which you want to share with your partner, you know, before you get married. You know, if you're at a Catholic church, you talk to a priest and things like that. Some of these institutions actually used to kind of help with going through these motions so you don't make some of these really big mistakes early on in your life.
- [47:31]
Michael Knowles
Okay, then I have a question to go further. So you say, well, sharing values with your spouse is going to be more conducive to flourishing than if you oppose your spouse. And I get that point. But let's say you do share value. Let's say you got two couples and they both share values, but they have different values. And one goes to church and one votes the right way and one has kids and all the rest of the. And the other doesn't. Does all the opposite stuff. They both share values with their spouses, but they have very different values. Can we say that one set of values is more conducive to happiness than the other?
- [48:14]
Dr. Youssef
I think statistically, I mean, you can look at some like having kids is associated with greater happiness. I mean, that has been borne out with clinical trial research. Being married is associated with greater happiness. Churchgoing is associated with greater happiness as well. And so. So, yes, we don't really have to guess.
- [48:37]
Michael Knowles
Yes. No. My theory on this from the systemic level is I think liberalism makes you unhappy. I think the ideology of liberalism, I'm not just knocking the. The leftists, even people who call themselves on the right who are liberal, meaning they think that the highest good is to maximize individual autonomy. Say, I think that makes you unhappy. I think it alienates you from your family and your community and your nation and everything else. I think it gives you unrealistic expectations of yourself because you think that you can transform your natural limits, you can transcend your natural limits, you can transcend your body. I guess, you know, you can be a man and you can think that you're a woman. I think it inclines toward a lot of sexually deviant ideologies, but just more broadly aberrant ideologies that tells you that, you know, you can flunk every class in school but still be an astronaut someday, or tells you you can be 5 foot 3 but play for the New York Knicks. And it says that if you don't have that belief that that will somehow depress you, that that will, you know, that will be bad for your self esteem. I think liberalism drives you crazy and.
- [49:46]
Dr. Youssef
It'S not just a thought that you need to have because that's actually been backed up with statistics that when they look at liberal women compared to conservative women, they are more depressed than that. And I'll go a point further because this is something that I see especially with like, you know, people call it, you know, like the oppression Olympics. Yeah. Like there is something about liberal ideology right now where you are being oppressed. You know, the system is against you. You don't have an internal, you don't have a locus of control. Like, you don't feel like you are in control of your life. You know, the way my life turns out is up to me and my responsibility, and I can control it. I feel like that ideology is very much like men are holding me down, you know, the government, the people, all of these types of things. It's not a very empowering ideology. It's not something that builds confidence in yourself and your ability to kind of navigate the world over time. And so that's something I also worry about.
- [50:43]
Michael Knowles
Do you have faith in the psychiatric profession?
- [50:46]
Dr. Youssef
No, no, absolutely not. You know, I feel like they've absolutely betrayed the American public in a major way. And I, and you know, I would want nothing more than the president of the American Psychiatric association to be pulled before a panel of senators and to be asked some hard questions, like why are 1 in 3 women over 60 on psychiatric medications? You know, why are 18% of our female population taking these drugs right now? Why are 17% of adolescent boys 14 to 17 diagnosed with ADHD right now? Why have SSRI? Why have antidepressant prescriptions gone up 500% while suicide, teen suicidal thinking have both gone up 50% in the last 30 years? Why is psychiatric disability going up? What are you doing? You know, I mean. And so I think there's been a massive betrayal, not just with the psychiatrists. I also think the National Institute of Mental Health in its prior form, it's getting reformed now by Bobby and his team. They have just been obsessed with biological cures for anxiety and depression. I think the, you know, you would think that with, you know, you know, 15% of the population, men and women, on these Drugs that someone at the NIMH would have said, hey, let's do a two year study where we look at people who get standard of care, just kind of plopped on the antidepressants and we compare it to people who get some relationship coaching, you know, nutrition help, you know, some coaching on life and purpose. Let's see how those two cohorts go. So we can really, we can really see, you know, is it safe for, you know, 15 to 20% of our population to be on these drugs? Because that's a lot of us and we should really know that. Well, they have never done any studies like that. They're just looking for biological targets for new drugs. I think that is a massive betrayal of the American public.
- [52:45]
Michael Knowles
So then can you go even further to say, yes, the psychiatric profession has this whole conversation of mental health and the obsession with mental health without ever dealing with the actual underlying issues of mental health. That, that's a betrayal of what the psychiatric profession is supposed to be. But you would not go so far as to say that the practice of psychiatry or clinical psychology is in itself a fool's errand. As if to say, I know some people, they're prominent people who say, nah, the whole thing is just kind of fake, you know, and it's trying to make scientific that which is a little bit more of an art, you know, the art of human relationship. Say, yeah, you still would defend psychology as a discipline or no.
- [53:35]
Dr. Youssef
I actually have my own misgivings about psychology. And a lot of this comes from the fact that many people stay with therapists indefinitely. And that makes me suspicious. It makes me feel like people are really paying for friends. And so I think a lot of that goes on. I also think there is, we're so censored these days as well. And I actually think that turns up in therapy. I think some therapists are afraid to actually take a stand on some things and say, I think you need to work on your relationships. I think you need to, you know, find. I think you need to find a job that is more aligned with you. I think you need to think about living a life in service of others. I think we're so agnostic in therapy. We're just like, well, what do you think about it? What do you think about it?
- [54:33]
Michael Knowles
Last example really got me too, because it seems rather modest to just say, hey, maybe you should think about anyone else ever. But even that might be too far. I don't want to impose my moral and values system on you.
- [54:46]
Dr. Youssef
Exactly. They really, I mean, they pussyfoot around the whole thing and they do not. And so I don't think it has backbone. This will make me sound really unscientific, but I'm gonna say it anyway.
- [55:00]
Michael Knowles
Great.
- [55:00]
Dr. Youssef
I actually really believe in coaching. I believe in people like Tony Robbins. I believe in these guys that can get you up and motivate you and just say no. Go out, work hard, live a life in service of others, get outside of yourself, don't be so me, me, me. And they give you more direction. Now that hasn't been studied in like randomized controlled trials. And so I know there's probably medical professionals listening here and just being like, that's unscientific. Well, I don't really think the other side works. I would like to see a blend of more empowering coaching styles with therapy. I mean, think like some people think of therapy as this panacea. It's like, oh, I'm depressed. I'm going to go and see this like 24 year old, like social worker who's going to be able to tell me something about my life and they're like, oh, she's got a therapy degree.
- [55:52]
Michael Knowles
She'S got a therapy degree and therefore she is expert and I'm doing something.
- [55:57]
Dr. Youssef
Yeah, she's expert. That's insane. Like if you actually have a complicated problem in your life, you go to a professional. Why? If. And so I think people should say, okay, I have interpersonal problems in my relationship. I'm going to find the person to help me with that. I, I don't like my job. I'm going to see a career coach. I'm not going to talk to the 20 year old clinical social worker who really doesn't know anything about life. You know, she has a, she does cognitive behavioral therapy or something like that. So yes, I, I think there are a lot of, I think there's actually a lot of problems in therapy as well.
- [56:32]
Michael Knowles
I've long thought that therapy is just confession for atheists.
- [56:37]
Dr. Youssef
Yep.
- [56:38]
Michael Knowles
And I go to confession. I should probably go more frequently than I do, but I regularly go to confession. And for those who are unfamiliar with sacramental theology, it means I go into a box and I kneel down, I first examine my conscience and I think about all the bad things I did over the week or two weeks or three weeks, however long. And then I list them in number and kind to a man who has been consecrated to the priesthood and I'm confessing my sins through him to God and, and he is given authority by God in my view and in the view of the Bible to forgive or retain my sins. And that's what I do. And then I leave the box and I feel better. And I think that something spiritually efficacious has actually taken place. But even when I try to recommend the sacrament to more skeptical friends of mine, I say, even if you do not believe in its spiritual efficacy, which is real, but you don't have to believe it at the moment, I promise you, the psychological effects of that are going to be very strong. And I really don't have any experience in psychology. I've never gone to a psychologist, but I've known a number of them. I strongly suspect the three words ego te absolvo from a man that I believe is consecrated to his position by God are going to be more powerful than the 24 year old psych major with some degree who says, gee, wow, that's really interesting. Tell me more. Time's up. Give me another 200 bucks next week.
- [58:02]
Dr. Youssef
Yeah, yeah. And of course it is. I mean, I think about how we live our lives now. I mean, if you can take 20 minutes, 30 minutes to actually sit down and take a moral inventory of things that you have done and really reflect on them, how could that not be helpful? Because, I mean, the way I see most people living their life is, oh, uncomfortable feeling. Let me whip out my phone and start scrolling. Scrolling through. We numb ourselves with drugs to pain. We numb ourselves with distraction. When you're going into confession, it's meditative. You're really reflecting on core principles, values, things that you want to practice which you know long term will improve your life and the lives of others. How could that not be a powerful tool?
- [58:54]
Michael Knowles
And in some ways it's such a perversion of psychology, is such a perversion of confession that in some ways it's an inversion because again, I'm getting most of this secondhand. But when I confess my sins, I feel a great degree of guilt for my sins, as I should. In fact, I say mea culpa, mea culpa, mea maxima culpa, my guilt. And then I confess them and then I believe God has forgiven me and I trust in God's grace. So I have a reason to let go of the guilt if I go to confession or if I go to a psychologist. What's the first thing you're gonna say? Don't feel. Oh, you shouldn't feel guilt, you shouldn't feel shame. Go blame your mother. Don't know. You have to let go of shame. It's very bad for you. You need to Love yourself. You need self care.
- [59:42]
Dr. Youssef
Exactly. And that's that whole locus of control which you kind of see in the more conservative groups, more religious groups as well. Responsibility. Self responsibility. I'm in control. Yeah.
- [59:55]
Michael Knowles
You need to take self ownership.
- [59:57]
Dr. Youssef
Yeah, yeah. And. And this is why I get really worried about ChatGPT as well. People use ChatGPT for therapy and I've experimented with it as well, asking it questions. And it is just like the therapist that you had acted out a moment ago. It's other people. It's not you that's so hard. I'm so sorry for you. That must be so difficult.
- [60:20]
Michael Knowles
I hear you. Wow.
- [60:21]
Dr. Youssef
I hear you. There's not like a hard ass in there. Take ownership of your life. Get in control. Get in the driver's seat. You can change things. It's not really an empowering message.
- [60:33]
Michael Knowles
A lot of times I want to hear more on the ChatGPT point. Cause that's very scary and I'm sure many more people are going to use it in coming years for therapy. But on the point of even the shame and the guilt, even if you think I'm crazy, even if you think God doesn't exist and the priests are deluding themselves or whatever, you can at least understand why I feel guilt going into the confessional and then I don't feel guilt after the confessional because I believe that the creator and sustainer of the universe, my very maker, who knew every hair on my head before I was born, has forgiven me. But if you don't believe that, if you instead go to some guy with a degree from, like, Wellesley College, who you are speaking to as the great Oracle, and you feel shame because you've committed bad actions, and then he says, no, you shouldn't feel shame. Why would you believe him?
- [61:31]
Dr. Youssef
Yeah.
- [61:31]
Michael Knowles
Is that gonna work? I just don't think that's gonna work.
- [61:34]
Dr. Youssef
Yeah, I mean, I wouldn't find it compelling.
- [61:39]
Michael Knowles
Doesn't do it for me. So, okay, so then they turn to ChatGPT. This is quite concerning because I've used ChatGPT for some research and a lot of time it's not reliable. Sometimes it's reliable, but when I say it's not reliable, I mean it'll just completely make stuff up and try to hide it. But sometimes you get interesting stuff, access to archives, if I'm doing historical research. Okay. So it can be a useful tool. You have to be very careful with it. People treat this thing like it is God, like it is omnipotent, like it can give you the secrets of the universe and like it can unfold your own personal mysteries to yourself.
- [62:21]
Dr. Youssef
It's highly disturbing. And the part of it that I worry about the most is when people start making chatgpt like a friend and they will have a boyfriend or a girlfriend. That is chatgpt.
- [62:36]
Michael Knowles
Is this real? I've read headlines about this. This is really happening.
- [62:39]
Dr. Youssef
This is real. And then people have a panic attack because I think after you put in 50,000 prompts, it will delete the memory. So you lose because when you use ChatGPT, it remembers things about you and so you get more accurate replies that are kind of matched to you. But when you go over a certain number of prompts, which you do, if you're treating this thing like a romantic partner, it dies. And then people really freak out when that happens.
- [63:05]
Michael Knowles
That's horrifying.
- [63:06]
Dr. Youssef
Yeah.
- [63:07]
Michael Knowles
So the fear is not even of treating chatgpt like a God or an oracle or something. It's treating it like your therapist or your friend.
- [63:16]
Dr. Youssef
It is. And you know, one of the scariest things about this technology is people can retreat into it. I mean, it doesn't, it doesn't have boundaries. It's not going to, you know, it's not going to be like your wife, where it's going to, you know, come after you if you're insensitive, you're not talking to it, or you're not, you know, attuned to the emotions. It just sits there and just kind of takes whatever you feed into it. And I mean, that is like the worst thing ever because you. I think people retreat into ChatGPT because they're so wounded and fragile with normal human relationships that they want something that feels safe. But it's the worst thing to do. You need to be out there interacting with people and resolving conflicts and not kind of shying away from everything. And so it essentially just, I mean, it allows people to retreat into this fantasy world. And I mean the whole thing with X lately and they're like, have you seen like the artificial intelligence, like anime companions that Elon has made?
- [64:15]
Michael Knowles
I saw something that was vaguely disturbing that he posted, but I didn't look into it much.
- [64:20]
Dr. Youssef
Provocative looking, like anime avatars. And I mean it's so twisted. I mean it's so disturbing and I mean, so.
- [64:29]
Michael Knowles
And you can treat the anime, the hot little 22 year old anime, as your girlfriend or something.
- [64:37]
Dr. Youssef
Yeah, yeah.
- [64:39]
Michael Knowles
Oh man. But actually that tracks because I suspect one of the big drivers of porn. And why, when you read these reports of. Well, especially it first came out of Japan, but I think you're seeing this here now too, is that guys will prefer porn to a girlfriend. And I remember I was having this conversation with my colleague Andrew Clavin, and he said, can you imagine? That's crazy. Why would anyone prefer porn to a girlfriend? I said, I totally understand why. Because your girlfriend has needs. She has needs. She yells at you sometimes. She is, like, tired sometimes. And porn is just whatever you want. And with ChatGPT, it's just that to the nth degree.
- [65:16]
Dr. Youssef
Correct. Yep. Yeah. It's a brave new world. This is, like, off topic from what we're talking about, but, I mean, in 10 years, we're going to have humanoid robots. I really believe that, powered with artificial intelligence. And I really worry about what the world is going to look like at that point.
- [65:34]
Michael Knowles
I have long said, once they perfect robots and AI because all new technologies are immediately infiltrated by pornography. Once they perfect robots and AI pornography, the human race has about 23 years left, and then extinction will set in because people will flock to it. I actually do want to talk about the porn issue, though, because people write in. It's certainly not just in my show. It's all over the place. Young men for years and years now have said, one of the biggest struggles in my life is I'm struggling with porn. And some are now speaking of pornography as a kind of a drug causing or fixing a chemical imbalance bring us all the way back to the top of our. Of our conversation. What do you make of that?
- [66:20]
Dr. Youssef
I think it's a really apt analogy. And I would put pornography, you know, in with things like overeating, sometimes even gambling as well, and taking psychiatric drugs. It is a way to numb feelings. It is a way to distract. It is a way to like. Because think about it, okay, why am I watching porn? Well, I can't get a girlfriend, right? That could be one thing. I'm fighting with my wife. It could be another thing. The spark has. Has disappeared in my marriage. These are complicated things to fix. So complicated that, oh, isn't it easier if I can just go get my desires met through pornography? I don't need to. I don't need to learn how to socialize better and go out and meet a girlfriend. I don't need to go through rejection. I don't need to talk to 10, 20, 30 people until I find someone. I can just do that. I don't need to understand what's happened in our relationship. Why has the spark gone away? It is a way of distracting. It is a way of Avoiding real problems in your life. And so I do think that feeling of anxiety.
- [67:23]
Michael Knowles
That reminds me of a comment, if you'll forgive the crass remark. There was a comment that a college buddy of mine made in college. He referred to procrasturbation.
- [67:37]
Dr. Youssef
Yeah.
- [67:39]
Michael Knowles
The feeling of anxiety. I have to write a term paper. I have to study for an exam or something. And that was actually the cause. He was describing, in a funny way, the very thing that you're describing.
- [67:49]
Dr. Youssef
I know. And before you had that, and maybe you would get up and go for a walk if you have some anxiety and you're just like, I don't want to do anything. I'm jittery. You'd work out. But now you can just do that and smoke a cigar.
- [68:03]
Michael Knowles
I don't know. That's what I do. I certainly don't work out. I occasionally go for a walk, but I don't know. Yeah, you have a cigar. Read a book. Like a pleasure book. Read.
- [68:13]
Dr. Youssef
Yeah.
- [68:14]
Michael Knowles
So if we're looking at systemic mental health problems, psychological problems, lifestyle problems, it seems to me one in five women, one in three women over the age of 60, being on these psych drugs is a big problem that we need to address. But if we're also looking at these social pathologies, the fact that virtually every young man in the country is hooked on porn that is damaging their relationships, screwing up their brains, that seems like a major issue to fix, too, before we start plying them with psych drugs.
- [68:45]
Dr. Youssef
Yeah, well, the issue with the psych drugs as well is they cause massive amounts of sexual dysfunction as well. So if we're gonna add, you know, I think the porn issue is definitely a distraction, and it's holding men back from going out there and just getting a girlfriend, getting married, and figuring that out. But these psychiatric medications, even the SSRIs, they cause profound sexual dysfunction, which is something that many people don't realize as well.
- [69:14]
Michael Knowles
Like you're talking about ed basically doesn't work or.
- [69:19]
Dr. Youssef
So there's two things there. So the first thing is that when people get on SSRIs, about 70% of them will experience. So it would be erectile dysfunction. It would be lower libido, muted orgasms, as well. You know, just a. Just a loss of interest. And they are told when they get on these medications, hey, this is just the trade off for not being depressed. It will go away when you come off the medication. What we have been finding recently. Well, not that recently, over the last 20 years, is some people, when they come off these medications, the Sexual dysfunction does not go away. It is permanent. And so they develop a condition called post SSRI sexual dysfunction. Based on what I've seen in the literature, the incidence is about one in 216, which. What? Yeah, I mean, I mean, so two. Yeah. Which is a huge amount when you.
- [70:12]
Michael Knowles
One in 200,000. I would never touch it. I would Never even consider. One in 216 men who use SSRIs will have permanent sexual dysfunction.
- [70:26]
Dr. Youssef
That's what I've seen on one study that has looked into that. And so if you think about 8% of men in the US are taking these medications, that's a lot of people now. So what PSSD does, and this is psychiatrists and doctors have been trying to explain this away for decades by saying it's performance anxiety. Hey, you have depression and anxiety. You're complaining about, you know, your sexual fun, your sexual functioning didn't return. You're just anxious. You have performance anxiety or something like that. They literally, it's, it's a horrific thing. They will develop something called genital anesthesia where they lose erogenous sensation down there. And it feels like, you know, what used to be sexually arousing actually just feels like you're touching the back of your hand or your arm. And so the sensation changes. On top of that, you know, they have the erectile dysfunction, loss of libido, all of that. They also develop cognitive, like really bad cognitive dysfunction, brain fog. And they feel lobotomized. They start to feel very dissociated, like severely numbed out on the medication to the point where they say, you know, if I hug my kids or I hug my spouse, like, I don't get like a warm feeling, you know, when I listen to that song from my childhood that I used to really enjoy, I don't get those prickles on the back of my neck of nostalgia anymore. They feel totally disconnected. And people hear me talking about this and they say they look like you right now. They look wide eyed in disbelief, Michael. And then I tell them this is already in the drug labels in the European Union, it's in the drug labels in Canada, it's in the drug labels in Hong Kong, it's in the drug labels in Australia. And this is where I'm so upset with the United States. Six years ago, the PSSD Network coordinated with other scientific professionals to submit a citizens petition to the FDA to get this put on the drug labels. And they've essentially just like let it sit on the back burner. They have not addressed it. This group also sued the FDA saying, hey, we need an action on this because the regulations say that they have to reply. I think it's within 180 days to any citizens petition. So they were asking, they were saying, here is the evidence. This is the same dossier we've given to the European Union, to Australia, to Canada. They have acted on this. They have put it in the labels. They are warning doctors about this problem already. FDA has just sat on this for six years. They sued them last year, I think, Sorry, I think it was earlier on this year to say, hey, we really want a decision about this. This is important. People need to know. And they dismissed it on a technicality. The FDA is sitting on this because they are trying to cover up one of the biggest scandals in modern medical history right now. And I think it is simply a disgrace. What's happening?
- [73:28]
Michael Knowles
Are you hopeful that this will now get through thanks to change in regime and Secretary Kennedy?
- [73:34]
Dr. Youssef
I'm very hopeful that this will come through because the thing that's happened in psychiatry recently, which is very unique, we're at a really interesting moment in time. Both conservative and liberal media are starting to actually turn on the establishment. For a long time it's just been the conservative outlets, but we've had articles in New York Times, Washington Post, npr. And once you start getting like liberal media as well as conservative talking about these issues, then that's where I think it's almost like the shame or the embarrassment or the fact that this is going to be a PR disaster for them is building up. So I actually think they are going to put it in there. But I think it's really sad because the American public, they deserved better than this. These. The FDA will review an entire dossier of scientific information, multiple clinical trials and animal studies in nine months to get a drug from a pharmaceutical company onto the market. But they've had this report for six years and haven't done anything. It's like their emphasis is on helping the drug companies and not on actually helping the American population.
- [74:44]
Michael Knowles
Well, Secretary Kennedy has for years warned about agency capture by the corporate interests that they're supposed to regulate.
- [74:52]
Dr. Youssef
Correct.
- [74:52]
Michael Knowles
There's nothing new. Obviously, the secretary understands the problem. Hold on one second. Go to goodranchers.com use code knowles. You know my feelings about Good Ranchers, Good ranch, Good ranchers powers me. I am at this point, I think at least 42% good ranchers meat. I had a delicious Good Ranchers ribeye just the other night. It is magnificent. With the holidays coming up, now is a more important time than ever to become a good rancher subscriber because you will get the absolute best meat at the best prices delivered straight to your door from American ranches. It's unbelievable. We're talking about 100% American meat from local farms and ranches delivered to your door. Super flexible. You can pause it, you can delay the boxes at any time. Very helpful for holiday travel. It's just the best. And you know, I look, there are so many great points about it. The fact that it is American, the fact that you know what you're getting, the fact that when you go to a grocery store, it says product of the USA or whatever. Very, very dubious labeling. It's just the best. And when I was a kid, you know, steak, that was like a real nice special occasion thing. You can make it part of your family's weekly multi time a week routine. It's just unreal right now. All new subscribers to any good rancher's box using code Knowles will get an additional $100 off your first three orders, 40 bucks off your first, 30 off your second, 30 off your third, and free meat for life when you subscribe. I don't know how it works. I think the CFO of good ranchers has the hardest job in America because the prices are just unreal. Go to goodranchers.com this holiday season full of delicious meals. Use code knowlescanawles goodranchers.com let's get back to the table. One of the neurological medical issues that's been dominating the news recently is that the Trump administration has said it's found a link between Tylenol and autism, that if pregnant women take Tylenol, it could lead to neurological problems in the kids, including autism. And this has led to liberal women guzzling bottles of Tylenol on camera and I think some have suffered serious adverse effects, actually. But then it turns out Trump didn't just invent this. Tylenol was treating about it themselves. And Tylenol said, we don't encourage pregnant women to take any of our products. Major medical institutions, Harvard, all the rest, the trade guild for the obstetricians and gynecologists who now say Tylenol is totally safe. They previously said that Tylenol had this connection to autism.
- [77:20]
Dr. Youssef
Your take, I think it's like, I mean, this reminds me of COVID and just the delusion that people have. I mean, it's like being on the left. I think they want to associate themselves with being the party of science. Right? That's. And that's it. And so if all of a sudden, you know, Trump is criticizing taking Tylenol. I hate Trump. He's obviously wrong. You know, you know, this, this is safe. And I'm going to do this despite him. I'm going to poison my body and potentially my baby with this medication.
- [77:58]
Michael Knowles
You're right. Of course. That's gotta be it. Because if Trump says it, it's unscientific and it's wrong. And then Trump says, no, no, I got it from Harvard and from the obstetricians and gynecologists and from Tylenol. I got it from them. And it's that, I guess the contempt for Trump, the presumption that he is anti scientific, trumps even the scientific credentials of the institutions and the drug manufacturer themselves.
- [78:23]
Dr. Youssef
Yeah. You know, and while we're on this topic, something that we didn't touch on, which I think is really important, is what the SSRIs actually do to the kids who are exposed to them when the mothers are pregnant. So anywhere between 3 and 10% of pregnant women are on SSRIs.
- [78:40]
Michael Knowles
Good grief.
- [78:41]
Dr. Youssef
Yeah. And so these drugs, they freely cross the placenta. And for a long time there has been concern about this idea that, okay, what is the impact of exposing a child's brain when it's going from the size of a speck to a fully formed brain in nine months? Like, if they are taking an ssri, that's going to kind of impact the serotonin system? Will that lead to changes over time that we should be concerned about? And so there's some pretty frightening research here. And I want to start quickly with the animal research, because you can't do a randomized controlled trial in, in humans at this stage where you just randomly assign some pregnant women to this and others, you can do it in mice. And so they do it in mice. And what they find is that the mice who are exposed in utero and during the sensitive periods of brain development, they grow up to display a higher rate of autistic like behaviors and decreased sexual activity. And so that is really concerning the other thing that we found.
- [79:46]
Michael Knowles
So hold on, because everyone's trying to figure out the cause of autism. Is it merely over diagnosed? Is it Tylenol? Is it vaccines? Is it, though I had not heard this before, that there might be a link between SSRI use in women, in pregnant women, and the development of autism.
- [80:03]
Dr. Youssef
Correct. So there is, there is epidemiological evidence, there's the animal studies, but there are some other studies which, which I'd like to touch on. I was just at the FDA about a month ago. I was talking with Marty Makari on a full panel about this. And we have 12 MRI studies now that show that the children who are exposed to these drugs in utero compared to do not. They actually have functional and structural changes on the brain scans. When you get the people exposed, the infants exposed and not exposed, they've also gone and looked at this later on when these exposed kids have become teens later on, and they find that there's actually changed signaling in the brain in the areas that control emotions, and that has correlated to worse mental health care outcomes. And so this is obviously worrying from the autism standpoint. But the other part of this is all of the transgender stuff that has been going on lately. I mean, you could say that a lot of this is, you know, social contagion. I mean, if you're on the left, you could say, you know, it's just increased acceptance right now. But since the early 90s, I mean, that. That's when we started putting a lot of moms on these drugs. And based on these animal studies, like, if these rats are growing up with decreased, you know, changes in their sexual functioning. Personally, I have also seen men who have pssd, who, after they have these sexual side effects, normal heterosexual men who used to be attracted to women, they find that they lose that attraction, and they start to question their sexuality. And so I hear these stories, and so I also wonder whether there is a link between putting kids while their brains are developing in utero and when they are children and before they have gone through their sexual maturity on these medications, which. Which have profound sexual effects and also impact the brain. What is that? What is that doing to people? Is this leading to asexuality? Is this leading to gender confusion? Is this leading to the rise in lgbtq? I mean, I've heard some stats lately that in Gen z, it's like 25% of them are associating with being LGBTQ. Yeah.
- [82:14]
Michael Knowles
Oh, yeah. And so that's reported by liberal media, NBC News, that sort of thing.
- [82:20]
Dr. Youssef
And so I do think that we need to ask that question. I mean, what is the impact of whether it's 3 or 10%? I've seen two different figures of pregnant women exposing their children to these drugs during development.
- [82:32]
Michael Knowles
Well, and also, there is a notable association between autism and the trans identity. So even just drawing a link between SSRIs and autism would get you an association with the trans ideology? Yeah. That's terrifying.
- [82:50]
Dr. Youssef
Yeah.
- [82:51]
Michael Knowles
We've talked a lot about the women turning to the men. And the boys, they seem to disproportionately like Adderall or be prescribed Adderall. I've never done an Adderall in my life. Some friends have referred to it as Diet Coke, though I've never been tempted. What is your take on the prescription or over prescription of Adderall for ADHD or just for people who call them smart pills at college or say they need them to focus at work?
- [83:17]
Dr. Youssef
Yeah, I think about a story of a friend of mine. His name's Cooper Davis. And when he was young he got put on Adderall because he was struggling in school. He ended up taking it throughout college and then he ended up going into journalism or something like that. Eventually the drug side effects caught up with him and he had to come off the medication. And when he was in his 30s, he realized that he had essentially been drugging himself into a job that he hated because off the medications he's like, I don't want to do this anymore. And so he had to reinvent his life at the age of 30 because he did not want to be on psychiatric medication anymore. And so that's one of the things that I really worry about in the US I feel like we worship at the altar of career success. And for many parents and for many students, that's how I have value. That's the most important thing for me. And they will drug themselves with these medications in order to succeed at that level. And so I worry that they're going to end up in careers that don't actually naturally energize them and inspire them and they'll end up doing things that they hate. The other thing about this, which this is what all parents should know, is the main effect of taking these stimulants is really to actually make boring subjects seem more tolerable and for kids to fidget less when they look at the long term academic outcomes. Now that's what most parents care about, like actual success. It doesn't do that. It does not convert to long term academic success because it seems like they're.
- [85:00]
Michael Knowles
Over prescribed because people want to stop boys from being boys. But listen, I wasn't fidgety. I was good in school. I was always good in school. And I had friends and classmates who were, who needed to sit down, but it was always on the assumption that, well, if you just get the kid to sit down and pay attention, then he'll get the good grades and go to the good college and get the good job. You're saying that doesn't happen?
- [85:23]
Dr. Youssef
No, it Just, it kind of sedates them. They become less of a problem for the teachers. The teacher can continue being boring. You know, they can be in a school system that really isn't that exciting to them. And the kid is just kind of, you know, on stimulants, like ultra, you know, chemically focused in just like doing the work. And they're like, okay, that's great. That's. That's great progress. They're not out there asking questions like, well, why do I think this is so boring? Like, what would actually be more interesting to me? Like, what would. What would energize me and bring me to life? They. They shut it down with the stimulant. And again we rob. We rob a person of the chance to be like, okay, school's not really for me, but like, I like this and I'm really interested in this and this is where my passion is going to be. And they would have done much better if they would just, you know, spend 10 years working on that passion. Eventually you can turn it into a job and a career and something that you love. But yeah, you can use Adderall to just push people through the dysfunctional school system into jobs that they hate.
- [86:26]
Michael Knowles
Okay, now I have a related question, but it's a little more personal. I have a lot of friends who are hooked on those nicotine pouches. Like heavy doses all day, rocking 15 milli lip pillies, double decky. Me, I'm not that into it, but I do have one or two pretty regularly. Low dose, but I'll toss one in once, twice, maybe three times a day.
- [86:51]
Dr. Youssef
Yeah.
- [86:54]
Michael Knowles
Is that bad? Is that like the Adderall? Is that diet Adderall? Diet, Diet Coke.
- [86:58]
Dr. Youssef
I don't think occasional use is bad when it comes to stimulants. And I'll lump in caffeine as well with this as well.
- [87:05]
Michael Knowles
I do a lot more caffeine than.
- [87:06]
Dr. Youssef
I do of the nicotine pouches in general. Nicotine and caffeine in randomized controlled trials, they do increase anxiety and they do impair sleep, especially if you go any more than a small cup of coffee, like before 10am Something like that.
- [87:21]
Michael Knowles
I have three pretty strong coffees a day ending at like 4pmHow do you sleep? Not well.
- [87:29]
Dr. Youssef
Yeah. Okay.
- [87:29]
Michael Knowles
I sleep poorly, actually, which you can tell from my under eye bags.
- [87:32]
Dr. Youssef
Yeah. So I'll tell a personal story. After my daughter was born, I was working at the fda and I was just come out of residency and it was a very new job. I was writing reports all the time and I Was drinking, like, three cups of coffee a day. And I was also using a lot of, like, chewing tobacco and, like, Zen, like, yeah, okay, all right.
- [87:53]
Michael Knowles
That's exactly.
- [87:53]
Dr. Youssef
Yeah. But every day, not like, one. Occasionally. Now, then, like, kind of like, you know, five to eight pouches in my mouth, like, heavily stimmied out.
- [88:01]
Michael Knowles
Wow, okay.
- [88:02]
Dr. Youssef
And working. Yeah.
- [88:03]
Michael Knowles
Yeah.
- [88:04]
Dr. Youssef
I ended up developing insomnia, and I started taking Xanax from a nurse practitioner as well. And so it kind of like, spiraled out of control. And then all of a sudden, I was taking Xanax every day for six months, and that started to make me worse. And then, thankfully, I caught it and I was able to come off at the time. Now, when I stopped drinking coffee and I stopped using so much chewing tobacco, I started sleeping like a teenager. And so what I would say is, for anyone who's having difficulty sleeping, for anyone who feels keyed up and irritable when they're sitting down with their kids at night and reading a book, and they're just like, I'm just uncomfortable. I just don't feel relaxed. I don't just feel at ease in my skin. Look at your stimulant use. Now, this is not going to be a blanket. Yes or no? I know lots of people who can have a cup of coffee a day and some nicotine pouches, and they're fine. But there are people who are sensitive to it. And so if you are having these issues, I would recommend come off the stimulants. Give it about five weeks or so. You will feel like a potato. You know, you just. It's really hard to concentrate, like, if you've been using a lot of them. I know I felt that way and I went through it, but you make for me. I came out the other side with much better sleep and a very smooth energy curve. I mean, the big thing that I used to beat myself up on was when I would read to my daughter at night, I'd feel restless, and I'd be like, I can't wait for this to be over. That doesn't happen anymore. I'm much more grounded and calm because I'm not on this stimulant kind of withdrawal roller coaster at the end of the day. I'm glad you brought that up, because I actually think caffeine and nicotine can be really overlooked as drivers of anxiety and depression, especially if you're using excessive amounts and it's impacting sleep.
- [89:53]
Michael Knowles
This might actually have led me to change my behavior. I went in here thinking, I'm not depressed. I don't really feel anxiety, but I. A little bit with the nicotine and definitely with the coffee. All right. And sometimes I get a little restless. I'm reading those books at night, too.
- [90:08]
Dr. Youssef
Yeah. Well, give me a call. And, you know, if you come off it and it improves, I would love to.
- [90:14]
Michael Knowles
I can be a testimonial.
- [90:15]
Dr. Youssef
Yeah, yeah, yeah.
- [90:18]
Michael Knowles
My question then is if all these drugs are so bad, if they not only don't deliver the promises they say they will, but they actually make patients worse. On such a wide scale, why are they so frequently prescribed? Is it just money? Is it just big pharma wants to make another buck? Or is there something deeper going on?
- [90:47]
Dr. Youssef
So I've thought about this a lot. I'm going to hit this at multiple levels, Michael. The first thing that I'm going to say is that for some people who have overwhelming, complicated problems, they want to believe that they have a chemical problem. They don't want to believe that they have problems that they can actually have agency over. It is reassuring to be like, it's not me, it's not my fault, it is my brain. And we should help those people break down their problems into little steps and guide them out of that. So I think there is a psychological component for some people.
- [91:18]
Michael Knowles
Say if it's something in my life and I have to figure out how to untie this knot.
- [91:24]
Dr. Youssef
Yes.
- [91:24]
Michael Knowles
And I can't figure out how to untie this knot, I'm going to be even more despairing than I already am. Please just tell me it's the structure of my brain and I can take a happy pill.
- [91:34]
Dr. Youssef
Correct. Yeah. That is psychologically a much more comfortable place to live in. Yeah. Not my fault. So. So there's that. And I know we. I touched a little bit on the. On the pharmaceutical industry at the start. People do not realize that when you have a billion dollar industry, and that's what this is, you know, with a big B, you know, they control the whole narrative about this. And so all of the academics at the leading institutions are all running clinical trials for drug companies. That's essentially how you become the head of Harvard, Yale, Baylor, Mount Sinai, any of these places. They are training the next generation of doctors. They are imbuing them with this idea that these are medical problems still, even though there's no evidence of that depression is a medical problem and these drugs are safer and more effective. I think we have really perverted guild interests coming out of the American Psychiatric association, where, you know, psychiatrists, we kind of differentiate ourselves from the other mental health professionals as being the ones who have the drugs. And so our, our organizations are also very pro drug as well. And so they overhype the benefits, they minimize the harms because it makes us look better and feel more important. But the final thing, and this is what I think that a lot of people, they already know this, I'm going to say this, but they've been feeling it for years, the insurance industry. So doctors are incentivized to see more patients in less time. You make more seeing four people in an hour than you would spending an hour with one person and helping them through their issues. And so when you just have like a family medicine doctor there who's got 15 minutes with you, you spent half the time talking about your cardiovascular health and then you say you're being depressed, that person has an incentive to get that wrapped up as quickly as possible. I mean, they could ask you about all of those things, but all of a sudden you're crying. All of a sudden there's a huge emotional load. It gets messy. They don't want to deal with it. So it's so much easier for them to say, well, you've got five out of nine symptoms on this depression rating scale. This means you're depressed. And you know, I don't want to hear about your problems, but I've got an FDA approved solution for this. Take the Lexapro.
- [93:52]
Michael Knowles
Yeah, I have a 1:30t time, so we're gonna. But I don't want to leave you with nothing.
- [93:57]
Dr. Youssef
Yeah. So it's a very clean, efficient way for them to end, to end the visit. And you know, and I, I don't want this to sound too hard on doctors because I know they, they want to help people, but it's just crazy that we've told the American public that they can actually go to their family medicine doctor and expect this person who has no training in relationships work. You know, they don't even help you with your physical health. I mean, they're just kind of dishing out statins these days.
- [94:30]
Michael Knowles
Yeah.
- [94:30]
Dr. Youssef
That we even expect them to do this. And so one of the big structural problems in psychiatry I think is we need to make coaches more available, you know, so you can go and see a family doctor and they don't feel like, oh, shoot, I have this person in 10 minutes. Here's a script. They go, you know what, you're having dietary problems. Don't worry, in my office we've got a dietitian. They're going to sit down with you. You're going to be able to get that taken care of. We have a lifestyle person, you know, we have someone who helps with relationships. We have someone who helps with purpose and meaning. We run groups here, you know, three days a week. You can come at 5:00'. Clock. We have a small group. We're doing these, these sessions where we can really help you over time. We don't need to look for a quick fix. That's the kind of mental health, mental health care that we actually, that we, that we need now.
- [95:20]
Michael Knowles
Because when you say the word coach, I like the idea that you're suggesting. When you say the word coach though, I think of like the scammiest, scuzziest guy who calls himself a guru all around life coach who knows the answers to everything and no proof that he's ever learned anything in his life.
- [95:37]
Dr. Youssef
Correct.
- [95:37]
Michael Knowles
But that's not what you're suggesting. You're suggesting. No, no, no. Here we're gonna have your dietary counselor and they're just gonna be kind of focused on that and we're gonna have, I don't know, coaches, but in, let's.
- [95:51]
Dr. Youssef
Just say, let's say expert, you know, an expert. Someone, someone with training. I don't necessarily think they need to be a registered dietitian or they need to be a licensed psychologist. I think they need to be someone who has training in the area that you are struggling.
- [96:06]
Michael Knowles
Yes. Well, think about it. When you go to the doctor, you're dealing with a physician's assistant the whole time anyway. How frequently are you actually talking to the board certified medical doctor for like two seconds every visit.
- [96:16]
Dr. Youssef
Yeah.
- [96:16]
Michael Knowles
So we, and we do this in every other part of our life too. You don't, you don't always need, you know, the gold standard, credentialed top person.
- [96:24]
Dr. Youssef
And in fact, and here is one of the, and this is why, you know, I may seem a little like kind of foofy because I'm like, oh, you know coach. And you know, this and that. But I actually think we need to wrestle away personal development from licensed professionals. One of the most effective treatments that we have for addiction is actually aa. And so Alcoholics Anonymous, this is, you can do a secular version, but traditionally it's a Christian faith based 12 steps, which is essentially a curriculum you're taking, taking a moral inventory, righting your wrongs, you know, admitting that you're powerless, handing your life over to something greater than yourself and allowing it to help you change. You do that in unstructured, you do that in group settings. Peer to peer. AA is One of the fastest growing community organizations out there. Many of them are kind of withering away. AA is growing. People really like it. These are not professionals. These are people helping each other who have a good curriculum.
- [97:26]
Michael Knowles
And so, you know, it's amazing too, I have friends, people I've known over the years, vastly different political views, vastly different ages, vastly different lifestyles. I mean, friends as disparate as you can possibly imagine. Religious, all of it. I've never heard anyone talk smack about aa and for people who have gone to it, I've only ever heard how much it benefited their lives. Yeah, totally across the spectrum.
- [97:54]
Dr. Youssef
And so, I mean, I would like to see us stop relying on professionals for these problems. I would like us to see. I would like us to be helping each other in community. I have a close friend called Laura Delano. She has a, a group called Inner Compass right now. And they are doing this kind of work for mental health problems. They are getting people together who are coming off these medications. They are putting them in peer led groups together. They've given them a curriculum. She is doing amazing work. And I really think we should be thinking more creatively about how to help people outside of. Go and see that doctor for 15 minutes.
- [98:31]
Michael Knowles
Okay, but hold on. Now this, I totally agree with you, but this then raises a question that some people aren't going to want to confront, which is you say, look, we need to stop worrying about all these credentialed people and focus on what's really working. And look, AA is really working. And there's some spinoffs, but it's kind of the OG one, which is really just a kind of practical instantiation of Christian counseling and. Well. Right. So I've thought about this even personally, how I can help some of my depressed friends where I could point to all the problems in their life. But I say ultimately, I think what a lot of it comes down to is they don't want to admit that God exists and wants things for us. And they want a secular version, they want a scientistic version. They say, oh, I could never. Don't bring your religious mumbo jumbo in here. And my sneaking suspicion is if you don't to some degree acknowledge God in your life in the AA way, to hand your life over to a higher power, an unnamed higher power. If you don't in some way do that, you're just not going to get better. Am I overstating it?
- [99:45]
Dr. Youssef
I need to think about that. I need to think about it more because I think the thing that I love about Christianity and I love about religion is that there is a right and wrong there. There is a way to do things. There are the values in there. Things like, you know, live a life in service of others. Can you think of, you know, any better timeless advice that has always, you know, led to fulfillment and good relationships and all sorts of, like, if you just follow that, all sorts of wonderful things happen into your life, you know, righting your wrongs, you know. And so I do wonder that. That I think that we are in a mental health crisis right now because of the loss of religion and because we've lost the timeless moral values that have come through religious teaching.
- [100:34]
Michael Knowles
I just suspect if I were a. I think if I were an atheist, I would be some form of hedonist. I'm not saying I would necessarily do a bunch of blow and hookers and stuff all day. I'm saying a hedonist or an epicurean, at least in the sense that I would. I would just do things that gave me pleasure, ideally higher pleasures, because I would have the reason to recognize that higher pleasures are a little less destructive than lower pleasures. But I think at the end of it, at some point, if I were those things, at some point I think I would kill myself. Because at some point I would become frail, become injured, become old.
- [101:12]
Dr. Youssef
Fill it inside.
- [101:13]
Michael Knowles
Yeah, at some point I'd just have enough. I'd probably just have had enough of the pleasures and I'd probably kill myself, which I think is mortally sinful and very, very terrible. But I don't. Without the existence of God and what that means for my place in the cosmos and how I should behave, I don't see how I would not at least be inclined toward the end point of depression, which is what we're all talking about.
- [101:42]
Dr. Youssef
And you'd be right, even statistically, because that's what we find. Yeah, you're less likely to be depressed if you grow up in a religious household. I mean, that's what we're saying. That makes sense.
- [101:58]
Michael Knowles
But imagine, you know, you're a psychologist. Like, if I were a psychologist, I'd probably give roughly the same advice to all of my patients and say, like.
- [102:06]
Dr. Youssef
Hey, some people would freak out. You need God in your life.
- [102:09]
Michael Knowles
You need God.
- [102:09]
Dr. Youssef
Like you're some radical.
- [102:10]
Michael Knowles
Yeah, the thing that every wise person has said for all of human history and every peasant, statistically, as probably for all of history, like, you need God. You need, like, good is to be done and pursued and evil avoided, kind of, you should live in an ordered way, kind of basic stuff. But if you could a psychologist get away with that? Now the patient comes in, oh, they'd get reported. They'd get reported. They'd lose their license probably.
- [102:37]
Dr. Youssef
Yeah, they would get reported. They would get, you know, negative reviews. This person pushing their ideology on me, this white male psychologist, conservative, you know, you know they are coming after. Yeah, they would come after you.
- [102:51]
Michael Knowles
The main thing that can help, you're not allowed to encourage.
- [102:55]
Dr. Youssef
I know it's so crazy because we know how effective AA is, but therapy is. They are so agnostic from all of that. And you've put your finger on what I think is one of the biggest problems in the mental health industry is that lack of direction in a guise to be accepting and all of that. They have completely removed any moral teaching from therapy. It's what do you think? What makes sense for you and your world and your family and all of that? Yeah.
- [103:24]
Michael Knowles
Cause this would be one reason why I would hesitate to go to a psychologist if I felt great psychiatric stress, which I don't happily, but if I did, plenty of people do. I would be reluctant to go to a psychologist because of the value neutrality of it in a secular culture. In order to have confidence that someone can give me the advice needed to improve my life, I need to know that they have a proper conception of what is good and what is bad. That is the most basic thing that they need to have. And the way that the system is set up, generally speaking, I have no way of knowing if that's true.
- [104:05]
Dr. Youssef
No, no you don't. And they don't even want to mention it on their websites because they're going to freak some people out or make them feel nervous. But you're right, I mean, good and bad is important. And have you fixed the actual problem that I'm having? You have no way of knowing that either. And the thing that surprises people is most of these therapists that come out, they've been trained in cognitive behavioral therapy. It's just essentially a manual that teaches people to reflect on their thoughts. There's nothing practical in these major areas of your life. It's a sad state.
- [104:39]
Michael Knowles
Rather than just reflect on your relationships like hey, leave your alcoholic pervert boyfriend, how about you just do that? Your life's gonna improve 800%. You do that.
- [104:52]
Dr. Youssef
Yeah, they would.
- [104:52]
Michael Knowles
Sorry to be judgy.
- [104:53]
Dr. Youssef
They'd be like, no, you have to let the patient discover it for themselves, you know, to ask open ended questions and maybe they will fall upon that truth in a couple of years.
- [105:02]
Michael Knowles
Yeah, yeah, yeah. Do you think you should leave Your alcoholic pervert boyfriend.
- [105:06]
Dr. Youssef
I don't know. I would be like you to.
- [105:07]
Michael Knowles
Don't want.
- [105:08]
Dr. Youssef
You don't want to enforce your views on them.
- [105:09]
Michael Knowles
You know, it's like, well, what am I here? What are they paying me for?
- [105:12]
Dr. Youssef
I know, yeah.
- [105:13]
Michael Knowles
I thought they were paying me for my views. No, maybe not. Because I guess there is this pretense that, you know, okay, in religion or in philosophy or in coaching even, that's, you know, that's got values, that's got a point of view that's loaded and prejudiced. But therapy is neutral. Therapy is scientific and therefore it's totally neutral and outside the realm of value judgments.
- [105:42]
Dr. Youssef
Correct? Yeah.
- [105:43]
Michael Knowles
Which is obvious. Not only false, but absurd. Absurd because it's impossible.
- [105:49]
Dr. Youssef
Yeah. And it doesn't work. And we know a lot of these other things work. We've seen it in aa. We see it bearing out in the statistics that why are people who are brought up in religious households happier? You know, what is it about that? What is it about their relationships and the way that they live their life and work? Do you think you could learn from that and bring some of that into therapy? But they don't. It's because it comes from academia, it comes from these colleges and these institutions, and they are allergic to that.
- [106:19]
Michael Knowles
So can psychology be reformed? This is a question that comes up with the academic institutions. Can they be reformed? Do they have to be bulldozed? And do we need to start again? Is there a way to reform the APA and the way that psychology is practiced? Or no, do we need an alternative?
- [106:42]
Dr. Youssef
I think, I think it is being reformed. Let me speak to psychiatry right now, because we're having, recently we're having some really big changes going on. So right now the. We've been able. Pharmaceutical companies have been able to do direct to consumer advertising since, since the 80s. And now the Trump administration with Secretary Kennedy, they are putting new rules there or they're rolling back exemptions to it, where essentially they have to list all of the risks with the medications on the ads, which will essentially make it impossible to do these big broadcast ads. Because the risks.
- [107:24]
Michael Knowles
You only get 30 seconds.
- [107:25]
Dr. Youssef
You only get 30 seconds. The risks are too much. So we're going to get back the media, right? And so that's going to. Because right now the media doesn't report on these things because they don't want to upset their advertisers. And so I think we are going to get the media back from the, from those moneyed interests.
- [107:40]
Michael Knowles
Well, that's a great point that actually Is might be lost on some people. And because it only occurred to me just now, anyway.
- [107:45]
Dr. Youssef
Yeah.
- [107:46]
Michael Knowles
When you're watching the new the nightly news and they advertise some depression drug on there, the question is not merely does the pharma company have the right to advertise at all? It's also how does the fact that the news is supported by the pharma company change the way that the news itself is reported?
- [108:07]
Dr. Youssef
Obviously, I'm glad you brought that up. And it is a good point to emphasize. Yes. There is a reason that, you know, editors aren't covering this stuff. This story comes across their desk and they go, do I really want to run this story that has a negative perspective of this drug when I'm making, you know, several million dollars from the manufacturer here?
- [108:26]
Michael Knowles
Right.
- [108:27]
Dr. Youssef
Aren't they just going to take their ad spend and go to some other company? I don't want to have to fire people. I don't want to have to let people go. And so, yes, that's exactly what's happening. And so when that ends, I think people are going to one, they're going to hear about the risks of these medications. They're not going to get such a lopsided view. And I hope we actually have. And people aren't going to like me for saying this. A much smaller pharmaceutical industry, I think jobs need to be lost. I think there needs to be less of an incentive to shove these drugs down the throats of Americans and things like that. I think we need less of that. If the pharmaceutical industry shrinks their influence over medicine over the American Psychiatric association, all of that will lessen. And I think that will trickle down into practice. I mean, when you lop off the head of the biggest negative influence in the space, which is the pharmaceutical company, I think the downstream effects will lead to much more balanced, correct mental health care.
- [109:30]
Michael Knowles
And even for those who would object and say, well, that would have a negative effect on jobs in America or GDP in America, I would say, well, you know, GDP is not all the same. Jobs are not all the same. And so wouldn't it be better to put American resources toward building things, innovating, rather than frying the brains of menopausal women?
- [109:48]
Dr. Youssef
Yeah. Yeah, I was just gonna say that. Yeah. Should we, should we measure the success of a comp. Of a country over the fact that we. Yeah. We don't have, you know, over a fifth of people taking these medications? Right. Wouldn't that, wouldn't that be a wonderful thing?
- [110:01]
Michael Knowles
Right.
- [110:01]
Dr. Youssef
Yeah. And that we're not having you know, one out of 216 men on these drugs, essentially, with sexual dysfunction and all of the problems that go on with that. I mean, that's so dark. It's so evil.
- [110:15]
Michael Knowles
Dr. Youssef, you if you had started the show just with just with the warning that this high number of men who take the SSRIs will have lifelong sexual dysfunction, I think we could have persuaded at least half the country not to take these drugs in about 15 seconds, rather than an hour and a half. In any case. Marvelous to hear all of this really, really important perspective. And thank you for hopefully helping to fix the minds and spirits of many, many Americans.
- [110:46]
Dr. Youssef
Thank you for having me, Michael.