A Harvard Neuroscientist Says We’re Medicating Normal Human Behavior | Dr. Adam Omary EP 237

Summary

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Podcast Summary: The Mikhaila Peterson Podcast

Episode Title: A Harvard Neuroscientist Says We’re Medicating Normal Human Behavior | Dr. Adam Omary
Host: Mikhaila Peterson
Guest: Dr. Adam Omary
Episode #: 237
Date: June 11, 2026
Duration: ~1 hr 22 min

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Overview

This episode features Dr. Adam Omary, a psychologist and neuroscientist who previously studied at Harvard, in a nuanced conversation with host Mikhaila Peterson. The central theme investigates the modern mental health crisis, the rise of psychiatric medication use (especially SSRIs), and the problematic overdiagnosis of what may be normal human experiences. They also discuss policy implications, societal trends, incentives in healthcare, and the wider context of human progress amidst unprecedented abundance and technology.

Omary draws on research—and his new work at the Cato Institute—to critique the medicalization of normal behavior, discuss shifting diagnostic boundaries, and explore the tension between libertarian ideals and effective policy responses to social, psychological, and institutional challenges.

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Key Discussion Points & Insights

1. The Modern "Crisis of Meaning"

Timestamps: 00:00–01:20, 32:25–35:51

• Comparison to Ancient History: Omary likens current "crisis of meaning" to Marcus Aurelius’ “emperor world problems,” noting that unprecedented affluence and ease create new existential challenges.
• Agency in Abundance: Abundance and lack of traditional threats shift our psychological battles toward meaning, responsibility, and motivation.
  • Quote:
    • “What we’re seeing now, this crisis of meaning, is basically emperor world problems at scale because we’re wealthier than any other time in human history.” —Adam Omary [00:17, restated at 32:48]

2. Gender Dysphoria & Controversial Treatment Protocols

Timestamps: 01:20–10:43

• Explosion in Diagnoses: Omary details how rare intersex conditions—formerly the main context for gender dysphoria—are now dwarfed by a surge of mostly adolescent cases, especially among teenage girls.
• Medical Interventions: Critique of puberty blockers and cross-sex hormones as experimental and, in many cases, harmful.
  • Quote:
    • “The Gender Affirming Care Protocol, hormonal and surgical intervention, has been a disaster...It’s a sensitive period for brain development, so we don’t understand the long-term side effects.” —Adam Omary [02:59]
• Research Climate: Harvard advisor Steven Pinker’s support was crucial; most mentors were unwilling due to controversy.

3. Overdiagnosis and Psychiatric Medicalization

Timestamps: 13:00–16:55, 65:31–67:47

• Expanding DSM: Each new edition broadens definitions and criteria, fueling a jump from ~130 pages to over 1,100.
  • Quote:
    • “Across virtually every condition, I think we’re overdiagnosing...30% of American college students are on psych meds, mostly SSRIs.” —Adam Omary [15:28]
• Pathologizing Normalcy: Ordinary distress or adjustment is routinely labeled and medicated.
• ADHD Example: School structure and expectations pathologize normal childhood behavior—especially in boys.

4. Societal Incentives & Policy Shifts

Timestamps: 17:02–23:06, 70:56–71:29

• Affordable Care Act’s Effect: The 2010 Mental Health Parity Act required insurance coverage for mental health, incentivizing diagnostic inflation (“supplier-induced demand”).
  • Quote:
    • “Immediately after that, in 2013, is when we have the most recent and also the largest and most expansive and loosest diagnostic criteria edition of the DSM.” —Adam Omary [21:51]
• Insurance & Diagnostic Inflation: Coverage requirements push practitioners to diagnose for reimbursement, even for adjustment to normal life stress.

5. The Limits of Psychiatric Medication

Timestamps: 16:57–19:02, 79:51–81:37

• Withdrawal Problems:
  • “APA doesn’t even recognize SSRI withdrawal. They call it discontinuation syndrome.” —Adam Omary [17:28]
  • “People internalize these diagnoses as though they have something wrong with them, when really life is challenging and we need social support.” —Adam Omary [72:14]
• Long-term Effects Unknown: Data suggests a substantial fraction cannot discontinue SSRIs without significant difficulty and withdrawal.

6. Social Media, Technology, and Mental Health

Timestamps: 19:02–32:25, 54:50–56:15

• Causality vs. Correlation: Most studies only demonstrate correlation between screen use/social media and negative outcomes; introverted, lonely kids self-select into more online time.
  • “The most robust effects aren’t on mental health...the most robust effects of screen use are on attention span.” —Adam Omary [23:06]
• School Bans and Academic Performance: Bans improve standardized test performance, likely due to removal of distraction rather than tech causing cognitive decline.

7. Solutions: Responsibility, Parenting, and Agency

Timestamps: 30:39–32:25, 35:51–39:14, 37:00–38:37

• Regulate or Not?: Government bans on tech access prompt workarounds and can worsen outcomes; responsiblity for children’s tech exposure should be primarily with parents.
  • “Do we regulate or leave it as a responsibility of the parents?...In any other case a kid gets access to a firearm or drugs, then the parent will be charged with negligence.” —Adam Omary [30:39]
• Teaching Resilience: Omary and Peterson agree that agency, responsibility, and working on real life problems are core to building meaning and resilience.

8. Human Progress & The Cato Institute

Timestamps: 13:03–15:27, 39:23–42:54, 52:23–53:58, 56:27–59:46

• Omary’s Role: Focuses on data-driven approach to social and mental health progress, noting improvements in lifespan, disease, literacy, and economics—contrasted with the mental health “crisis.”
• Progress Psychology: A proposed subfield analyzing what psychological traits optimize progress, and how negative traits (tribalism, negativity bias) hinder it.
• Think Tanks, Policy, and Public Discourse: Cato’s nonpartisan libertarian approach allows for greater diversity of ideas; faster, more public-opinion-facing work than academia.

9. Trade-Offs, Modernity, and Institutional Trust

Timestamps: 44:15–50:49

• Physical and Mental Health Trade-Offs: Industrial food, birth control, and abundance increase agency and longevity but have side effects.
  • “Everything is trade offs...we’re not atrophying our brains, but we’re trading off a type of long term delayed thinking into a type of multitasking and fast paced information processing.” —Adam Omary [46:41]
• Collapse of Institutional Trust: COVID and frequent manipulation have left populations cynical and less trusting of institutions, compounding adaptation challenges.

10. Philosophical Foundations: Libertarianism & Agency

Timestamps: 76:28–79:51

• Free Will and Determinism: Omary introduces the connection between libertarianism as a philosophy of agency and its psychological importance.
  • “If you act like you don’t have free will, then all that happens is you get bitter and resentful and you use your free will in unproductive ways.” —Adam Omary [77:42]
• Resilience and Suffering: Peterson emphasizes that learning to suffer well and anticipate eventual relief fosters hope and robust mental health.

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Notable Quotes & Moments

• On Overdiagnosis and Pathologizing:

  “According to the NIH, according to the National Institute of Mental Health, 50% of American adolescents have met criteria for mental illness at least once in their lives...If it’s 30 to 50% of the population, it’s ordinary levels of distress. And we’ve forgotten that.” —Adam Omary [65:56]

• On the Narrative of Progress:

  “People don’t like to hear it. They get weirdly defensive, like they’re clinging on to the narrative that the world is so bad. I don’t know why, but yeah, you look at the data...” —Adam Omary [41:33]

• On Medication and Honest Disclosure:

  “Take psychiatric medications if you want to, but know what happens if you’re on them long term. Like, you should be told that…” —Mikhaila Peterson [49:33]

• On Philosophy of Agency:

  “I like this libertarian philosophy of rather than, you know, you’re a victim of your hormones and it needs to be diagnosed as something’s wrong with you, like you’re recognizing ahead of time this is a predictable result. And I’m just going to try to navigate around it with my free will and with my agency.” —Adam Omary [79:42]

• Memorable Exchange:

  “I went to college because I had to. I go to Peterson Academy because I want to.” —Adam Omary [11:53] (reflecting on shifts in education and motivation)

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Noteworthy Sections with Timestamps

• Harvard research & controversy: 03:40–04:21
• Gender affirming care outcomes: 04:21–07:15
• Financial incentives in mental health diagnosis: 13:00–16:55, 19:02–22:37
• DSM expansion: 15:28
• SSRIs, their side effects, and withdrawal: 16:57–19:02, 17:28
• Correlation vs. causation (social media & youth mental health): 19:02–23:06
• ADHD overdiagnosis: 65:31–67:47
• Philosophy of agency and resilience: 76:28–81:37
• Book and future projects ("Psychology of Progress"): 39:23–41:33
• Data & resources:
  • Human Progress project: humanprogress.org [13:03, 41:33, 81:45]
  • Peterson Academy offering: 10:32–11:53, 81:54

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Resources & Where to Learn More

• Dr. Adam Omary at Human Progress/Cato: psychology.humanprogress.org [81:45]
• Human Progress Twitter/X account: @HumanProgress

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Tone & Style

The conversation is intellectually rigorous but accessible, candid, and occasionally humorous (dark jokes, anecdotes about academic bureaucracy, references to Stoicism). Both Omary and Peterson emphasize skepticism, humility, and the provisional, evolving nature of science—alongside a libertarian-leaning wariness of government overreach and institutional groupthink.

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This episode provides a detailed, critical exploration of the rise in mental health diagnoses and medication, ties them to policy and societal changes, and situates these challenges in the context of overall human progress. Both experts advocate for personal agency, responsible skepticism, and data-driven reforms over simplistic narratives and interventions.

Transcript

[Adam Omari]

Marcus Aurelius, he's an emperor 2,000 years ago, and he writes about, I don't want to get out of bed. I'm worried about gluttony because I have, like, literally all the best food in the world brought to me on a platter. So he has extreme first world problems. And what we're seeing now, this crisis of meaning, is basically emperor world problems at scale because we're wealthier than any other time in human history.

[Michaela]

Adam Omari, welcome back to my podcast.

[Adam Omari]

Glad to be back. As harmful as they've been, 30% of American college students are on psych meds, mostly. SSRI' APA doesn't even recognize SSRI withdrawal. They call it discontinuation syndrome.

[Michaela]

I don't even know how to explain that.

[Adam Omari]

In order to mandate age, to prevent children from being able to access harmful content online, it means that you have to have age checks for all users, including adults. That introduces unconstitutional privacy risks.

[Michaela]

Doctor Adam Omari, welcome back to my podcast.

[Adam Omari]

Glad to be back.

[Michaela]

You're a doctor now?

[Adam Omari]

I. I am. I managed to survive Harvard.

[Michaela]

That's amazing. You're alive. You look good. Okay, so we want. Well, first of all, if anyone hasn't seen the old episode, can you give a brief background about who you are and what it is you do?

[Adam Omari]

I'm a psychologist and neuroscientist, and I was at Harvard studying gender dysphoria. But in the last episode, we didn't talk so much about that. We talked about hormones and brain development, sex differences in brain development, particularly during puberty and intersex conditions. So I did a lot of research before I got to studying the transgender phenomenon. Research on very rare intersex conditions, genetic anomalies, most of them endocrine disorders, that result in hormone imbalances, that result in personality differences, including, in extreme cases, gender dysphoria, and in even more extreme rare cases, intersex ambiguous phenotypes and genitalia, which definitely connects to the transgender debate. And that's how I became dragged into this research. And what I tried to talk about in our last podcast is on both of these extremes of the transgender abate, on the transgender activist side, you often hear these radical claims of, sex is a social construct. Sex is a spectrum, it's not binary. And often, if you inquire what they mean, they'll say, well, look at all these intersex conditions. And it's true, they exist, but we're talking about one in a hundred thousand people for any particular condition or fewer. So those exist. But it's not just that. It's not like intersex is a third sex. It's. They are genetically male or female, and they have these specific anomalies that lead to these specific intersex phenotypes. And they can be much more likely to experience gender dysphoria. So I made the case that historically, transgender people very likely had some rare genetic condition that resulted in them feeling like they're in the wrong body. And I have a lot of sympathy for those cases. But as we've seen in the last decade or two, there's been an explosion in gender dysphoria cases in. Yeah, especially in teenage girls. And the Gender Affirming Care Protocol, the hormonal and surgical intervention has been a disaster. I warned about that when we did this podcast two years ago, and I managed to do my dissertation on what is driving this surge in gender dysphoria cases, particularly among teenage girls.

[Michaela]

Wow. How was that dissertation received?

[Adam Omari]

In different ways, better and worse than you would expect. So the better than you would expect is that as an institution, Harvard protected me and my advisor, Steven Pinker, made it possible. So on one hand, if there was not an advisor who was willing to support me doing the research, I wouldn't have been able to, period. And at Harvard, Pinker was the only person. So I'm very grateful that I had his support. It is concerning that everyone else was not willing to do it, and I ended up switching advisors to be able to pursue this topic.

[Michaela]

Oh, I didn't realize that.

[Adam Omari]

Yeah, because I was in the neuroscience lab studying hormones and sex differences. And in that lab, that's where I learned about mostly from animal research. It was animal research where puberty blockers were first administered. And you see, the tragic part is that that the things that sex hormones do to the brain during puberty, people talk about adolescence as a sensitive window for higher order cortical development. The types of prefrontal cortex regions that help mature emotion regulation capability. So the theory for gender dysphoria is if you're prescribing puberty blockers because the secondary sex characteristics of puberty are distressing, because you have this felt mismatch between your biological sex and your desired gender identity, and that's going to exacerbate depression, anxiety, and in extreme cases, suicidality, the strong argument was always, would you rather have a trans kid or a dead kid? And they point towards the high suicide rate among transgender people, which is true, they do have among the highest suicide rate. But that's very different from A causal argument of if you don't give them puberty blockers or hormones or surgery, then they're going to be more likely to commit suicide. And the part that really disturbed me is that we know just from typical variation in hormone levels, especially across the menstrual cycle or on birth control, that hormones can massively impact your mood, and that's within normal small scale fluctuations. So if you're talking about far outside the range of normal development, cross sex hormone and hormone administration, that is much more likely to destabilize your mood in a way that can paradoxically make the very suicide outcomes that were tried to prevent much worse. Yeah, and we didn't have the data at the time that we last spoke two years ago. Now we have more robust longitudinal evidence on this first cohort of kids that were on puberty blockers and cross sex hormones. And it's exactly what you'd expect to find. Unfortunately, the majority of them, which who already had very high rates of depression, anxiety and suicidality, they get even worse. And again, the tragic part is it's a sensitive period for brain development, so we don't understand the long term side effects of it. It's not just that they're worse, they come off of the hormones and then they're better. Hopefully that's the case for many of them. But because you're messing with brain development during this sensitive window, we don't understand the long term side effects. Also on fertility, many detransitioners, like I know you've interviewed Chloe Cole, they're going to have lifelong side effects from these protocols. So I'm really concerned about that. I'm glad that the pendulum has shifted back. I joke that instead of gender affirming care, we should have called it Dysphoria Enabling interventions or dei.

[Michaela]

Oh, yeah, that's not bad. Dark, but good. Oh, man. Okay, so how do we want to start this? So I like, from my political position, I suppose, and what I'm exposed to, what I see is this huge pushback against the transgender movement, listing things like, there's actually increased suicidality when you give gender dysphoric people these treatments. What are you seeing? Do you think that's representative of America? Are we moving away from it? Are hospitals starting to shut down these, like, transition clinics? Is that like, are we actually going in the right direction now?

[Adam Omari]

There are many lawsuits being filed by detransitioners for medical malpractice. And as we talked about last time, the whole thing was an experimental protocol to start. Now, I've met many of these psychiatrists and I believe most of them are acting in good faith. And it's a reasonable ish hypothesis that, okay, if the gender dysphoria is caused by these bodily features that are causing such strong distress, then maybe if we intervene, then we can help them. It's about as reasonable sounding a theory to me as looking at someone who has anorexia and thinking, okay, maybe we'll help them if we give them weight loss pills or surgery. Like maybe. And academia at its best should be entertaining at times radical hypotheses and letting the data speak for itself. Now, it's very different when you're talking about vulnerable kids that can't consent to experimental treatments. When it comes to transgender adults, I'm a strong libertarian. I think they should be free to do what they want with their bodies, even elective harmful procedures. I think we should have more openness about the potential side effects. But I am completely supportive of them. And in fact, though I'm optimistic about the direction that we're moving towards from a medical perspective that as you mentioned, many of these gender clinics are being shut, shut down. It turned out that in most cases the interventions either weren't working or even making the underlying symptoms worse. But at the same time, we shouldn't be defunding this type of research. If the government is going to fund research at all, it shouldn't be tied to any specific political agenda. What I found ironic, and I've written about this, is that the very conservatives that were most welcome to the idea that gender dysphoria is being driven by social contagion and that a lot of these treatments have harmful side effects. They were the same ones to pull the research funding into what the side effects would be. So I think that Europe is doing this better, even though I don't think these treatments ever should have been allowed to start with, they're doing longitudinal follow up on this first cohort of kids because again, we have to understand the long term side effects. Imagine your favorite lecture, dial that up on Max, put that on steroids, and then add some cinematic elements to it. That's the best way I could describe a Peterson Academy lecture.

[Michaela]

There's always that one professor who's like, oh man, you know, you gotta take this one professor. They're the best. But at Peterson Academy it's all of those. That one professor,

[Adam Omari]

I'm still paying off College from 10 years ago. And I'm also still questioning the value that I got out of college.

[Michaela]

It's very common nowadays for students to be in thousands and thousands of dollars of debt. It breaks my heart that interest rates that are just going to keep on piling up on them for an education that doesn't entirely serve them, you are

[Adam Omari]

stuck in the room.

[Michaela]

You have to do a particular set of courses.

[Adam Omari]

I have to convince myself to stay focused.

[Michaela]

It's just pretty dry with Peterson Academy. It's a fraction of the cost and you get access to all these different topics.

[Adam Omari]

It goes anything from sciences, nutrition, why

[Michaela]

we get sick, all the way up to history. Tons of courses, tons of really good lectures. I'm always looking for high quality educational content. Peterson Academy provides it all.

[Adam Omari]

The instructors are amazing. They're so well known in their field that you just want to pay attention.

[Michaela]

I access.

[Adam Omari]

The more I listen, the more I

[Michaela]

learn, the more I want to learn.

[Adam Omari]

I just keep expanding and I just want more.

[Michaela]

Traditional university can sometimes ground you down.

[Adam Omari]

Peterson Academy will be able to scratch that itch of you wanting to learn and continuing to grow as a person.

[Michaela]

I can't wait to see where Peterson Academy goes. There's just so much potential and it's just the beginning.

[Adam Omari]

I went to college because I had to. I go to Peterson Academy because I want to.

[Michaela]

You just kind of have to focus on what's to actually change your life. Stop paying attention to what things are supposed to look like and actually aim for something and you might just stumble across something like Peterson Academy. Seems like a disaster. I'm also, especially with dad being sick this year and like the impact of medication, long term medications, the impact that had on me. I'm sorry. And because I'm so pregnant, I think I'm so irritated at this idea of, oh, you have this really complicated issue. Here's the solution that we can provide you. When it's much more nuanced than that, even in terms of mental health, which is like, yeah, you're very depressed, but here's a pill that just fixes the imbalance. And it's like, clearly that hasn't been working because our mental health issues are skyrocketing and you've done a bunch of research. Actually, you know what, let's start with Cato. Let's start with Cato and then get into that. You're at the Cato Institute now, right? Can you describe what that is, what that does?

[Adam Omari]

Cato Institute is a libertarian think tank, policy research organization. And I'm on the human Progress team. There's a great website, human progress.org. you can see all these great statistics about increase in lifespan, decrease in disease, Rates increase in literacy, worldwide increase in economic productivity, basically human progress, more of everything good, less of everything. And we use global data, publicly available, everything you can check for yourself. Everything is replicable and open source. So I'm doing mental health research because despite this robust evidence that by so many metrics we're living in the best time in human history, you also look at psychiatric diagnoses and they're at all time highs. And worse than that, it's in the wealthiest, freest countries that have the highest depression and anxiety rates. So a lot of people look at that and they think there's some fundamental problem of progress, of modernity. There's evolutionary mismatch, we're experiencing a crisis of meaning. It's hard to get data on things like that. And I try to be a data driven skeptic. So when I hear crisis of meaning driving an all time mental health crisis, I think, okay, that's one good hypothesis. On the other hand, maybe it's a sign of progress that we're seeing psychiatric diagnoses rise because there's less stigma, there's more mental health awareness, we have the resources to attend to mental health problems. I think all of that is part of progress and part of what's driving this. But I've also been writing a lot about Cato, now being a libertarian think tank. We're also extremely suspect about government overreach and the financial incentives that come into, in this case, healthcare expansion. So when the very providers that diagnose the conditions are the ones that stand to benefit financially from seeing more psychiatric disorders, it's not surprising that there's an incentive to over diagnose. And if you look at the dsm, the American Psychiatric Association's textbook manual that lists all of the mental health conditions and the criteria for diagnosing them, it's gotten bigger with every successive revision. The original one more than 60 years ago was about 130 pages and the new one is 1,130 pages.

[Michaela]

Wow.

[Adam Omari]

So it's expanded a lot. And people will say, well, it's expanded because we have again greater mental health awareness, better screening, there's more nuance in how we define the disorders. That's all true, but also across every successive revision, the criteria for diagnosis have gotten broader. So what I've been writing a lot about recently is psychiatric over diagnosis and across virtually every condition. I think we're over diagnosing and as you mentioned, forget about relatively rare interventions like puberty blockers, as harmful as they've been. 30% of American college Students of Gen Z are on psych meds, mostly SSRIs. And I know you've been doing a lot of research into.

[Michaela]

I, I know the personal experience. The. Yeah, like the stats I pulled because it, they're kind of hard to pull. Right. Was 20% across the board. But I hadn't heard the 30% of Gen Z in universities.

[Adam Omari]

Yeah. My understanding is it's about 20% across the board, including for Gen Z. But there's also a large sex difference because it's mostly women who are diagnosed with depression and anxiety. So it's closer to 30% for females, closer to 10% for males. And also across the board, for whatever reason, 30% among college students. So the college student rate is much higher. That could be in part because college students are now majority female.

[Michaela]

Yeah. Oh my gosh, that's wild.

[Adam Omari]

And we don't understand the long term side effects as you've been writing about, that's for sure.

[Michaela]

And it's looking, it's seriously not looking good. I, I read a study recently and it was people who'd taken, I think they were specifically looking at SSRIs and it was people who'd been taking them for more than two years and 78 of them had some type of withdrawal. And it was, I think it was 30% out of the, A hundred percent of people couldn't get off them. So the withdrawal you could say was bad enough that they couldn't stop taking them.

[Adam Omari]

And APA doesn't even recognize SSRI withdrawal. They call it discontinuation syndrome.

[Michaela]

Yeah, I don't even know how to explain that. It's so frustrating. I've been so frustrated by that. Do you know what, have you seen any studies about what percentage of women who are on an SSRI started with birth control? Because I'm wondering if that's a huge trigger for depression and anxiety in the first place. But I haven't seen any research about it.

[Adam Omari]

I have no idea. But to your point, our underlying biology is so complex and hormones and drugs interact in complex ways. Also, all your experience with diet, like again, we have, we have very little understanding, although we're seeing emerging research that even like your gut microbiome can seriously impact your mood, let alone intervening with much more extreme pharmaceutical interventions. So I'm, I'm concerned about the long term side effects of all of these, but I'm glad we're talking more openly about it.

[Michaela]

Yeah, I think we're headed in the right direction. And at least I think if people know I know that the guidelines are being changed, which, the tapering guidelines, which is really important. And once the tapering guidelines change and people understand, oh, if you're on a psych med, you need hyperbolic tapering, they'll understand that this isn't such a casual medication if you can't just suddenly stop taking it and revert back to normal. If you need this lengthy taper to have your brain adjust back to being normal, then you can infer, oh, this medication is actually quite, quite intense. It's not just like a serotonin vitamin that you pop.

[Adam Omari]

Yeah, I think, I think in RFK's recent initiative to create billing codes for not just prescribing but deprescribing medication, that was a step in the right direction. And on the subject of Medicaid and financial incentives, one of the strong arguments that you'll hear for this mental health crisis that supposedly young people in particular are living through is you see this hockey stick like phenomenon. So, like slow increases in depression and anxiety, and then right around 2010, like, sharp increase, especially in young people. So a lot of people, Jonathan Haidt, social psychologist being one of the most prominent examples, attribute that right around 2010, this sharp increase to the advent of smartphones and social media. I've also been writing a lot about critiquing that underlying research. So it's true that there are correlations between social media use and depression, anxiety and loneliness. Kids who are most depressed, anxious and lonely are the most likely to use social media. You might also remember from our podcast, we talked about me being homeschooled and addicted to video games and spending like, well over 10 hours a day on screens. So maybe there's a little bit of what Freud would call reaction formation, like a little bit of defensiveness and fighting against the thing that, that, that calls out your blind spots. But if you look at the actual data, there are lots of individual studies that show associations between social media use and these negative mental health outcomes, but they're mostly correlational. It's mostly self selection that you have kids like me who are, you know, already overweight, lonely, depressed, homeschooled that are seeking out connection online. And as poor as my childhood was, I think that it would have been even worse if I didn't have video games and if I didn't have online social connection. And if you look at meta analyses, especially the ones that control for other personality traits that independently predict both negative mental health outcomes and increased screen usage, like introversion, then you see that the effects disappear. So the largest meta analyses show that these social media effects are mostly correlational and mostly null when you control for other confounds. And the alternative explanation to this hockey stick phenomenon, also in 2010, is when the Affordable Care act introduced this mental health parity provision. So before 2010, it was not legally required for insurances to cover mental health services. They weren't considered an essential service. The Mental Health Parity act introduced mental health care as an essential health service. So again, speaking in Cato language, in terms of financial incentives, this opened the floodgates to what economists would call supplier induced demand. Here's a thing that previously wasn't eligible for insurance coverage and you need a diagnosis for insurance coverage. So after you open, you legislate a requirement to open the floodgates to insurance money, you create a strong incentive for diagnosis. And immediately after that, in 2013, is when we have the most recent and also the largest and most expansive and loosest diagnostic criteria edition of the dsm. So I look at that and I think it's a striking coincidence and it seems more causally likely to me than these social media correlations.

[Michaela]

I completely agree that like that makes perfect sense. I didn't realize that was exactly at the same time. And that does make sense to me that if you're introverted, you are going to spend more time online. And I can tell from like, so my, my 8 year old, you can just tell that giving kids screens all the time, especially if this is a healthy kid, isn't good for the kid. But I would, I would agree that it, it's likely, it's not causal, it's likely correlation.

[Adam Omari]

Right? The most robust effects aren't on mental health. The most robust effects of screen use are on attention span. And even when you look at attention span and education outcomes, the best studies on this are quasi randomized control trials looking at different schools within the same district. So they have similar demographics and you're more or less naturally controlling for those socioeconomic confounds. And you're looking at, okay, this school bans smartphones, this neighboring school doesn't. You don't see any significant differences on mental health outcomes or bullying. What you do see big effects is on standardized test scores. So kids do better with smartphone bans. Now, even there, I don't look at it and say social media or smartphones are so harmful to attention span that kids are literally getting dumber. I look at it as a neuroscientist and thinking about the first principles of brain development like it's, it's the same brain matter. It's the same level of computational power. We can just specialize and redirect to different areas. So we talked about this last time, actually in the context of sensitive windows for brain development. You have these heightened windows of plasticity. And the extreme examples are both in animal studies where you experimentally manipulate, say blinding certain animals. What you'll see is that the visual cortex will atrophy, but then the other sensory cortices like the auditory cortex will grow in and start to fill that brain region and, and you see the animal develop more acute sense of hearing or of smell. And we see the same thing in congenitally blind or deaf humans. So that's neuroplasticity at work. So starting from those same principles, let's say you have a developing brain that has a finite amount of smarts or computational power. And you can either specialize in slow traditional learning, like the types of critical thinking and reading long text passages that you do in standardized testing and traditional education, or you specialize in fast paced multitasking, the types of intelligence that's optimized for with video games and social media. And indeed that's what the research shows. It's not that you're getting dumber, it's that you're getting worse at a very specific type of long term critical thinking task, but you also get better at multitasking. Now, not to say that objectively one is better or worse, but again, thinking like an evolutionary psychologist and neuroscientist, there are different trade offs, but you have the same level of brain power.

[Michaela]

That's cool. I don't know what to say to that. That's cool. I think that makes, that makes sense to me. It's also hard to tell with the advent of AI and how the future is going to be exactly how humans need to adapt. Right?

[Adam Omari]

See, I've been writing about AI and mental health too. Actually the fun thing about this role is because psychology connects to basically everything policy related and technology related. So I get to opine on all these different areas. So like in the context of AI, people are talking about chatbots and AI therapy, or in these extreme cases, AI psychosis, AI driven suicide. So oftentimes people point towards some potential for harm. And that's kind of what we're talking about in all these examples here. There are real potential harms, say of AI, of social media, of diet, of elective procedures. Then the question is, what do we do about it? And often people rush in for government solutions saying we need to regulate, we need to prevent this harm, but regulation creates harm. Too Diagnosis creates harm too. So also when people look at over diagnosis and when they say, well, the DSM has been getting broader. Yes, but worst case, that just means we're generating some false positives. But we're expanding access to care. Wouldn't you rather do that than under diagnose? But people forget that when you label someone, especially a child with a diagnosis, who's. Okay, get this. According to the CDC, there was a 70% increase in autism and in the three years post Covid. Now, autism is a rare genetic neurological disorder that is characterized by social difficulties. Gee, I wonder why there is a 70% increase in social difficulties following a pandemic where we shut down the world and left kids outside of the normal social environment.

[Michaela]

Yep. I was also gonna say for. For Jonathan Height's work on social media, what I do think is realistic is people are talking more about it. So you get social contagion really easy on social media. So perhaps around 2010, which isn't even, I think, when social media really took hold, I think it was a bit later than that. At least for me. I was probably more involved in it in 2012, like quite a bit more than 2010. But you get support groups, you get people saying, these are my symptoms or these your symptoms. And then you can find all your people so easily because of the algorithm. And that I think would have more of a potential negative effect depending on what the contagion is than amount spent than just social media as a whole, like the ideas that are in social media. Does Jonathan Height talk about that? Is he talking about that causing mental health problems like what people are talking about on social media or literally just screen time?

[Adam Omari]

Yeah, it's homophily. And we certainly see that with the gender dysphoria epidemic and also with eating disorders like anorexia, with self harm, like cutting in all those cases. I agree with you. Social media, if it has any causal effect, it's not directly on mental health, but it's on who you're talking to and what you're hearing. So that's where most of Haidt's critique is. And he also pays a lot of attention to cyberbullying. Again, there's a completely separate policy question that we need to be having because a lot of people, I mean, first the question is, is this thing harmful? And what I've been calling attention to is often the harms are on a less robust evidence foundation than people would have you believe. But even where the harms are real. Okay, what do we do about it? Do we Ban social media for kids under 16 like Australia has just done. It's not working. Teenagers are smart. They know how to install a VPN and reroute their traffic through another country that doesn't have the ban. They know how to access the dark web. So in many cases the bans, if anything it just gets them off the big platforms like Instagram that have the most robust safety checks and they're exploring darker corners of the Internet that don't have the same regulations. So that's again, it's like the hormones for gender dysphoric youth. It's well intentioned and yet it might make the underlying problem worse. Not to mention that in order to mandate age to prevent children from being able to access harmful content online, it means that you have to have age checks for all users, including adults. And that introduces unconstitutional privacy risks.

[Michaela]

That makes sense.

[Adam Omari]

So what do we do about it? Do we regulate or do we leave it, like most forms of potential harm that children should be protected from and recognize it as a responsibility of the parents? So in a lot of these big lawsuits that we're seeing against social media companies right now, they're claiming that there's an underlying harmful association, which again I'm more skeptical about, but open to the possibility that it's there. Certainly in some minority cases there are direct causal harmful effects. What we can't say is that, you know, at the level of systematic reviews and meta analyses across the board, we can say something is harmful. But there are definitely individualized cases of harm. Even in those cases. Is it the company that has been negligent or is it the parent that has been negligent? Because in any other case a kid gets access to a firearm or drugs, then the parent will be charged with negligence. You don't go after the company that's produced it.

[Michaela]

Yeah, might be an unpopular opinion, but I'm probably inclined to think it's the parents fault. Now I don't have a teenager yet, so maybe my view will change once I have a teenager. But if you end up in a, in a cycle of negative Reddit threads, probably not great for your, for your mental health. But then maybe there needs to be some oversight by parents being like, are you in a chat room? Like where are you on the Internet? As opposed to just saying social media as a whole is bad because I also don't see how you're going to avoid, especially in five or 10 years, how we're going to avoid the Internet with the advent of AI like it's going to be so ingrained in society, especially when there are robots walking around.

[Adam Omari]

Right, right. What I've written a lot for human progress about recently is the fact that we have this innate negativity bias. There is an evolutionary mismatch. You know, like diet is the classic example. In an ancestral environment where fat and sugar and high calorie foods were rare, it's adaptive to develop a strong taste for it. But in a modern environment of industrial food production, over consumption is the greater risk. So there's all sorts of evolutionary mismatch. Negativity bias being a great example. You would rather mistake a stick for a snake than a snake for a stick. Evolution has selected for people to be a little bit neurotic, a little bit overly threat sensitive and media hijacks that negativity bias. Not even because there's any perverse incentives, it's just a natural incentive, like you want to get human attention, then anything negative is going to orient human attention again because in an ancestral environment and even in a modern day environment, it's adaptive. But it's also even more adaptive to be mindful of the fact that we have this negativity bias and be selective about what information you allow into your life. So I think that this is a form of progress. And the interesting thing, if you've explored stoicism at all, Marcus Aurelius, former Roman emperor, he writes about in his meditations in his diary. He basically has a whole bunch of first world problems. He's an emperor 2,000 years ago and he writes about, I don't want to get out of bed. I have all these servants that can do my job for me. Um, I'm worried about gluttony because I have like literally all the best food in the world brought to me on a platter. I don't want to go outside and exercise, but I know it's good for my body. I don't really want to read because I can just have all these concubines brought into my bed chambers and I don't have to do anything if I don't want to than like have sex and have grapes fed to me by these beautiful women. And other people, power hungry people, would be glad to do my emperor job for me. I can outsource all of that. So he has extreme first world problems. And, and what we're seeing now, this crisis of meaning that we're talking about is basically emperor world problems at scale. Because we're wealthier than any other time in human history, we are having to contend with the same problems that the Founder of stoicism contended with the fact that we would rather have to avoid gluttony or avoid sleeping in and being lazy because we're wealthy enough and safe enough that we can afford to. So that's difficult. Responsibility and agency is difficult. I think this is why your dad was such an influence on us, especially on young men like myself. Growing up in this environment of extreme abundance, but also extreme ease and being able to take the easy way out and be lazy, but being able to instead, you know, rally for responsibility and create the own, the meaning in your life as opposed to just having it handed to you in the daily struggle for survival. It's difficult, but it's worthwhile. And it's amazing to me from a human progress angle that now those are the problems that we have to face instead of the default problems of starvation and seeking out a safe shelter.

[Michaela]

Do you think a percentage of people aren't going to make it? Not to be too dark about this, but like in, in order to say you have everything and you're in this abundant society and you don't have any motivation, isn't that highly reliant on how conscientious you are? Isn't that a lot of that personality driven? And if so, then what are those people going to do?

[Adam Omari]

It is. And I like that you're thinking like a personality psychologist. I worry about the bell curve all the time. And I don't just mean about intelligence, but conscientiousness, like you said, neuroticism as well. So there's always going to be some tale of a distribution of people that are going to have it easier and have it harder, but they still fundamentally have to deal with the same challenges. But I don't mean that in a pessimistic way like they have to deal with it. I mean it like the solutions are going to be the same, even if they're harder to implement, as hard as it's going to be to adopt more responsibility if you're for biological reasons, lower in conscientiousness and higher in neuroticism, if anything, all the more urgent it is for you to adopt that mindset.

[Michaela]

Yeah. So do you think that can be taught? Do you have recommendations?

[Adam Omari]

I think it can be taught. And I'm optimistic as an evolutionary psychologist that, you know, you said for people that don't have any motivation, I don't believe such people exist because at the very least we have these inherited biological motives. We want to avoid pain, avoid starvation, avoid boredom even. That's why we talk about addiction and doom scrolling because people don't want to be bored. I mean boredom is healthy for creativity to some degree. But even you say like someone who supposedly has no motivation, well they're doom scrolling because they're bored. And that implies an intrinsic motivation to try to avoid boredom or, or they're overeating because again, eating is just naturally pleasurable. We evolved that way. So what I'm trying to do in this broader mission as a psychologist of human progress is to better understand our evolutionary psychology and try to gamify it so we can optimize psychology. It's like Maslow's hierarchy of needs.

[Michaela]

Yeah, I had this conversation with dad about five years ago. Cause we were talking about what do people do when they can't figure out what to do with their lives. I was like, well, figure out where the problems are and then fix the problems. Like everybody has some issue that they could probably work at. And that's a place, that's how I started where I was like, okay, this autoimmune disorder is a huge problem. It's ruining my entire life. I guess that's what I'll do with my life is figure out how to not have an autoimmune disorder. And I think that applies to every human is like what part of your life is suffering and what can you do to fix it? And there you have something to do.

[Adam Omari]

Right. So it's like a fundamental. Is the glass half full or half empty? I mean, for every problem that's pointed out and like I mentioned, one of the major critiques of the human progress narrative is well, how can you say we're living in the best time in history when and then, you know, name all of these new problems that are unique to this time in history. But for every problem, I mean, if we didn't have any problems. Your dad talks about this too in Dostoevsky's Notes from Underground. Like if you had nothing to do but lay in bed and eat cake, you'd be bored, you'd be depressed, you'd be nihilistic. So. And a lot of people are again, it's the, it's the stoicism emperor world problems.

[Michaela]

That's cool. Okay, you talked about the meaning crisis and before we started talking you mentioned a book. Can you describe this upcoming book?

[Adam Omari]

This is the long term vision for psychology of human progress. So in the same way that there are many different disciplines within psychology, social, developmental, cognitive, evolutionary, clinical, we want progress psychology to be its own subfield. So if you've heard of this somewhat still niche world of progress studies. It's a lot of Silicon Valley tech bro, libertarian types, not just startups, but this broader world of how do we optimize human existence. You hear a lot of it with AI too. So people are coming at it from different angles. There's progress studies in terms of optimizing health, so maybe I'd place you in there. There's progress studies in terms of AI alignment, there's progress studies in terms of our institutions. How can we remove a lot of the corruption and perverse incentives, including the incentives, the perverse incentives in our healthcare system, like for over diagnosis, like we were just talking about. And more importantly, underlying all of this, all of these different problems and potential solutions are psychological problems and solutions. So that's not just what are the psychological traits that we should try to optimize for in terms of mental health and fulfillment and creativity and purpose, but also what are the psychological traits that hinder progress? Tribalism, zero sum thinking, negativity, bias. And how can we be more mindful of that and navigate around them?

[Michaela]

That makes sense. And you mentioned you're working with Marion Tupi, Sarah Hill, a bit who's in the Cato Institute that people might know.

[Adam Omari]

Marion tupy runs human progress.org yeah, my

[Michaela]

dad has been such a fan of his for like 10 years. I remember before all, all the like YouTube infamy and everything, he was kind of obsessed with the X account human progress because it was always tweeting out, it was like, well technically actually things are going in the right direction. Here are all the studies.

[Adam Omari]

Yeah, and it's funny, people don't like to hear it. They get weirdly defensive, like they're clinging on to the, to the narrative that the world is so bad. I don't know why, but yeah, you look at the data, [e-mail] and all of the data is open source from publicly available like oecd, our world and data international data sets. So we're not creating the data, we're not spinning the narrative that things are better, we're just illuminating where it is. And again, we're willing to contend with where the data says that things are worse. And the main place that the data is worse is mental health outcomes. So I'm looking at that still with a healthy view of skepticism of is it actually worse or could the data say it's worse because the diagnostic standards have shifted? And it's a combination of both. I think that there are real problems that are making people more nihilistic if they Lack agency. But agency also seems to be the solution to this. And there are other real pressing problems grounded in this type of international data, like the fertility crisis. And I think that's fundamentally tied to this crisis of meaning. Like having a child is the most long term optimistic bet on the world that you can take. And a lot of young people aren't taking that bet.

[Michaela]

This is true. Interesting. I'm probably more inclined to think that there's some, that something has made people sick recently, you know, that it's not just. But I mean, I come, I come at this from more of a health perspective, but I can't imagine, for instance, one of the arguments when I was diagnosed with juvenile rheumatoid arthritis, it was unseen. I think that was 1999 when I was diagnosed and it took five years to diagnose because doctors hadn't seen it. And now it skyrocketed. I don't, I don't want to give this stat, but it went from something like one in ten thousand to one in a hundred or something. It, those numbers aren't right, they'd have to be double checked. But it, it's way more prevalent. And one of the arguments is, well, that's because we can catch it faster. But I didn't know anybody in my school that had joint pain. You know, it wasn't there. And so I'm more inclined to think that something recently has made people more sensitive physiologically to something that's causing depression rather than just a meaning crisis. But I think we're gonna need a lot more data to figure out exactly what there is. There's theories, there's a vaccine theory, there's the diet theory, of course, like more processed foods causing chronic illness. But I think that plays a huge role.

[Adam Omari]

I think you're right. That certainly in terms of physical health and even mental health or obesity too,

[Michaela]

even just the rising obesity rate, diet

[Adam Omari]

plays a whole, a huge role. Lifestyle plays a huge role because people are just less active. The fact that you don't really have to be physically active to survive or to put food on the table anymore in most industries of work in wealthy western democracies. So again, I look at that still as a sign of progress, like genuine problems we need to contend with. But let's say it's the case that because of food industrialization there are all sorts of additives that turn out to have tiny harmful cumulative effects on physical and mental health that are impairing us from optimal health standpoint. On the other hand, life expectancy is just about higher than ever. And if we think about the evolutionary and historical perspective, for most of human history, the median age was 40. Most of human history, deaths in infancy and in childbirth were crazy high. And now they're at all time lows. So the human progress angle is, yes, we have real challenges to face, but on the other hand, we're able to acknowledge those because we have billions of people putting their minds together because we have these advancements in food production and technology and energy and so forth. So also on this point you mentioned Marion Tupi. So he's leading this whole human progress initiative. You also mentioned Sarah Hill, who you had on your podcast, Salman Peterson, Academy birth control expert. So she's writing a chapter for us in this book on the psychology of progress on the trade offs of birth control. Like it's great in terms of expanding agency and gender rights, women's rights. On the other hand, yeah, there are real meaningful challenges, whether that's the literal psychological side effects of disrupting hormones or even institutional side effects. Like when we see such a change as now a majority of people earning degrees are women, we see changes in institutional culture that probably contribute to the rise in cancel culture that we saw in the last decade.

[Michaela]

So that's Adam puts gently, yeah, so

[Adam Omari]

that's not to say that we should regress, but it's to say that everything is trade offs. Even, you know, smartphones and brain health, everything is trade offs. We're not atrophying our brains, but we're trading off a type of long term delayed thinking into a type of multitasking and fast paced information processing. Everything is trade off. So that's the central thesis of the book. I mentioned those two. And we're going to have chapters from various experts in different fields, including hopefully on diet, on physical health. Again, not just thinking psychologically in terms of individuals and their personalities and mental health, but also psychologically in terms of tribalism and what types of people feed into what types of institutions and what type of institutional norms enable progress versus hinder progress. Now, on one hand there is a strong bias, the free market bias, but the bias is not because we're libertarian. We're libertarian because we see that this is what the data shows enables progress. Free markets genuinely enable innovation and material prosperity. And anti free market societies, especially communist regimes, are the exact opposite. Hundreds of millions of deaths and unfortunately people, especially on the left, still have not gotten the picture. But that's why we're continually fighting for freedom and trying to do it not so much in a polarized way. But in a, in a data driven nuance, just take a step back, don't listen to us, listen to the data.

[Michaela]

I like that. And I can see that with abundance in food, even though there were some malevolent, I would say, players creating the food pyramid and putting chemicals into our food, you could see that if a society was to suddenly become abundant in food, there's going to be this kind of blip where people figure out what to eat when they're exposed to everything. And so maybe in the long term games like well at least we have an abundant amount of food compared to before but we're in this intermediary period where we're not entirely sure what to eat because everything's been manufactured to taste so good. But in the long run maybe a good thing.

[Adam Omari]

Yeah, I think more freedom is always good. And it gets trickier, especially from a philosophical perspective. You know, what is the right amount of voluntary suffering? Not even the types of healthy sacrifice to develop yourself. But you know, some people really like smoking, some people really like junk food and they say, you know, I know this is going to shave years off my lifespan, but I would rather live 60 years as a smoking McDonald's eater than 80 years on a strict carnivore diet.

[Michaela]

Yeah, yeah, go for it. I, I, I, I have exactly that perspective is people should be able to do, adults should be able to do basically whatever they want, but they shouldn't be lied to in order to come to the conclusions they're at. So like take psychiatric medications if you want to, but know what happens if you're on them long term. Like you should be told that and eat whatever you want. But know what the, like potentially chronic disease is the outcome. Like and it does get tricky from a philosophical perspective when you involve the government, which I'm usually not interested in doing because I think usually that goes in the wrong direction. But, but then it's hard to say what to do with this society that's already addicted to all these things because they've been lied to for so long. So we're not starting at zero for like medication foods. We're not starting at zero and saying eat whatever you want. Here are all the ramifications if you decide to eat unhealthily. Here are all the ramifications if you decide to take medication long term. We're starting with a society that's already in the midst of it. So then do you need government input? Probably. I, I still don't know if it's useful or not, but it becomes a much Harder question.

[Adam Omari]

One of the questions that keeps coming up in this progress psychology project is what do we do about institutional trust? Which is at all time lows and really deservingly so given how much people have been lied to. Especially like Covid really blew the roof off a lot of this. Not just because it was a strong example of government overreach and manipulating public information, but also again, the cumulative effects of years of lockdown and the psychological stress and handicapping an entire generation of young kids socially. I think a lot of the political polarization and craziness we're seeing are downstream ripple effects of that and we're going to probably see it for generations to come because again, you know, psychologists overuse the term intergenerational trauma, but in subtle ways. You're going to not just see that young kids who grew up during the pandemic are going to change and they're going to influence our institutions, but they're going to parent in different ways and those children are going to grow up differently because that sort of parenting. So I'm not trying to sound determinist or doomer. If anything, it's literally my job on human progress to be an optimist and I am a data driven optimist. But yeah, we need, we need more transparency, more openness, more research, more data. And conversations like these are a step in that direction.

[Michaela]

Agreed. Does the Cato Institute run studies as well?

[Adam Omari]

We're running some studies on the human progress team. There's a whole polling center. I can't speak much to what other policy departments are doing. Think tanks are kind of like research universities. So it's quite big. Basically every policy area that you can think of, health, economics, foreign policy, defense, all sorts of things that I'm sorry for my colleagues for leaving out. We have experts on everything and the people at Cato are brilliant. And what I love about it is there's true diversity of thought like you were supposed to have in academia. I mean, there is a self selection bias to the extent that we're all libertarian, or libertarian leaning at least, and free market thinkers, but there's so much diversity.

[Michaela]

But you're right. So it's fine and we're right.

[Adam Omari]

Yeah, I think we're right. And again, look at the data. Look at if you treat history as a set of quasi experiments. Well, it's not an accident that we're having this conversation in America and you immigrated here because of the greater freedom. Right. So you get these brain drain effects and your father as well. And it's like a Rich get richer phenomenon. It's like this Matthew principle that seems to be a natural law and that's why a lot of people critique free markets. But it's not the free market that's the problem. It's the underlying diversity of capability and value production. Like this is a far deeper evolutionary problem.

[Michaela]

Agreed. Do you guys do any studies on like tribalism particularly I guess on social media? I feel like just from what I've seen, it's skyrocketed since COVID and there's got to be some. I was talking to dad about this the other day actually was there's got to be some personality traits that are associated with people who end up leading kind of these fringe conspiratorial tribes. And he was assuming it has something to do with dark triad. And I'm just wondering if there have been any studies on that at all showing sociopaths, I guess or psychopaths or whatever you want to call them people and high in the dark triad on social media, amassing large followings. Have you, do you guys look into that at all?

[Adam Omari]

At Cato we're not looking into dark triad traits specifically. So the existing research literature certainly shows that that the types of social media trolls are disproportionately high in dark triad traits. And especially when it's anonymous online interaction, you see the worst behavior brought out. And we are commissioning studies for this broader psychology of Progress project on social media polarization. Misinformation. What do we do about it? Because again we're not trying to say literally everything is getting better all the time. We're trying to say on average, if you could choose to be born in any time in human history, probably this is the time to be. And there are real challenges to face there. And the solution to those challenges or the first step to solutions is understanding what the problems really are. So yes, we're commissioning studies on that and I'm relatively new here. I'm the only psychologist at Cato, which allows me to be much of a generalist. But as I mentioned we're relying on outside expertise from others topic experts and I have a biostatistics background as well. So I, I feel that I am particularly strong at evaluating study methods which across any discipline like the statistics are the statistics. So I have a pretty good bullshit detector.

[Michaela]

That's so cool. So what's the goal of the Cato Institute? Is it, is it kind of awareness and to try to help society stay positive? Is that the underlying goal or is there something else?

[Adam Omari]

The, the four main taglines are advancing limited government, individual liberty, free markets and peace. And we could talk about how each of those lead to a more prosperous society or. But also, I think it's useful to think about what think tanks do in the broader political ecosystem. And this is pretty new to me because before deciding to cancel my academic career by pursuing literally the most controversial topic, although it worked out for me and I'm really glad that I did. You know, your dad talks about when you commit to seeking the truth, your life becomes an adventure. So I couldn't have predicted that I would have ended up in this great job at Human Progress and at Cato, but it's worth it. So most think tanks, as far as I understand it, are more explicitly partisan. Like you have the Heritage foundation that has contributed to the Project 2025 agenda. On the left you have Brookings and Centers for American Progress. Very different definition of progress. There you have aei where my friend Carol Hooven is. So think tanks are very friendly, especially on the more conservative libertarian side. Very friendly to more of the heterodox thinkers. Rob Henderson is at Manhattan Institute, which is also more conservative than Cato, more conservative than libertarian. So they're all kind of like research universities and they employ a lot of either concurrent or former academics to do policy research. What's really different from my perspective is the pace of the work. So, you know, rather than writing one or two peer reviewed academic journal articles per year, I'm doing like one or two or more op eds per week or per month and we're reaching larger audiences. So again, everything is trade offs, like at the cost of some depth, even though we do great in depth policy analyses that are basically peer reviewed academic papers. And many Cato scholars, and many think tank scholars generally remain active in publishing academic papers. No one reads them. So then you condense it into like a Washington Post or Wall Street Journal article and they get larger readership. So I'm basically doing both. I'm keeping up with the research in terms of these psychology studies that I'm commissioning. I'm also writing a lot, basically every week about whatever is fashionable in terms of mental health or public policy. So all think tanks do that. I think what's really unique about Cato, aside from being the largest libertarian, is that we're non partisan, most are explicitly partisan. And that means, again, it contributes to this strong diversity of thought. It's like you can support Trump in his tax cuts one day and critique him on his immigration policy or on starting a war the next day. So there's A lot of true diversity and principled rather than partisan.

[Michaela]

Cool. I don't think I really knew what a think tank was other than knowing what the word think and tank was.

[Adam Omari]

And then just assuming I am now a professional overthinker, before I was just a part time overthinker.

[Michaela]

That's so funny. Okay, so just out of curiosity, more about think tanks, are these, are these non profits? Do people donate? How do they stay alive? Because you can't stay alive by. By writing articles, right? Yeah.

[Adam Omari]

CATO is non profit. I think all tank think tanks are nonprofit, but I'm not entirely certain of that. Most of them probably are and rely on donations. The more partisan ones probably take direct political money, but I'm not sure of that. Cato definitely doesn't. CATO is individual donors, like people that believe in advancing individual liberty. And again, lots of former academics or people that are just notable public figures, like Rob Henderson is a good example ending up at Manhattan Institute. My understanding is that think tanks have kind of two mainstreams of recruitment. So there's like you're recruiting policy analysts and economists and people that are going to do research kind of behind the scenes and then you're recruiting people that are already notable public figures just because they align with your philosophy. And it makes a lot of sense and it's advantageous to have them on board and to put your branding on anything that they do. So like anytime Rob Henderson goes on your podcast now he's advertising Manhattan Institute. So to some extent I get to do that for Cato. Mine is kind of a unique case because I'm doing both because I'm relatively early on in my career, during grad school, I was doing a lot of writing and public speaking about, in this case the controversial gender dysphoria debate. I think that if anything, Cato, well, Cato definitely doesn't take a particular stance on it. And this is a good example of the diversity of thoughts. So I think everyone at Cato and really like Americans broadly are more supportive of what transgender adults want to do. Most of the concern is about children. So on one hand you can make a strong libertarian argument that children can't consent, therefore it's unethical. On the other hand, you could make a strong libertarian argument saying that, well, when children can't consent, it falls onto the parents and it's within the realm of the parents liberty to decide what they want for their child. So most hopefully all libertarians would recognize that there's some level of extreme harm or neglect and there's some level of inherent rights and value to a child that if a parent is severely abusing them, then they need to be protected and it makes sense to look towards the government for that. But where do you draw the line? And particularly for experimental, potentially harmful medical procedures, where do you draw the line? So there are some people, some libertarians even, who look at that and say, well, even children, especially where's the Cutoff for child? 16, 17 year old has more agency and maybe they should have more say in what they do with their body, even with harmful elective procedures. At the very least, I think what we agree about is we need to have more openness about what the harms are and what the interventions are actually doing. And we certainly have not had that from the people promoting gender affirming care.

[Michaela]

Yeah, that's for sure.

[Adam Omari]

So there's a lot of healthy diversity of thought there. And my case is unique, again because I was speaking publicly about this issue. I think what they liked is that I was doing it in a hopefully unbiased, data driven way. I was certainly trying to do that. And that it meant that I wasn't shy of talking about whatever the spotlight issues are. Like. I didn't want to just remain in a narrow academic specialization where only me and my five colleagues would ever read each other's papers. Like, I wanted to have more of an influence in public discourse. So I get to have this somewhat unique role, being both the early career researcher, policy analyst type, but also getting to have more of this public intellectual role, doing podcasts like this.

[Michaela]

That's so fun.

[Adam Omari]

It is really fun.

[Michaela]

Congratulations. That's amazing. I didn't even know that was a job really, but it sounds, it sounds perfect.

[Adam Omari]

Yeah, It's a great example again of just committing to trying to tell the truth and do good in the world and not be concerned about the long term consequences. Not holding your tongue. I debated when you first invited me on your podcast two years ago whether to do it because I knew that I would get a lot of pushback, particularly from my peers at Harvard who were already saying mean things about me. But it was worth it and one indirect path that I couldn't have predicted. And Marion Tupi, who's been on your show and who's taught for Peterson Academy, he saw it, he liked it, he liked me. This opening came up and it's a small world. So a lot of the people that are in CATO circles are also in ARK circles. The alliance for Responsible Citizenship conference that your dad puts on.

[Michaela]

Yeah. Weird. That's very, very Cool, though. Okay, let me see. I. I have a. A few more questions to ask you. Okay. We didn't talk about. So you've been writing these articles. I saw an article pop up, and I don't think I even saw it. Because you shared it. I think I saw it from somewhere else, but it was on the Wall Street Journal, and I think it was adhd.

[Adam Omari]

So there's two separate ones you could be referring to. There's the Wall Street Journal 1, which is talking about RFK's recent psych meds press conference, and the financial incentives that go into that, which I think we already covered both of those. And then separately, there's adhd. I wrote an article for the Dispatch on ADHD over diagnosis. And again, this is continuing. The broad theme of ADHD is yet another example that's being massively overdiagnosed, in my opinion. And if you look at the diagnostic criteria within successive revisions of the dsm, they've gotten broader with time. There are more financial incentives. And just if you look at the structure of the school system, especially if you're thinking like an evolutionary psychologist, it's not surprising that young kids, especially young boys, don't sit still for eight hours a day in a classroom. And I don't think we should be medicating them if they can't do that. That's normal and healthy. What's abnormal, but also remarkable that many kids can adapt to it. That's also neuroplasticity at work. I'm concerned about pathologizing ordinary human behavior. And I think we ought to be conservative in, in the scientific sense and in the medical sense of where we draw the line. According to the NIH, according to the National Institute of Mental Health, 50% of American adolescents have met criteria for mental illness at least once in their lives. Yeah, of course, at any given time, it's closer to 30%, like we discussed. That's still insane. Again, if you're thinking about this like a personality psychologist and like a clinical psychologist, like from this Bell curve acknowledgement, well, 30 to 50% of the population is ordinary human behavior by definition. If we're talking about clinical psychopathology, you can debate about where to draw the line, but you're always talking about an extreme tail of a distribution, the distinction between ordinary and pathological. It's in the definition, it's in the word psychopathology. It has to be pathological to be diagnosable. If it's 30 to 50% of the population, it's ordinary levels of distress. And we've forgotten that.

[Michaela]

Yes, yes, I know. I've been thinking about that quite a bit in terms of mental health because so over the last couple of years I've had multiple pregnancies which are extremely destabilizing, like psychologically, because your hormones during pregnancy are insane. And then postpartum are insane. And then the stress of dad, especially this year, being so unbelievably sick that I've been like, I don't feel good. Like, if I was anyone, realistically, if I was anyone other than me, I'd be like, I need some sort of antidepressant or something because I'm depressed. But I, I've also seen people go through stressful situations. A relative gets cancer or like your close loved ones gets cancer, you're going to be depressed. You're not going to be the same person you were. There are periods throughout your life where you don't feel good and things are hard and you could be like, this is not tolerable. I don't feel good. And that's normal human stress. And it's not supposed to feel good. And it shouldn't be, it shouldn't be medicated for sure, because then you don't even process the emotions you're going through. Like we, we haven't even talked about that. What about the fact that people are going through trauma, say, and get medicated and then they don't process the emotions? That's gotta be an issue long term.

[Adam Omari]

Right? I'm concerned about that as well. So this is another good example of the perverse financial incentives that come in, in the way our healthcare system currently operates. So most therapists and psychiatrists aren't deluded enough to believe that 30 to 50% of young people are mentally ill. They're navigating an insurance system and they're trying to provide care and they're thinking, all right, if you've just gone through a breakup or the death of a loved one, you probably don't have major depressive disorder. You probably are in need of short term support, and yet you still have to. If the patient is going to receive any sort of insurance reimbursement. And they probably won't go to therapy if they can't. So there are adjustment disorders, which is often the shorthand that's used, which are temporary by definition. But again, depending on coverage and eligibility, a lot of times you'll see over diagnosis. So that, you know, let's say adjustment disorder is the diagnostic tag and is an adjustment disorder.

[Michaela]

Is that something, that's something in your Environment like cancer or divorce or something like that is that what's an adjustment disorder?

[Adam Omari]

Basically the catch all term for this person is going through a hard time. And the unspoken awareness is this isn't really a clinical disorder, but we have to treat it like a medical disorder otherwise there won't be coverage. So it's like the open secret within the therapeutic industry. Talk to any therapist about it. They'll, they'll be open about. Yeah. Adjustment disorder is what you do when you have to diagnose something, otherwise you won't receive coverage. But wow, nothing's really wrong with them.

[Michaela]

That's not good. Even though term adjustment disorder is kind of pathological. What?

[Adam Omari]

Well, adjusting to this difficult life circumstances,

[Michaela]

disorder, sticking disorder in there.

[Adam Omari]

That's manipulative point again. So we need to have a conversation about what types of mental health services and support can you receive if you don't have a medical disorder? Because the therapeutic industry has expanded to fill the void. I think that historically you'd find in community.

[Michaela]

Yeah.

[Adam Omari]

And from family, all of that has fragmented. So again, everything is trade offs. I don't look at that and say it's an inherently bad thing. I look at it and think it's a predictable result. That there's going to be a strong incentive to create or expand the closest existing support service. And there's a fine line between what is a medical problem and what is a mental health problem and what is an adjustment problem. That you really just need some advice and some support and someone to listen to and you could get it from a friend, but if you can't, then it makes sense to pay for a therapist. I'm, I think that's a good thing. The bad thing is that people internalize these diagnoses as though they have something wrong with them. When really life is challenging and we need social support.

[Michaela]

Yeah. Dad said when he had clients, and I learned this from a long young age is before he said you're, you know, there seems to be a major depressive disorder or something going on here. He'd be like, do you have friends? How's your work? How's your love life? Like, is anyone around you dying or hurt? And go through all these elements of human life to make sure there wasn't something that was contributing to your stress levels, that that would, was making you depressed. And I don't know how many specifically psychiatrists do. I don't know how many psychologists do that, but I don't know how many psychiatrists actually do that. Rather than getting somebody to fill out A background questionnaire on depression and then just looking at that and saying, well, this looks like depression without delving into trauma or life situated life, life circumstances. So hopefully, I guess, hopefully with RFK kind of bringing awareness to psych meds that we'll get more clinicians doing that. But I don't even know what psychiatrists are taught, how they're taught to figure out how people are sick. Is it mostly based on questionnaires? Because that's how my experience went when I was a kid. It was like, yeah, you have arthritis, which is already reason enough to be depressed as a kid. But I was just diagnosed from a Beck Beck questionnaire. Do you have any idea what the norm is like an ADHD test? I know that that's mostly questionnaires.

[Adam Omari]

So I can speak as a psychology researcher and I rely on public health data at population scales and certainly for these prevalence estimates for all disorders that you hear from CDC and nih. Most of those use surveys because they're not able to do the types of in depth psychiatric interviews that you would need for proper clinical assessment. So they use surveys that are typically correlated with depression, anxiety, autism, whatever it is. But they have major blind spots, especially the autism one like we talked about, which is surveys. Oftentimes parent reported surveys that ask items like my child struggles with eye contact, struggles making friends, prefers to be alone, things that are associated with autism but are also associated with social anxiety or even ordinary shyness. So it's easy to get false positives on surveys, but these are just the prevalence data. So when you hear a suspect claim from NIH, 30 to 50% of young people have experienced mental illness. Part of it is survey bias. Now if we're talking about actual diagnoses and over diagnosis, then that's driven by the clinician themselves. I'm not a clinician, I don't see patients, I'm not a psychiatrist, I can't prescribe medicine. So I can only look at the population level numbers and guess what they're doing. But again, when you look at the incentive structure that they're paid more when they diagnose more, particularly psychiatrists, because you can do an hour long therapy session or you can do four 15 minute prescription write ups. So psychiatrists have strong incentives to see more patients. Now this isn't to say they're greedy and they're prescribing when they should be doing therapy. There's also a strong short supply of psychiatrists. So most of the time you're seeing a master's level counselor for therapy and then if you need meds and if they're doing their job right, like you and your dad mentioned, if you've thoroughly evaluated all areas of your life that you can't find any obvious cause to your depression, maybe it makes sense to start exploring medication. But certainly if it's, if it's viewed just as a crutch or viewed as the first solution, that's very likely to best case serve as a crutch that avoids you getting to the root of your problems. Worst case leads to long term side effects and dependency and things you were talking about earlier.

[Michaela]

Yeah, and that's a huge problem. Okay, Adam, my pregnancy brain is burning out. That was a lot of information.

[Adam Omari]

One last thing relating to your pregnancy. So you were talking about, basically the psychological concept would be how much agency you ascribe to yourself and how you navigate problems. So you could take this victim mindset of how difficult things are going for you and how you pathologize it, like something must be wrong with you or with the world or it sounds like you're recognizing, you know, my hormones are out of whack, this is impacting my mood. I'm going to sort of take a step back, kind of like the Alan Watts mindfulness perspective, and recognize, you know, there's me at my optimal decision making capacity and there's me in pregnancy brain. So we've been talking about political libertarianism, but there's another interesting definition of libertarianism. So in the free will debate in philosophy, there's determinism. We hear a lot about that. The anti determinist stance, the technical position is libertarianism. So this is related to philosophically the libertarian political movement that's all about individual freedom and agency, but entirely separate philosophy literature on libertarianism.

[Michaela]

So I would say versus determinism, okay.

[Adam Omari]

Versus determinism. So determinism would be this stripping you of your agency, your deterministic system. You're a byproduct. Whether it's genetic determinism, like everything ultimately traces back to biochemistry. You have no free will. Robert Sapolsky is a great example of this neuroscientist who doesn't believe in free will or even on the social constructivist determinism. So the interesting thing and the sad thing, a lot of developmental psychologists are implicitly or explicitly determinist. So the nature or Nurture debate, and I host the Nature and Nurture podcast. So I'm quite familiar with the debate territory. But it overlooks the libertarianism, free will debate. If you have free will and agency, it doesn't much matter whether you're a byproduct of genes or environment. Genes or environment is inherently reductionist and determinist. So what I like about the libertarian philosophy, not the political philosophy, but the free will philosophy, is that it grants people agency or it acknowledges agency where it exists. Because as your dad talks a lot about, if you act like you don't have free will, then all that happens is you get bitter and resentful and you use your free will in unproductive ways. So what I really liked about you describing the challenges of pregnancy, you did it in a very libertarian way of acknowledging that this is a voluntary choice, presumably voluntary if you're mindful about when and when not to use protection. And it's, it's worthwhile and there are downsides, but it's obviously, I mean, you can speak to this. I don't have children yet, but probably the world's greatest blessing. So everything, everything is trade offs. And I like this libertarian philosophy of rather than, you know, you're a victim of your hormones and it needs to be diagnosed as something's wrong with you, like you're recognizing ahead of time this is a predictable result. And I'm entering into this and I'm just going to try to navigate around it with my free will and with my agency.

[Michaela]

Well, thank you. This is me on a podcast, though this isn't the me that my husband sees. There's more victimhood there. But yeah, I think from being one of the benefits from being miserably depressed for so long and then going through antidepressant withdrawal and being completely batshit for two years was I figured out. And this is one of the ways I survived, honestly, I figured out when my thoughts didn't make sense, didn't quite make sense, and I was like, okay, there's me, something in me is me. And then there are these thoughts I have that don't make sense, but that's not me. And so I can go through these periods of pregnancy because I hate being pregnant. It makes me dumber. I say, like, more, I can't. I have short term memory issues. You get tired, you get nauseous, I have meat aversions. I'm physically uncomfortable. It's just an unpleasant experience. But you can have unpleasant experiences for a period of time if they pay off, especially if the payoff is obviously worth it, like having kids. But, but I think a really good thing to do for people is while they're going through unpleasant experiences to stay hopeful for a window at the end and for things to get better at the end and then learn that they can be resilient through these things. And then it's not as anxiety provoking. You can be like, this is a bad year. This is a period of suffering. I'm going to do as well as I can. I'm not going to be as productive as I normally am, but I've done this before and I can do it again. And then it's not some existential horror on top of whatever you're experiencing. So resiliency is important for people to learn for sure. Otherwise, how are you supposed to stay mentally healthy and be a human?

[Adam Omari]

That's human progress at the individual level.

[Michaela]

Yeah. Cool. Okay. Adam, where should people go if they want to learn more?

[Adam Omari]

Psychology.human progress.org Cool.

[Michaela]

Okay. And I think we should get you on PA if you want to teach a course.

[Adam Omari]

I would love to.

[Michaela]

Okay. That's amazing.

[Adam Omari]

Psychology of human Progress.

[Michaela]

Yes. Let's do it. That sounds great. Well, thank you so much for coming on again. That was amazing.

[Adam Omari]

Thank you, Michaela.