Today, Explained – "How antidepressants got political"

Podcast: Today, Explained (Vox)
Date: November 20, 2025
Hosts: Sean Rameswaram and Noel King
Guests: Dr. Meg Jay (Clinical Psychologist, Author), Sarah Todd (STAT News Health Reporter)

Episode Overview

This episode explores the growing use and controversy of antidepressants (specifically SSRIs) among young people in the United States. The hosts unpack how social trends, political movements, and shifting medical attitudes have turned SSRIs into a political flashpoint. The discussion covers the increased mainstreaming of antidepressants since the 1990s, the impact of social media, misunderstandings about efficacy and side effects, and recent political rhetoric, including statements from HHS Secretary RFK Jr. The show asks: Are SSRIs overprescribed, and what happens when their benefits and risks become politicized?

Key Discussion Points & Insights

1. The Social Media “Antidepressant Influencer” Moment

• [00:00–00:22] The episode opens with clips from social media users and “Lexapro girlies” discussing their antidepressant experiences—framing SSRIs as almost lifestyle treatments for mental health bandwidth.
  • “Girl, take your crazy pills. You know you're mentally ill.” – [00:09], social media quote
  • Hosts highlight a generational shift: More young people than ever are on SSRIs, drawing both attention and concern from public health experts.

2. Antidepressants’ History and Youth Usage

• [02:05–03:32] Meg Jay recounts the early ‘90s era of Prozac Nation (by Elizabeth Wurtzel) when SSRI use among young adults was rare.
  • "Still, in the 1990s…it was still pretty unusual to have a client on meds." – Dr. Meg Jay [03:19]
• The medical establishment originally intended antidepressants for adults, but gradual expansion led to adolescent and even child prescriptions.

3. The Big Rise: 1990s to 2020s

• [03:32–04:19] Jay outlines the stats: early 2000s, about 10% of young adults were on SSRIs; today, it’s closer to 20%.
  • “By the early 2000s, about 10% of young adults were on antidepressants. Today, it's about 20%.” – Dr. Meg Jay [03:36]

4. Social Media’s Double-Edged Role

• Social media has increased mental health literacy but also created “social contagion,” where young people self-identify with mental health labels by what they see online.
  • “Many young adults see videos about depression and anxiety…then they decide they have these problems and want to try these medications, too.” – Jay [03:54]
• University studies find a disconnect: administrators think social media is to blame for the crisis, while students cite stressors like finances and school pressures. [04:34]

5. Are Antidepressants Truly Effective for Young People?

• [05:29–06:42] Jay discusses SSRIs’ partial effectiveness and the misconception that they’re “silver bullets.”
  • “They’re only effective about 50% of the time. …I don't think that's something young people understand.” – Jay [05:39]
• Side effects include emotional blunting, reduced motivation, and sexual side effects.
  • “My antidepressant helped to tamp down my panic attacks and my anxiety. But what I didn’t realize was just how numb the medication had started to make me feel.” – Patient experience [06:44–06:56]

6. Getting Off SSRIs: Harder Than Getting On

• [07:18–08:43] Tapering off can be challenging, since the brain adjusts to new serotonin levels. Many experience a return of symptoms, leading to a cycle of reliance.
  • “When you introduce a different level of serotonin into the brain and then you try to go off meds, your brain doesn’t like that.” – Jay [07:44]

7. Long-Term Effects on Developing Brains: The Unknowns

• [08:43–09:28] Most SSRI studies focus on adults; little is known about long-term effects in young, developing brains.
  • “This is all an experiment in the making…we don’t really know what the long-term effects are going to be for kids…who are taking these drugs right when their brains are wiring up.” – Jay [08:55]

8. Conversations with Young Patients: Skills Over Pills

• [09:49–11:13] Jay describes how young people are more likely to self-diagnose and request medications, but often lack coping skills for normal life challenges.
  • “In terms of young adult development, they don’t really understand that it's very normal to have symptoms of depression and anxiety. It doesn’t mean you have a disorder.” – Jay [09:56]
  • Jay’s approach: prioritize life skills and coping over immediate medication.

9. SSRIs in the Political Crosshairs

A. RFK Jr., HHS, and the “Make America Healthy Again” Movement

• [15:31–18:20] Sarah Todd from STAT News discusses how SSRIs have become a talking point in current politics, especially via RFK Jr.
  • RFK Jr. has claimed coming off antidepressants is “harder than getting off heroin” and questioned their safety.
  • “Listen, I know people, including members of my family, who’ve had a much worse time getting off of SSRIs than…getting off of heroin.” – RFK Jr., per Todd [18:16]

B. Are SSRIs Addictive?

• SSRIs are not addictive in the classic sense (no dopamine spikes like hard drugs), but about 15% of users have withdrawal symptoms—ranging from mild headaches to rare severe symptoms like suicidality. [18:30–19:24]
  • “They are not addictive…They do, however, have the potential to cause withdrawal symptoms. …About 15% of Americans experience withdrawal symptoms.” – Sarah Todd [18:30–19:10]

C. Mass Shootings and Antidepressants: Evidence and Misinformation

• [19:43–20:47] RFK Jr. and others have implied links between SSRIs and mass shootings; evidence shows this is baseless.
  • “I found one paper…over the past 30 years, they looked at all the mass shootings in the US, just 4% of the perpetrators had been on antidepressants at any point in their lives. There’s really no evidence…” – Todd [20:23]

D. SSRIs and Pregnancy

• [20:59–22:18] Recent FDA scrutiny has focused on SSRIs’ safety in pregnancy. Leading OB/GYN authorities maintain they are safe, and untreated depression presents greater risks to both mother and child.
  • “SSRIs are safe during pregnancy…risks of depression going untreated is much higher.” – Todd [21:00, summarizing guidelines]

10. Overprescription or Appropriate Response?

• [23:19–24:42] Rates of prescription have risen, but so have reported mental health concerns—especially in certain demographics (teen girls, LGBTQ+ youth).
  • “Antidepressant prescription rates have gone up. It’s also true the rates of the symptoms that antidepressants are meant to treat have gone up as well.” – Todd [24:18]
• Social media and internal research (like Facebook’s own data) suggest platforms like Instagram exacerbate distress.

11. “Just Asking Questions”: Stigma and the Politics of Doubt

• [25:42–27:02] The Maha (Make America Healthy Again) movement’s rhetorical strategy is to “just raise questions,” even where there’s no scientific evidence to back up claims (e.g., SSRIs and mass shootings).
  • “Asking questions about that could wind up perpetuating stigma against taking antidepressants, which could be really harmful for the people who could otherwise benefit from them.” – Todd [25:48]

Notable Quotes & Memorable Moments

• “Antidepressants are a blunt instrument, so they don't go in and target just feelings of sad or just feelings of anxiety. They can have a bit of a flattening effect across many areas.” – Dr. Meg Jay [05:53]
• “It's a time of what I call first and worst. So you have your first and worst jobs and apartments and roommates and breakups and so it can be a really tough time.” – Dr. Meg Jay on young adulthood [10:32]
• “SSRIs are not the be all, end all when it comes to mental health, but part of a suite…that could be used in combination with…talk therapy to helping people feel less lonely.” – Sarah Todd [26:30]
• “I think asking questions about that [SSRIs and mass shootings] could wind up perpetuating stigma against taking antidepressants…” – Sarah Todd [25:48]

Timestamps: Key Segments

• [00:00–00:22] Social media’s “antidepressant influencers”
• [02:05–03:32] Dr. Meg Jay on the history of SSRIs and youth
• [03:32–04:19] The rise in antidepressant rates among young people
• [05:29–06:42] Efficacy and risks of antidepressants for young adults
• [07:18–08:43] Withdrawal and discontinuation challenges
• [09:49–11:13] “Skills over pills”—navigating real-life problems
• [15:31–18:20] RFK Jr., SSRIs become a political issue
• [18:30–19:24] Physical dependence, withdrawal vs. addiction
• [19:43–20:47] Mass shootings and unfounded SSRI claims
• [20:59–22:18] Pregnancy, SSRIs, and official medical guidelines
• [23:19–24:42] Are SSRIs being overprescribed, or is there a youth mental health crisis?
• [25:42–27:02] The dangers of “just asking questions” and resultant stigma

Takeaways

• Antidepressant use among young Americans has dramatically increased—reflecting both greater awareness and potentially over-medicalization of distress.
• Political rhetoric and misinformation, especially from high-profile leaders, have muddied public understanding of SSRIs’ risks and benefits.
• The science shows SSRIs are not addictive in the traditional sense and have no proven link to mass shootings.
• Experts urge nuanced views: recognize both overprescription risks and the value of SSRIs when thoughtfully prescribed, alongside therapy and supportive interventions.

For listeners new to the debate, this episode provides a balanced, evidence-based look at why antidepressants are in the spotlight—and why making SSRIs political might obscure what actually works for young people’s mental health.