I started this conversation with Psychiatrist Dr Josef Doerrin knowing it would stir something in many of you. And it did in me, too. Because we’re talking about the invisible currents beneath modern psychiatry – the ones most of us never see, but that quietly shape our choices, our children’s futures, and our sense of what’s “normal” when we’re hurting.
Josef is not an outsider throwing stones. He’s a board-certified psychiatrist, a former FDA medical officer, and a drug safety physician for several pharmaceutical companies. He’s also a man who entered psychiatry with a deep love of philosophy, psychology, and the human spirit – and who quickly learned the field was far more focused on efficiency than on healing.
“I thought psychiatry would be about helping people with life hardship,” he told me. “But the system wasn’t set up to address the root causes. We were giving out medications for problems of living – not just severe mental illness – because it was quicker, easier, and what the system was built to do.”
Behind the Curtain of the FDA and Pharma
From the outside, it’s tempting to imagine cartoon-villain executives making decisions in smoke-filled rooms. Josef says it’s not that simple. Inside the FDA, companies do list the known side effects in the official drug labels. But once a drug is approved, there’s no requirement – and no commercial incentive – to make sure the public fully understands the risks.
Marketing departments take over, sending speakers to conferences, publishing articles, and crafting messages that highlight benefits while downplaying harms. And because every major company plays by these rules, there’s a powerful, unspoken agreement to keep the conversation upbeat. After all, share prices – and people’s jobs – are on the line.
Short Trials, Long Prescriptions
Many psychiatric drugs are approved after only two short-term trials – sometimes as little as eight weeks – often in very specific patient groups. But in the real world, people stay on them for years, even decades. We simply don’t have long-term safety data for most of these medications, especially when it comes to children and adolescents whose brains are still developing.
And yet, in schools and clinics, parents are sometimes told their child will be suspended or expelled unless they agree to medicate. The pressure is real, and so is the fear of being seen as “neglectful” for wanting to try other approaches first. The Cost of Emotional Blunting
One of the most compelling – and confronting – parts of our conversation was Josef’s personal experiment with antidepressants. He wanted to know firsthand what he was prescribing. On Zoloft, he noticed a calm detachment, a sense of watching his life rather than fully living it. Friends saw a change. His wife found it easier for him to ignore her in everyday tensions.
This emotional blunting, while sometimes helpful for acute distress, can slowly erode intimacy, spontaneity, and empathy. In children and teens, it can disrupt not just relationships but identity formation. In some cases, sexual development is also affected, leading to confusion or distress years later.
The Rare – but Life-Changing – Risks
There are serious, permanent side effects that don’t make it into everyday conversations:
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- Persistent Sexual Dysfunction (PSSD) even after stopping the drug
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- Protracted Withdrawal Injuries from tapering too quickly
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- Drug-induced states misdiagnosed as new mental illnesses, leading to more prescriptions
These are uncommon – but they’re unpredictable, and when they happen, they can take years from a person’s life.
What He Wishes Patients Knew
Josef isn’t anti-medication. He’s pro-informed choice. His hope is that doctors, patients, and families start with the truth: most emotional suffering is better addressed through emotional support, therapy, and social change than through medication alone. When drugs are used, they should be for the shortest possible time, with eyes wide open to both benefits and risks.
“I can’t in good conscience recommend antidepressants to anyone except in the most severe cases,” he told me. “The potential for permanent harm, even if it’s rare, is too high. But for someone who’s in crisis and has no other options, that choice might still be right – as long as it’s made with full awareness.”
Why This Matters for All of Us
We live in a culture that sells us the story that sadness, overwhelm, or restlessness is a medical problem to be fixed. That the most responsible thing we can do is to seek a diagnosis and start treatment. But what if the real work is slower, less profitable, and infinitely more human?
It’s time to re-balance the scales. To spend as much on addressing poverty, housing, and trauma as we do on marketing new drugs. To bring back the art of listening, attuning, and supporting people through the messy, beautiful work of being human.
Until then, we each have to hold the line for ourselves and our children: to ask the hard questions, to seek the full picture, and to remember that we are not broken for struggling.
