2:44:50 - "Just because someone is emotional, doesn't make them wrong" - Dr. K Thanks, I needed to hear that. I really did.

What's extremely fascinating (and also valuable) about this conversation, is that it's two psychiatry academics talking to each other in (mostly) layman's terms (with some necessary medical jargon in between) in front of a lay audience. Think about how rare that is and how common it should be.

Therapist here. This episode is WONDERFUL. I'm learning a lot. Thanks, Dr. K and Dr. Horowitz, for combining your brilliance for us!

As someone who was forced on to various medications at a very young age because people told me that I had a chemical imbalance, it was extremely validating to hear Dr. Horowitz saying what I've felt since I was a kid.

I once went to a sleep lab because I couldn't sleep through the night and was tired all the time. They told me everything is normal except that I am waking up frequently throughout the night. They asked if I had EVER been on antidepressants and I said yes, about 8 years ago. They told me this is a normal side effect of taking antidepressants that often does not go away when you stop. I was completely shocked! I experience this and it is noticeable. Why was I only being told this now when it was too late? Why did nobody tell me this before I started??? If I had known that I would have to live with this problem the rest of my life, I never would have started them.

Instead of my diagnosis being "disempowering" it was actually the opposite for me. I finally had an explanation for my thoughts and emotions and understood that it wasn't "just the way I was" and it was actually something objective that I could work towards improving. Accepting myself for who I am and realizing that there are practical things that I can do to improve my mental health was very empowering for me.

It's refreshing to hear Dr K acknowledge that suicide is sometimes a measured, rational decision that's an alternative to daily suffering/struggling. While it's important to encourage others to keep fighting, we often unintentionally gaslight people who are on the brink: "you have so much to live for" and "it'll get better" don't line up with the experience of a person who feels empty and hopeless.

i love how this talk is "i agree with you but" and the butts are adding more layers of complexity or different point of view about topic, all is done with great respect. I wish one day our public debate will reach this heights of cultural discussion

Maybe its just the state of mind that I am in currently but I have been glued to this conversation with almost 100% of my focus.

48:55 - 50:17 THIS. EXACTLY THIS. this is why we're more depressed than ever, especially when forced to live in a economic system that doesn't care for us, a culture of hate, and a society that's on the brink of collapse. couple that with ASD-like tendencies to see patterns in a pessimistic way and that's why folks have given up on trying. even me. and unless a systematic paradigm shift happens yesterday, i've given up hope, because no one can understand what i've been through and how i think and feel.

One of the things that really keeps me on HG is the way that Dr K pushes back on his guests.

I'm glad you challenged him on his bias, and it seemed he was glad too! Helps make a strong point stronger, and gives us the nuance we need.

It's so refreshing to listen to two people openly discussing and challenging each other with strong grounding in scientific evidence

I'm a big fan of Mark Horowitz' work. He has helped so many people. Thank you, Dr. Horowitz!

Please have discussions with more doctors, this was amazing

This video is so timely for me. I stopped my antidepressants (lowering over the course of months) three weeks ago, and then I started feeling very severe “relapse” symptoms. I’m still going through them right now. I thought it meant that something in me was inherently wrong and needed the medication to fix since this is far from the period that they say withdrawl symptoms should happen, but after listening to this, I feel a lot more hope about my situation.

Man Dr. K’s communication style is so solid. Guy is humble too.

Could you please talk about pssd in the future. Its a delibitating condition caused by antidepressants and symptoms include persistent genital numbing and emotional numbing even when you're off the drug and this can last for years and in some cases its permanent. Doctors dont know much about it if at all. Our community of sufferers are desperately trying to get this condition recognized so a cure could be found sooner than later. We just want our lives back, many thanks ❤

There was a really funny moment for me personally in the stream at 1:50:21, when Dr. K adresses that Dr. Horowitz may have trouble emotionally processing contradicting evidence to his point. This moment was like a clash of eastern vs western perspective, where Dr. Horowitz argues correctly that it doesn't matter what his personal view is as the peer review process takes into account biases leading to objective knowledge, whereas Dr. K was talking about the subjective experience Dr. Horowitz brings to the table, who might have trouble accpeting use cases of SRI's. Both are actually correct.

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I don't know why some comments are triggered by the fact that one is bias? From what i see is both Dr.s trying to reach a common ground moving towards a noble goal. Despite their personal biases, both are acknowledging each other. If anything, these comments seems like they are being bias without acknowledging the other party.

To anyone who's ever been a victim of bullying / hate / violence because of their appearance, gender, orientation, race : DO NOT ever let a hateful notion 'there's something wrong with me' sink in. Trust me, it's a recipe for self hatred, I've wasted half my life feeling it. When we suffer and we need a break, it's only natural to think: 'maybe if I wasn't 'different', if I was 'normal' I would be accepted. No, haters will always find something to pray upon. I've always had kinda androgynous look, which was a fuel for bullies when I was growing up. I embraced it, used it to my advantage in my acting / modeling career, I was almost the face of Leon in these new Resident Evil games :) Remember; There's never anything wrong with you.There might be extremely toxic people around you who can see our potential and value but will keep and drag us down with intent and hideus determination. They do it out of jealousy, they don't want to see us happy or sucessful. They want us docile so we can be manipulated.

had no idea the serotonin deficiency causing depression was debunked wow i’ve always heard about that theory thank you Dr K you’re the best most informative mental health channel i watch by far

you should check in more often with dr. horowitz, great dialogue.

This is phenomenal. I want another podcast by psychologists for psychologists

1:02:50 i really like his explanation of "depression caused by a chemical imbalance" is a category error, in a way i think the chemical imbalance explanation denies the personal experiences that might have led up to why you have depression in the first place.

This video has completely changed my perspective and understanding of my depression and anxiety. Literally EVERYONE needs to watch this video. Thank you so much Mark Horowitz and Dr. K for helping me.

I was able to get off my SSRIS doing meditation and running for a year before i got off. There is significant studies showing these works and their free so there is no profit motive. I also got rid and resolved of the issues that were causing my depression. Turns out that family that acts less than family can be a major cause. You can find better family out there in the world, there is a lot of good people out there.

best content on youtube. thank you for videos like this.

Coming off Effexor was hell. Doctor gave me zero warning.

The experiences Dr. H describes very much reflects my experiences coming off of ssris after 5 years. The numbing is real and was actually helpful in that first year when I was stressed in grad school, but after that period was done, I had a job and making a stable income, I had the time to explore life changes to help in the long term and shouldn't have had continued use for the remaining few years. I'll go easy on myself though while I struggled finding a good therapist and ssris helped trying to navigate the therapy system. It was actually this channel and HG coaching that helped my life perspective the most and gave me the tools to make my life and therapy experiences better. Thanks for all you do HG 😊

I am thankful to be able to listen in on this discussion and in some ways debate. Really appreciate this quality of information being put out for free.

This was such a good stream and I think a reason why so many have mistrust in doctors and pharmaceutical companies. If it’s not watching a loved one battle with opioid addiction or overdose, it’s feeling gas lit over real and debilitating symptoms from psychiatric medication. I think that’s been a lot of the starting point for many anti vaxx and new age type people too. It’s also why many are hesitant to start ssris and stuff as these few pills don’t fit everyone’s needs especially when depression can come on for a variety of reasons-hormones, environment, trauma, burn out, stress, genes, etc. they treat symptoms, not cure the issue at hand usually. We also aren’t allowed to properly process and grieve and breathe either. Covid changed so much yet we were supposed to return to normal. For me, I get very bad seasonal depression during the winter months as I live up north and have limited exposure to the sun and before my period my anxiety goes through the roof and nothing works. I can’t take hormonal birth control either because it messes me up bad. I feel like sometimes doctors don’t try to look at all the symptoms and how to fit them and give us a generic bandaid in hopes of alleviating some of our complaints. During the periods I struggle with like winter I’m expected to be how I am in the winter or when I’m not on my period, when I literally cannot be that person I was. I’m at my lowest energy point yet instead of resting like everything else does, we have to work, go to school, work out, clean etc.

My mind was absolutely blown when Horowitz said that 1 in 6 people in the western world are on antidepressants. I'm certain these drugs have their place, but just based on intuition that seems like an absurdly high number indicating overprescription

Hearing Dr. Horwitz go off about SSRIs reminds me when I watched Dope Sick (short series covering Purdue Pharma's involvement in the opioid crisis).

I am so eternally grateful that AD withdrawal is finally being discussed. Tens of thousands of us have had our lives turned completely upside down by this. Also, fun fact, in the book Children of the Cure, David Healy discusses that the man who came up with the hypothesis actually abandoned it after a few years. Also, the book called the Emporers New Drugs gets into the nitty gritty of the data of dozens of clinical trials and how ADs do not out perform ADs on a long term scale. It’s a very dry read and kind of boring but it is highly informative.

Thank you Dr K, I have been enlightened by your conversations with other streamers in these couple days. When you were talking with them it felt like you were just talking with me. I'm felt so related and eye-opening with some new thought that you have taught them

Dr. Horowitz I wish you mentioned PSSD. Many people are coming out about this condition post-discontinuation. I hope it's something that will be more open to discussion. Just trying to spread awareness!

This person is speaking truth…same here. No one will be making money off it.

1:32:10 Yup, same without ADHD meds. I'm not able to really feel or control or do whatever with my emotions without dopamine. Not having dopamine numbs every part of me and my body and mind as well, which is why without meds, therapy and changes never worked or lasted.

Dr k asking questions that sounds like its about to attack the logic only to agree but getting detailed information in the process. It sounds frustrating to answer the questions but it's awesome to hear and extremely informative.

SSRIs are extremely hard to come off of. It isn't that you can't. It's that coming off them (even if they aren't working) is going to fuck you up even worse than you already are.

Every issue in my life rn is a result of medical malpractice… a marathon runner, triathlete now I’m a mess but getting better w the help of photo bio modulation, HBOT,methane blue and other vitamins and meditation

this talk was amazing for the indepth discussion (even tho could only follow along 80%), and the last 40 minutes is a perfect example of Dr K's incredible insight and rhetoric. Great work 👏

This certainly put the research into perspective. Knowing that it cames from someone affected by the drug. It makes sense that he is putting so much effort in the research. Because he can be easily get descrited by that declaration.

I would love more content on PMDD, I was really surprised when that was brought up since it doesn’t seem to be talked about as much. It literally turns me into a different person, I literally feel like there was a switch in my brain and I literally feel like my entire outlook changes. I tried SSRIs for PMDD, and would love to find more options since I don’t think SSRIs luteal phase and taking it everyday worked for me. personally of course

1:09:18 Same here. My depression(s) were from environmental stuff, things that happened, situations, (financial) insecurity and my needs not getting met. When all of that resolved or some of it, I got significantly better sometimes, but it never lasts and always coems back when the life circumstances change again. I can agree with him here (like with most stuff both said and brought to the table) that this is the case for some of us.

This interview literally changed my entire view on my approach to my own mental health. Thank you from the bottom of my heart Dr. K, Dr. Horowitz and the entire HealthyGamerGG team ❤

The last few videos have really resonated with me, thanks you making them

I think it's interesting that the general consensus is that antidepressants help because they numb your negative feelings. While I would describe my depression as being numb. I'm on my third type of antidepressant and it's the first time that my emotions have come back and with that, I can just feel sad instead of numb/depressed... Am I the only one who has experienced this the other way around?😅

These manufacturers have blood on their hands. Hundreds of millions of ruined lives, shattered dreams, broken homes. This man is a beacon of hope.

Dr Horowitz, if you see this, thank you so much for coming on! It was an amazing discussion!! If you’re looking to peruse through Dr K’s content, I’d recommend checking out the HealthyGamer Bootcamp playlist, as that has the majority of his ideas I also really, really love the 4 Part series where he live trains coaches on how to do effective motivational interviewing, which would be crucial for your ideal clinic. Lastly, the interviews are my absolute favorite type of video. Feel free to ask the subreddit for video suggestions as well! Thank you again, as someone hoping to go to medical school, this was a thoroughly engaging talk

This was an amazing conversation! So much information. Extremely useful. Love it.

As a Premed student, this was a fantastic stream!

Subscribed yesterday and that is already one of the more informative content I ever watched. Congratulations and keep the great work

1:16:21 - I really liked this discussion about "What does get better" mean and the different models/perspectives by which to view drugs. Very insightful!

The book by Johann Hari Lost Connections as well as his TED talk is also highly recommended.

I feel like one thing that isn’t mentioned is that someone who chooses to take antidepressants might have tried the alternatives before. If you’ve tried the exercise, mindfulness, therapy etc and none of them worked, it’s better to try an antidepressant than to give up on life, in my opinion. That has been my experience, I tried all the other stuff first, and I always roll my eyes when people talk about how effective exercise is for depression and how much better it is than to take SSRIs. If exercising fixes you, great!

2023 was the most stressful year I’ve had with zero control of events in my life. The nonstop stress caused me to gain 20lbs within a month and never was able to drop it despite having lost weight and been disciplined in previous years but also not able to temper the stress has become very destructive and I fear it’s getting out of control.

As a resident psychiatrist, really enjoyed this conversation and the topics it touched on. I would have been interested to see Dr. K ask Dr. Horowitz on his opinions on diagnoses such as Schizophrenia or Bipolar I. Compared to typical cases of MDD, these diagnoses (in their severe forms) certainly appear more "biologic" in multiple ways. Episodes often dramatically improve with antipsychotics (for psychosis) or mood stabilizers (for mania). Dr Horowitz made a couple of statements regarding psychiatry as a whole when it seems this conversation is mainly discussing unipolar, nonpsychotic depression. We regularly use antipsychotics and mood stabilizers with well known (and potentially more severe) side effects due to the favorable benefit/risk ratio in these illnesses for many patients. Is he as skeptical of an appropriate use of these meds as well compared to SSRIs?

I'm really glad you upload these 👍

What an incredible guest and conversation. Thank you so much for this

This conversation was phenomenal!!

Two brilliant men and a great conversation that could have been had anywhere. Please have him back on

I’m really glad Dr. K asked such penetrating questions to Dr. Horowitz. However, in terms of clear bias, I would say Dr. K appeared to be the one less open to contradicting evidence and more defensive of his own practices/what was taught to him by mentors he clearly respects. His questions, to me, seemed more critical/“gotcha” type of questions (sort of like he’s trying to find ways to poke holes in Dr. Horowitz’s position, but with an attitude to discredit rather than to truly take in what he’s saying and consider it evenly) throughout the whole interview. On the patient side, I (and lots of other people, including those for whom SSRIs have improved their lives) have had the experience of going to a psychiatrist and very easily/immediately getting prescribed drugs, sometimes a cocktail of them, and getting into a cycle of taking them, them not working (or working then not working eventually), taking different ones, trial and error, dealing with side effects, then either resigning oneself to what little they offer (which is not more than placebo) or trying to get off them and REALLY going through a tough time. Dr. K, your bias in this interview is that you place a lot of your self-worth on making it into Harvard and Mass Gen, and also in being a successful medical doctor after your early failure, and therefore part of what he’s saying with passion (not a “crusade”- which implies unfounded fanaticism/intensity) and as an activist threatens *your* identity. Frankly, I’ve never seen you do an interview like this- where you invite someone to your stream and spend 2+ hours criticizing and minimizing everything they’re saying. Dr. Horowitz’s opinions and experiences aren’t fringe experiences. And he is indeed an MD/Ph.D- he likely knows more about this than you do, especially because the stakes have been so high for him. Someone who has battled treatment resistant depression for decades as he has wouldn’t caution against casual SSRI prescribing (or anything that could potentially work) lightly when the stakes of being wrong are literally life and death. Great informative interview, but I think some humility (and even empathy) would have gone a long way.

Really intelligent and enlightening discussion. Thank you.

1:19:45 - Okay, that numbing effect from antidepressants regarding physical tissue was new for me and I never read about that from others (never took antidepressants myself and I choose not to for several reasons, them being a harm for ADHD people usually also or straight up not working included - and there are studies on pubmed over this also and they confirm this, btw). So that is interesting. And glad he'll release a book about things like these.

Yup, antidepressants are sometimes given out like candy and without exploring much more about the why's and other stuff of a patient and other possible conditions. Not to mention those post-antidepressant effects that cause lasting numbness and more and last quite a few years or longer for some. It's irresponsible for stuff like this to keep going and being prescribed so easily etc.

Thanks for having Dr. Horowitz on! 🙌

Those last 20 minutes were incredible. Not to diminish the fascinating talk with Dr Horowitz, but the discussion on the invalidation of issues being the cause of so much discourse in todays society was so beautifully stated.

Withdrawing from Xanax and effexor was the worst and I was cut cold turkey by my doctor.

my psychotherapist keeps pushing me to take antidepressants because he thinks I have Major Depressive Disorder (MDD) but I’m too concerned about the side effects and withdrawal effects. I have C-PTSD as well so he thinks me taking antidepressants will greatly help his treatment. I will NEVER take antidepressants. I am doing other stuff like exercising more (I went from sedentary lifestyle to 3 times at the gym a week), eating healthier, obviously therapy, and I am trying to seek other alternative ways to improve.

Thank you for sharing this information.

Starts at 7:11

This was a very interesting conversation. Thanks for sharing.

Dr. K is a master of having conversations

One Love! Always forward, never ever backward!! ☀️☀️☀️ 💚💛❤️ 🙏🏿🙏🙏🏼

I loved this talk, always a lot to learn from. Although I know it wasn't the focus of this stream or the studies mentioned, I wish they would've touched a little on depression in bipolar disorder since the mechanism seems very different (and mostly so is the treatment, when done right), yet at the same time bipolar depressive episodes are still viewed as MDD episodes, at least diagnostic criteria-wise (although they can be even more severe especially after crashing from mania/hypomania), given how similarly they present, I feel that it's relevant to include bipolar depression when talking about depression. It's interesting because on another stream, even Dr. K answered a question about bipolar disorder being different, in that there's still a strong case for a "chemical imbalance" hypothesis there, unlike classical depression, or at least that it's definitely an illness/disability, defined by such a tell-tale presentation of symptoms (i.e experiencing at least one hypomanic/manic episode), and much more dependent on genetic predisposition & hardwired brain circuitry rather than circumstance. Whereas a lot of things can fall into the (unipolar) "depression"/MDD bag, and they often get conflated ("feeling depressed"/subclinical depression, clinical/MDD, dysthymia, adjustment disorder, etc.), in this talk they are even talking about a different perspective, about whether we should even think of the latter as an inherent illness or not; which does not seem to apply to bipolar disorder (or a lot less so). I would be curious to know their take on it. While I do find the "numbing" theory about SSRIs compelling and justified, it feels less intuitive when thinking about how they can cause manic switches in bipolar (almost suggesting that they at some level they induce genuine activation, rather than the usual numbing mechanism). But I realize it's probably a lot more complicated than that (most likely coming down more to how the brains of people with bipolar react to these agents differently, rather than the inherent function of the chemical itself).

I was depressed because I kept avoiding buying a house; I took Lexapro and it made me go insane which got me evicted and sued, so once I was homeless, I was forced to buy a house which reduced the cause of my depression but now I have a broken brain with anger confusion and rage which I didn’t have before starting and stopping Lexapro cold turkey

Timestamp: 01:31:57 Therapeutic effect of psychotherapy in the prolonged and counterproductive use of a numbing therapeutic agent. You can't find the root nidus of psychological infection, drain the infection, and allow for proper healing.

For me, my depression - and I know that is not the case for everyone - usually does come back when my emotional needs are not met and my ADHD acts up worse again AND hormones. Hormones (and PMDD) play a massive role for me also. But dopamine as well (and less serotonin). My brother didn't even have any success with 5 antidepressants, those being SSRI's as well as SNRI's (?). But yeah, if we have a great time in life for a while (a few weeks to a month), the depression gets better, but as soon as smth bad happens or we get chronically stressed again, we become resistant to dopamine and feeling good and it goes to crap again. Not to mention all of us also have neurological disorders that also make us more prone to it, though, so yeah.

2:31:48 Okay, that CBT example makes a LOT of sense. And since there is also less individuality there (not necessarily just that and the case for everyone, ofc), it worked even less or close to not at all for me (and my ADHD; since I was or felt unable to do anything I got told to or didn't know about the ADHD yet and just thought I must have social anxiety, which is not entirely the case and just fueled by the ADHD).

Just incredible!

Great interview! Love to see the enthusiasm in both of you. Dr. Mark Horowitz 👏👏 Go Mark go! 🔥 1:54:14 "when there are peer-reviewed studies suggesting antidepressants are effective" those clinical trials have methodological flaws as Dr. Horowitz had mentioned, so the conclusions or interpretations of the data of those studies is misleading. 2:22:38 so interesting, thanks for sharing it. Meditation as a technology to remove the subjective bias of our mind, it's to cultivate the metacognitive ability to observe ourselves, placing the locus of control in ourselves.

I would love to see a similar talk to this about panic disorder

Is it possible that yhe emotional numbness can make the depression worse? When I was in my late be ths tried the medication route to solve depressive episodes. This ended up making me so numb i became suicidal, though this was more like a logical choice (which some say isn’t possible). I was like i can't feel saddness but i can't feel joy, so why do i keep living. This almost ended badly, with even my therapist telling me I can't that depresseed because I'm medicated and that we can discuss it at my appointment. Somehow i survived but i left that therapist and the meds that i was on. I honestly feel like surviving without mrdical intervention was due to divine intervention as i went into that with a lot of information. Point being I felt nothing and remember nothing fo the two weeks following that. This was in 1983, i was 18 almost 19 and now iam two and a half months from 60

Man, now I'm not sure if I should take the meds that were prescribed to me. The side effects freak me out, and I don't have the medical knowledge to figure it out on my own. The only people I can ask are the same people that would prescribe them in the first place.

16:27 This is the same argument I made with my doctor when she cut off my anxiety meds but raised my Zoloft. It's idiotic when they tell you it's not the same thing.

Delays in withdrawal symptoms is a huge takeaway.

2:27:37 Exactly. It's usually "shit life syndrome" and circumstances (or genetics etc.) or another condition (like ADHD, for example) causing this. Or heck, trauma, PMDD, CPTSD etc. even.

Dr. Horowitz helped me so much in my journey to get off SSRI's. I have akathesia currently from Paxil withdrawal. Just verification that its real , was incredibly helpful!

Really wish that psychiatrists would include non-SSRI antidepressants in these conversations.

I am not surprised that doctors know nothing about withdrawal. That's why you should not get "help", but always solve issues yourself with everything but drugs.

Amazing video thank you

1:31:30 Ironic that it's the reverse/opposite with ADHD meds :D But also helps one remember therapy advie and coping techniques then and even pay attention or regulate thoughts, emotions and behavior better (which I'm usually unable to otherwise - I'm sadly not medicated yet, though).

Had panic attacks (but didnt' know that's what it was at the time), depression and killer anxiety as a graduate student (full ride scholarship). I did no drugs (ever) and didn't drink alcohol (health choices/loved my mind and didn't want to fuck it up). But I was in bad shape emotionally/mentally at the time and needed some help. First drug prescribed was Lexapro, which was amazing for anxiety but within two weeks I knew I'd have to give it up (muscle tremors/nightmares). Next was fluoxetine and that was good enough and I never had withdrawal (quit cold turkey in the summer -- nobody mentioned seasonal affective disorder or vitamin D deficiency -- let alone the fact that graduate school was a waste of my time, didn't fit my goals, and put me in a culture that mirrored my worst experiences in childhood [among many other things, graduate advisor was sexually harassing me and threatening my scholarship]). Fast forward 20 years I'm diagnosed with CPTSD, ADHD and Epstein Barr -- all conditions I've had from childhood (Epstein Barr since 12). Well, that explains a lot. Also, can't absorb vitamin B9 from my diet well (that's a genetic issue many, many people have; see MTHFR Mutation - lucky I didn't have worse mental health conditions given that!). Antidepressants were never the right treatment. It was a lazy answer.

This video got posted at the perfect time, I’ve been having a lot of distrust in the medical system ever since I was put on anti depressants without being told of the horrid withdrawal effects. Although fluoxetine has helped me I now have something against it as it can make me feel the worst I’ve ever felt. Any advice would be greatly appreciated as well :)

Great video, loved it!

I would LOVE to watch Dr K talk about Jiddu Krishnamurti, whose whole philosophy was about using meditative awareness to assess your own conditioning.

Therapy might be economically viable in UK and EU, but in the US, therapy is expensive. Even with insurance, copays add up fast.