WE’RE AGAINST MEDS But Not Coffee, Wine, or Control Issues

This morning, before I even met with a new patient, her mother, a physician, said to me, “I just want you to know, we’re against meds.”

I have heard it many times before, and it always makes me pause. It is said quietly, almost like a warning. Sometimes it sounds protective, sometimes proud. What it usually means is, “I don’t want to believe I, or my child, might need help.” It is not rebellion. It is fear. Fear that needing medication says something about your character instead of your chemistry.

Nobody lies awake at night worrying that their child’s asthma inhaler reflects bad parenting. But say “Zoloft” or “Adderall,” and suddenly the room fills with guilt. Psychiatric medication carries a kind of moral weight that blood pressure pills never do. They are not seen as tools. They are seen as verdicts.

• Percentage of parents who tell me “we’re against meds”: roughly 70 before our first session.
• Percentage who whisper it: nearly all.
• Estimated U.S. adults who take some form of prescription medication: about 70%.¹³
• Estimated U.S. adults who admit that includes psychiatric medication: about 16%.¹²
• Medical conditions that still carry moral judgment: one.

And here is what I always wonder: if someone is truly against medication, why come to a psychiatrist? Why not a therapist, who does not prescribe? I think it is because part of them is not against medication. Part of them is just afraid to need it. Coming to see me is often the first act of quiet bravery, a way of saying, “I want to understand what is happening, even if I am scared of what the answer might be.”

Another thing I hear often, especially from parents of younger children, is this: “I thought therapy would be enough to help, but it clearly isn’t. I think it may be time to consider medication.” Those words carry both relief and grief. They mark the moment when a parent stops fighting the idea that their child’s struggles reflect their own failure, and starts seeing them as something that deserves real treatment.

Yet depression takes nearly 50,000 lives every year in the United States¹, and ADHD affects about one in ten children². Those are not moral issues. They are medical ones. [Image of chemical imbalance in brain]

Marc Maron once said, “When I got on antidepressants, it didn’t make me happy. It just made me less interested in driving into traffic.”³ That is not weakness. That is survival.

The Curious Case of “Natural” Medicine

Here is the irony. Many people who avoid Prozac on principle will buy a sixty-five-dollar “mood-boosting mushroom elixir” from Instagram without hesitation. If it grows in the ground, it feels pure. If it comes from a lab, it feels suspicious. Both alter brain chemistry. One comes with clinical trials. The other comes with a coupon code.

• Annual revenue of the U.S. supplement industry: over $55 billion.⁴
• Annual ER visits linked to “natural” remedies: about 23,000.⁵
• Number of Instagram wellness influencers with medical degrees: zero.
• Number of people who have died from taking an FDA-approved SSRI as directed: statistically negligible.
• Likelihood that “natural” means “unregulated”: 100%.

Ricky Gervais once said, “You trust the company that sells you crystals, but not the one that figured out penicillin? Okay.”⁶

The Gospel of Healthiness

The same moral theater plays out in vaccine hesitancy. The logic is identical: “I’m healthy enough not to need it,” or “My body knows what to do.” People claim purity while worshipping at the altar of ivermectin, zinc lozenges, or whatever the latest “alternative” sacrament might be.

It isn’t about science. It’s about identity. The word “vaccine,” like “antidepressant,” makes people feel contaminated. They believe they are protecting their “natural” selves from corruption, when really they are protecting their illusion of control.

• Percentage of Americans who delayed or refused the COVID-19 vaccine citing “health” or “natural immunity”: over 40%.²⁶
• Percentage of those same respondents who reported using unapproved alternative remedies: nearly 30%.²⁷
• Number of times “I trust my body” has been tested under peer review: zero.
• Estimated number of people who think mRNA reprograms DNA: too many to count.
• Biological difference between vaccine hesitancy and medication stigma: mostly vocabulary.

The purity argument is always the same story in new packaging — kale instead of chemistry, crystals instead of compliance, wellness instead of willingness.

Glasses Are Medication Too

If psychiatric medication is “unnatural,” what does that make eyeglasses? They literally change how we see reality. About sixty-four percent of American adults wear them⁷, and no one accuses them of dependency. You do not hear anyone say, “I prefer to see naturally,” while missing the stop sign.

Hearing aids work the same way. They fix a sensory distortion. Depression, anxiety, and ADHD are sensory distortions too, just turned inward. Medication does not make you someone else. It helps you experience the world more accurately⁸.

Everyone Medicates Something

Let’s be honest. Everyone medicates something. Some people take SSRIs. Others take caffeine, control, or compliments. Everyone medicates something; some just choose more photogenic chemicals. One person swallows Wellbutrin. Another swallows resentment. Either way, it is chemistry at work.

• U.S. adults consuming caffeine daily: about 85%.
• People who describe themselves as “against meds” while drinking coffee: uncountable.
• Antidepressants clinically proven to increase serotonin: most.
• Social media likes proven to do the same: temporarily.
• People whose favorite outfit functions as emotional armor: all of us.

Research in Cognitive Therapy and Research found that what you wear can shift mood and confidence almost as much as a mild antidepressant⁹. So yes, your favorite outfit might actually be Prozac in polyester.

Bill Burr once said, “You ever notice people who say they don’t believe in therapy are usually the ones who need it most? Same with pants.”¹⁰

 

It’s Not About Strength. It’s About Stigma.

All this “I’m against meds” talk is not really about medicine. It is about identity. We are comfortable fixing what we can see, but we hesitate when the repair is invisible. It feels safer to think sadness or panic are character flaws than to accept that they might be as biological as nearsightedness¹¹.

Around sixteen percent of U.S. adults take psychiatric medication¹², but nearly seventy percent take at least one prescription drug of any kind¹³. We accept pills for cholesterol, hormones, or heartburn without hesitation. But when it comes to the brain, people still whisper.

• Conditions Americans feel most comfortable disclosing to friends: hypertension, reflux, migraines.
• Conditions least likely to be disclosed: depression, bipolar disorder, schizophrenia.
• Number of people who say, “I’m off my statins,” with pride: zero.
• Number of people who whisper, “I started Lexapro”: too many.
• Correlation between stigma and treatment delay: direct.

Psychiatric medication does not erase you. It helps you return to yourself. Glasses do not make you dependent. They help you see. Antidepressants do not make you artificial. They help you live¹⁴.

George Carlin once said, “There’s no such thing as bad drugs. There’s only bad relationships with drugs.”¹⁵

The Fear of Nomenclature

This morning, a patient told me she was afraid to start a medication that is, technically, an “antipsychotic.” She worried it might make her “go crazy.” She is not psychotic. She is anxious, overwhelmed, and sleep deprived. What she fears is not the medicine. It is the word.

Psychiatric nomenclature often makes conditions sound catastrophic. “Antipsychotic” simply refers to partial dopamine blockade. That’s it. A small shift in how the brain communicates. But when the name sounds like a horror movie, people assume the plot ends in madness.

So, I explain what dopamine does, how too much creates chaos and too little causes apathy, and how a partial reduction can actually bring balance. Understanding that helps. Language shapes everything: fear, shame, and trust. If a cholesterol drug were called an “anti-fat-blood agent,” no one would take it either.

• Most feared class of psychiatric drugs: “antipsychotics.”
• Number of patients using them for mood stabilization or sleep, not psychosis: millions.
• Number of medications whose names sound worse than their effects: too many.
• Number of neurotransmitters implicated in human happiness: at least four.
• Number of them mentioned accurately in most news articles: one, if we’re lucky.

Maybe it is time we stop sorting medication into good and bad, natural and artificial, brave and weak. Maybe it is all part of the same human effort to live clearly and comfortably¹⁶. The body and the mind are not separate worlds. They are neighbors, trying to help each other out¹⁷.

The stigma surrounding mental illness still runs deep¹⁸, even though the World Health Organization ranks depression among the leading causes of disability worldwide¹⁹. Understanding brain chemistry should not carry shame any more than understanding insulin or blood pressure. Addiction science shows that substances themselves are rarely “evil.” It is our relationship with them that defines the harm²⁰.

Writers and clinicians have been saying this for decades. Andrew Solomon wrote that depression “is the flaw in love,” not the absence of it²¹. Allen Frances, the psychiatrist who helped write DSM-IV, later admitted we had “medicalized normal sadness” instead of teaching people to tolerate pain²². Marsha Linehan built her therapy model on radical acceptance²³. Oliver Sacks wrote case studies that treated neurological difference as biography²⁴. And Kay Redfield Jamison, both a psychologist and a patient, reminded the world that mood disorders are not weakness but weather²⁵.

Maybe the better question is not who takes medication, but who still believes they are supposed to do life without help.