Doctor's Note

Exercise as good as antidepressants? See my last video, Exercise vs. Drugs for Depression

There are other ways meta-analyses can be misleading. See The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

More on the ethical challenges facing doctors and whether or not to prescribe sugar pills in The Lie That Heals: Should Doctors Give Placebos?

I’ve used the Freedom of Information Act myself to get access to behind the scenes industry shenanigans. See, for example, what I found out about the egg industry in Who Says Eggs Aren’t Healthy or Safe? and Eggs and Cholesterol: Patently False and Misleading Claims.

This isn’t the only case of the medical profession overselling the benefits of drugs. See The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure (though if you’re worried about your mood they might make you even more depressed!)

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  • Jane

    You forgot to mention that these antidepressants can cost $200-300/month or more as dosage has to increase because they aren’t working. That is a super bad side effect!!

    • Doctor Dave

      Yes, Jane, and he also forgets to mention that food choices can have powerful effect on psychology. Please see Neal Barnard’s recent blog at Dr B is a trained psychiatrist who has contributed a lot to healing diabetes with a vegan diet, but he initially got into this area by looking at the acceptability of the vegan diet. There is a lot more on this subject, too. Isn’t this the Nutrition Facts web site? Why has this link to diet been omitted from recent videos?

      • Joseph Gonzales R.D.

        Hi, Dr. Dave,

        Let me see if I can help. I respect Dr. Barnard and have worked with him extensively on many studies, including some on diabetes. Agree 100% ” food choices can have powerful effect on psychology”. This video perhaps does not discuss diet because Dr. Greger hits on that in other videos here, and here. In his last video he mentions exercise as a means for possibly reducing depression.

    • Joseph Gonzales R.D.

      Good point about costs, Jane.

    • Lisa Taylor

      Even with health insurance, my copay doubled to $40 this year. I can’t afford much needed weekly therapy sessions now. And many therapists in DC don’t accept health insurance which I find unethical and reprehensible. Not everyone in DC is rich enough to pay $350-$400 a week for therapy. Why become a doctor of any kind if making money takes precedence over helping people in need?

      Fortunately, as a healthy vegan I decided to double up on my dark, leafy greens intake and experienced a dramatic lift in my mood within 24 hours, and without side effects. Still, I find therapy essential to my mental and physical well-being (I live with rheumatoid arthritis and generalized anxiety disorder too). Going without has been difficult.

  • Noe Marcial

    Thank you! I have saw many times friends on medication being more depressed than before at long term, and having a strong feeling of addiction towards the antidepression pills.In the last videos I watched dr greger questioned the pharmaceutical industry..and they have good lawyers, it will be good to have good ones on the side of impartial science.. Just in case.

    • Karen

      I must be an anomaly as I feared issues with the possibility of becoming addicted, but it never posed a problem for me. A combination of talk therapy and appropriate medication as well as the correct dose helped me. I have also not been meds for over 10 years now too. I am not against medication as for many people it helps.

      • GeorgeBMac

        Part of the ‘addiction’ could be fear of relapse – which is reinforced by PCPs telling their patients to ‘always take your medicine’.

        Technically, that is not addiction. But it has the same effect: a lifetime of drugs that cannot be escaped.

        • Karen

          Thank you for your response and you’re right relapse and addiction are not the same things. It is unfortunate that it is heard that way. I find it interesting the different interpretations that people have. At the time, despite being diagnosed as clinically depressed I did clarify with the prescribing doctor. He emphasized the need for follow-up care citing that medications often need to be tweaked.

          • Kim

            Karen, did you watch the video? The research seems to show that antidepressants actually work through a placebo effect; patients think they need them, think they’ll get better, and so they do. Pointing out that antidepressants have helped you or helped others you know proves nothing about the efficacy of antidepressants themselves as opposed to the placebo effect.

  • BB

    It is sad and unfortunate that pharmaceuticals seem to be the first and preferred choice of treatment by doctors. Even fake pharmaceuticals (placebos) are preferred to discussing diet and exercise. I see this time and time again with friends and family who are fighting chronic diseases. Medications are the focus. They are rarely asked about what they are eating and if they are moving.

    • Kim

      Or what the other conditions of their lives are like. Do they work, and if yes, do they like their job? Do they have a rich social life and friends, family, etc. or are they isolated and lonely? etc.

  • Julie

    An additional, terrible side effect of anti-depressants: “certain medications, such as Prozac have been linked to increase risk for violent, and even homicidal behavior”. Most of the school and mass shooters were taking anti-depressants. Even though these are troubled souls before taking medication, anti-depressants still seem to increase the likelihood of violent behavior. “Despite international drug regulators warning that these drugs can cause mania, psychosis, hallucinations, suicide and homicidal ideation, Congress has yet to investigate the role of psychiatric drugs in the vast majority of school shootings.”

    • masobel

      There was also an interesting article in the NYTimes written by Richard Friedman about the drastic increase in use of psychiatric meds in the US military and the corresponding increase in suicide rate.

    • MA

      Hi Julie. The sad fact about the publicity of school and mass shooters is that the story is usually written one of two ways:
      > the shooter was emotionally disturbed and on medication at the time of the incident. OR
      > the shooter was emotionally disturbed and was not on any medication or under a doctor’s care.
      Seems the media is opportunistic and writes the stories both ways.

  • Jerry

    After trying a laundry list of psychotropic meds for depression, loosing my mojo and my wife, and loosing my sense of empathy for others from prozac, I tried what might be called bibliotherapy or cognitive therapy in the form a book by Dr. David Burns called The Feeling Good Handbook. I haven’t had a major bout since.

    • Karen

      I read the same book by Dr. Burns and it was excellent as well as many others.

  • teaspoon2

    You are one hell of a good person and true physician! Thank you for saying what so many are paid to remain silent about.

    • Kim Churchman

      True that!

  • Kris

    It could be that depression is not one but many different diseases and so, it’s necessary to find the right medicine that works for the individual. One may work well for one person but not help another at all. At present this may mean a process of trial and error. One friend found that wellbutrin worked well for him well it made me feel sick. My sister has been on Prozac for years with good results while it lost its effectiveness in me after two years. However, I’m now of the opinion that it’s best not to trust big pharma and to use exercise, a vegan diet or talk therapy, or whatever works without drugs.

    • Joseph Gonzales R.D.

      Hi Kris.

      You bring up a great point. I agree with you about finding medications that work. In the video Dr. Greger mentioned that those suffering from greater than moderate depression (I think it was 11% of the study participants) did find success with medication. Finding the right one is important for those with depression. The purpose of this video is not to discourage people with severe depression who need medication to simply exercise and eat a clean diet to rid their problems. No way, that scenario is highly unlikely. I think there is a place for all to coincide, such as finding the right medications and the right therapy supplemented by a healthful diet and exercise. The fact of the matter is that people are over prescribed the kind of medications. To avoid publishing crucial data that deals with our mental health is completely irresponsible and unethical.

  • rumicat

    Oh good grief. Most people need more exercise and more positive social activities in their lives, but finding time for this is sometimes next to impossible. And even then it’s not enough for some folks. The same way some people are more likely to dislocate their shoulders, some people are more likely to feel down. It’s biochemical diversity and eating broccoli and taking a walk is just not going to be the solution for everyone
    I’ve been on a plant based diet for four years and I exercise 4 to 5 times a week. It does help quite a bit, but it’s not enough to overcome the perimenopausal insomnia I’ve been dealing with for the past year. Low dose prozac, which I waited way too long to try, has changed my life for the better. Even when I only get five hours I’m able to function and be a much nicer person to everyone I care about. Too much judgement people!!!

    • rumicat

      And YES antidepressant drugs really do work for some people.

      • Brux

        How do you know? How do you know it is not the placebo effect?

        • rumicat

          I don’t think anyone taking psychoactive drugs can ever know for sure, but I can tell you I’m not a person that likes to rely on medication. I control my blood pressure by diet, exercise and avoiding caffeine because I don’t like the side effects of bp meds. I don’t even take Tylenol for fever because I figure my immune system should be allowed to do its job. But I’ve noticed a big difference in my energy level and coping skills on just a small dose of prozac that my family would attest to.

          • SeedyCharacter

            Rumicat, I’m glad to hear the Prozac is working for you. It sounds as though you’re conservative about your use of meds and aware of when to make judicious use of them. As a psychotherapist, I’ve seen plenty of folks benefit from anti-depressants–whether or not that’s been due to a placebo effect, I don’t know. But their side effects have often been quite problematic.

            Sometimes it takes the medication to give folks enough energy and motivation to incorporate movement and healthier eating into their lives. There’s a lot of self-medication happening with the “comfort/junk foods.”

            I’m not sure if you’ve tried melatonin for your insomnia but it’s been extremely helpful for me and my middle-aged friends. Melatonin is not produced as effectively in older folks and a little supplementation often helps. I get sublingual 5 mg tabs from Trader Joe’s for just a few dollars and they work like a charm. (If you try melatonin and it doesn’t work, I’d encourage you to try different brands and dosages before you give up.)

          • rumicat

            Thanks Speedy. Melatonin has helped with falling asleep sooner but not with the late night waking that started a year ago. Even the time release wasn’t of any use. Benadryl works, but it’s not good for your blood pressure. I’ve been managing sleep issues for years, but the problem became much worse recently. My mothers has been using sleep aids for decades, so I imagine there’s a genetic component. My brother has milder sleep issues. People who consistently sleep well at night should count themselves lucky. I sometimes wonder how many people who are diagnosed with depression are just suffering from an undiagnosed sleep disorder.

          • SeedyCharacter

            Have you tried taking another melatonin when you do the late night waking? There’s also tryptophan, magnesium, the herbal teas . . . though you may have tried all of those. There’s a really great radio program by a brilliant functional medicine doctor, Dr. Dawn Motyka (MD, acupuncturist, etc.) You can listen (online) on Saturday mornings or via her audio archives any time. (The archives are broken down by topic so you can listen to only the ones you want. She has years worth of archives–a treasure trove of integrative medical advice) You can also email her and call in with your questions and she WILL answer them–highly recommended! On her March 7th program she talks about sleep and the use of antihistamines for sleep purposes (scary new study linking use to dementia). She gives a range of healthier alternatives for sleep. Good luck.

          • Brenda Ludlow

            I read an article online recently written by a neurologist. He found that all his patients with sleep problems and headaches had Vitamin D deficiencies. Lemon flavored cod liver oil before bed has improved my sleep. I take a TBSP to get 100 percent the daily allowance of vitamin E. But over the years I have had many different vitamin deficiencies…at 19 yrs old I had an iodine deficiency (?). I no longer take antidepressents bc they make me not eat. For lent this year, instead of giving up a food item, I have been focusing on detoxing my digestive tract. Antidepressents effect sleep too. I agree with you in that lack of sleep can be depressing. So how will I ever get well taking an antidepressent that causes poor sleep?

          • Lilyfan2

            So glad I happened to find this site today. I think the body, mind, and spirit is a wonderful healer if given the right care, of food, exercise and a good positive attitude. Most of the medical profession seems to turn to a heavy handed drug approach for most every ailment. Just my opinion here.

    • Joseph Gonzales R.D.

      Great points, rumicat. I made a post about the fact diet and exercise alone may not (and is perhaps not the most responsible choice) work for those dealing with more severe depression. In your case, insomnia will not subside by an extra serving of broccoli, as you mentioned ;) However, still important to eat a healthful diet and exercise for various responds beyond mental health. I am so happy you found a regimen that works for you! No need to suffer unnecessarily, and no need for blame or guilt :)

      Onward and Upward….


      • Kim

        I believe that in time people will leave off dealing with the numerous issues everyone here is talking about with pharmaceuticals, which can be criticized on multiple grounds (some work through placebo effect, there are potential side effects, their function as “band-aids” that cover up the real roots and solutions to problems, etc.). I’ve dealt with severe depression and anxiety. At one point it was so bad I suffered from severe insomnia and the little sleep I could get would get cut short by nocturnal panic attacks. I was in a horrible state. I’m glad to say I didn’t turn to meds, but instead relied on support from family (including talk therapy with loved ones), good nutrition, exercise, getting outdoors, etc. I’m feeling much better nowadays. I think most people are too dismissive of all the factors that go into creating good health (including mental health): it’s not enough to just eat healthy and exercise. We need to work at getting everything in our lives in balance, and coping with what we can’t change for the time being (broader societal problems) while working to improve those conditions so that the future can be a brighter place for everyone, one where these issues are rare or perhaps even non-existent. Past hurts and traumas must be dealt with. We need good relationships, we need downtime and fun, we need meaning in our lives (whether it’s through our jobs, volunteer work, whatever).

        I believe our current medical view of depression and other mental illness leads people to see themselves as “broken” and damaged, to see themselves as having something wrong with them, and it makes people believe they need medication, etc. to function. People become disempowered, and see themselves as victims of their own biology. Meanwhile, pharmaceutical companies get to make big bucks. We’re seeing more and more people saying no to this, though.

  • Brian R Gard

    I was prescribed Paxil 19 years ago, Doctor told me I needed to be on it rest of my life! I was anxious, could not sleep, depressed, exhausted, sleeping 1 – 3 hours a night for months. I took half a pill slept 13 hours first night, was able to get to work by 8 but on weekends slept till 1 pm after going to bed about 10:30 at night 13 1/2 hours of sleep. It worked, I felt better, was recovering from divorce and death and terminal illness of both parents. After six months quit the medicine exercise and diet and time cured me and never used prescription medicine of anykind since. Medical Doctor was full of crap that told me I needed it the rest of my life along with a lot of another baloney we were told about both parents and their illness. I cannot deny however that the Paxil gave me virtually instant relief from my almost unbearable agonies at the time I took it, but I did not want to live that way, the side effects were weight gain, sweating, and the odd feeling that even though my life had gone to hell I was happy about it, I deserved and needed to be depressed to move on and so I did.

    • Joseph Gonzales R.D.

      Wow. SO powerful. Thanks for sharing your story, Brian. I think so many members can benefit from this. Shoot, I know I did. Such a complex issue surrounding mental health and it is so personal. Glad to hear you are doing well.


      • Brian R Gard

        Joseph, I resisted the anti depressant for months, but it was immediate relief, I was told it might take weeks,
        in 3 days it was a different world but that too was troubling, especially the strong side effects on my body. I had to gain some time away from the life tramaus of death and divorce and financial hardship but held on and recovered, I took to exercise because that was something I had always done, than got real serious about nutrition, there were a lot of factors but that little pink pill had awesome power, I certainly do not expect and do not want to ever use it again. Thanks for the compliment!

        • Kim

          I was also on Paxil, for about a year and a half, when I was in my late teens. At the time, I attributed my recovery in part to this medication, but my current view on the matter is that it was getting help and attention from my doctor, my family, and my friends, as well as my renewed faith and perceived relationship with God (I’m now at atheist, but there is no denying the power of belief to give one strength, happiness, etc.!) that got me better. Looking back, I can’t know for sure whether the antidepressant had a positive effect, no effect, or a negative one, but based on some of what I’ve learned over the years, I don’t believe it was needed at all in my recovery, and that it probably worked through a placebo effect. There are some that believe that long-term antidepressant use makes people more prone to depression, though I’m not yet convinced that this is an actual effect of the drugs rather than being attributable to other factors (for one, thinking of oneself as being “neurologically damaged” and believing that one needs medication to be normal and to function is not very encouraging stuff). The concern that it might do that is enough for people to avoid them, though, IMO. I’m, for the time being, even more concerned about people, especially children, who are being put on stimulant medications, which seems to me even more likely to have the potential to permanently disrupt the brain’s reward systems.

  • b00mer

    There’s an awesome episode of “The Nature of Things” about the placebo effect. Those in Canada can watch it directly on the CBC website, others can view it here:

    It touches on effectiveness of antidepressants, as well as other fascinating topics like 1) quantifying the placebo effect and 2) placebo treatment for Alzheimer’s. Deceptive and unethical behavior from industry and government aside, the actual science and potential of the placebo effect is pretty cool.

  • Benjamin VP

    There was an interesting opinion piece in the NY Times last September about Lithium:

    It claims that the amount of lithium in the soil used to be somewhat higher, so everyone was getting some with their regular diet, but that it’s been rather depleted now, leading to the much larger numbers of people being diagnosed with depression.

    I’d love to hear Dr. Greger’s or Joseph’s thoughts on how solid the literature is on this, and which way it points.

    • Joseph Gonzales R.D.

      Whoa. Never heard of this. Lithium in drinking water? Super interesting indeed. Unfortunately I have not seen the research to point one way or the other. As of now, no lithium for me – thank you :)

      Thanks Benjamin feel free to continue this conversation if you find some good literature.

      • psisai

        I agree. There’s enough stuff in water already that’s probably not totally needed.

  • Larry Litt

    Do you have an opinion on Laughter Yoga (Hasya Yoga) as an alternative therapy for some types of depression? There are valid claims for its mind/body effectiveness especially for long term stress relief.

  • Miguel

    We knew all this over 10 years ago thanks to Kevin Trudeau. Now he sits in jail for 10 years.

    • Brux

      From Wikipedia:

      Kevin Mark Trudeau (/truːˈdoʊ/; born February 6, 1963) is an American author, radio personality, infomercial host, salesman and convicted fraudster who has promoted various unsubstantiated health, diet and financial remedies. Several of his books, including Natural Cures “They” Don’t Want You to Know About, allege that both the U.S. Food and Drug Administration and the pharmaceutical industry value profit over treatments or cures. He is currently incarcerated at Federal Prison Camp Montgomery, near Montgomery, Alabama, and is scheduled for release on July 18, 2022.

      Trudeau’s activities have been the subject of both criminal and civil action. He was convicted of larceny and credit card fraud in the early 1990s, and in 1998 he was sued by U.S. Federal Trade Commission (FTC) for making false or misleading claims in infomercials promoting his book The Weight-Loss Cure “They” Don’t Want You to Know About. In 2004, he settled that action, by agreeing to pay a $500,000 fine and consenting to a lifetime ban on promoting products other than his books via infomercials.[1] On November 29, 2011, the Seventh Circuit Court of Appeals upheld a $37.6 million fine levied against him for violating that 2004 settlement. Additionally, on remand, the district court modified its final order, requiring that he post a $2 million bond before engaging in future infomercial advertising.[2][3][4] In April 2013 he was reported to have filed for bankruptcy to avoid fines and stay further Federal prosecution.[5]

      • stamm

        Is this an attempt to use Wikipedia as some sort of real info? Because it’s very hard to separate its’ facts from Wikipedia”s much more voluminous biased opinions and slanted facts. Besides Miguel already stated that he was in jail. The question is not whether he was adjudicated, but rather whether that adjudication had any merit. If you’re trying to say that it did, you failed to appeal to any legitimate authority to do so.

  • Susan

    The pharmaceutical industry is the sister industry to the chemical or pesticide chemical industry and their tactics are the same only showing the positive effects or what the corporation wants you to know.

    What the largest chemical company in the world wants us to know is that glyphoshate still works to kill weeds, Why then are weeds becoming resistant and why is Monsanto repeatedly asking the U.S. EPA to increase the amount of herbicide that can be used in and on food crops without showing a significant adverse effect? And, why is the corporation changing the dna of seeds to resist 3 very toxic herbicides to make killing weeds and all life even more profound. One chemical has never been used on food before but when it was ingested it caused seizures and death in no uncertain terms. Yet this chemical as well as dicamba, which is contaminated with dioxins, and glyphosate was initially patented in 1964 by Stauffer Chemical as a metal descaling agent for cleaning pipes and boilers and then bought and patented in 1969 by Monsanto and patented as an herbicide which it registered and commercialized without any chronic long term studies, patented as a mineral chelator, and as an antibiotic and sold all over the world using the rhetoric that it is non-toxic. It appears that nothing could be further from the truth, but with the disappearance of studies from the US EPA libraries between 2005-2007 including those that showed the clinical effects of herbicides used with genetically engineered crops, the U.S. EPA now has to rubberstamp whatever the corporations claim. (P.E.E.R. library closures)
    Glyphosate and the other chemicals used with Glyphosate Modified Organisms are now in the marketplace in white potatoes, fed to livestock, farmed fish, pet and wildlife in zoos and breeding farms, and fed to pregnant women, and their fetuses, as well as infants, toddlers, children and anyone else who does not eat certified organic crops or meat and dairy. But also according to studies coming in from around the world, Glyphosate has been identified in the urine of dairy cows, and other livestock, and in humans! In most cases in Europe it is from eating meat and dairy because unlike the USA, Glyphosate Resistant Organisms are not yet used to grow food.
    To learn more about glyphosate, go to:

  • Brux

    Good video … I suspected this for a long time. The theory behind antidepressants does not make any sense to me. There is no good theory as to how they work, why they work or that they work. It is a bit like saying if you car is broken, open the hood and pour oil in the engine compartment. There is no indication that not enough oil is the problem, or that just putting it anywhere in the car is going to help. That is what they do with antidepressants pretty much. They use these powerful drugs because they found out the same thing with other treatments, such as lobotomy or electroshock – it supposedly cures about 1/3 of the people, it harms another 1/3, and it doesn’t do anything to the last 1/3. Who would not be depressed living in an idiotic society like we have that does this to people.

    This is a giant scam on people to grab money, and who knows what these drugs do to people. Really the only thing you have in this world is the amazing matrix of your nerve cells that all work together to form the most complex thing in the universe … and we think we know how it works or what goes wrong with it when people get depressed? HA! How about people get depressed because the world is messed up and most people have no understanding or control over their lives and are deprived by the economic and political system – and powerlessness makes people depressed.

    If the medical system will do this to people on the scale they are doing it, what else are they doing as well? They put poisons in our food. They pollute our air, water and land. Everything is wrong about the way our society and economy works, but we seem to have no say, no control and like you say here – we cannot even get information to discuss things.

  • MA

    I am a person who has had a life-long struggle with depression and generalized anxiety disorder, just like my mother who chose not to seek treatment. While I fully support Dr. Greger, I think the message underplays the effectiveness for those of us who require these meds to remain vertical. I am concerned that some people who see the video will not seek treatment, when it would be advisable.
    One well-known aspect about psychotropic (depression meds) is that scientifically, it is unclear exactly how these medications actually work on the brain. In addition, every human being is a unique chemical plant with individual enzymes that may or may not respond to a particular medication. This would be a reason why reports are, that some drugs do not work.
    Second, it is not advisable to seek treatment for depression from the family doctor. Their education on these powerful medications are most likely limited to what the pharmaceutical reps have told them. This kind of illness is best left in the hands of someone who specializes in the treatment of depression and others. A good psychiatrist will know when a medication is not working for an individual and will make the adjustments in the early stages, and if a person adopts a tolerance to the treatment after a time the psychiatrist will recognize the symptoms and make the adjustments. Then continue to monitor.
    Third, sometimes a life-long course of therapy is required. Again, this would be people such as myself who do have severe depression. In the early years of my diagnosis, various doctors would only prescribe for a period of six months. What would inevitably happen is my mental state would gradually decline, which I failed to see only when things around me had fallen in such disrepair due to bad choices in mates, poor relationships with friends-or the wrong ones, or I couldn’t find my words to form a sentence, or had missed assignments putting me seriously behind. For people with these kinds of issues, the right kind of medication on a consistent basis is a life saver. This does not mean I have no feelings, or am unable to cry. I would suggest here that those would be signs of over medication, in my opinion.
    So when publishing such a powerful message to the general public, please keep in mind that they may have a relative who is genuinely depressed and do not need someone else to tell them that they heard the pills weren’t effective. Or a spouse may not be supportive and hears this kind of message and refuses to provide financial support for the prescriptions.
    The fact is that people like me are in the minority. And unfortunately, we are a silent minority due to the extreme bias towards our disease at every turn.

    • Charzie

      I am in total agreement. While I do feel all drugs are overly prescribed and especially anti-depressants, not all cases respond to diet and exercise. Though it has drastically improved many facets of my life, the anxiety and depression that seems to be present in nearly every family member has not been mediated by it, and much to my disappointment, only resorting to the use of meds has been any help in controlling it, as proven through our own “blind” trials because i didn’t want to believe it.

      • Kim

        This is in no way a “blind trial”: you knew you were on an antidepressant, not a sugar pill. You were open to being proven wrong, and you believe you were, but of course it’s possible that you simply detected “feeling different” in some way while on the medication, and you believed it was making you better. If you’d believed the medication was making you worse off, harming you, you’d likely have felt worse. I think it’s entirely possible, and based on other data probable, that we’re still dealing with a placebo effect here.

        • Charzie

          Yeah Kim, I wish it was as innocuous as “feeling different”! I know no one has ever had a shortage of Celexa for starters, I hate pharmaceuticals, and you have no idea how long I fought to stay away from the drugs and all the other routes I tried! The first time I quit taking it all was good for about a month, and when I started having paralyzing symptoms, it took me a couple
          of weeks to put 2 + 2 together and realize what might be going on. Even though I am not very suggestible, I didn’t want the element of suggestion to influence me so I had a friend dole out either a 1/2 of a Celexa or a 1/2 of a headache remedy per day to see if I would notice the difference, (they looked identical) and only he knew what I was getting. The first 2 days nothing. The 3rd day- unknown to me then- I got the Celexa and it was night and day. Continued this “blind trial” for 2 weeks and every time the same result, so NO, no placebo effect. There has always been asylums and mental illness, it isn’t new. What IS new is the proliferation of it in modern times, a whole different “animal”. My WFPB diet has gotten rid of diabetes, excess weight, arthritis, fibromyalgia, high cholesterol, high BP, IBS, and a host of other crappy issues. Not the mental ones. I am currently trying NAC (N-Acetyl L-Cysteine) an amino acid antioxidant and glutathione precursor, that crosses the blood brain barrier and seems to have good results with these issues, (and others) and would love to see Dr Greger do a video on it because they are finding so many applications for it. HINT HINT!

    • Joseph Gonzales R.D.

      Thanks, MA. I appreciate you taking the time to write down these thoughts. I agree mental health is individualized and a complicated issue. The important thing to remember is never placing any blame or guilt on an individual who suffers from depression. I hope you realize that was not the intention of this video. Please read my comments below, as other have addressed similar concerns.

    • Kim

      I respect your opinion, but believe you to be mistaken. I’ve also suffered immensely from depression, anxiety, and panic throughout my life, and am now in the process of recovering without medication. Some might claim that my suffering must not have been that great then, but nothing could be further from the truth. I believe that what’s most likely to be happening is the people who are helped by medications are those that believe their medications will work, and their recovery can be attributed to the placebo effect. The placebo effect is powerful stuff, but that doesn’t change the fact that these medications possibly don’t work on their own and carry the risk of serious side effects, and people can and do recover from serious “illness” without medication.

      I believe that, just like the animal agriculture and processed foods industries lie to the public about the healthfulness of their food products, the pharmaceutical industries have a vested interest in keeping us ignorant of the real reasons people can end up feeling consistently overwhelmed, dejected, suicidal, etc. which have more to do with lack of good self-care, lack of meaningful relationships or opportunities, observing the state of the world, etc. The reasons are varied and can be different for each person. I don’t believe there’s anything neurologically wrong with any or at the very least the vast majority of these people. I believe these are normal responses to a very insane kind of society. We should very much expect that people are going to find it hard to function in the world as it is. That said, there’s a lot we can do to help us live better lives, and hopefully if we all gravitate towards saner ways of living (eating plants, rejecting consumerism, living simply, exercising, stress management, having fun, maintaining good relationships, contributing positively to this world, etc.), maybe one day our society will become more sane, too.

  • fatoldlady

    please put a twitter link on the transcripts

    • Joseph Gonzales R.D.

      Looking into this, thanks!

    • Tommasina

      Thanks for the suggestion! Just wondering why you’d like the transcripts linked to instead of the page itself. Our thought is with a link to the page, people can choose to watch the video or read the transcript. We’d love to hear your thoughts. Thanks!

  • PAsuburb

    I took an antidepressant (sertraline) for mild depression for a while and felt it helped. The problem started when I got off, which I wanted to do because my symptoms went away and also because all of the articles out there like this one made me start to have misgivings about it. Despite tapering off very gradually, I’m left feeling way worse than I ever did before starting the drug – insomnia, generalized anxiety, irritability – none of which I had before starting it. Am now trying to deal with these withdrawal effects through exercise, diet, qigong classes (kind of like Tai Chi), fish oil and SAM-e supplements – basically all of the things I wish I’d tried back when all I had was mild depression. Why is this happening? Any suggestions? Does this ever end?

    • Joseph Gonzales R.D.

      Oh no! Sorry to hear that, PAsuburb. I am not sure what is going on, as I mentioned mental health is SO personal and must be individualized. My suggesting is going back to your doctor/psychiatrist and explaining the situation. You may benefit from going back on the medication? True, side effects exist, but let’s not forget the side effect of feeling super crummy. That one alone may trump all other side effects. I hope you find a solution as soon as possible.

      Best of luck,

      • PAsuburb

        I appreciate your response, but that is exactly what I don’t want to do – unless that is the only option. I feel this is an issue which very little is known about and for all I know, this will resolve with some time. I’m not ready to throw in the towel yet. I wish there were some good resources for people in this situation. I’m like Cathi – I really feel duped.

        • Charzie

          There is info out there, see my post about NAC above.

    • Cathi

      I had the same experience with sertraline. Although I would never have acted on my thoughts, I was so deeply depressed I felt I would rather die than continue to feel the way I did. After three plus months, I finally gave up and went back on the medicine. I did feel better rather quickly, but I don’t like the side effects or being on a daily medicine. I’d love some suggestions too. Has my brain chemistry changed after being on sertraline so long (probably 25 years)? Is there any hope to get off, or is it too late. I feel so duped!

    • fred

      My guess is that over time these drug do change the biochemistry of your brain/body. The side effects are real…withdrawal is real when you quit. I’d try melatonin….l-theanine…a TBSP of beef gelatin before bed. Eventually try to get that refreshing well slept feeling in the morning…elusive, but possible?

      • Brenda Ludlow

        Ahah i’ll have to check and see if gelatin has glycine.

    • Brenda Ludlow

      Hi. Stopping antidepressants had a very similar affect on me. I happened upon an article online that indicated that the medicine down played the glycine recepters in my brain. I bought the amino acid at health food store, mixed 3000mg in water, it tasted like sugar, and took it at night. I got over the withdrawal side effects. I also read glycine feeds cancer. To be honest my health for the last 20 years has been so poor with regards to exhaustion and not having any true root cause that if I die, then the illness is over. Last doctor I saw recognized my blood sugar level was too low across a three month average and the hypogylcemia was causing anxiety. Antidepressants caused me to not eat. I have gained 10 lbs and no longer feel like something bad is about to happen all the time. I hope you feel better soon :)

    • I would suggest you read Peter Breggin’s book, Psychiatric Drug Withdrawal: A Guide to Prescribers, Therapists, Patients and their Families to understand the challenges of getting off these medications. As he points out it is important to work with a health care professional skilled in this area as well as a personal support network.Another book on the issue of mental health and the rise of medication usage is Robert Whitaker’s Anatomy of an Epidemic. Good luck.

  • Elaine Gardner

    I am so Thankful that I didn’t go the anti-depressant route. After doing a low carb diet 15 years ago I became very depressed. Then 3 years ago I became Vegan and my depression went away. Thanks bananas! and Thanks Doc.

  • Drjembe

    I plan to try and taper off Celexa which I’ve been on for 4 1/2 years. I too am concerned about the withdrawal symptoms. Can Dr. Greger share any research about best practices for tapering off anti-depressants? It would certainly be appreciated by many of us.

    • PAsuburb

      I second that request! And suggestions for what to do when tapering off hasn’t worked so well – as well as explanations of what is going on – would be helpful as well.

    • ekonak

      A very good scource to get off antidepressant medication is Dr Breggin.
      See his books and short videos.

    • Psych MD

      Generally speaking the more gradually the drug is tapered the lower the likelihood of bothersome discontinuation symptoms. Assuming you are on the usual therapeutic dose of 30-40 mg. a conservative tapering schedule would be to take 30 mg. daily week one, 20 mg. daily week two, 10 mg. daily week three, and 10 mg. every other day week four, after which you would stop the drug. For patients who are extremely sensitive to discontinuation issues an alternative method would be to switch from Celexa, which has a half life of 35 hours, to Prozac, which has an extremely long half life more than nine days. Acute discontinuation symptoms with Prozac are rare since it is essentially self tapering due to its long half life.

    • Joseph Gonzales R.D.

      Hi Drjembe. I’m not sure of any sorry. However one of our member doctors, Dr. Forrester, mentions a resource in a comment below. Please know this is such a touchy subject and there are many opinions and comments here that I feel I need to remind everyone the importance of relaying information here with your medical team. Always a good idea to share Dr. Greger’s resources with your doctors for their input. The more everyone knows the better, I feel :-) Thanks so much for your questions I wish you the best in good health.

      Kind regards,

  • Bryce Webster

    I have been vegan for 2 years and for the last few months low fat high carb whole foods plant based, and a week ago I got my first B12 supplement and in about 4 days of taking it my face shoulders and chest had broken out with acne. I looked it up and its said to be a rare side effect of B12 supplements. I havent taken it for 3 days and I can already tell my acne is getting better. so the question is should I continue to take B12? will the acne get better? different type of B12? I have the mouth spray methyl-B12.

    • Joseph Gonzales R.D.

      Hi Bryce. I am not sure about B12 supplements causing acne. I do know B12 is super important if you’re following a vegan diet. Maybe lower doses could help? Or fortified foods? Dr. Greger has recommendations on B12, if interested. Check with your doctor and maybe try a different kind? Let me know what works or if can be more help.

      Best to you,

    • K

      Not sure if you’ll see this given that you posted 3 months ago, but I got the same effect with my small 50 mcg supplements, and I solved the issue by crushing them and taking smaller amounts at a time. I probably take the equivalent of 10 mcg or so per dose, sprinkling the powder on my food. I’m not at all convinced that regularly mega-dosing B12 is safe, as per the lack of long-term trials demonstrating the safety of this (there do not seem to be any short-term toxicity issues). I prefer to take small amounts more frequently (anywhere from once a day to every 2-3 days).

  • Daniel Wagle

    My mother took anti depressant drugs, but she still committed suicide. My brother recently started taking these pills and has recently gone on disability. I think it made his weight gain even worse. I, on the other hand, have been going to psychotherapists for years and I have slowly but progressively gotten better over the years. I can function much better on my job and in my relationships than I could before. I believe in exercise as well as a mostly Vegan diet. However, I think the skills a person learns from psychotherapy can be the most useful tool in combatting depression. It has helped me to relate to other people better. Pills don’t teach life skills, counseling can. I think the impulse control I learned from psychotherapy also helped me to improve my diet, as well as being consistent in exercising.

    • Joseph Gonzales R.D.

      Right on, Daniel! Thanks for sharing man.

      Best wishes,

  • Cynthia

    I see that some people are a bit upset by questioning the effectiveness of anti-depressants. A psychiatrist told me that medications should be part of a total regimen and that too many people neglect improving their health in other ways, kind of like taking cholesterol pills while continuing to eat a cholesterol heavy diet……the medication can only do so much. Heck, even the doctor can only do so much, then we should do for ourselves!
    No one has mentioned how medications can be man-made isolates of chemicals naturally occurring in whole plants, such as salicylic acid in willow. Sometimes I think of medications as “processed” food and try to use the “whole” version first (if it is practical) to see if I can get results au natural.
    Pharmaceutical medications can be like placebos in that they are NOT effective for everyone, and when considering the costs and side effects so many people suffer from, I believe it is reasonable to question big pharma and advocate for effective medications.

  • years ago a dr. wanted to put me on prozac for PMS symptoms, prozac was the latest wonder drug. I refused and took tryptophan for awhile, (an amino acid) until that was removed from the market!

    What finally worked for me was energy psychology. There are many kinds such as EFT, (emotional freedom technique) EMDR and TAT. There is a professional association of psychologists that study and teach this work.
    They all work with energy points on the body, that you tap on as you tune into your feelings. It releases the traumas from your body. Mind body works for me, and now I do chi gong, which is also energy work. these methods might help people as they get off drugs. Our body holds traumas that can cause depression.

    • Brenda Ludlow

      Thank you for sharing your solution to depressive experience. I’m going to research these energy techniques. I appreciate your post.

  • SeedyCharacter

    Here’s a great book that critiques the world of psych meds and psychiatry:

    Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis Daniel Carlat (Author)

    (Amazon summary) IN THIS STIRRING AND BEAUTIFULLY WRITTEN WAKE-UP CALL, psychiatrist Daniel Carlat exposes deeply disturbing problems plaguing his profession, revealing the ways it has abandoned its essential purpose: to understand the mind, so that psychiatrists can heal mental illness and not just treat symptoms. As he did in his hard-hitting and widely read New York Times Magazine article “Dr. Drug Rep,” and as he continues to do in his popular watchdog newsletter, The Carlat Psychiatry Report, he writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences.

    • Psych MD

      I am medical director of a 62 bed community-based psychiatric hospital serving everyone from the homeless indigent to the high-functioning insured. We provide individual therapy, group therapy, activity therapy, arts and crafts, a gymnasium with exercise equipment, a basketball court, and swimming pool. All patients speak with a registered dietitian who, if I’m not mistaken, is vegan. They are all interviewed by an activity therapist whose job is to explore the patient’s recreational interests and help guide them in a healthy direction. They all meet with a discharge planner who helps coordinate appropriate aftercare. I have not read Dr. Carlat’s “expose” but I do know that our patients receive humane,high-quality treatment.

      • SeedyCharacter

        Psych MD: Thanks for this overview of your hospital. Beyond having your patients “speak with a registered dietitian” how many sessions do they receive while inpatient and then once discharged? Do your clinicians do detailed dietary assessments during patient intakes? Do you order labs to evaluate nutritional deficiencies such as B12 and D? Are there group cooking and nutrition classes in your program and available for recovering patients? Does the food served in your facility model the ideal diet for people with psychiatric illnesses? Are nutritional prescriptions included in the treatment and discharge plans? If so, you are lucky to work in such a progressive, integrative hospital. I know many insurance companies approve just one or two nutrition consults when what most patients need is intensive education and regular follow-up care to change a lifetime of poor eating and related lifestyle patterns that contribute to their conditions. (There’s the other problematic issue of what many conventionally trained R.D.s advise in their consultations, but that’s another matter.)

        Because Big Pharm is so powerful in its drive to sell their meds and have insinuated themselves so pervasively on insurance company boards, I have found coverage for nutritional/lifestyle approaches to be sorely lacking. I incorporate nutrition guidance into my psychotherapy practice (I have received some specialized training), but I know of few therapists who do so (or are qualified to do so). Sadly, I know of no local psychiatrists who incorporate nutritional treatments based on the kind of evidence NutritionFacts shares with us. Local folks with psychiatric issues get the best nutritional support from integrative/functional physicians, but many of these clinicians are financially inaccessible for various reasons.

      • Arjan den Hollander.

        I’m an astronaut, no really! homeless indigent to the high-functioning insured. Pffff…

        Can NF team start cracking down on this mystery Nazi doctor narcissist please?
        The man just keeps making my alarm bells go off.

  • GeorgeBMac

    Perhaps the ‘mopping up the floor without turning off the tap’ analogy fits here:

    People leading sedentary lives filled with anxiety, anger and negative thinking keep feeding the depression. The easy way for both patient and physician is to try to “cure” it with a pill rather than addressing the root cause with: Cognitive Therapy, Exercise, Stress Management techniques, a healthy diet, a healthy social structure, etc….

    While it is true that those things can be hard to implement during a serious depression, they can at minimum prevent a recurrence.

  • zaofer200

    infarction in subjects using anti-diabetic and/or antidepressant agents
    compared to non-users: a nationwide register study in Sweden” EASD 2013.)
    another importanr issue

  • Paula

    I am helped with my anxiety/depression with exercise, vegan diet, yoga……and Zoloft. I have tried without the zoloft a number of times and physically see a huge difference in mood and focus. Again, I am doing all the the non medicine techniques..have been for years…. And still feel that Zoloft helps a great deal.mi am saying this so people on antidepressants don’t feel failure or regret after listening to this video. Thank you.

    • Joseph Gonzales R.D.

      Agreed Paula 100%. Thanks so much for sharing your experience it is so important for folks who do take medication to not feel any failure or regret after listening to this, as you said. I think the idea is just being more aware about the research on anti-depressant medications and the pharmaceutical companies.

      Thanks again,

  • Wyman Kingsley

    For an excellent result and 98% success rate for depression, please google Dr Neil Nedley, you won’t be disappointed, he will reconfirm everything just viewed and more, all the best

  • Robert S Hoffman, MD, FACPS

    This video accurately reports some of the problems with “evidence based medicine” when the industry conspires to hide “evidence.” However, like other well intentioned analyses by those looking at studies, and meta analyses of studies, instead of treating patients, it dangerously distorts and misleads the public. There are many examples in and out of medicine of the dramatic negative sequelae of covering up evidence, from the convictions of people like Martha Stewart to the enormous jury awards in cases involving the Dalcon Shield and breast implants. In both cases, the concealing of negative evidence led to the awards, even though the products themselves did not cause the many of the damages attributed to them. The studies attempting to demonstrate evidence of efficacy and evidence of adverse effects in patients, or those accepted for “studies” are themselves deeply flawed and most of them don’t involve real world patients and real world treatment strategies. Meta-analyses merely compile more bad data. Garbage in, garbage out. And the nocebo effect, the “side effects” of placebos are as likely to negate the potential benefits of medications as the placebo effect is likely to provide the benefits attributed to them. It is exceedingly difficult to demonstrate antidepressant efficacy in a “study” of human beings, given the innumerable variables that can’t be controlled and the methodological limitations of studies on people, for many reasons, but the absence of evidence is not evidence of absence, any more than it is in every medical specialty, including oncology, where extremely toxic chemotherapies are employed on the basis of evidence of additional days or months of tormented survival. Those of us who treat real depressed human beings, in the real world, and the patients whose lives are literally saved, or saved from endless suffering can attest to the undeniable efficacy of antidepressants. I and many of my colleagues preach the value of good nutrition, as recommended on this site, to which I am an avid subscriber, and of exercise, both of which many of us practice as we preach. I am far more qualified to report the real world evidence, not theoretical or epidemiological or statistical evidence of the benefits to patients of meditation, exercise and healthy diet than you are to address the utility of medications for one of the most disabling, costly conditions suffered by human primates-depression. They are not mere placebos and they are certainly not among the most potentially dangerous medications prescribed by physicians. That patients treated with them are more likely to suffer recurrences is testimony to the nature of the illness and the likelihood that the sickest are the most likely to receive medication. For those of us dedicated to relieving suffering, every potential beneficial intervention, from various psychotherapies, to mindfulness to acupuncture, to nutritional supplements, to herbs and vitamins, is in our armamentarium or by referral to expert colleagues. Anti-depressant medications are clearly the most effective, alone and in combination with other treatments. We who treat the depressed know that the same way we recognize our wives, without the necessity to collect data and determine who they are probabilistically. We may need studies to demonstrate the potential superiority of actual drugs to placebo, in order to have them made available to us, but it is direct clinical experience that persuades us about which drugs work and for whom, and which treatment emergent adverse events reflect true side effects, and the relative frequency with which they occur. Fortunately, we now have genetic testing to help us take some of the trial and error approach to which we have been condemned and choose medications more likely to help and less likely to cause real side effects in individual patients. Your clever, facile video does a serious disservice to the depressed people who watch it and believe it enough to eschew potentially beneficial treatment. And the cost of depression, literally in the cost of missed work as well as treatment, and the suffering that can’t be calculated numerically far exceeds the cost of medication, though the costs of medicines in this country, at the hands of big Pharma, now for generics as well as branded drugs, admittedly often border on obscene gouging.

  • Em

    I support questioning drug companies and making sure people are informed but we have to be careful, especially when dealing with mental illness. I took anti depressants for 5 years because I had to. I would not be here typing this message if I hadn’t taken them. They most definitely helped me come out of my catatonic depression. Now, I no longer need them and do find that consistent exercise and a health diet helps my mood significantly but please don’t dismiss real results from real people who have had to rely on them in order to survive.

    • Joseph Gonzales R.D.

      Thanks, Em. I most definitely agree with you. I just replied to Paula (here), a member who posted about her experience below. Thanks for adding the extra note of caution.


  • Bernard

    I am 71 years old and don’t know what depression is. No matter. This is the best website on the planet for nutritional facts and guidance. This coming May 9th I will have been a vegan for one year. How ” ’bout them apples,” as my late uncle used to say. I wasn’t sure if I could do it, but it was surprisingly easy. Keep up the good work,! Dr. Michael Greger and his staff are the best. It’s where you’ll find the truth.

  • Bernard

    Pen and ink change to my previous comment. Change website comment to read! Sorry folks. Hmm. Note to self: Add more Turmeric to diet this week. :-)

  • Diana

    I understand that exercise helps with depression. But how do you get a depressed person that has no desire, motivation and energy to go and exercise?

    • Joseph Gonzales R.D.

      Hi Diana. I’m not sure there is a right answer. I think it is so individualized and depends on the level of depression, past experiences, struggles, how someone deals with stress, how they have dealt with stress in the past, what they have in their life, what they have to look forward to, their social support system, diet. Counseling can be a very good thing. Also, exercise can be defined as gardening, chasing children around, walking. I always try to encourage people who don’t necessarily enjoy going to the gym, lifting weights, or running on a treadmill, to find activities they enjoy or think of ones performed in the past, as a kid. Of course I am not qualified to really say what is best so forgive me just trying to empathize a bit. Diet has been shown to boost moods, but then again how do you get someone who is depressed to change their eating patterns? Certainly a good topic for discussion.

      Thanks for your question,

  • John Kimmel

    If exercise, drugs and placebos all have the same benefit for treatment of depression, what’s the likelihood that all three are placebos?

    • Joseph Gonzales R.D.

      Good question, John. I am not sure they were all considered to have the same benefit for treatment, but the research Dr. Greger presents is interesting.

  • Ray Tajoma

    FDA itself is a “Placebo” government agency (totally useless and more harmful than harmless). 98% of processed foods and cooked foods are “Placebo” with more harm than good (Hamburger, hot dog, fried chicken, french fries, Coke, Pepsi, Budweiser, milk, omelette, cheese, steak, bacon, potato chips, candies, etc….)

  • Cathleen

    I’m aware of the research. I am also one of those people whose life was saved by antidepressants. All those alternative methods were ones I couldn’t use BECAUSE I was so suicidally depressed I was almost totally paralyzed. It took several years to find the correct dose – the original one was too low – and there may have been negative consequences. But I’m alive and might not have been.

    As I’ve gotten older and more content with myself – as the self-loathing component of depression has eased – I find that I occasionally get a bout of depression that seems to be purely physical. The bouts can hit with no warning and seem to have no obvious trigger. As I read more about this, I may try reducing my dosage very slowly and see what happens. I’ve tried before and got hit with very severe depressions.

    I am not recommending this for everyone. Those who are able to use exercise or diet — more power to them. I use Prozac in conjunction with long-term therapy and it might have been less effective without that. I’ll never know. It wasn’t just the therapy that helped, however; I won’t go into details, but have many years’ experience that prove this to my satisfaction.

    Generic Prozac, if it words, isn’t all that expensive any more – at least if one has insurance. And there is low-priced coverage for those with very low incomes provided by some companies and many public clinics. I know there are many people who do not have insurance, but don’t be scared off before you ask if the alternate methods haven’t worked for you.

    • Joseph Gonzales R.D.

      Hi Cathleen. Thanks for sharing your experience that is such a powerful statement! I most definitely agree with you. Others have shared similar experiences throughout this tread and I have commented below if you’re interested in reading more.

      Thanks again for commenting,

  • Dr. Mike

    I have been practicing psychiatry for 33 years and I have some concerns about your recent presentation about the comparison between antidepressant medications to placebos. I agree that antidepressant medications are most useful for more severe depression with significant sleep disturbance. I fear that the tone of your discussion will discourage some people who could benefit from these medications from using them. I also believe that there are historical reasons why the studies from the time period included in the meta analysis demonstrate little separation between placebo and medication response.
    First there are other ways of differentiating pharmacologic from placebo effect. One study looked at what happens when you randomly substitute placebos for active medications in people who are experiencing benefit from medication. A much higher percentage of those switched to placebo relapsed compared to those continued on active medication. If the medication effect is predominately placebo, this loss of response should not happen.
    Another approach is to look at the effectiveness of these same medications in treating Obsessive Compulsive Disorder, OCD. In this patient population the placebo effect is quite low where the medication effect is quite strong. Is this because we are treating a different disease of because we are treating a different patient population. I think the answer is a little of both.
    The evidence for a different patient population comes from looking at effectiveness studies involving Lithium over time. In the 1960s the difference between Lithium and placebo was large. By the 1990s that difference had shrunk considerably. Is Lithium loosing effect or are different patients being used in the studies. My clinical experience suggests the latter.
    What are the differences in the study populations. At least a couple of characteristics. First, in the 1960s we were a predominantly Freudian culture and the idea that medication could treat mood disorders was novel. There was little expectation of success to feed the placebo effect. Second, and more important, is the fact that medication responders never make it into pharmacology research these days. They have been successfully treated by their primary care physician. The people who make it into these studies have personality disorders and other complicating factors, making them a population with low medication responsiveness and high placebo response. I can attest to this characterization from my time at the University of Pittsburgh doing screening examinations for research protocols. The fact that very few patients with OCD are successfully treated by their primary care physicians means that more medication responsive patients make it into research protocols.
    Therefor, without an historical perspective, one may not truly understand research findings, even those provided by meta-analysis.

    • Joseph Gonzales R.D.

      Hi Dr. Mike. I really appreciate your comments. They are helpful for me and our members to better understand the issues with research on anti-depressants. Many members have expressed similar concerns and I have commented on their experiences here and throughout this thread. Please feel free to add to the discussing as you lay out important points.


    • Darcelle Rancourt

      I was diagnosed with clinical depression at age 17 after a suicide attempt and by age 34 the diagnosis changed to Major Depressive Disorder (severe, ongoing). My first suicidal thoughts were at age 11 and continued for over 20 years.

      I have been on literally dozens of antidepressants with no success other than the side effects. The response has consistently been to try a different drug or dosage as psychiatrists struggled to figure out what I hadn’t tried yet. It was eventually determined by one that I was “drug resistant”, although, that did not stop the push for prescriptions as the general consensus is if you’re depressed you should be on *something*.

      This video is the first that’s made sense to me even though I fall into the “severe” category that antidepressants are supposed to help. While I understand the concern, please know that for people like myself this video brought understanding and validation. It’s the first time I haven’t felt ‘crazy’, for lack of a better term, for the literally decades I’ve been saying these medications don’t work for me.

      I transitioned to a whole foods, plant-based diet as a last resort to alleviate my depression. I’d seen evidence it worked for physical ailments, but hadn’t for mental until these videos. It was something I hadn’t tried, I had nothing to lose and, in fact, was very close to another attempt. Information such as this has helped save my life. I have experienced more and longer lasting improvement in my depression over the last 6 months through diet than I have the past 20+ years with medications, therapy, etc. Friends and family who have witnessed my suffering over the years have been both shocked and impressed by the improvement.

      While I understand your concern, this video helped me and I’m so thankful it exists. People like myself who have found no success with modern day medicine need to know it’s not because there’s something wrong with us and that there are alternatives. What I’m most frustrated about is not that I sought psychiatric help, but that at no point was a change in diet ever recommended to me as a course of action. I feel I’ve suffered unnecessarily most of my life because nutrition wasn’t ever a consideration.

  • Timothy

    In a talk Peter Gotzsche pointed out that placebo may not be better than doing nothing. It’s like spontaneous breast cancer remission. Depression – when left untreated – has a high rate of disappearing on its own. The drugs are addictive, that’s why people keep being hooked on meds for so long. So perhaps doctors don’t really have to lie and prescribe placebo. :-)

  • tulip

    I hope somebody quickly shuts down this idea that lying to patients is a good one.

  • Matthew Smith

    Vitamin D and Vitamin D3 are vitamins that have been recommended for depression. B12, as this site notes, should be supplemented in the diet of the Vegan. B12, the main ingredient in five hour energy, can give people a lot of power in their lives, as can these other two safe vitamins. I would argue that antidepressants cause suicide not just in teens anymore, in my opinion, they cause stigma, weight gain, and impotence in all who try them. I have a lactose intolerance and am going to start eating less milk (go Vegans!, I’ll get close to being one), but I think I’d drink Lactaid just for the D vitamins. If that still doesn’t make a patient feel better, they could drink a tea made from flower petals, such as hibiscus or elderflower tea, and eat nuts or be with a plant that they can identify. This is a great cause of the delta brain wave which can heal a person and make them feel better. If they wish to achieve more, they could drink green tea, known for causing the alpha brain wave, as do D vitamins, More than 80 million Americans live in an institution every year, most of them chronically so, all for mood disorders and what gets misrepresented as illness may for the most of them a mineral gap, such as Vitamin D, B3, or B12. Long known to be nutrition facts as the cause of illness in a growing world.

  • Robert S Hoffman, MD

    I wrote a long rebuttal to the misleading blog about antidepressants after Jane’s comments and submitted it. Where is it?

    • Joseph Gonzales R.D.

      Hi Dr. Hoffman. I am not sure? Has a Jane commented on here? I did see your post below and I am thankful for your comments. I am sorry you feel the video is doing a disservice to those who suffer from depression, that is certainly not the intention of the video. If you scroll through the comment thread I feel many who do suffer from depression have voiced their experiences and mentioned, as you did, how we need be cautions how these results are interpreted. I certainly agree.

  • Dr. Marc A Bouchard

    One of the fundamental problems with this discussion and debate, it would seem, is the generally poor health and behavioral health literacy of the population at large. Medicine is an esoteric, complex, and nuanced profession founded in countless scientific studies and years of collective experience. Physicians diligently work to stay abreast of the necessary knowledge and new information and discoveries in their respective fields, and given the volume of published literature every month, this is no small feat. The problem comes when non-medical experts, armed with scientific knowledge apply that knowledge out of context. I agree with the many concerns raised in this posting that caution must be applied to findings such as these presented in this video. I absolutely agree with the video that our understanding as psychiatrists of mild to moderate depression is such that antidepressant medications are often as effective as individual therapy and behavioral interventions (such as changes in sleep, diet, and exercise), and also not very superior to placebo. However, it is dangerous to generalize this truth to all presentations of depression and the public at large. Lost in translation are such important facts that the true etiology of depression has not been completely elucidated yet, that depression may manifest for multiple reasons, and that treatment of such a complex disorder must be tailored individually to each individual. Without a comprehensive understanding of the field or the disorder arise problematic generalizations such as that antidepressants are wholly bad, addictive, always cause suicide or violent behavior, that all depression represents or can be cured by vitamin or other micro-nutrient supplements, or dismissal altogether. This of course is no fault of the public, but should be owned by society for educational neglect of such important issues, and the fields of medicine and psychiatry for not clearly disseminating correct and concise information and challenging myths and over-generalizations that lead to and continue stigma and disbelief of the veracity of behavioral health issues and their effective and rational treatments.

    • DJ

      I have to say that there are some doctors who actually keep up with all those studies, unfortunately, I haven’t seen one of them! The doctors here try to hand out the same medications for every patient and get angry, slam the door, and walk out if a patient wants more information, such as side effects. They are also unwilling to accept the fact that not everyone can take every prescription. Also when a patient presents their allergy list to the doctor, that doctor says that “that can’t be”! That has happened to many patients here. It has happened to me personally several times.


    I have been researching this for years. As there is no definite understanding of depression it always bothered me that we would be passing out powerful drugs for possible solutions.

    We now have several, double blind, independent studies that prove that exercise and or meditation are both more effective then medications.

    One European study had a better result with placebo’s then medication.

  • R. Miller

    your site! I was just watching/listening to your piece on
    Antidepressant drugs and their placebo effect and thought I’d share an

    Several years ago I had my GP hand me a sample of Gabapentin to take
    for my anxiety. Of course, I’d been indoctrinated to do as instructed
    by my physician, so I began taking it and in less than a week, I noticed
    it not only helped to assuage my anxiety, but also made me feel like I
    could easily “check out” of my own life – like everything that mattered
    to me could easily be ignored and forgotten. I became scared at that
    point, and quit taking the drug in the second week.

    The aftermath is that the drug permanently altered my brain
    processing and I no longer process information (make connections) in the
    same way I used to and counted on for my career in the visual arts. I
    never saw anything in the literature that suggested what happened to me,
    but it made me realize that doctors don’t necessarily know very much
    about the drugs they prescribe and drug manufacturers don’t do their due
    diligence before putting it on the market.

    Ever since, I try to stay away from all drugs as much as I’m able
    to. I realize some of them are functional and necessary, but I also
    realize all drugs come with a cost.

    R. Miller –

  • Justin

    Dr. Joseph I have 2 questions: First, if the meta studies are concluding that no one medicine works better than placebo for a “group” of depressed folks, is it still possible that each medicine is effective beyond placebo level for its own segment of the population? For instance, could it be that Prozac is amazing for 15-20pct of the population, Wellbutrin works great for its own 15percent, and so on? Maybe it’s just hard for me to swallow this idea that it’s all placebo effect, but my experience was that some meds were bad for me, some were neutral but annoying, and one or two helped me significantly. If I had been enrolled in one of those studies, measuring just one drug, the chances are that I also would have been a data point saying that one specific drug had no real benefit. Are there any studies using a range of meds the way psychiatrists actually prescribe them, versus placebo?
    Second question: Are there any serious studies telling us how effective St John’s Wort and other herbal remedies for depression are versus placebo (and versus Prozac et al)?

    • Joseph Gonzales R.D.

      HI Justin, I think you bring up important points. These medications can certainly have different effects on different people. It’s important when addressing mental heath to realize how individual a treatment must be. There is some researchSt. Johns Wort add depression. It doesn’t appear that it helped from this study, or this study, but I see no problem with looking for herbal alternatives that may help. Dr. Forrester also mentions important notes about depression, as well as others in this thread. I hope that is helpful.

  • Kim Churchman

    And I was just mulling over, this past few days, scheduling an appointment to get on an antidepressant. Mostly I’m bored and not exercising enough, and not getting enough phytonutrients.

  • K

    The small advantage antidepressants had over placebo effect is likely because the research being looked at here used inactive placebos. Research using active placebos detect zero difference, hinting that the effect of antidepressants really is due to the placebo effect entirely, not the placebo effect + some small help from the pill.

  • Greta

    Love the information on antidepressants, but I think you should redo the video to take out the disparaging remarks about homeopathy since they aren’t the topic of this video and you obviously haven’t had any experience with or knowledge of homeopathy. I also think it would be nice to acknowledge Dr. Kirsch since he took a real risk writing “The Emperor’s New Drugs” revealing all this information about antidepressants. Keep up the good work; love your videos and articles.

  • US_RN

    The stigma of depression is a real and painful one. My adult daughter, age 35, has suffered with depression for most of her life, taking prescribed meds, being hospitalized and contemplating suicide on several occasions. Her greatest fear? Having to go through the roller coaster of meds helping for a time, no longer ‘working’ and the vicious cycle of going from so called baseline to the depths of depression and back ‘up’ to what is her baseline, and what most would consider being a functional depressant, similar to a functional alcoholic lives-getting by, making it, but nowhere near well. As a mother and a well educated RN actively advocating for her best interests, I am ever vigilant. To add to the challenge, my daughter was diagnosed with relapsing remitting MS at age 22. Over the past years since her MS diagnosis, she has moved from working full-time, having an active social life, to preparing to apply for permanent disability. She has not been able to work for over a year, has had three hospitalization for MS flares, permanent vision loss in one eye from optic neuritis, depression, and a new diagnosis of bi-polar disorder and dysthymic disorder. I strongly suspect she has a Vitamin D deficiency and hypothyroidism, and we are currently waiting for lab results on these concerns. Depression, and MS. The chicken and the egg.

  • freyja.h

    What does the research say about natural antidepressants like 5-HTP and SAMe?

  • Johan Sterk

    So anti-depressant medication does not work in those who do not need them? Some finding!

  • tcascade

    Last month, at a wilderness medicine conference, I heard a fascinating presentation by Dr. Perry F. Renshaw, psychiatrist and biophysicist. This article is a pretty good summary of his talk.

    Given that vegetarians and vegans have lower levels of creatine, I’m curious to know if anyone is aware of any studies that have looked at creatine supplementation, as a treatment for depression in vegetarians and vegans?

  • StarchBaseDiet

    what are better alternatives for antipsychotics drugs?and ,Does it better to stop taking these drugs? ( risperdal consta for example)

  • Apostol

    Is there any benefits of using psychedelics like Ayahuaska and LSD on treating severe depression or other mental illnesses?

  • Rosemary Torrance

    I’m looking for a vegan gasterontologist in Toronto. Any suggestions?

  • This is a good video, but I think it’s important to say at the outset that antidepressants have been effective for SEVERE depression. As the trials showed, only about 1/10 people are severely depressed, but true SSRIs work well for them. As an amateur athlete who struggles with severe depression, I can definitely tell you that exercise alone will not cure severe depression. Clara Hughes, a multiple Gold medal winning athlete for Canada (in a number of sports!) still takes an antidepressant, and she works out four hours a day or more.

    I am grateful that SSRIs work for me. But the trials are flawed, and usually they are far too short to determine if the drugs are working well. And as the video suggests, if you feel better the day after you start taking an SSRI, it’s not the drug, it’s the placebo effect.

  • Keziah Gabriel

    Dr. Greger, is it possible that these studies show a poor effectiveness because the patients involved in the trial have been incorrectly diagnosed with depression? Psychiatry is an endlessly complex specialty and diagnosing mental illness, even one as ‘common’ as depression, is actually incredibly difficult. If, for example, the patients were incorrectly diagnosed it could explain why these drugs are not consistently effective in trials. Another possibility is that depression needs to be sub-classified into biological responders and non-biological responders as the ‘root; cause may differ. For example, many patients with border line personality disorder or persistent dysthymic disorder report symptoms of depression but rarely respond to antidepressants. I would love you hear your thoughts. Kind regards… Junior Dr. G