Today, Explained - How antidepressants got political

Episode Date: November 20, 2025

More young people are taking antidepressants. And there's a brewing backlash to the meds on the right. This episode was produced by Avishay Artsy, edited by Jolie Myers, fact-checked by Melissa Hirsch and Hady Mawajdeh, engineered by Patrick Boyd, and hosted by Noel King. Image credit Mahsun YILDIZ/Getty. Listen to Today, Explained ad-free by becoming a Vox Member: vox.com/members. New Vox members get $20 off their membership right now. Transcript at ⁠vox.com/today-explained-podcast.⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Online, it's easy to find the antidepressant influencers. The Lexapro girlies, the Lexa-Hose, the Zoloft gang. Girl, take your crazy pills. You know you're mentally ill. Just go ahead. Take your crazy pills. So I got the prescription for this Lexapro and... I have so much mental bandwidth 24-7 now and I'm just like locked in, geeked up. That's my PSA about my mental health and taking antidepressants for today.

More young people than ever before are taking a class of antidepressants called SSRIs, and this fact has drawn the attention of the public health establishment. Mr. Kennedy, do you think that people who take antidepressants are dangerous? Coming up on today explained how antidepressants got political. Support for this show comes from the Audible Original, The Downloaded 2, Ghosts in the Machine. Quantum computers, the next great frontier of technology, offering endless possibilities that stretch the human mind.

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Robert J. Sawyer does it again with this much-anticipated sequel that leaves you asking, what are you willing to lose to save the ones you love? The Downloaded 2. Ghosts in the Machine. Available now, only from Audible. Today X-rayed. My name is Meg Jay. I'm a developmental clinical psychologist

and the author of the 20-something treatment and the defining decade. All right, let's go back in time about 31 years. A book called Prozac Nation hits shells written by Elizabeth Wurzell. It's about being a young person who's prescribed SSRIs.

I'm the girl who is lost in space. The girl who has disappeared. always, forever fading away and receding farther and farther into the background. How did we start down this path of putting young people, teenagers, 20-somethings, on these kinds of medications? Antidepressants were developed for use in adults originally, but over time, doctors gradually began prescribing downward to younger and younger people, including young adults like Elizabeth Wurzell, and then teenagers and kids.

Just like the Cheshire Cap, someday I will suddenly leave. But the artificial warmth of my smile, that phony, clownish curve, the kind you see on miserably sad people and villains in Disney movies, will remain behind as an ironic remnant. Still, in the 1990s, when this book came out about less than 5% of young adults were on antidepressants, and when I first started seeing clients in 1999, it was still pretty unusual to have a client on meds. What's happened in the meantime the last 25 or so years? Well, times have changed by the early 2000s, about 10% of young adults were on antidepressants today. It's about 20%. Or about one in five of my clients will come in and say that they're already on medication. Social media has definitely played a role.

It's increased social awareness around mental health, which can be a good thing. but it's also led to some social contagion. Many young adults see videos about depression and anxiety and the medications that people are taking, and then they decide they have these problems and they want to try these medications too. You have those moments where you just find yourself smiling and you're like, wait, is this what antidepressants do?

I also feel like it's kind of helped my mood just every single day, like not snapping all the time at every little thing. Rainbows and sunshines. That's all I see. it's rainbows and sunshines. I'm like, this whole time, you've been holding on this prozaki, like, for what? So in a recent study of university presidents, about 85% said that social media was a leading cause of mental health problems in their students. When you ask the students

themselves, only about 33% said it was a leading cause, that they were more likely to say it was stressors around school and work and family and finances and friends, and that that is what was making them feel stressed and anxious, not social media per se. This past week has been really crazy with school work and just like other work on the side. Like college requires you to spend money, bro. Anything you do cost money, bro. I'm just really introverted and it's harder for me to get out there and put myself out there. But I can say that.

That said, I do think that young adults go on social media and they learn a lot about mental health, but also a lot about medications that then they decide they want to try. Are antidepressants actually helping young people? Well, it's an interesting question because, of course, they help some people. I think the research can be misleading. If you look at the total of research on antidepressants, they're only effective about 50% of the time. I don't think that's something that young people understand that when they decide to take antidepressants, you know, there's about a 50-50 chance that this will have a benefit for them, and they also don't understand what the risks are.

they're not a silver bullet. They can help some people. They can be life-saving. But in other people, they solve one problem and they create another problem. So one client of mine went on antidepressants to feel less anxious about a relationship, but then he wound up feeling less driven at work. Antidepressants are a blunt instrument. So they don't go in and target just feelings of sadness or just feelings of anxiety. They can have a bit of a flattening effect across many areas. So, yes, you may feel less depressed or you may feel less anxious, but many clients will also say, I feel less happy, I feel less motivated, I feel less driven, I have less interest in sex, I'm less able to enjoy it. For years, I just felt like I was going through the motions.

My antidepressant helped to tamp down my panic attacks and my anxiety, but what I didn't realize was just how numb the medication had started to make me feel. For such a long time, I was not able to feel joy. I didn't realize it was happening to me until I started tapering off my medication that I was on for five years. I was on antidepressants for a really long time and they destroyed my libido. So it can really restrict the range of your feelings in general and your engagement with life. You've laid out how antidepressants really can help. They don't do everything that every person wants, but they do do some things. But let's say that you go on them as a young person and then you want to go off them.

Is that difficult? Is that perilous? It can be difficult. And I think this is what so many young adults and teenagers and their parents may not understand is that usually when a young adult tells me they want to go on antidepressants or they've gone on antidepressants. It's to deal with a situation that is happening and that could get better over time, should get better over time. should get better over time, but they think, we'll all do meds, and this will help me get through that situation. But when you introduce a different level of serotonin into the brain, and then you try to go off meds, your brain doesn't like that, because it has gotten used to this new level

of serotonin. So when you try to go off medication, your brain is going to complain about that, and it's going to suddenly feel anxious again and depressed again because you've removed what it was that was helping you feel better, at least for a time. So what happens is that young adults will try to go off the meds. They start to feel worse. That is upsetting. And then they decide, well, I guess maybe I need to go back on the meds. So they can be harder to get off of than they are to begin.

How much do we know about whether or how these drugs change early development? If they do. Yeah. Well, we don't know. And that's the problem. So most studies on SSRIs have been done on adults whose brains are fully developed. But even on adults, we have very little long-term data. So this is all an experiment in the making. So, you know, we don't really know what the long-term effects are going to be for kids, teenagers, young adults who are taking these drugs right when their brains are wiring up and sort of connecting in terms of sexuality. and feelings and engagement and drive. We don't know the long-term effects. And how does this change, if at all, the way that you talk to young people?

These are your patients, and I'm sure that they're, you know, they're aware of this conversation. Young people, teenagers, 20-somethings are really smart. How do you talk to them about it and how do you introduce concerns, address concerns? What are those conversations like? You know, you'd be surprised. Young adults are definitely aware of mental health conversations, but I think one thing that's changed over the last 10, 20 years is that they're much more likely to come in and say, I have this disorder, I have that disorder. I'm on this medication. I need that medication. So they're savvy but not savvy in that I think in terms of young adult development, they don't really understand that it's very normal to have symptoms of depression and anxiety. It doesn't mean you have a disorder or that you're always going to have a disorder. It also doesn't mean that medication is the only way that you can get better. I think something that not enough doctors are talking to young adults about is just how difficult it is to be a 20-something, to be in your young adult years.

It's a time of what I call first and worse. So you have your first and worst jobs and apartments and roommates and breakups. And so it can be a really tough time. It doesn't necessarily mean that you have a diagnosis or you have a disorder or that you need medication to deal with these issues. I take a more skills over pills approach and help people problem solve rather than panic about what's going on in their day-to-day life. That's Meg Jay. She's the author of The 20-something treatment. Coming up, Maha comes for Prozac. Support for Today, Explained,

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Did you say Lyme disease is a highly, likely, militarily engineered by a weapon? I probably did say that. Or the claims about vaccines and autism. but Kennedy was also confronted by Senator Tina Smith. This is personal for me. When I was a young woman and I was struggling with depression, thankfully I had the resources to help me get through it, including a new generation of SSRI uptake, reinhibitors, which helped to clear my mind. Who pushed him on past remarks where he expressed suspicion about SSRIs. I'm happy that you had a good experience on SSRIs.

many Americans have a very good experience on it. Others have not. But that would be an issue between them and their physicians and not for the future head of H.A. Sarah Todd is a health reporter at Statt News, and so she has been covering all of this. Sarah, whether to take antidepressants is a personal decision. But in 2025, what we've seen is this increasingly politicized language around them. I think the SSRIs are the devil. I think selective serotonary uptake inhibitors, zombie-fi people and change their personality and make them not who they are. Terrible.

America is ridiculously over-medicated, particularly in the area of antidepressant drugs and anxiety drugs and so on. We have more people ever in our history on antidepressants, and yet we're more depressed than ever. So something isn't working. Do you feel like it's something new that SSRIs are kind of a political football? It's a good question. I mean, so with the caveat that I am, the age that I am,

So I don't remember the introduction of Prozac on the scene, for example. But I think that my impression is that they have had periods in which they've been more political. I believe that at that time, you know, when Elizabeth Wurzel was writing Prozac Nation, there was a concern that they were going to be sort of like the opiate of the masses and people were just going to numb themselves. And then I feel like that faded away for a while. And now it seems to be very much back in the conversation with the rise of the American a Healthy Again movement. Yeah, Maha has really focused on antidepressants, among other things. And the main sort of voice of Maha would be HHS Secretary RFK Jr. What has he said about

antidepressants exactly? So there have been a couple different claims. One was that he said in the past, I believe at his confirmation hearings, that getting off antidepressants was harder than getting off of heroin and that antidepressants were addictive. Listen, I know people, including members of my family, who've had a much worse time getting off of SSRIs than people have getting off of heroin. All right. That's pretty pointed language there. What do we know about the facts?

Are SSRIs addictive? Are they hard to come off? They are not addictive. They don't produce the spikes in dopamine that you would be. get with alcohol or drugs like cocaine or heroin, which are so pleasurable that they have you sort of seeking out your next hit as soon as you come off of them. Instead, they work by targeting serotonin in the brain, which is a whole different part of your system. So it'll make you feel more stable, but not that kind of high that you might get off of a drug. They do, however,

have the potential to cause withdrawal symptoms. So that part is a genuine concern. About 15% of Americans experience withdrawal symptoms. And that can be a really wide range, some at the not so severe scale, like a headache, and some more concerning everything from insomnia to, you know, very serious suicidal ideation. That would be less common, but it can happen. All right. So I imagine if you're a person who's come off of SSRIs and you've had those real difficulties, it might feel like I was addicted, even though they're. don't meet the dictionary definition of addiction. What else has RFK Jr. said about SSRIs? Another comment that he's made is suggesting that they're linked in some way to mass shootings.

We're following breaking news out of Minneapolis, multiple law enforcement agencies are responding to reports of an active shooter at Annunciation Church in south central Minneapolis. contribution of some of the SSRI drugs and some of the other psychiatric drugs that might be contributing to violence. You know, many of them had black box warnings that weren't of suicidal ideation and homicidal ideation. So we need, we can't exclude those as a culprit. And that's one where the evidence is very clear that this isn't true. I found one paper that said that over the past 30 years, they looked at all the mass shootings in the U.S. Just 4% of the perpetrators had been on antidepressants at any point in their lives. There's really no evidence that they're linked to violence.

All right. And then this summer, the FDA raised questions about taking SSRIs during pregnancy. The FDA's parent agency, of course, is Health and Human Services. What are the concerns there? So the concern there is really about the potential effects. on the babies from taking antidepressants. And this is a complicated issue. The American College of Obstetricians and Gynaecologists

says that SSRIs are safe during pregnancy, and they say the risks of depression going untreated is much higher than the risk for the parent and the child of taking the SSRI. Robust evidence has shown that SSRIs are safe in pregnancy and that most do not increase the risk of birth defects. However, untreated depression in pregnancy can put our patients at risk for substance use, preterm birth, preclampsia, limited engagement in medical care and self-care, low birth weight, impaired attachment with their infant, and even suicide. And then there is a fair amount of research that's been done on SSRIs.

there are some studies showing that babies might initially be fussier when they're first born, and that will go away with time just as they adjust to not receiving the medication. And there really aren't any clear, serious risks that have been associated with SSRI use during pregnancy. We talked in the first half of the show about how around one in five young Americans are taking SSRIs. And the Maha mindset, as you know, is to quote, question the medical establishment and to be very skeptical of things that have gone mainstream. We need to think before we put our kids on these drugs and we need to listen to RFK Jr. in the fight to bring our kids back to healthy children. RFK Jr. just wants to get

the issues out there. He just wants to study them. He wants to be able to look at these things from both sides. Like, why is that so difficult for people? And so I guess there's a question here, which is, as SSRIs go mainstream, are too many people taking them? Are they being overprescribed? What has your reporting told you about that question? So when it comes to antidepressants being overprescribed, especially for children and young people,

which is, I think, what the Maha movement has frequently focused. And it's a good topic to dive into. A study published in pediatrics says people between the ages of 12 and 25 received antidepressants at a 64% higher rate than before the pandemic. But it was already growing before that. But it's also true that reported rates from young people of feelings of sadness and hopelessness have gone up, especially for certain demographics like teen girls and teens who are part of the LGBTQ community. And internal research from Facebook acknowledges its Instagram app is toxic for teen girls, making body issues worse for one in three teen girls.

Court filing say meta's algorithms, photo filters, push alerts, and the endless ability to scroll through platform feeds all contribute to the harmful effects on young users. So it seems like it's true that antidepressant prescription rates have gone up. It's also true that the rates of the symptoms that antidepressants are meant to. treat have gone up as well. So I think the big takeaway to me is that mental health for young people is a very real issue in the U.S. and something that we should be doing a lot about. As someone who covers health, you're aware that the Maha movement asks a lot of questions

about many different things, fluoride, Tylenol, vaccines, seed oils. We're not against fluoride. We just want to give people a choice. And if you add the fluoride, those who don't want it don't have a choice. When you talk about the risks of Tylenol, that naturally opens the conversation to vaccines and the cycle that they create. We've covered some of these things on the show before, and we always ask our experts, what happens when you start asking questions like, do antidepressants cause mass shootings? Every time you raise the question like, hey, it seems like a lot of the school shooters that we know about, to the extent we know anything about a lot of them, they seem to be on these drugs. Has there been research into that?

Are antidepressants linked to problems for babies? What's the knock-on effect of all this? Yeah, it's such a great point. And I think the effects of just asking questions will depend on what the questions are. For something like SSRIs and mass shootings where there's no evidence to suggest that that is a reality in any way, I think asking questions about that could wind up perpetuating stigma against taking antidepressants, which could be really harmful for the people who could otherwise benefit from them. So that's certainly a concern. When it comes to asking questions

about something like, are antidepressants overprescribed for young people? I don't think that that's necessarily a harmful path to go down. I think that we should be thinking about antidepressants not as the be-all end-all when it comes to mental health, but as part of a suite of potential treatments that could be used in combination with everything from talk therapy to helping people feel less lonely. So it's a complicated issue. I don't think that it's always bad to ask questions, but I do think it's good to think about what the potential implications are of suggesting bad effects when there's no evidence to suggest that that would be the case. Sarah Todd of Stat News.

Avashai Artsy produced today's show, Jolie Meyers edited. Hadi Mawaddy and Melissa Hirsch checked the facts. And Patrick Boyd is our only engineer. I'm Noil King. It's today explained. You know, Support for today explained comes from Sacks Fifth Avenue. Fancy, Sacks Fifth Avenue makes it easy to holiday your way. Whether it's finding the right gift or the right outfit Sacks is where you can find everything like a Chloe bag.

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