When we’re in pain, it’s natural to want it to stop, and as quickly as possible. We all look for the easy way out, and why not? There’s no reason to hurt for nothing. But the problem is that sometimes, this suffering has a purpose. Sometimes it’s an important message we need to listen to. And when we rush toward medication to numb the pain without asking questions, we might miss something important.
⚠️ Important : The following information does not constitute medical advice – it’s just the information your doctor is supposed to give you.
Table of Contents
How Did We Get To This Point?
It’s completely legitimate to criticize psychiatry for its past and present failings, which are well-documented throughout history. But we need to understand that psychiatry emerged to address a real and urgent need: caring for the “mentally ill” in our society.
The reality is that humans are sadly predictable: when faced with difference, they abuse. A person who becomes disruptive due to psychosis, mania, or paranoia had to be controlled so they wouldn’t be a nuisance, and this was often done in terrible ways. Chained, locked up, beaten and tormented, these people suffered the same fate everywhere in the world, often until death – far from the romantic image of the beloved “village fool” cherished by their community.
It’s worth noting that asylums have existed since the Middle Ages, but they were true prisons for the “insane,” like Bedlam in England. The fact that the word “bedlam” still exists in everyday English, shows that the horror of these places hasn’t been completely forgotten. It was only at the end of the 18th century, under the influence of the Enlightenment period, that doctors had the revolutionary idea that these institutions could actually heal rather than simply contain.
The idea was promising, but within a century, the demand had exploded: between 1800 and 1904, the United States went from a few hundred patients to 150,000. This explosion was partly due to a neurosyphilis epidemic (5-20% of the population had syphilis, 6% of whom developed psychiatric disorders), increased alcoholism, and major social changes: where families once took care of their elderly and sick, they now preferred to send them to the asylum. Doctors had to manage 300-400 patients each instead of the originally planned 20-30, and the psychiatric asylum became little more than a human warehouse.
It’s easy to talk about mistreatment, and it’s probably factual. But the reality is that most patients in these places were genuinely ill – many ended up dying there. The others simply couldn’t rejoin society because they had lost all contact with reality. This partly explains the desperation of psychiatrists who were frantically trying to find a solution: hydrotherapy with ice baths, rotation therapy, massive bloodletting, violent purgatives, lobotomies, and electroshock treatments…
And this also explains their immense relief when three discoveries revolutionized psychiatry: lithium in 1949, which effectively calms manic episodes; chlorpromazine in 1952, which makes hallucinations and delusions disappear in psychotic patients; and imipramine in 1957, the first antidepressant capable of lifting patients out of deep melancholy. These medications transformed psychiatric wards overnight: psychiatry finally had effective tools against mental illness, and the most severely affected patients finally had treatment that significantly improved their quality of life.
But this pharmaceutical success had unexpected consequences. Psychiatrists gradually forgot the relational aspect of their work. No need to spend time listening to and reassuring a patient when five minutes is enough to check a prescription and manage dosage. This transformation of the psychiatrist into a simple prescriber, coupled with the enormous power they still hold today (the ability to lock people up against their will and force treatments), triggered a massive revolt against psychiatry in the 1960s.
Ironically, this movement wasn’t completely wrong. Even though it was mistaken in denying the existence of serious mental illnesses and their suffering, it was right about one essential point: the excessive pathologization of human experience. This revolt still exists today in other forms: social media movements, communities advocating alternatives, medication withdrawal support groups. But at least there’s much less tendency now to deny the existence of serious illnesses.
Subsequently, pharmaceutical companies, having discovered an extremely lucrative market, funded the research needed to broaden the definitions of mental disorders. The psychiatrists’ diagnostic manual (DSM) went from 180 disorders in 1968 to 297 in 1994 (a number that continues to grow), often under the influence of lobbying campaigns rather than actual scientific evidence. But is the systematic medicalization of the human experience really the only way forward?
The Problem with Medication
If you go to a psychiatrist, they’ll almost certainly prescribe you one or more of the following medications:
Antidepressants
In cases of severe depression, these medications genuinely do save lives. If you can’t get out of bed in the morning, they help you regain enough energy to function and potentially find other solutions. And even though there’s a significant placebo effect, that doesn’t mean there isn’t real relief.
The problem is that depression is a bit more complicated than “chemical imbalance”, which was mostly marketing. Today we talk about inflammation, trauma, genetics, environment… everything’s connected. And the medication’s side effects are minimized: sexual problems in most people, weight gain, emotional numbing… It’s also a lot harder to stop taking it than they tell you.
Benzodiazepines
Truly effective for panic attacks or severe anxiety, they can provide necessary relief while you find other solutions.
The issue is that finding these “other solutions” often takes months, even years, and with benzodiazepines, dependence sets in within weeks, and withdrawal is often worse than the original problem. Long-term, memory and concentration are damaged, and in seniors, the risk of dementia increases.
Antipsychotics
Essential for psychosis, schizophrenia, and severe manic episodes, antipsychotics (or neuroleptics) allow people with these conditions to regain their lucidity and have a relatively normal life.
The problem is that today, they’re prescribed for anything and everything: “treatment-resistant” depression, “agitated” children, “difficult” elderly people… One in five patients develops permanent involuntary movements called tardive dyskinesia. Newer antipsychotics are described as safer, but in reality they just have different side effects.
Mood stabilizers
Lithium remains one of the few psychiatric medications with solid evidence of effectiveness for bipolar disorder. It can really stabilize manic and depressive episodes.
The problem is its toxicity: you’ll need regular monitoring of your kidneys and thyroid. Other stabilizers are actually anti-seizure medications: we don’t really know why they work, and side effects vary depending on the specific drug.
Sleep medication
If you haven’t slept for a week, you can’t deny their effectiveness: they’re there to make you sleep, and that’s what they do.
So what’s the problem? Tolerance: you often need to increase doses to maintain effectiveness, and they can cause significant dependence without solving the underlying problem. Stopping can also trigger rebound insomnia that’s often worse than the original insomnia.
Systemic Problems with Medical Treatments
Most medications are only tested for a few weeks or months before being approved, even though many patients will take them for years. So we only find out what the long-term effects are after the fact. Plus, many of these drugs are prescribed “off-label” – meaning for conditions they were never actually tested for (like anti-seizure meds for bipolar disorder). This is completely legal, but it basically means you’re a guinea pig.
And to top it off, half of psychiatric patients take at least two medications at once – this is called polypharmacy, and these drug cocktails quickly become unpredictable. The interactions are largely unknown because studies don’t test combinations, and doctors generally ignore or don’t account for these interactions anyway.
⚠️ Important : Psychiatrists readily prescribe psychotropic drugs, but tend to downplay just how difficult it is to stop them or reduce doses. For information on gradual withdrawal, check out Le Manuel de Sevrage des Psychotropes by Psychotropes.Info and SoutienBenzo, available free online.
The Pathologization of Daily Life
Psychiatry is trying to medicalize normal human experiences. There’s obviously a financial motive, but I think it’s also about an interventionist mindset that can’t handle difficult emotions – just like our Western culture, which only knows how to flee, repress, or numb them. For neurodivergence, it’s simply the unapologetic pathologization of difference.
It’s normal to feel sad when you’re grieving, or anxious about the current political, economic, and ecological instability of the world. Don’t let yourself be labeled for every little thing. You’re a human being first and foremost, and a diagnosis is only useful if it helps you or improves your quality of life. Otherwise, it’s just a way to categorize humans, an attempt to manage anxiety and control life’s diversity and unpredictability.
Moreover, we’re just beginning to realize how much the nervous system influences how we act and think when it’s dysregulated following difficult events. This is undoubtedly the future of psychology, because it forces us to look at pathology from a different angle: having a normal nervous system reaction to an abnormal situation isn’t a mental illness.
The Ideal Treatment: A Holistic Approach
First things first: rule out the most common physical causes
Before consulting a psychiatrist, I recommend asking your GP for blood work to check that you don’t have a physical issue that’s mimicking psychiatric symptoms.
Blood tests to request before a psych consultation
- Thyroid panel: TSH, T3, T4 (Warning: doctors often only prescribe TSH. Explicitly ask for T3 and T4 to get a complete picture of your thyroid function)
- Vitamins: B12, B9 (folic acid), D
- Minerals: Magnesium, calcium
- Metabolic panel: Fasting glucose, HOMA index (insulin resistance), kidney and liver function
- Ferritin (anemia)
- Hormones: Cortisol, testosterone/estrogen depending on sex
Other physical causes to rule out: Sleep apnea, autoimmune diseases, chronic infections, medication side effects…
Reading Between the Lines on Lab Results
Pay attention to the results too. Doctors tend to never worry about anything as long as the results are “within normal range.” This lack of nuance in interpretation can miss important weak signals for the patient. A ferritin level that’s technically “normal” isn’t necessarily “optimal,” and can still make you feel tired and depressed. You might need a higher level to feel good. Thank goodness the internet and AI are there to help you double-check things yourself… For a more comprehensive approach, you can also consult a naturopath or nutritionist who will know exactly which tests to ask your doctor for and how to interpret them properly.
Check Your Lifestyle
Get enough sleep, pay attention to how well you’re sleeping, watch what you eat, stay hydrated, exercise regularly, and manage your stress… that’s basically 90% of taking care of yourself. If you’re not sleeping enough, too exhausted to work out, and living off takeout for months while dealing with a tough, stressful job, of course you’re going to feel terrible – and your doctor can prescribe whatever they want, but it’s not going to help much.
Consider Therapy
Our relationships can either support us or tear us down. Same with our past – the experiences that shaped us can become a huge source of pain if they left us with a messed-up way of seeing the world. Getting the right kind of therapy to work through losses, deal with trauma, and figure out how to relate better to others and yourself is the most effective way to tackle psychological problems without necessarily needing medication..
More Than Just Pills
Ideally, we should see medication as just one treatment tool among many equally important ones – a last resort for most situations, after working on your lifestyle, relationships, and environment, and after doing the personal work to understand why you’re not feeling well.
And this goes for people with real mental health conditions too! It seems even more important to combine medical treatment with everything else. Giving people medication and then sending them on their way without any other kind of follow-up seems totally irresponsible to me, and really just a short-sighted quick fix.
When Medication Has Its Place
Conditions That Need Pharmaceutical Treatment
For psychosis – especially schizophrenia – despite the side effects, these medications are essential, because without them, you risk being unable to manage daily life without 24/7 care. For bipolar disorder, lithium is very effective at preventing manic or depressive episodes, and for severe depression, taken short-term, antidepressants can literally save lives.
There are conditions that really do need pharmaceutical treatment. If your problem significantly affects your quality of life, and medication can relieve your suffering, don’t hesitate.
A common fear is the fear of dependence. And it’s a legitimate fear, because it’s not easy to accept that you might need medication long-term. That’s a loss you have to grieve, for starters. But don’t forget: you’re already dependent. You depend on air, water, sleep, food, human connection, society. Dependence is part of life. So one more thing, is it really that big a deal? What matters is feeling better – you didn’t seek help for nothing.
A Temporary Solution
For other problems, it’s a question of pros and cons. You can take short-term treatment while doing therapy work on the side. Kind of like a crutch. It doesn’t mean you’ll have to walk with it for life.
When There’s No Other Choice
And sometimes, you might just not have any other option. We live in a society that often creates the conditions for psychological distress: economic instability, social isolation, burnout… Sometimes you can’t change your circumstances right away, for financial or other reasons. Maybe you can’t sleep well because you live in a noisy neighborhood and can’t move. Changing jobs isn’t necessarily within everyone’s reach. And even if you know you need to see someone, you might not have the time, energy, or money.
Sometimes the only solution is taking medication to cope. And that’s just how it is – it’s not your fault, you’re not weak, you haven’t “lost” – you’re simply doing your best to survive.
Take Back Control of Your Life
So what should you actually do when faced with a diagnosis and potential medication?
First, remember that you have the right to accept or refuse medical treatment. The decision is yours, and yours alone. Don’t let anyone intimidate you – you’re the only one who has to live with the side effects. And medical coercion is illegal. A doctor is ethically and legally obligated to respect your free and informed consent, so if you feel like they’re trying to pressure you or taking advantage of your vulnerability and exhaustion, find a different doctor.
Your psychiatrist is also supposed to inform you of ALL potential side effects, withdrawal difficulties, treatment success rates… But they’ll probably struggle with that, given that consultations usually last 15 minutes. Fortunately, you can research this yourself thanks to the internet and AI. Pay special attention if you’ve experienced trauma or if you’re neuroatypical, because the treatments are completely different.
Do your own research on your diagnoses, the labels they give you, and the treatments they suggest. You’re the only one who has to live with the consequences of your choices. And trust yourself. Doctors don’t have magical powers, and despite what they think, they don’t know everything and don’t know you better than you know yourself. Respect their medical expertise, but believe in your own human expertise, your feelings and intuition, and be an active participant in your care, even when it’s hard and you’re exhausted. No one’s going to save you except yourself.
Conclusion
The medication approach has become the norm because it’s simple and quick, but it only masks symptoms instead of healing. Even worse, the very existence of these pharmaceutical solutions has created a “miracle cure” mentality: no need to change your lifestyle, do difficult therapy, or question your toxic relationships when you can just get prescribed a pill. Rather than encouraging us to take back control of our lives, it positions us as victims, dependent on a medical system that actively discourages autonomy and questioning, submissive to our great “experts,” the doctors.
Psychotropic drugs do have a place in treatment, but shouldn’t be used systematically and exclusively. Humans are complex neurobiological beings, and we’re nowhere close to understanding everything about the brain and mental health. The truth is that in 50 years, we’ll look back and probably be horrified by the quality of today’s care, just like we are about past treatments. It’s sad, but it’s also wonderful because it simply means we’ll never stop innovating and searching for solutions to treat illness and improve quality of life. In the meantime, we just have to do our best with the information and knowledge we have today.
Sources
History of psychiatry:
- Shorter, E. (1997). A History of Psychiatry: From the Era of the Asylum to the Age of Prozac – Reference book on the history of psychiatry
Antidepressant side effects:
- Montejo et al. (2001) – Spanish multicenter study, 59.1% sexual dysfunction side effect rates Link
- Williams et al. (2010) – European study, side effect rates of 37-61% Link
- Safak et al. (2025) – Recent study, side effect rates of 84-88% Link
Withdrawal difficulties:
- Hengartner et al. (2020) – Prolonged withdrawal syndrome, average duration of 37 months (up to 166 months) Link
- Moncrieff et al. (2024) – 40% of patients have symptoms lasting more than 2 years Link
- Psychotropes.Info and SoutienBenzo – Le Manuel de Sevrage des Psychotropes – Complete guide on gradual withdrawal from psychiatric medications, available free online Link
Benzodiazepine dependence:
- Hood et al. (2012) – Physical dependence can develop in 3-6 weeks even at therapeutic doses, 40% have moderate to severe withdrawal after 6+ months of use Link
- Lader (2011) – Review on benzodiazepine dependence and withdrawal difficulties Link
Cognitive damage from benzodiazepines:
- Barker et al. (2004) – Meta-analysis showing persistent cognitive deficits after withdrawal, no complete recovery in the first 6 months Link
- Crowe & Stranks (2018) – Updated meta-analysis on medium and long-term residual cognitive effects Link
- Zetsen et al. (2022) – 20.7% of long-term users classified as having cognitive impairment, greatest effects on processing speed and sustained attention Link
Dementia risk in seniors:
- He et al. (2019) – Meta-analysis showing increased dementia risk (51% increased risk) in long-term benzodiazepine users Link
- Wu et al. (2023) – Review of 5 meta-analyses, all show correlation (38-78% increased risk) but causal relationship remains uncertain Link
Sleep medications:
- Soldatos et al. (1999) – Meta-analysis showing development of tolerance and rebound insomnia with rapid-elimination hypnotics Link
Trial duration vs real-world use:
- Ward et al. (2025) – Systematic analysis showing median duration of antidepressant use in the United States is approximately 5 years, while median trial duration is 8 weeks; 88.5% of trials last ≤12 weeks and none exceed 52 weeks Link
Polypharmacy:
- Mojtabai & Olfson (2010) – US national study showing visits with 2 or more medications increased from 42.6% in 1996-1997 to 59.8% in 2005-2006, and visits with 3 or more medications from 16.9% to 33.2% Link
Tardive dyskinesia:
- Carbon et al. (2018) – Meta-analysis showing that “20% of subjects on second-generation antipsychotic treatment presented at least mild tardive dyskinesia” and overall prevalence is 25.3% Link
Lithium:
- Shine et al. (2015) – Cohort study of 500,000 individuals showing that “lithium treatment is associated with decline in kidney function, hypothyroidism and hypercalcemia” with increased risk of stage 3 chronic kidney disease (HR 1.93) and hypothyroidism (HR 2.31)) Link