Dr. Josef Witt-Doerring
Appearances
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so the influence and the power of the drug companies has corrupted academia. And then the final thing, the final reason why you don't hear about negative stories about these drugs is that for many companies, especially big ones, and you'll see this when you watch TV, they're running drug ads. A huge amount of profit in media comes from drug ads.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so even then, they are going to be less likely to support any negative content that's critical. And so it creates this thing where you seem like a crazy person if you start saying things like, hey, these drugs don't fix chemical imbalances. They're just masking the problems. People go, I've never heard of such a thing before. I've only ever heard the opposite from people.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But it's just, essentially, it's just money from drug companies.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah, so I mean, when we think about the things that make humans depressed, and I mean, we think about, I mean, the main ones that Sigmund Freud would always talk about, he says, love and work. And I think that's a great way to think about it. We are social creatures. And so relationships tend to be some of the biggest things that make us unhappy. But we also need purpose.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so we need to be doing something that we like. And so those two areas are significant. But then when we get outside of those things, I start to worry about drug use as well, especially overuse of caffeine and nicotine, but also things like cannabis. I also worry about medical problems that are missed. Big things can be dietary issues. We have a lot of people with dietary problems.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
They have problems with insulin because they eat poor foods. And so your physical health can also lead to you feeling unhappy. And so those are the main ones that make humans unhappy. Now, so what are the drugs doing? Well, the drugs are disrupting your neurotransmitters. And when we're talking about SSRI-type medications like Prozac, which I think is the main one that's used in dogs,
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
they are typically inducing an effect of emotional blunting. Sometimes they're a little energizing and that can lead to aggression, but generally the effect is one of emotional blunting. And if you're someone who's anxious or you're feeling depressed and you're being tormented by a lot of anxious thoughts, if you can blunt your emotions, you are going to perceive that as therapeutic.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And that's why many people take the drugs and they willingly take them because they are... they are benefiting from that drug effect.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But it's not fixing the underlying problem. And when we start talking about long-term use, that's when we run into problems.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And I think it's because it's become so commonplace. Everyone knows someone who's taking these medications now, and it seems so normal. And And one of the reasons why doctors can put people on these medications so easily is that they lie to them about... Well, they don't lie to them per se, but they leave out a lot of the information which people really ought to know before getting on the meds.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And the main one being that these drugs... I've never been studied for longer than a year in a controlled clinical trial setting. And when we have 50% of Americans on these drugs for over five years, drugs which clearly cause tolerance and dependence and the effects wear off and you need to take higher and higher doses. And so they're changing your brain.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Your brain is fighting against them to stay in balance. We've never done a clinical trial on these drugs that lasted longer than a year. And some people take these drugs for decades. And so if people knew that, they would know that they're really in the unknown. And from what I see clinically as a psychiatrist, here's what happens to people when they take them long-term.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
You get some people, the drug effect will stay there and it will work for them. But then you get some people where it just wears off and they need to go on higher and higher doses to get the same effect. Then they need to get on more and more medications to maintain it. And then we have some people who get worse. They develop a condition called...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
tired of dysphoria, but it's essentially brain changes that make people have high anxiety, low energy, low and low motivation. And they get stuck in this chronically depressed state that's induced by the drug. And if we're not even talking just about what the drugs can do to people, there's also an opportunity cost about being on these meds.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
You know, what if because you went on these medications long term, you never experienced the impulses to fix your relationships or to go and find that job that you should actually be doing? You know, you did quit the one that you're doing now. But what if it means you neglect a health issue that was making you anxious and that's just festering in the background?
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I mean, if you don't fix these problems at their root, they get worse. And so I worry about all of the long-term problems with these medications long-term. And let me tell you this, this is the exact same with dogs because before I got on this podcast, I did some research. I couldn't find a single clinical trial in dogs that went longer than six weeks. And so these vets out there-
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
So, yeah, so coming off psychiatric meds, especially the antidepressants for humans, can be really challenging. So... there's a huge variation in what people experience coming off these meds. I talk to some people and they've been on the meds for three, four years. They can come off in two months, no problem. They go back to their life. In fact, I actually think that's the majority of people.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But there are some people that when they try and come off, For reasons we don't understand, their brains are just not very elastic. They have a very hard time adapting to the drug being removed. And then they can develop really severe withdrawal problems. And sometimes these can go on for years. It's a condition called protracted withdrawal. And it can make the person very unwell.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's not the most common outcome, but it can happen. And because of that, I mean, that's what I do now. I find these people who are having a really hard time coming off the drugs, and then I do these very gradual, slow tapers to help them come off, typically after they've failed to come off quickly. Yeah.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Ivan, do you have any difficulty getting the dogs off medications when you take over their care?
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah. Yeah, a lot of these dogs haven't really been given the opportunity to find a non-drug ways of coping. And instead of doing that, you're putting them on drugs that flatten their emotions and... And the same thing happens with humans. A lot of the people that I speak to at the taper clinic, they'll come to me and they'll say, I just want to feel like myself again.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yes, I don't really feel bad emotions, but I don't really feel good emotions either. I have pretty low motivation. I'm not that excited about anything or doing things like I used to be. I feel like I'm just...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
um you know um sort of like you know passive you know just just living but not really alive and and they hate that feeling and and i guess i mean it saddens me to think yeah and i mean it saddens me to think that you know you have this lovely dog um and um um you know it's having some separation anxiety or that or there's some issue going on and then The way we treat that is by blunting them.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I think you might have said this, Ivan, because I've been on your social media. It's like if you left a child alone in a house for like 12 hours and the child became unhappy, would you drug that child? That's essentially what I feel like a lot of people do to dogs.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah. And this is one of the things that I worry about with humans as well. Because they often say drugs and antidepressants are the best combination. And I guess maybe for some people that's true. If they're so depressed, they couldn't even do the therapy without getting a little nudge from a drug. But we're essentially talking about a drug that is going to affect...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
your mood and your personality and how you respond to things happening to you on a daily basis. And if you blunt that, you're also going to have a lot less material to work with. In fact, a lot of the people that that when I'm pulling them off medications, if they've been on them for decades, they tell me it's like their maturation was stalled.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
If they got on the drugs as a teenager, they're learning to regulate their emotions for the first time in their 40s when I'm pulling them off and everything is coming back to them. It's not like they've really taken gains or taken a lot of gains from while they're on the drugs. It just kind of flattened things. So they never...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
really got to have that experience of having to work through difficult emotions and deal with that. That's really part of the normal process of maturing. And then so we get it all when we pull them off the drugs.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
That's a really good question. For some people, it will be just removing the medication because it's impacting their ability to be connected with the world. Some of the humans, when I ask them, can you describe...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
they're having a lot of side effects to the meds i'll say can you describe what it feels like um to be you and then they say it's like i'm watching my life through a television you know i'm not feeling the emotional responses to things when i hear my favorite song come on i don't get prickles down the back of my neck you know because it reminds me of my youth when i hug my child or my spouse
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's harder to feel those feelings of connection. I mean, it actually just is. I mean, it is the effect of the drug that is blunting the emotions.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
So this is the thing that's gonna be challenging, because dogs can't say that they're not feeling well on the drug. It's really hard to know. So with antidepressants, Many people, I mean, they may or may not be aware of that they have this thing called a boxed warning. Now, a boxed warning is the highest warning a drug regulator can give for a medication.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It means that when you get the drug, it has this big black box on the front of it, and it says... And it says what the risk is. Now, for the antidepressants, it's that the drugs may make you more suicidal. And this is crazy. People will think this sounds crazy, but this is real. When they've done clinical trials and they look at the rate of suicidal behavior in people under age 25...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Well, thank you so much for having me. You didn't miss – I think you got the biggest parts. Yep. So I'm a board-certified psychiatrist, and I've been doing this for over 10 years now. And a big thing that makes me a little bit different from other people is I'm an expert in drug side effects. And that's what I was doing in the pharmaceutical industry and at the FDA.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
there are more suicide attempts in the groups of people who get the drug compared to the groups who get placebos.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
You know, let that sink in for a second.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Taking an antidepressant will make you more likely to have a suicidal behavior than taking a placebo. Yet we use these drugs in people under age 25 all the time. It astounds me why we do that. Now, the reason these drugs can make people suicidal is that they can cause paradoxical effects.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so when I say paradoxical, I mean it's like a random effect that just happens to someone because they have the genetic susceptibility. And the example I usually like to use to explain this to people in a relatable way is you could have 10 people sitting around smoking a joint. Nine of them are giggling and they're laughing, they feel relaxed, and you get one person who becomes paranoid.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
That's what happens with antidepressants as well. The majority of people are feeling emotionally numb, which is the intended effect of the drug. But you can get one person who starts to feel more depressed or even more aggressive. And... And if that's already an unhappy person and they start to have this paradoxical reaction where they feel even worse, that can push them into a suicide attempt.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah, yeah. Let me link it. And so, I mean, for me, I don't know how suicidal behavior might turn up in a dog. I imagine it could be self-injurious behavior. Maybe they start to bite their paws or their arms or they start to do something like that. But also, you know, what we've seen in humans is And this is in the drug labels.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I mean, it has, you know, aggression, hostility, you know, all of these things are already in there. They've been observed to be these idiot, these paradoxical reactions. And And these side effects have led some humans to do terrible things like mass murder, people strangling their family members, killing their whole families and then turning the weapons on themselves.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
These have gone to courts of law where juries and judges have heard all of the evidence about what that person was like right before they got on the drug. how their behavior drastically changed, and then usually how their behavior got better when they removed the drug. Juries have heard these stories, and based on what we know about the drugs and the side effects, they have...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
they have let people off who have essentially harmed other people during these things. They've also allowed people to sue companies. One man got $6 million out of SmithKline Beecham after a side effect resulted in the death of multiple family members by his father-in-law. This is a gentleman called Donald Schell. And so... We do know that these drugs can make some people unexpectedly aggressive.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And in my day-to-day job now is I run a private practice with my wife. We're in 10 different states across the U.S. And we help people safely come off medications when they've started to have side effects. And so... That's likely where Ivan has kind of found me. I talk a lot on Twitter and on YouTube about the problems that I'm seeing in my patients.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And, you know, Ivan, when I was preparing for this, I was looking at, you know, one of those two studies that you had mentioned. And in one of the studies, they have a doubling of aggressive behavior. You know, the dogs who got the drug, the Prozac, aggression as a side effect was seen in 12% of them compared to 6% of them who didn't get it. Now, and so...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I mean, that would just be another thing that people would need to be aware of, um, before putting the, the, the, their animals on these medications is if, if you start to see, you know, a typical aggressive behavior or violence, um, these are potential side effects of the drugs.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's a great analogy, and we use them in the same way in humans. We will give SSRIs to people with depressed mood, to people with anxiety, to people who have PTSD and trauma. We give it to women who have uncomfortable periods and are irritable around their periods because the drug doesn't work in any specific way. It's a chemical blanket. You know, they wipe out emotions.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I mean so anything that's that that generally tends to make people anxious and and and Irritable it can it just turns the volume down on the on the on your emotions Good and bad ones. It's just like cranking a knob down and it'll work for many different things but not in any specific way the tapering or tapering
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And I also use my research background from being at the FDA and in the pharmaceutical industry to try and break down complicated things like drug studies and research and make them accessible for people. Yeah.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Because I do have a... No, I'm smiling because this is like... This is like the greatest question that I've ever been asked before to start talking about antidepressant tapering with dogs. I love it. I love it. It's great.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah. Yeah, this is a great question. And so what I would What I would say the most important thing would be is to try and get a sense of the dog's baseline behavior before you taper because you're going to be looking out for withdrawal signs. What do we notice in humans? Humans will start to become more anxious and they might have a hard time sleeping. They can look dizzy as well.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And sometimes they have like brain zaps, although that's really hard to notice if you're configured. It's going to be hard to notice that the dog's having brain zaps. Maybe you'll notice some twitches or some ticks. And this is just assuming that the physiology of the dog will behave in a similar way to the human when you're taking it off.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
As I mentioned before, most people can come off these medications I would say in a couple of months. Honestly, that's way too fast for what I do but I talk to a lot of people and they can come off pretty quickly. The most important thing that you need to be aware of is that if the So if the person starts to look like they're becoming very uncomfortable, you slow down the taper.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so that might be the same with the dog. If when you're removing the medication, you notice the dog is very irritable, maybe very on edge, you might want to just wait. You might want to wait two weeks or just until the dog looks like it's settled down a bit more and then keep on dropping the dose.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I'm going to have to rely on you and your community to sort of educate the world on how to do this well, whether it's something that can be done in a couple of months or maybe it takes six months. Maybe for most dogs, it's pretty quick. Maybe for a select few, it takes longer. But the golden rule is to, if the dog looks very uncomfortable, put it back on the last dose where it was comfortable.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And then the next time, drop it by a smaller fraction. In humans, we drop the dose every two to four weeks generally, no sooner than every two weeks. It might be different from dogs. We'll have to get people to comment below this video on YouTube or wherever it is to start sharing their experience of weaning their animals off SSRIs and how it went. We'll have to crowdsource this one.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I think... Yeah, I think it's both things. And so we do know that exercise is a very good antidepressant for some people, not everyone. Now, the people that I see it work really well for are the people who are sedentary. They don't move. They sit behind their computer all the time. They're not active. Human beings, we're designed to move.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
We're designed to be out in the sun with the vitamin D effects and the fresh air. We're meant to be moving our bodies. If you just sit behind your computer all day and drink three cups of coffee and you never see the sun, you feel bad. And that's why when we do these clinical trials, when we do these studies, we always find that exercise really makes people feel a lot better.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And yes, it's a distraction, but I think physiologically, being outside in the sun, moving your body like your biology is designed to, is a great way of regulating your mood and getting energy out.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Let them do something to, you know... Well, I think, I mean, a lot of people, they're not really... You know, they just get a dog. And...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I don't know, maybe they have to move for work and they used to have a yard and now they don't have a yard and they're in a, you know, in an apartment and their job is busy, you know, their job is very busy or they have a child and all of a sudden they can't meet the needs of that animal anymore. Um, and, and I mean, that's, that's, that's, that's really sad.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And then it's, it's, it's very complicated because, um, What do you do? You know, you have to, I guess you have to find a family for the dog that is better able to meet its needs. Right.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
For a long time, the use of antidepressants was justified. I mean, I'll say it like this, was almost sold to the public in a way where the medications were thought to be fixing an underlying chemical imbalance. And the reason it was able to be sold in this way was because throughout the 60s and 70s, we started to learn more about what these drugs were doing.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
So I have no problems with people deciding that they want to be on the medications. And so generally what I like to see is when a person is unhappy, that you really try and find out why. And the major buckets are relationships, purpose, And then also, you know, stopping any substances that are making them sick.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And then also looking for medical problems or nutritional problems or problems with their food. If you have done all of those things and the person is still suffering a lot. I think with a very clean conscience, you can go ahead and say, well, we've tried everything. You're exercising. You're eating well.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
We can't really explain where this is coming from, and we want you to have a good quality of life. And then we explain the risks to the person. This is the evidence base. These are the risks. Do you feel comfortable with them? And if they say yes, then I think that's completely valid. You've done a good job. You've tried everything you could.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
If it's not working, with a clean conscience, I think it's fine to use the medications. And another thing that comes to my mind when I think about dogs is the very real possibility that the behavior could lead to the dog being euthanized or to the dog being rehomed or something like that.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so I actually start thinking about children with autism or parents with dementia because sometimes that's what we're looking at. with families that are caring for these people. And it's the same for them. You want to make them as healthy as possible. You want to do everything you can. But sometimes, especially with adults who have dementia, who are just getting worse,
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
the most humane thing you can do might be putting them on an antipsychotic medication or some antidepressants because it allows you to control their behavior better. It allows them to stay in the home with you longer.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And if that means that your grandparent or your parent can stay with you and you can look after them and you don't have to send them to a nursing home, these aren't easy decisions to make. I mean, these are ones that are very complicated and they're challenging. But there's never a right answer. It's never right or wrong to use a medication. You look at the individual circumstances for the person.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And at the beginning, we would just give them to people and we would notice, you know, there'd be some mood elevating effect. We didn't know what caused it, but eventually, as science improved, we found out that these drugs were actually boosting chemicals like serotonin, norepinephrine, adrenaline, you know, these very core neurotransmitters that help regulate our mood and cognition.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
You try everything you can. And if that's just the way it needs to be, then that's okay.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yes, yeah, you're definitely creating, you're making things easier for the person who runs the kennel, but making things more complicated for the dog and the next owner, when they're going to have to deal with a dog that's developed a physical dependency to a medication and has to go through withdrawal.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so this idea took place that maybe these drugs are actually working in depressed people because we're boosting these neurotransmitters. These people, they have a deficiency in the neurotransmitters and we're boosting them. Well, it's a reasonable hypothesis. But the issue with that is that
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah, and I also imagine it could be very... It might be very... for the person who adopts the dog because some people may say, I actually want a very docile dog. I want one that's kind of, you know, doesn't, you know, is very mellow. And if you go and adopt a dog from a shelter who's on SSRIs, And, you know, it's very mellow, it's very calm. And he said, Oh, this is a good fit for me.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And then you bring it home and you take it off the medications. And then it's real personality comes out. And all of a sudden, it's like, I want you to interact with me. I want you to take me out. I want to move my body. I mean, that's also I mean, that could also be very confusing for an owner.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
So what I would love to see is not that we get rid of any of the medications, is that at least for the humans, the doctors really emphasize getting to the root cause of why people are unhappy and being honest with them, you know, and helping them do that. You know, I would love to see us Help people more with their relationships, with their work, with their physical health.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And set realistic expectations and say, listen, this could take you a couple decades to figure out. You have to cultivate these things in your life. Good relationships, work that you love. These aren't shortcuts. There is natural pain along the way. And to set those expectations.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I'd love to see us get people to stop using so much caffeine and nicotine and cannabis to clear up their minds and then also to eat good food and to move their body every day. If we can do that, I think the amount of people who need these medications will go down a lot. The meds aren't really the problem. The problem is how we talk to people about them as if
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
you know the reason they need them is a brain illness and the drug fixes the brain illness and the drug is safe and effective even though it's never been studied longer than
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
you know longer than a year and it leads to all of these problems down down the road i mean if we could just help people with the things that actually underlie the depression and not lie to them about what the drugs are doing we'd be in a much better place and i hope we could do that for the dogs as well you know that it will translate that that level of thinking can translate over into the the animal world
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
There's also a competing hypothesis, and that is that there's no actual problems in the brains of the people, but the drug effect is simply masking the symptoms that the person is having. Now, that's a much less sexy idea, and it's actually a lot harder to sell because intuitively, people...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
We've been doing this in humans for decades. You stick a needle into the space between the vertebrae in the lower back and you get it into where the spinal cord is and then you suck up cerebral spinal fluid. This is the fluid that is kind of going around your brain. It's what the brain kind of floats in and what the spinal cord floats in.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
You suck up that fluid and then you look for serotonin or the metabolites for serotonin. And we've been doing this in humans for a very long time and trying to correlate it with different moods. And that's why we know. And that's what Joanna Moncrief found.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
was that there was no correlation between the neurotransmitters and the people who were depressed compared to the people who were not depressed, who had the levels drawn. It has nothing to do with low or high neurotransmitters. It's not that simple.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
don't have motivation and just... I think that's very unlikely, personally. In almost all of the people that I've met who have been depressed over the last 10 years and kind of longer, it's very hard to find someone who doesn't have a reason why they're unhappy. I think depression and anxiety is... it's mostly due to life hardship and then medical problems or substance use. Now,
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
There are some people who are just more nervous and that's their temperament. Generally, they tend to have more depression because when bad things happen in their life because they're more emotional and they feel things stronger, they will be more likely to be depressed. This is women as well. Women experience depression at a higher rate than men.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
They're much more emotionally attuned and emotionally sensitive than men and so they're more likely to develop depression. Your question is, is it still possible that there is someone out there and they come out and they're just depressed and there's nothing out there?
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's always a possibility because you have to be humble and know that there are some things that we may not know about the human brain and we're still learning things. I think it's a possibility but I reckon it's 99% of the people with depression or anxiety. Interactions and environment. Yeah, it's due to life and problems.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I think that's the extraordinarily rare case that it's completely a brain problem.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
People don't like the idea of taking a drug to paper over a problem, to mask a problem because it feels wrong. It feels like we're not really getting to the root cause. It's also sort of linked in with ideas about maybe taking non-prescription drugs, things like alcohol. You worry about, well, I don't want to do this to escape problems.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And that's one of the dangers of using the medications in humans as well. There's a sense of, well, I'm doing what the experts are telling me. I'm looking after my mental health, where your depression or your anxiety is so much more than taking a pill. You know, there's so many things, like I mentioned, cultivating relationships and work that you love, looking after your health.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But it gives people a false sense of security that, yes, they're really handling things when they might not be. And, you know, like I mentioned, I take people off meds who have been on them for two decades. And when they come off, we're rebuilding their lives, you know, and teaching them how to process their emotions. And so in some ways, it might actually be...
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
slowing things down for them, unfortunately.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Right. Yeah, that's kind of what I wanted.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I also know that if people use this a lot, they can develop a dependence and they need to use more and more. So when you think about the drugs out of this drug-centered model, people are a lot more concerned about taking them.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I think one that's really good for people to listen to is the one, it's called Psychiatrist Hurt by Drugs He Prescribed. It challenges the whole profession. And the thumbnail has a photo of Mark Horowitz and it says, I got really hurt. And that one I think is a great story because it talks about a psychiatrist who everyone assumes is meant to know the risks of these medications.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But he falls for the same narrative. And so I think that's a really interesting one. I mean, some of these stories are really – can be really quite emotional and sad. I mean, we have – You know, if I think about another one, we've got, I feel like there's an interview I did with a gentleman called Matt Marin, M-A-R-I-N, it's called Surviving Akathisia and Protracted PsychMed Withdrawal.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
He's just a very likable person. He's young. He's attractive. And he kind of talks about how he got lulled into taking these medications and then how it caused him a whole bunch of problems. And let me see if I had one more. He asked for three. This is very sad.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah, the last one would be Benzo's Killed My Husband, interview with Kelsey Krause. This is a story of a woman who loses her husband because he comes off the medications too quickly. And I talk a lot about this on my channel. It's a condition called protracted withdrawal, where some people, if they come off their meds too quickly, they experience a traumatic brain injury.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's almost like they've had a very severe concussion. And this happens to her husband and she fights to keep him alive for years, but eventually fails. And that's a very moving interview. So I think, I mean, those would be the ones that I really think are quite powerful. But I don't want people listening to this. These are sad stories. I mean, these aren't uplifting stories.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
They're very raw and they may make some people feel uncomfortable.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But if you tell someone, well, there's probably a genetic problem wrong with you and this drug is going to go into your mind like a magic bullet and fix the issue, it can seem a lot more justifiable. It's like, well, I'm not papering over my symptoms. I'm not hiding them or masking them. I'm fixing a medical problem. Now, Ivan, you mentioned Joanna's paper just a moment ago.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
So, so, so, um, yeah, best place I'm, I'm on every single social media platform I can think of like the, the, the main ones. And so the biggest channel is the YouTube channel. It's Dr. Yosef. It's, it's spelt in the, with, in, with the German way. So J O S E F. Um, and, um, You can find me on Instagram, TikTok, X, under either Dr. Yosef or Taper Clinic, at Taper Clinic. That's T-A-P-E-R Clinic.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
That's usually my handle there. And we also have a website. It's taperclinic.com. And we work in 10 of the most populous U.S. states doing drug tapering for people. And so... you can come to our website if you or maybe you or someone else that you know is interested in potentially doing a drug taper.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
I actually think I'm going to do a dedicated video on dogs and Prozac. I think because this got me really interested.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And if it's okay, I'd like to add to that just that the studies looking at these in dogs, they go on for six weeks. And so when the vet says this is effective for the dog, you know, dogs live for 15 years. You know, we, we have no idea really what it's going to do in the longterm.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Um, and these drugs, like any other drug that acts on your mind and alters your neurochemistry, you know, you, you build tolerance. And so you may end up, it may stop working for the dog, or you may need to go on a higher dose and the dog has side effects. And, you know, when you go to a higher dose, there could be problems. And so it's, um,
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
yeah you know i think there's a lot less certainty than than than well i know that doctors convey and i imagine maybe the vets could be the same oh you know safe and effective we do it all the time you know and then people don't hear yeah for the six weeks you know the study went for well super i am very very grateful and uh if you if you really if that was
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
yeah yeah and so this was a really big deal at the time you know a group of researchers led by joanna mong brief and out at university king's college london they essentially did a review of every single study out there that had looked at serotonin in depression and so looking for correlations you know in these depressed patients when we bring them in if we if we draw the central spinal fluid
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
you know out and we look at the metabolites of serotonin you know are they are they lower you know they never found it you know they would do autopsies of the brains of people who had a lot of depression and they would look for the concentration of you know serotonin receptors on the neurons absolutely no difference and then they also touched on
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
really high-tech brain imaging studies, things called functional MRIs, where you can look at structures in the brain, and you can also look at the way the physiology of the brain changes. And they got all these people with depression, and they got normal people, and they could not find any reliable differences between them. So what this means is that
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
There is no underlying chemical problem that we're seeing with people who have depression, at least not one that we can test for. Maybe we haven't found it yet. But the idea that we are fixing well-known problems with these drugs is false. This doesn't mean that there can't be things out there like temperament. We know that temperament is kind of genetic.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But it's not this easily understood thing where it derives from this one thing in the brain. It's likely polygenic, meaning it's made up of multiple different genes. But that's not a disease. This is just normal human variation that you get some people who are more nervous and some people who are more extroverted.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Yeah, yeah, yeah. And that's just normal human variation. I mean, some people are taller, some people are shorter, some people are more athletic and less. And all of these different things have survival advantages, and they're completely normal. And so what this paper by Joanna Moncrief
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It really brought to the fore, at least for humans, that when we are using these drugs, we are not fixing broken brains. We are papering over anxiety and depression with a drug. And that made a lot of people very uncomfortable to hear that, but it's the truth. And that's why that paper was such a big deal.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Well, see, a lot of this comes down to commercial forces, right? And so I mean, most doctors have known for a long time, essentially, depression. Why do people get depressed? Well, it could be due to life circumstances or it could be due to maybe things we don't understand.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
And so I think we've always had this idea that there was this interface between maybe your temperament and just the natural variations between people and then also stresses in one's life. What the drug companies wanted to do was they wanted to downplay the life hardship. When life hardship leads to depression and anxiety, they want to downplay that because that's not what their product fixes.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
They wanted to paint depression and anxiety as more biological than it was because that's what they had the solution to do. And when you have a group of powerful companies who have billions of dollars of marketing spend, And in the US, they used it on television. You know, there are old ads from, you know, the 2000s, where there's this bouncing Zoloft blob.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
It's Yeah, yeah. And it says, you know, if you're suffering from depression, you may, you may have a chemical imbalance that's going to be fixed by these drugs. Now, I think for most people, it's understandable that a drug company is going to play shenanigans and they're going to market things in a way that increases the amount of sales.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But the thing that most people don't realize is that the medical community, especially the leading academics, have been corrupted by the pharmaceutical industry. Most people think doctors get corrupted because sales reps for the drug companies, they come in and they bring them sandwiches. And because the sales rep is sexy, it's meant to convince the doctor. I'm sure that plays a part.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But as someone who used to work in drug companies, let me tell you how the real corruption happens. The fastest way to excel in your career as an academic psychiatrist, now these are the people at Harvard, Yale, UCSF, the leading institutions out there and internationally as well. The fastest way to make a name for yourself as an academic is to work with drug companies.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
Now, the reason for this is they will let you run their clinical trials, they will write publications for you, and they will fly you around the world. And all of these things will bolster your curriculum vitae. And that will allow you to get promotions.
Training Without Conflict Podcast
Episode Sixty: Dr. Josef Witt-Doerring
But what this means is that for very competitive academics who really want to rise to the top of their profession, they're not going to speak out about the drugs. They are going to actively avoid saying negative things about it because as soon as they start doing that, they're not going to be supported by the drug companies anymore.