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I cannot stress this enough: I live for the day these cruel bastards get gulaged. This shit is why I'm a leftist.
this post was submitted on 18 Jun 2026
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Given that it is the US, and RFK specifically who is responsible, it’ll probably cause a lot of unnecessary suffering for the people who need it the most. But I believe the idea itself is actually neither wrong nor bad.
Long argument incoming:
There is no conclusive evidence supporting the idea, that any mental health issue is caused by a chemical imbalance in the brain. At the same time, there is plenty of research pointing to the contrary. The reasoning has basically been, that since introducing X chemical to the brain helps it must mean that lack of X is the problem - with no further evidence to support it. Two major arguments against this reasoning are as follows:
By accepting the chemical imbalance hypothesis and using that reasoning when prescribing medication, we end up overprescribing medication while neglecting to investigate treatment that could actually be more helpful. This is a problem, since medication is both expensive and has many severe side-effects that people just have to live with if the only perceived alternative is to keep being depressed, psychotic, etc.
In the end it boils down to something akin to the cars vs. public transport debate. Public transport is undeniably better, but it requires the political commitment to invest in the necessary infrastructure. As long as this infrastructure is non-existent, and we live in a world of paved roads, owning a car can be a life saver.
The same can be said about psychiatric medication. It only becomes the necessary, or go-to, treatment because we are unwilling to address the bigger causes of our suffering - and by bigger I mean something much more drastic than just public transport infrastructure.
All of this to say, that the idea of deprescription can be helpful if we in turn focus on changing society and the way we live, both together and as individuals. However, merely limiting the access to psychiatric medication without changing anything else will only lead to suffering.
Many of my trans siblings all over the world are denied HRT with the exact same idiotic argument that openly, shamelessly dismisses empirically observable beneficial outcomes: Apparently, it is not ok to shoot up estrogen simply "bEcAuSe wE dO nOt kNoW tHe uNdErLyInG cAuSeS" of gender dysphoria, disregarding that these causes can only be observed through looking at symptoms in the first place.
That "fuck empirical evidence for patient health, my ivory tower garbage about how we do not yet properly understand this phenomenon trumps your human rights" bullshit is the entire justification for why healthcare is taken away from us, and you use the exact same reasoning to justify Robert Fucking Kenney Jr. taking healthcare away from people. Oh yes, it will be a bad thing when he does it, you at least admit that much, but i guess his heart is in the right place, because while you midly object to the implementation, you fully agree with the core of this policy.
I do not need anybody to understand why trans people exist to shoot up estradiol and i do not need anybody to understand what causes ADHD to take methylphenidate. In both cases, the proven and demonstrable benefits these medications have for an overwhelming number of patients are reason enough to justify treatment.
IT IS NOT REQUIRED FOR THE TREATMENT OF ANY CONDITION THAT WE FULLY UNDERSTAND WHAT CAUSES THIS CONDITION. EVIDENCE FOR THE EFFICACY OF A TREATMENT IS ENTIRELY SUFFICIENT. IT IS A BETTER EMPIRICAL FOUNDATION THAN LITERALLY ANYTHING YOU ARE ADVOCATING FOR.
Let's disregard for a moment that ADHD is not fucking me over because of capitalism, but makes it impossible for me to life a normal life even when i am unemployed and can, for the time being, focus on just existing and then getting my life in order. I'm a privileged European living in the last days of our welfare state existing, so this is actually my material reality. I get money for nothing while i try to sort my shit out. I have a really cool ergotherapist who is competent and supportive and woke and who teaches me little life hacks, i have a trans inclusive psychotherapist, i have not quite the kind of healthcare you dream of but thanks to careful research, living in the right place and just being extremely lucky i come pretty close. I am as close to the living example of your idea how to treat mental health problems as you'll ever get. And i can't get anything but the miost basic chores done without medication, no matter how well i manage my time and how much i body double and how many other skills and copes i employ. In spite of having zero responsibility, i struggle to take care of myself, to socialize as much as i want or to pursue hobbies and activist work adequately. It just does not work, because my brain says no. That's how mental disabilities are sometimes. But you don't know anything about that, all you know is that i should clean my room and stand up straight with my shoulders back. That is literally what you are arguing, Jordan Peterson self help bullshit, but from a leftistperspective where the antidote to chaos is not fascism, but socialism. Do you think i could function like this under AES? LMAO, fuck off. You do not know jack shit about these things, sorry to be so blunt but stop making judgements about the lifes of disabled people. It is insulting. It is openly insulting what you do.
I'm gonna axe the part where i get into the politically illiterate part of your post. I do not have the spoons for that. I have procrastinated grocery shopping for more than an hour to type out this reply already because guess what, i lack the medication to do this any faster because my gatekeepy psychiatrist will not prescribe me methylphenidate until next week, if she will do so at all, so i have to save my remaining stock for absolute emergencies. Isn't it great how the gatekeeping you advocate for saves me from being given side-effect heavy medication for a condition we do not properly understand yet? I will not waste another hour where i tear you apart further. But believe me, you would deserve it. You would also deserve a much more hostile reply than this, but then the mods will tone police me and you will refuse to listen, so have this instead and please take it to heart. This goes for all the ableist pro-RFK cryptochuds in this thread. Fix your hearts or die, i am serious.
Another good post :cat-trans: thank you serial experiments
SSRIs work less than half the time? would be cool if we could determine someone was in the lucky third before delaying other treatment or subjecting people to horrible side-effects. HRT and stimulants have much better records.
I'm unsure how to reply to your comment. I don't think I've experienced someone being so hateful towards me before. I'm sorry that I hurt you.
See my comment above for some elaboration, but I am not arguing that people should have their access to medication removed. And I don't believe that the cure to mental health issues is self-help. We can discuss it further, but only if you would find it meaningful.
I'm just really really allergic to people arguing in favor of medical gatekeeping, which is almost hardwired into the goals you're arguing for. I've had to navigate systems like that during my transition, i am back to having to do this now due to my ADHD, in fact exactly because my country's healthcare system is biased in a direction you are advocating for when it comes to adult ADHD. What you're writing just hits very close to home and i'm tired. I don't know how much longer i can go on unmedicated. I just want to do more than existing, why is that so much to ask when there is an obvious, workable solution?
Also, like i said, that kind of outburst is an actual symptom of my disability. I don't feel that way now, and that kind of swiveling back as if nothing happened is also fairly typical (and comes with its own problems), but i seriously couldn't stop that shit anymore after a certain point. It's something i'm working on, and yes, somewhere down the line i may end up taking an atypical antidepressant to rein it in because frankly, this stuff is overwhelming and i don't like the pace at which i'm making enemies. Just to reiterate, there are a fuckton of ADHD symptoms that have literally no relation to functioning under late stage capitalism and that can still ruin my life if they go unchecked. This issue is more complex than some people here assume.
I think a big difference between these two is that public transit infrastructure and car infrastructure are both competing for the same limited physical space. The more paved roads and highways, the fewer railways. Psychiatric medication and general improvements to society do not have that kind of dynamic. Lowering the amount of prescribed antidepressants won't have any effect on outside circumstances that make people depressed.
I generally agree, and the comparison was mostly to get the point across that medicatiin is not 'bad'. But one could argue that there is a similar competition regarding the ideas of what constitutes a cure/treatment/wellbeing etc. The psychiatric and medical industry is very intent on furthering the use of psychiatric medication as the safe, correct and responsible way to deal with mental health issues, while downplaying the feasibility of other options.
"The trans industrial complex is very intent on furthering the use of hormones and irreversible surgeries instead of resolving your struggle with gender roles through open-ended therapeutic measures" oh wait that was not what you were saying, it was only the literal same argument applied to another diagnosis, based on the fact that the same guy who is attacking SSRIs right now has argued against gender affirming care in this way before. Funny how much you keep sounding like a literal transphobe.
Oh sorry, i did not want to write another reply to you. That was mean. It was also a collossal waste of my time. I guess that's what happens when you have unmedicated ADHD, you just get sidetracked. I should probably read another self help book or talk to my therapist for another year to fix this, after all not understanding the underlying causes of my condition is only a concern with a pharmacological treatment of my symptoms and when i do behavorial therapy it is suddenly ok not to know understand what is going on in my synaptic clefts.
yeah pretty much my opinion
I wrote in another comment to another post how imagining we know anything about why psychoactive substances do what they do is mere hubris, and it is. This argument is misguided, comrade. At best, it's utopian thinking. What is happening in practice is maximal suffering, with no benefit to public health (or positive outcomes on the individual level!) - how do we change society? Inventing a world where deprescription as it has been and is actually implemented ceases to exist somehow is utopian.
There's no contradiction between rejecting the chemical imbalance theory (which was originally a marketing scheme for Zoloft) and supporting the use of psych meds for those who benefit from using them.
I'm going to try and go a different direction here since other commenters have already said everything I'd like to say: psychiatry is extremely faddish, and deprescribing has been gaining some powerful friends the same way other interventions have in the past. As such it deserves to be treated with the same critical eye as any other trend in the field. Deprescribing is hot now because there is a way to profit from it. Any benefit or risk that accrues is incidental to the further commidification of disability and disabled people. Other people have written at length about this, if you're disabled you've probably seen it yourself: what drives trends in treatment is what treatment is available and who can monetize it. If it weren't profitable we wouldn't be seeing such a push for deprescription now, the same way we wouldn't have seen anxiety become depression become bipolar disorder (merely changing the name for the same underlying phenomena as different medications come on or off patent).
Benzodiazepines were considered largely benign until the manufacturer of Buspar decided to salt the literature to make space in the market for their "non-addictive anti-anxiety medication". MDD and GAD got redefined in the DSM as SSRIs emerged as alternate "serenics" or "anti-depressants". Social anxiety as a diagnosable nosological entity distinct from other anxiety disorders only exists because Paxil needed a new indication to extend its patent life. PMDD as a distinct nosological entity distinct from what had existed before but been coded as PMS or PMT (non-billable) is a thing because Prozac was going off patent and the manufacturer reformulated fluoxetine as a pink tablet to keep their rate of profit up. BPAD got fuzzed to include "has moods" as the market for "mood stabilizers" appeared around the turn of the century.
There have been no real advances in psychopharmacology since the introduction of the SSRIs and SGAs in the 1980s. We've been running on fumes and recombining old treatments for decades, creating prodrugs (Vyvanse/Elvanse) of 100 year old drugs, or turning ketamine into a single-enantiomer nasal spray. There's no money to be made in psychopharmacology now. Everything is generic, there's no marketing teams creating the pressure that there was 20, 30, 40 years ago.
The failure of nosology to account for human experience has nothing to do with whether somebody benefits from a medication or not. Force-tapering people is violence, but there's money in violence. There's metrics to create and hold prescribers to! We can further enclose and extract rent from the human experience and from human suffering in ways that don't differ from forced prescribing (or overprescribing, whatever) at all. Medication has no moral valence by itself but the choice to prescribe or deprescribe (and the necessity of a prescription to access certain medications in the first place) does.
And lastly, there is the whiff of disability-as-moral-failing and disability-as-contagion to this reasoning. Whether the cluster of experiences we call ADHD is nosologically coherent or not doesn't change the fact that there exist drugs that improve executive function and quality of life for certain people, and those people (myself among them) should have access to the medication they need without judgement or gatekeeping. "If we could treat the underlying causes then disability would cease to exist" is ahistorical. It's the same argument RFK is making, ultimately.
While I am (maybe a bit too) hyperbolic in my comment, I would never argue that we can eliminate mental illness, not even in a utopic world.
I also want to point out that I in no way whatsoever support deprescription in the sense of either force-tapering, removing access to medication or obstructing the path to recieve medical help.
When I have encountered ideas of deprescription previously, it has been connected to initiatives such as:
Nah that's super easy to deny. Sucks to pay 80€ for a 3 hour round trip. Sucks to be squeezed in between strangers if you are lucky enough to get a seat. Sucks to be stuck to an inflexible schedule that the transport company fails to keep. Sucks to be stuck in a box with 100 people during flu/covid season.
There are certainly plenty of things better about public transport but it's not better in every conceivable way. There are reasons I prefer riding my bike when feasible.
To take this back to mental health ... not really sure what you meant by the analogy in the first place.
Just that one being 'better' in a best-of-all-worlds scenario doesn't mean that we should disregard the other on an individual level, since circumstances might differ.
Of course its not as definitve as i made it out to be, that was just for the sake of making a point, as this is about mental health and not transportation (I also prefer my bike).
Thank you for laying it out far more eloquently than I could. Psychoactive medication, or at the very least antidepressants, are not treating the underlying condition we call depression (or ADHD, BPD, whatever) and they never can. Fighting against their overuse should be celebrated. Of course, taking into account the party behind this changes things somewhat, but on a fundamental level, I think we should strive to lessen our dependence on psychoactive drugs.
Yeah okay, except there is no way to treat ADHD without stimulants. You're taking away some peoples only ability to function
I'm sorry, I wasn't notified of your reply. But I'm not clear on where I said I don't want to treat people? Why are you talking about me "taking away" anything? My position is that psychoactive drugs are being recommended too much, especially in indications like anxiety and depression. And that's not even touching the subject of hospital care, where you will still see cases of sedative/anxiolytic abuse (from the doctors' side!) to better manage an unpleasant patient.
Other people in this thread have made claims that evidence of treatment efficacy is sufficient grounds to treat. If that were the case, we wouldn't need to have phases 1 and 2 of clinical trials. The critical axiom of medicine and healthcare is "do no harm", and that applies on a population level as well. Psychoactive drugs can have serious side effects and they shouldn't be viewed as pills you pop just to get some spring in your step.
To reiterate, I'm not against pharmacological treatment of conditions like ADHD, GAD, depression etc. As you say, sometimes it is the only viable option. But that was not my point; my point was that these are powerful substances that we don't fully understand and we should treat them with respect, not throw them at people from all angles.
E: I just realized, I disagree with the statement that there is no way to fight ADHD without stimulants. And I'm not talking about "just focus harder" or similar nonsense, rather prevention. Any medical professional worth their salt knows prevention is better than treatment, and there is good evidence (as far as I remember) that some chemicals, lifestyle factors etc. play a role in ADHD as risk factors.
I see, sorry for jumping to conclusions. It's a touchy subject for me.
No worries, glad to have cleared that up. I'm a bit miffed that I only noticed the debate three days later, because I would have something to add, but oh well. I'll limit myself to saying that I have a medical degree, and
has made me view pharmacological substances (in general, not just psychoactive) as a sometimes necessary evil. They can help people function, save lives even; but you should always think before you prescribe them. I think that's where a lot of the disagreement in this thread stems from. Me and some other people saw the text linked and thought "great, reducing unnecessary prescription is exactly what we want (in principle, RFK is not a great source)" while you and some other people thought "oh no, RFK's gonna try to take away access to needed medication".
ITT: People who don’t understand how much ADHD meds help people in personal life (hobbies, hygiene, etc.), not just for work and school.
Seriously, some of you still have a D.A.R.E. mindset when it comes to stimulants
fr, this thread makes me wanna scream
I will indulge my inner pendant and point out that there are a couple of non-stimulant treatments for ADHD that have their place, but they all have in common that none of them are as effective as stimulants are.
There's a reason stimulants have been first line treatment for what we call ADHD now since some dude first gave some hyperactive kids Benzedrine in the 1930s. I'll dig out the study if I can find it. They work, they're well tolerated, and they're safe. Even if they weren't, I'd rather be able to function and take them than have fucking RFK or whoever tell me I can't for my own good.
And there's another point to make here: we only know stimulants work for ADHD because some dudes decided to give them to kids and see what happened. There's a lot of throwing shit at the wall and seeing what sticks in psychopharmacology, or used to be. Moving away from that model hasn't made treatments any better, either. I have a psychopharmacology textbook from the 1950s in my collection that treats serotonin's presence in brain tissue as a mere curiosity. Everything was adrenergic then, and only a fool would think serotonin does anything but affect bowel function and platelet aggregation, according to this textbook. No one even knew dopamine was found in human brain tissue at that point, either, and it would be decades before its function as anything but a metabolite of noradrenaline would be recognized. I see today the same imperious tone being taken towards serotonin in the literature now that it's had its moment in the sun, just as other neurotransmitters got sidelined when there was big money in serotonin. BDNF and tPA are sexy in the literature right now. In 10 years it will be something else entirely.
None of this has anything to do with what works, or what doesn't. Potentially safe and effective treatments for various conditions have been mothballed because there's not enough market share for their development to be profitable. Shit, "cries a lot" is on the depression screening because SSRIs are great at suppressing the ability to cry, irrespective of whatever else they do. It's true that drugs are big business, but the supplement industry and the crunchy granola "holistic" fascist wellness shit are also absolutely raking in the cash. We don't hear about that enough in these discussions. Supplement dudes see the opportunity to get their bag, and they're taking it.
Regarding ADHD specifically I think we (in most of the western world at least) live in societies that demand a lot from the individual regarding planning, structure, bureaucratic work and timeliness - all things that are difficult for most people with ADHD. So yes, that would be taking away their ability to function as members of society.
In this sense, ADHD medication is still not a cure, but a tradeoff that allow us to keep having the same expectation of peoples ability to comply with the above values, regardless of who they are. As the expectations become more demanding, so does the need for ADHD medication.
My original point was not that it is good to take away medication and leave people to themselves, but that (in the case of ADHD) embracing neurodiversity and the demands we put on each other as a society could lessen the need for medication, thereby making less medication = good. Of course this is very much an oversimplification of what would be needed.
For me, the biggest problem is that there appears to be very little awareness in politics about this tradeoff. Keeping the same kind of societal demands and also wanting less medication is impossible and harmful.
Oh right, i'm back. Thank god i am not an AmeriKKKan living in a food desert, but live in a mostly walkable environment where i can do this stuff quickly. I seriously do not know how i would get anything done if i would need to drive for half an hour first. But guess what, it is still not enough. You cannot change society to the point where it allows me to live the way i want to because the problem is not structural, it is neurochemical. Material conditions under capitalism make it worse, more stressful, often more costly because i have to pay late fees all the fucking time, living with ADHD under these conditions often fucks me over in ways that relegate me to the bottom rungs of capitalist society, like that one time where i had to drop out of college because of ADHD or that one time where i lost my job because of it or that other time where i lost my job because of it. All of these are actual issues were capitalism intersects with my disability.
But people like you, YES YOU, who pretend that my problems are not actual problems are another factor that makes my life harder. You do not do the thing that most other ableists do, where you argue that i am lazy and should just pull myself up by the bootstraps. Instead you are a socialist ableist who dismisses my problems as mere symptoms of capitalism. But that does not change that you dismiss my symptoms to the same extend that any chud who thinks i'm just a stupid loser who refuses to pull her own weight dismisses them.
And this is how i know that you do not spend enough time with people who have ADHD. We are also impacted in all other parts of our lifes. I struggle to keep contact with anybody but my very closest friends that require the least amount of effort to socialize. I struggle to maintain relationships because i am forgetful and can't listen and lack the spoons to be mindful and bring little gifts and i get distracted during sex. Having a functioning relationship with somebody who has another form of neurodivergence is a struggle, having one with a neurotypical person is outright impossible for me. THESE ARE COMMON DIAGNOSTIC CRITERIA FOR ADHD BTW. This condition is not defined solely by how we fit into a work or school context. It constantly interferes with out social lifes. Do i have to get into how impossible it is for me to be patient with ignorant know it alls like you who seriously carry water for RFK jr. because they love to talk down to me so much? Do i have to explain to you how hard this shit makes it for me not to crash out all the time, how severe my abandomnent issues are, how i spiral because i can't move from one emotional state to the other or how sometimes the exact opposite happens and i do not clear arguments up properly because i cannot remember how mad i was 5 minutes ago? Don't worry, that is not happening right now, i'm in hyperfocus now, so it's all good. Maybe i should make a list of the hobbies i have abandoned over my life next. I would do the same with activist work, but i can't do that without doxxing myself.
But yes, clearly the problem is only how a poor bean like me does not fit into late stage capitalism. Socialism would of course fix me. Don't get me wrong, it would be necessary to actually live with dignity, but it would still require meds. If we would get socialism and you'd be the general secretary, i would be fucked.
SHUTTHEFUCKUPSHUTHTEFUCKUOPSHUTTHEFUCKUOP OH MY GOD PLEASE JUST SHUT YOUR STUPID MOUTH
But that is literally what you are defending here. This is a thread complaining about how that exact thing is about to happen in the US and your reaction to that is "well i think he has a point actually."
"Embracing neurodiversity" is not what you are doing, you are shitting all over it.
This is too insulting and dismissive to reply right away, i would only get mad at the sheer ableism and cruelty on display, but i'll come back to this later. I've made another post itt that lays out why this is so infuriating to me, maybe read that if you want a perspective that is not ableist garbage.
I see a lot of my adhd friends struggle to get stuff done they want to do, hobbies, hangouts, finishing projects etc. It effecting their social lives. I think they'd still want to finish hobby projects regardless of capitalism or not.
Yes that would be nice. It's really hell trying to fit into a structure that your body refuses to conform to
It sure is. I just wish we could lessen the burden on people, so they wouldn't have to go through all that in the first place.
There are non stimulant treatments like strattera and i think wellbutrin affects adhd? but I haven't personally tried them. I agree with you that stimulants are very helpful and shouldn't be gatekept from people who need them though. And they're coming after drugs like those too since they're an SNRI and NDRI respectively
some or most ADHD should just be accommodated but that's not the society most of us live in
I like to accommodate my ADHD by taking stimulants so I have enough executive function to wash my clothes and read interesting books
i have fully given up on reading but technology like those single unit washer/dryers and having one in my apartment instead of having to walk up and down several flights of stairs three times to get to the laundry room would go a long way toward doing the laundry more consistently
To quote myself because i do not have the time to reply originally to this ableist horseshit:
I'm gonna indulge in a bit of snarkiness, because this comment frustrates me and I feel the need to refute it even after three days.
Did you know that thalidomide was very efficient in preventing early pregnancy vomiting? Or that benzodiazepines were much more efficient as anxiolytics than the preceding class of barbiturates. Antibiotics in general, we don't even need to mention them and their efficacy. Oh and if you want to help someone in shock with oliguria, load them up with diuretics, that's the most efficient method of inducing urine production after all!
My point is, understanding the causes of a condition is critical in finding an actual cure. You can have treatments, symptomatic or otherwise, even without it (see lithium for BPD, valproic acid for epilepsy, many others) and that's fine. But claiming that you don't need to understand the safety profile, potential side effects, risk groups, or anything other than efficacy is, as you say, horseshit.
The examples we were talking about were mostly amphetamine, methylphenidate and estradiole, all of which have been in use for many decades and are extremely well-studied in their side effects. I actually didn't say ONCE you do not need to be aware of a drug's side effects, it's frankly dishonest to claim i would have said "we do not need to understand anything other than efficacy" when i said "understanding efficacy is more important than understanding the exact neuroscience behind things like ADHD or transness". These are VASTLY different statements.
I still think your objection is making fair valid points that i will not debate because i obviously agree with them, but do not put words into my mouth 3 days after i've crashed out on a completely new account that did nothing but well actually RFK jr.'s policies. That's uncalled for.