Is critical psychiatry creating its own myths?

I’ve just watched Joanna Moncrieff being interviewed on It’s your life with James “JC” Cooley” (see video), one of several video podcasts to which she has contributed. She says that antidepressants numb people, which may initially be helpful, but cannot be a long term solution because they may prevent people being “tuned into what they need to do to feel better”. She talks as if the numbing is a physiological effect, but I think it is more likely to be the result of a placebo reaction (see eg. previous post). Any apparent benefit of antidepressants because of a placebo reaction may not last, or may diminish over time, and/or cause a nocebo effect, such as emotional numbing because people do not think their psychosocial problems have really been dealt with. 

I’ve expressed concern before about how social media can misrepresent the truth about psychiatry (see eg. previous post). Video podcasts may be helpful in promoting personal perspectives, such as Jo’s, but there are not necessarily the same checks on transmitted information as more traditional forms of communication. As far as I know, Jo cannot point to any academic reference to support SSRI antidepressants being pharmacologically emotionally numbing, In fact SSRIs were introduced partly because they tended to be less sedative than tricyclics, the previous generation of antidepressants. I’m not of course saying that patients do not complain of emotional numbing with antidepressants, particularly over the longer term; the argument is about the mechanism of this effect. There does seem to be a need for discussion on this issue in the academic medical press.

As I’ve also said several times before, although ideologically I am close to Jo, I do worry about her niggling overstatement (see eg. previous post). She makes very clear in the interview on the JC Cooley show that her motivation for change is not necessarily to stop people using antidepressants, but more to ensure they are properly informed to be able to make a decision about them. She also says she’s always had a “rebellious streak”. Misplaced authority should be challenged but the rebel within Jo may need to be tempered by accuracy and truth. It’s important critical/relational psychiatry does not merely replace the myths of biomedical psychiatry with its own myths.