I'm very much in the "try everything before SSRIs" camp and just went through the whole gambit in the medical system over SSRIs. Doctors basically threw them at me during a short term health crisis. So yes, there needs to be reform. I think diet (including gut/brain axis health - and don't sleep on brain/dental axis health), exercise, vitamin D/sunlight, relationship quality, sleep quality, specific nutrient imbalances, redlight therapy, sauna therapy, and a whole host of other therapies that are not pharmaceutical should be considered first. In fact, I think traditional and alternative medicine (with at least some research support) should all be used first before pharmaceuticals. I'm not going to apologize about that view. I think it's the right view.
As a side note, did you know most serotonin is produced in the gut? the brain and gut are deeply interconnected. there is little doubt now that diet plays a huge role in mental health. similar symbiosis exists between the gut and brain with GABA and other neurotransmitters. This doesn't even begin to get into the HPA axis (with adrenal gland function outside the brain) and it's interconnection with mood regulation.
on these points, there is little doubt at all that when the human body is functioning optimally it is because we are doing the foundational things right like diet, exercise, relationships, sleep, etc. Unfortunately, the medical establishment pays very little attention to these foundational elements of mood and optimal functioning.
As another side note, it's shocking that the incoming head of HHS doesn't understand the difference between addiction and dependency and for those reading a long - "addiction" is the intense craving that you want something, where "dependency" is where your body (in this case your brain) has adapted to the presence of a substance and uses it to establish homeostasis such that when you take that substance away, your body (in this case your brain) is thrown out of equilibrium and suffers certain effects until it can regain its balance. The other factor is "tolerance", where the body (in this case the brain) requires more of the substance in order to produce the same effects (or in some cases it simply stops working). The most wicked substances in this discussion - heroin, narcotics, benzos, alcohol, nicotine/tobacco, etc. generally cause dependency, tolerance and addiction. In addition, these substances cause active harm to the brain during use other than short term use. They are by definition extremely dangerous. In fact, you can die from trying to quit using most of them unless you are extremely careful. So the idea of going to a "farm" to detox from most of these substances is not only idiotic, it's also highly dangerous.
SSRIs are not addictive and they generally do not create a tolerance nor do they do active harm. They are however, extremely likely to create dependency in those patients that take them. It is solely because of the dependency issue that I am so adverse to taking them. However, if after trying other remedies it's clear SSRIs need to be tried, then they need to be considered. And there is virtually no risk of addiction or tolerance in these medications.
But back to the issue at hand, what this all underscores to me is the lack of innovation and discovery in the field of managing anxiety and depression, and that to me is inexcusable and something that must change.
I think RFK is an absolute nut job and he needs to be ousted as soon as possible (I realize that isn't happening). I just hope we don't lose access to what we currently have available and the knowledge we currently have gained, and maybe, just maybe we can have a silver lining with a focus on other remedies in addition to and not in lieu of those remedies already available to us.
I have family that uses these meds, if they are outlawed, I will have to help them get their scripts somehow because in many cases after decades of being on them - with effective results and no other issues other than dependency - there is no route to permanent cessation of these drugs.
I am not cautiously optimistic though. It could be a bumpy ride.