Suffering, Salvation, and SSRIs

my hateread of 2026: Chemically Imbalanced by Joanna Moncrieff

Hello my slugs, apologies for disappearing a little.. I’ve been working on this VIDEO, and also, I have decided to change my entire life and move back into the city. Just things that happen when the escitalopram kicks in, I guess!

As long-time readers know, I love to do an annual hate-read, where I pick apart a book I know I’m not gonna like as a fun intellectual exercise. This year we’re looking at Joanna Moncrieff’s new book Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth. And spoiler alert: it’s about Calvinism, because all roads lead to the Protestant Work Ethic somehow!

Moncrieff, a critical psychiatrist, has spent most of her career warning the public against antidepressants (I wrote about how she’d also convinced me, for a while, here), and Chemically Imbalanced is her ultimate anti-antidepressant manifesto. She argues, based on randomized controlled trial data and the work of a very famous placebo researcher, that SSRIs are essentially useless.

Her book, in my read, relies pretty heavily on cultural assumptions about the harms of drugs in general, and tends to discount the positive experiences that people report on SSRIs in particular. This culminates in a neat little gift for conservative figures who argue, like Moncrieff, that suffering is an opportunity for personal growth.

In the video I discuss a countertext, and I thought a mini-list of further reading would make a nice little extra. So, here are a few books that have influenced me and will expand your perspective on this issue:

• Ordinarily Well: The Case for Antidepressants by Peter Kramer / the countertext in question, Kramer defends clinical experience in the face of critics who over-rely on trial data to write off SSRIs entirely.

• Strangers to Ourselves: Unsettled Minds and the Stories that Make Us by Rachel Aviv / possibly the best book I’ve ever read on how multiple narratives about mental illness — medical, spiritual, political — all can exist at once in people’s lives. This offers a great counter to the binary at the heart of Moncrieff’s argument, that depression cannot be both a reaction to circumstance and an illness. Specifically, see the chapters on Bapu and Naomi.

• Psychopolitics by Peter Sedgwick / a political argument for the concept of illness from the left, and a great counter to the Szazsianism of Moncrieff’s work. Read chapter 1, 6, and 7 in particular.

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