Michael Smerconish: This Commentary Cost You $48,000,000. $40 Trillion with a “T”

13,385 views Aug 22, 2026

The national debt has crossed a staggering new threshold — but the number itself may not be the most troubling part. Michael Smerconish looks at how America got here, why both parties share responsibility, and what decades of tax cuts, spending increases, entitlement costs and crisis response have done to the nation’s finances. With interest alone now costing more than $1 Trillion a year, the consequences are increasingly hitting Americans through mortgages, car loans and everyday purchasing power. So why has Washington largely stopped talking about it — and what happens if nobody is willing to make the difficult choices required to fix it?

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Axios: Robot smash human records

 👟 Robots smash human records
 
Photo: Kevin Frayer/Getty Images

In Beijing yesterday, two robots ran faster than Usain Bolt’s 9.58-second world record in the 100-meter sprint, clocking 9.39 seconds. Braking was another matter: The machines slammed into a thick mat after the finish line.

The five-day World Humanoid Robot Games, with 2,000+ robots, combines sports with simulated factories, restaurants and offices, Reuters reports.

The intrigue: China makes the majority of the world’s humanoid robots. The U.S. has stepped up scrutiny.

Reality check: Humanoid robots can run quicker than the fastest humans. Now comes the real test: Can they handle packaging and warehouse operations, and reliably perform precision tasks like connecting cables — working like humans in less flashy jobs?Photo: VCG via Getty ImagesA humanoid robot plays tennis during the opening ceremony.Photo: Tingshu Wang/ReutersOne of the robots caught fire after a 100-meter race.Get the latest.
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Mad in America: Antidepressants Can Change Peaceful Citizens into Killers

Antidepressants Can Change Peaceful Citizens into Killers

By

 Peter C. Gøtzsche, MD

 –

August 15, 2026

One of the best guarded secrets in psychiatry is that antidepressants increase the risk of violence, including suicide and homicide.

It took 13 years, after having denied it at a hearing,1 before the FDA admitted in 2004 in a black box warning, updated in 2006, that children, adolescents and young adults taking antidepressants have an increased risk of suicidal thinking and behaviour.

By including events occurring in the follow-up period after the randomised phase in the trials was over, two researchers recently documented, based on placebo-controlled trial reports at the FDA, that antidepressants double suicides in adults.2 They likely also double suicides in children. Trial data are too scarce to prove this but in 2003, the FDA announced that the risk of suicidal events in children is 4% on drugs, twice the placebo risk of 2%.3

A series showing a woman's face as she transforms
Dire warnings in the FDA approved package inserts

It is revealing to read package inserts but the one for Lexapro (escitalopram) spans 26 pages.4 As no doctor can possibly know more than a tiny fraction of all this, I have summarised the bits about violence against self or others.

”Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt.”

Monitoring patients daily, irrespective of age, is a dire warning about how dangerous antidepressants are. The package insert states that any psychoactive drug may impair judgment, which is important to remember in homicide cases. It mentions that all patients should be monitored for any unusual changes in behaviour, and they should call their healthcare provider right away or call 911 if an emergency and if they are:

  • acting on dangerous impulses
  • acting aggressive or violent
  • feeling agitated, restless, angry or irritable
  • having racing thoughts
  • having reckless behaviour
  • having unusually grand ideas.

Among serious symptoms that may occur if patients stop Lexapro too quickly, the most serious one, akathisia, is unfortunately not mentioned (it is only mentioned among the regular side effects, not withdrawal effects). What comes closest are irritability and feeling restless, which are much more benign symptoms.

The FDA is far too industry friendly and it has a huge problem with corruption.5,6 The 2004 warnings from Health Canada went much further than FDA’s. They declared that “patients of all ages taking these drugs may experience behavioural and/or emotional changes that may put them at increased risk of self-harm or harm to others.”7

The Canadian drug regulator came close to admitting that antidepressants can cause homicide at all ages.

The role of akathisia for violence

Akathisia is characterised by intense restlessness, inner turmoil, agitation, and a compelling need to move frantically around. Patients may think they have gone mad and may describe it as wanting to jump out of their skin. They cannot control their agitated manner and can experience unbearable rage, delusions, and dissociation.8

Numerous studies and observations have shown that akathisia is a very strong risk factor for violence against self and others.8-13 Already in 1998, Pfizer scientist Roger M. Lane described akathisia as a drug-induced condition where patients may feel that “death is a welcome result.”14

Akathisia is a drug harm. In his role as an expert witness in a lawsuit, psychiatrist David Healy found evidence in internal company documents that 25% of healthy volunteers experienced agitation and other symptoms of akathisia while taking paroxetine.15 Other authors wrote about a person that “After 3 days on paroxetine, he sat up all night forcing himself to keep still because he wanted to kill everyone in the house.”16

In 2016, my research group showed in our systematic review of placebo-controlled studies in human volunteers that antidepressants double the incidence of FDA-defined activating effects that increase the risk of violence.17 The same year, we found, based on the clinical study reports the drug companies had submitted to drug regulators, that depression pills increase aggression 2-3 times in children and adolescents.18 The patient narratives listed homicidal threat, homicidal ideation, assault, sexual molestation, a threat to take a gun to school, damage to property, punching household items, aggressive assault, verbally abusive and aggressive threats, and belligerence. You never see such things in published trial reports. And even though akathisia was sometimes miscoded as hyperkinesia, or not coded at all, it occurred twice as often on the pills than on placebo.

Akathisia is much underreported in published trial reports where it is often mislabelled, e.g. as nervousness, agitation or agitated depression.10,11,19

Many people who have committed homicide while taking depression pills were behaving normally before starting them, developed akathisia when taking them, and returned to their normal personality when they came off the offending drug.20,21

Eli Lilly knew already in 1988 that twice as many of the fluoxetine-treated patients reported new activation in the clinical trials as placebo-treated patients, 38% versus 19%.22 This means that fluoxetine causes activation in one of five patients treated with the drug (as the difference to placebo is about 20%).

When David Healy and I examined the two study reports Eli Lilly had submitted to drug regulators to get fluoxetine approved for childhood depression, we found that precursors to suicidality or violence occurred more often on fluoxetine than on placebo, and for the biggest trial, the number needed to harm was only 6 for nervous system events (a category used by Eli Lilly) and 10 for severe harm.23

We found several instances where the children very likely suffered from akathisia, which was typically miscoded as agitation, but also as euphoria, hyperkinesia, hypomania, mania, and increased impulsivity. In one of the studies, 19 fluoxetine versus 6 placebo patients experienced restlessness (P = 0.005), 9 versus 1 had nightmares (P = 0.02), and 7 versus 4 felt tense inside. These adverse events all increase the risk of suicide and violence. The published trial reports were highly misleading, as they did not reveal these grave harms.23

In sertraline paediatric trials, 8 of 189 patients (4%) discontinued the drug because of aggression, agitation, or hyperkinesia, compared with none in 184 patients on placebo (P = 0.007, my calculation).24

Akathisia also occurs when patients take antipsychotics.8 In one study, 79% of 52 patients with schizophrenia who had tried to kill themselves suffered from akathisia.25 Another study reported that half of all fights at a psychiatric ward were related to akathisia.26

Covering up that antidepressants can cause homicide

Suicide and homicide are related. Whether on drugs or not, a suicider sometimes kills the family, too. To claim there is no relation is equally untenable as claiming that an increased risk of suicidal thinking and behaviour does not carry an increased risk of suicide, but this is precisely how drug companies and leading psychiatrists have argued, again and again.27

The data suggest that the risk of homicide is doubled, just as the risk of suicide is doubled. According to internal company documents, 0.65% of the patients in clinical trials became hostile on paroxetine compared with 0.31% on placebo.24 An unpublished company study showed incidents of serious aggression in 80 patients, of which 25 resulted in homicide. Like for suicides, there is no upper age limit where homicide cannot occur. A man aged 74 strangled his wife, and another was 66 when he became delusional on fluoxetine and killed his wife who was found with 200 stab wounds.24

The authorities routinely hide information that relates the pills to homicide in order not to raise concerns about the safety of the pills. It therefore took quite a while before we learned that the Germanwings pilot who took a whole plane with him when he committed suicide in the Alps, and that the Belgian bus driver who killed many children by driving his bus into a wall, also in the Alps, were both on a depression pill.

That antidepressants can cause homicide is beyond doubt.5,6,9,10,20,21,28-30 FDA Adverse Event Reporting System data showed that SSRIs are the most strongly and consistently implicated drugs associated with “homicide, homicidal ideation, physical assault, physical abuse or violence related symptoms.”28 A cohort study from Finland found that use of antidepressants increased the risk of homicide by 31% (P = 0.02),30 but such studies underestimate the risk because people who have come off their drug might suffer from akathisia as a result and commit homicide for this reason but would be counted as non-users.

The killers don’t always have akathisia. Although it predisposes to out-of-character violence, there are additional mechanisms of action that greatly increase the risk of crime and violence, including emotional blunting where patients care less for themselves and others; removal of the usual inhibitions people have with loss of conscience and control over their behaviour; and psychosis.9,20

It is characteristic for many drug-induced homicides and near homicides that the offenders by all objective and subjective measures were completely normal before the act;20 that they were not themselves and had difficulty understanding what happened after they came off the pills and returned to their normal self; and that they had often taken the drugs for non-disease-related reasons, e.g. for fun, stress, insomnia, being bullied or marital problems.5,10,21,24

Several high-profile homicides have been committed by patients in a drug-withdrawal state, which also may cause akathisia.9,20 It is a clear sign that the psychiatrists generally don’t know what they are doing and what they are causing that they virtually always interpret such events as disease symptoms and continue with the drug or increase the dose.8,27

I know three people who have killed or became close to kill under the influence of antidepressants and shall describe their stories.

Psychiatric denial in Australia and New Zealand

In 2014, Australian farmer Bill Thomson, whose only son James took his life at age 19 while on venlafaxine, wrote that he wanted me to go on a lecture tour to inform people about how dangerous depression drugs are.31

Bill was a superb organiser. In February 2015, I gave 17 lectures in 11 days at public venues, hospitals, and universities and was interviewed for radio, TV, and newspapers. My visit was covered by 85 different media and a Danish documentary filmmaker followed me and made the film, Diagnosing Psychiatry.32

Shortly before I came, two Australian child and adolescent psychiatrists, Jon Jureidini and Peter Parry, and I published the article, “Dreams of a Quick Fix, Gone Awry,” about the tour where we noted what was wrong with psychiatry.33

The power structure in Australian psychiatry was very disturbing and I heard many stories about how the higher-ups had prevented an open debate about life-and-death issues, particularly professors Ian Hickie and Patrick McGorry who had numerous conflicts of interest in relation to the drug industry and had conducted unethical trials.31

A year earlier, Maryanne Demasi from the Australian Broadcasting Corporation (ABC) had worked on a documentary about antidepressants. David Healy and I used a lot of time refuting Hickie’s arguments. He teamed up with McGorry and their power was so great that when they refused to appear on camera, ABC’s leadership cancelled the documentary. This was wrong. Journalists can just say they refused to comment.

Hickie’s denials of the facts were typical of leading psychiatrists in any country. He denied that depression drugs increase the suicide risk in children referring to Robert Gibbons’ work, which is scientifically dishonest;6 he claimed that FDA’s black box warning about the suicide risk wasn’t justified and might have caused harm; he said suicidal thoughts are not the same as completed suicides; and he opined that the reason there was no wide debate about psychiatry was that the critique came from fringe groups.

In 2024, Hickie said to ABC that when the usage of antidepressants goes up, suicides and suicide attempts go down; that depression is a biological disease that leads to social problems, not the other way around, which is also totally false;34 and that depression drugs and ECT are “wonderful treatments.”35 For Hickie perhaps, not for his patients.27

Ordinary Australians are smarter than Hickie. In a large survey, people thought that antidepressants, antipsychotics, electroshocks, and admission to a psychiatric ward were more often harmful than beneficial.36 This agrees with the science,27 but the social psychiatrists who did the survey were dissatisfied with the answers and argued that people should be trained to arrive at the “right opinion.”

Bill arranged another lecture tour, “Mental health in crisis,” in Australia and New Zealand, in 2018, for US science journalist Robert Whitaker, author of two famous books,8,13 and me.

Maria Bradshaw from New Zealand, whose son Toran hanged himself only 17 years old,6 assisted him. After Toran’s death, Maria had genetic testing conducted, which showed he was a slow metaboliser and had been overdosed. He was prescribed fluoxetine after a breakup with his girlfriend. A year later, a psychiatric registrar prescribed it to him again, against Maria’s wishes. The registrar recorded no diagnosis and found no evidence of depression, anxiety or any other mental disorder. Toran developed horrible symptoms on fluoxetine both times, compatible with akathisia. Maria established the CASPER organisation where those bereaved by suicide help other victims of gross medical malpractice. She told me that the media had credited CASPER with a 20% drop in youth suicide.

While preparing for the tour, Bill told me that people at the University of Auckland were so keen to have me speak that they offered a venue at no charge. Two days earlier, a student had killed herself a week after starting an SSRI. They also lost a student in 2011 in a high-profile murder two weeks after a young man had his antidepressant dose doubled.

A Canadian, David Carmichael, heard about the preparations and offered to join us to lecture on the role of antidepressants in his killing of his son Ian, which we accepted. David was prescribed paroxetine in 2003 to help him deal with cash flow worries after being falsely37 told that he had a chemical imbalance in his brain.38 A year later, he started on the drug again, for anxiety caused by sleep deprivation. He became psychotic and calmly strangled his 11-year-old son, Ian.

David thought that taking Ian’s life was morally right because of his delusions, which made no sense to him when he was no longer psychotic after he had been taken off paroxetine.

He was charged with first-degree murder but was judged not criminally responsible for reason of insanity, which the psychiatrists on both sides agreed about. In 2008, he received a conditional discharge allowing him to live with his wife and daughter again, and an absolute discharge a year later. After this, he built a career as a prescription drug safety advocate.

Double homicide in Holland

I was an expert witness in a double homicide case in Holland in 2016 where—like in so many of these cases6—serious professional malpractice played a key role.39

It was a gruesome story. Aurélie Versluis killed her two children while having indisputable symptoms of akathisia on paroxetine but her pleas for help were ignored. When she became suicidal, her psychiatrist advised continued use of the drug instead of withdrawing it.

Versluis told two people about nightmares where she slit her children’s throats (which she ultimately did and also tried to commit suicide). Two days prior to the homicides, she told her supervisor and several other people that she was ill and was not feeling well. She visited her family doctor who had prescribed paroxetine and her company doctor, but both dismissed her, and her psychologist did not have time for her.

She was not herself, which a forensic psychiatrist confirmed three days after the homicides, but her doctors continued to harm her. They stopped paroxetine cold turkey when she was in the psychiatric penitentiary, causing serious harm that persisted for five months.

The prosecutor asked for a 14-year jail sentence and a hospital order for compulsory treatment. I told Versluis’s lawyer that nothing would work for her other than keeping her away from psychiatric drugs. Versluis was sentenced to 9 years in prison followed by preventive custody. She should have been released because of drug-induced insanity.

The expert for the prosecution, Professor Anton Loonen, did not have any arguments against my testimony, which included a criticism of his report to the court. In the middle of the proceedings, he suddenly handed over a document to the court he had written in Dutch. He suspected I suffered from a mental disorder that made me seriously disinhibited and advised that I should be examined by a doctor to protect myself from myself. The lack of ethics in psychiatry seems bottomless.

Versluis had unmistakable symptoms of akathisia but Loonen disagreed and considered himself an expert on akathisia.

I contacted Versluis in 2024 asking if I could interview her for our documentary film project about psychiatry.40 She abstained. She had taken a new name, was out of prison, had a job and a boyfriend, and was well-functioning.

In 2025, she asked to see me when she was in Copenhagen on holiday with her boyfriend. She met him in prison where he served a sentence for having killed his wife, also under influence of a psychiatric drug. I asked how she felt now, so many years later. She still cried when she came to think of her two children.

Two more children killed by psychiatry in an endless row of people who killed themselves or others when taking drugs that don’t work for them.41 Professional denial kills.

Double homicide avoided by pure luck

British documentary filmmaker Katinka Blackford Newman, also a victim of horrible medical malpractice, came very close to killing her two children.39 While going through a divorce in 2012, she was prescribed escitalopram even though she was not depressed, only distressed.

Katinka invited me to the launch of her book, “The pill that steals lives,”42 in 2016. She told the audience that she was very lucky to be alive, and not serving a life sentence, as she could have killed her two children after the pills made her psychotic.43 She has made a very moving 8-minute film44 about her story and there are links on her homepage45 to documentaries and stories about people who killed themselves or others or were seriously harmed in other ways by antidepressants.

Katinka’s psychiatrists didn’t realise it was the pill that had made her ill. They diagnosed psychotic depression and forced her to stay in hospital and take a dangerous cocktail of drugs. But her 11-year-old son Oscar knew it was the pills. What saved her was that her private insurance ran out.

I wrote in the introduction to her book that it describes in vivid detail how ordinary people can become murderers if they take antidepressant drugs. I interviewed Katinka for our film and interview channel,46 and she will also appear in our upcoming documentary, The Illusion of Psychiatry.40

Lack of justice

The justice system is usually harsh towards people who commit homicide under the influence of antidepressants, and it is highly unlikely that psychiatrists become convicted for medical malpractice. This is because judges rely on experts who won’t accuse their colleagues of wrongdoing and won’t admit that the drugs can cause homicide.47

Psychiatrists lie routinely in court and I have experienced in court cases in Denmark, Alaska, Holland, Quebec, and Norway that judges don’t care in the least that what they have been told by the experts has been untruthful.6,27,39,47,48

I fail to understand the verdicts because we cannot say in an individual case beyond reasonable doubt that the drug didn’t play a role in the homicide.

The American way of handling these killings is particularly cruel. Kurt Danysh was 18 years old when he was prescribed fluoxetine in 1996 by a general practitioner who failed to perform any psychological testing.6 He became restless and violent and shot his father, the person he loved the most, two weeks later in a totally out-of-character mood.49 But even though the prosecution’s own expert stated that Kurt’s criminal actions were based on insanity caused by a mind-altering drug, Kurt was sentenced to 22.5 to 60 years in prison.

Eli Lilly lied in court, claiming that fluoxetine would not cause aggressive behaviour. It was later revealed that Lilly had concealed data from 1988, which linked fluoxetine to violence.22 Animal studies have confirmed that fluoxetine can cause aggression, e.g. in mice50 and hamsters.51

In a 2014 letter endorsing a reduction of Kurt’s sentence, his prosecutor wrote that he was convinced that Prozac could have played a role for the homicide, but the judge determined that he lacked the legal authority to reduce the sentence.49

Kurt gained a paralegal degree whilst incarcerated and launched the SAVE campaign (Stop Antidepressant Violence from Escalating) in the hope of saving other children from his fate. He was released in 2020 after serving 24 years and will be on supervised parole until age 78.

David Crespi was on fluoxetine and three other drugs, which he had taken for a couple of weeks, when he killed his two twin daughters aged 5 with a knife in 2006.52,53 He pleaded guilty to avoid the death penalty and got two consecutive life sentences without the possibility of parole in North Carolina, although he became his old self after coming off the drugs. His wife fought for him for the next 20 years advocating against the use of SSRIs but now has severe Parkinson that requires around-the-clock assistance.

What’s the logic when one insane person who killed one person became a free man after 24 years while another insane person who killed two people will never get out of prison? Why will Crespi never return to his family and his other three children? Who benefits from this?

In 1989, Joseph Wesbecker shot 8 people dead, wounded another 12 and killed himself one month after he started fluoxetine.6,22 Lilly won a jury verdict and claimed it was “proven in a court of law … that Prozac is safe and effective.” However, the trial judge suspected a secret deal had been struck with the plaintiffs and eventually forced Lilly to admit this. Infuriated by Lilly’s actions, he ordered the finding changed from a verdict in Lilly’s favour to one of “dismissed as settled with prejudice.”

Psychiatrist Peter Breggin was an expert in support of the family, but his own attorney, who knew about the secret deal, betrayed him and presented a weak case.9 After this deal, Breggin’s attorney sent back the revealing documents to Lilly where they disappeared against the law impeding other lawsuits. Alarmingly, incriminating documents also disappeared at the FDA.22 Throughout the 1990s, while swearing publicly that fluoxetine didn’t increase the risk of suicide or violence, Lilly quietly settled lawsuits out of court and kept the incriminating evidence hidden by obtaining court orders to seal the documents.

In Canada, a judge ruled in 2011 that fluoxetine induced a 16-year-old boy to knife a friend to death.20,54 He had become a different person, impulsive, unpredictable and suicidal, with fantasies about violence. His family doctor and his parents alerted the prescribing psychiatric clinic to the boy’s deteriorating condition and raised questions about continuing Prozac, but the clinic continued the drug and doubled the dose.

The judge declared that the boy’s basic normalcy after he stopped Prozac confirmed he no longer posed a risk of violence to anyone and that he had none of the characteristics of a perpetrator of violence. He sentenced the boy to 10 more months of additional custody after he had served for two years.

Those who should have been in jail are the boy’s psychiatrists, for serious medical malpractice, as Health Canada warned that SSRIs could cause violence already in 2004.7

In 2001, a US jury found SmithKline Beecham (now GlaxoSmithKline, GSK) liable for deaths caused by paroxetine.11,29 Donald Schell, aged 60, had been taking paroxetine for just 48 hours when he shot and killed his wife, his daughter, his granddaughter and himself. Internal documents showed that the company was aware that people could become violent from paroxetine but did not warn about it. Documents also revealed that healthy volunteers had experienced anxiety, nightmares, hallucinations and other harms from paroxetine and that two of them had attempted suicide.

In 2002, the GSK spokesperson, Dr Alistair Benbow, lied in front of a running camera in the BBC documentaries about paroxetine.6,55 He denied that paroxetine could cause suicidality or self-harm while he sent data to the UK drug regulator one month later showing exactly this. The drug regulator also lied to the public, saying that this information was completely new to GSK—which had known about it for around ten years. The head of the drug agency even echoed the drug companies’ untruthful assertion that it was the disease, not the drug, that increased the suicide risk.

Even ten years after the Schell verdict, GSK denied that paroxetine can cause people to commit homicide and suicide and that there are withdrawal problems.56

Currently, Lindsay Clancy from Massachusetts is on trial.57 She is charged with three counts of first-degree murder after she strangled her three children and tried to commit suicide by jumping from a second-floor window into her backyard, which made her paraplegic. This is another horrible story of medical malpractice that made a happy and caring post-partum mother insane.

Conclusions

Psychiatry’s crimes against humanity must stop.27 We must warn about the harms of antidepressants and bring people to justice who contribute to the suicides and homicides by lies and medical malpractice. And we must insist that patients be warned and informed fully when doctors want to prescribe these dangerous drugs.

References

1 Bass A. Side Effects – a prosecutor, a whistleblower, and a bestselling antidepressant on trial. Chapel Hill: Algonquin Books; 2008.

2 Gøtzsche PC. Observational studies confirm trial results that antidepressants double suicides. Mad in America 2025;Feb 8.

3 New Pediatric Labeling Information Database – Detail. FDA 2003;Jan 3.

4 Package insert for Lexapro (escitalopram). FDA 2017;Jan.

5 Gøtzsche PC. Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing; 2013.

6 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.

7 Health Canada advises Canadians of stronger warnings for SSRIs and other newer antidepressants. Government of Canada 2004;June 3.

8 Whitaker R. Mad in America. Cambridge: Perseus Books Group; 2002.

9 Breggin P. Medication madness. New York: St. Martin’s Griffin; 2008.

10 Healy D. Let them eat Prozac. New York: New York University Press; 2004.

11 Breggin P. Brain-disabling treatments in psychiatry: drugs, electroshock and the psychopharmaceutical complex. New York: Springer; 2007.

12 Bass A. Side effects – a prosecutor, a whistleblower, and a bestselling antidepressant on trial. Chapel Hill: Algonquin Books; 2008.

13 Whitaker R. Anatomy of an epidemic, 2nd edition. New York: Broadway Paperbacks; 2015.

14 Lane RM. SSRI-induced extrapyramidal side-effects and akathisia: implications for treatment. J Psychopharmacol 1998;12:192-214.

15 Letter from David Healy to the UK Medicines Control Agency. 2000;June 7.

16 Medawar C, Hardon A. Medicines out of control? Antidepressants and the conspiracy of goodwill. Netherlands: Aksant Academic Publishers; 2004.

17 Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-92.

18 Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65.

19 Breggin P. Talking back to Prozac. New York: E-reads, 1994.

20 Breggin P. Psychiatric drug withdrawal: A guide for prescribers, therapists, patients and their families. New York: Springer; 2012.

21 Lucire Y, Crotty C. Antidepressant-induced akathisia-related homicides associated with diminishing mutations in metabolizing genes of the CYP450 family. Pharmgenomics Pers Med 2011;4:65–81.

22 Lenzer J. FDA to review ‘missing’ drug company documents. BMJ 2005;330:7.

23 Gøtzsche PC, Healy D. Restoring the two pivotal fluoxetine trials in children and adolescents with depression. Int J Risk Saf Med 2022;33:385-408.

24 Healy D, Herxheimer A, Menkes DB. Antidepressants and violence: problems at the interface of medicine and law. PLoS Med 2006;3:e372.

25 Planansky K, Johnston R. The occurrence and characteristics of suicidal preoccupation and acts in schizophrenia. Acta Psychiatr Scand 1971;47:473-83.

26 Crowner ML, Douyon R, Convit A, et al. Akathisia and violence. Psychopharmacol Bull 1990;26:115-7.

27 Gøtzsche PC. Is psychiatry a crime against humanity? Copenhagen: Institute for Scientific Freedom; 2024 (freely available).

28 Moore TJ, Glenmullen J, Furberg CD. Prescription drugs associated with reports of violence towards others. PLoS One 2010;5:e15337.

29 Paxil maker held liable in murder/suicide. Wisner Baum 2001;July 9.

30 Tiihonen J, Lehti M, Aaltonen M, et al. Psychotropic drugs and homicide: A prospective cohort study from Finland. World Psychiatry 2015;14:245-7.

31 Gøtzsche PC. Whistleblower in healthcare (autobiography). Copenhagen: Institute for Scientific Freedom; 2025 (freely available).

32 Pedersen AT. Diagnosing psychiatry. Documentary film 2017.

33 Jureidini J, Gøtzsche PC, Parry P. Dreams of a quick fix, gone awry. Mad in America 2015;Jan 19.

34 Gøtzsche PC. Psychiatric Diagnoses Cannot Attack People, But the Reification of Mental Health Issues Is Harmful. Mad in America 2026;March 11.

35 McLaren N. Primum pecunias multas faciamus. Niallmclaren.com 2024;Feb 27 and McLaren N. On urban myths. Niallmclaren.com 2024;May 14.

36 Jorm AF, Korten AE, Jacomb PA, et al. ”Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aus 1997;166:182-6.

37 Moncrieff J, Cooper RE, Stockmann T, et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry 2023;28:3243-56.

38 Carmichael D. Know your drugs. Undated.

39 Gøtzsche PC. Antidepressants can cause homicide. Gøtzsche’s Perspective 2026;June 3.

40 Gøtzsche PC. World premieres in Norway 23-26 September for our two documentary films: Cochranium and The illusion of psychiatry. Gøtzsche’s Perspective 2026;March 30 and Rethinking Mental Health: Mad in Norway International Film Festival. Films.

41 Gøtzsche PC. A story of bad science: How defenders of antidepressant efficacy make their case. Mad in America 2026;July 28.

42 Newman KB. The pill that steals lives. London: John Blake; 2016.

43 Gøtzsche PC. On the brink of murder because of an antidepressant. Mad in America 2024;Mar 28.

44 Newman KB. The Pill that steals lives – a family’s journey to discover the side effects of antidepressants. Video 2021.

45 Antidepressant risks. Standing up for a safer world.

46 On the brink of murder because of escitalopram. Interview with Katinka Blackford Newman. Broken Medical Science 2026 (in production).

47 Gøtzsche PC. Why Lawsuits about Psychiatric Malpractice Are Difficult to Win. Brownstone Journal 2025;Nov 6.

48 Gøtzsche PC. Psychiatric Patient Won a Forced Treatment Case Against the Norwegian State. Mad in America 2026;March 12.

49 Kurt. Antidepressant risks. Standing up for a safer world. Undated.

50 Young E. Prozac triggers increase in aggression in mice. New Scientist 2001;Nov 12.

51 Ricci LA, Melloni RH Jr. Repeated fluoxetine administration during adolescence stimulates aggressive behavior and alters serotonin and vasopressin neural development in hamsters. Behav Neurosci 2012;126:640-53.

52 Kim Crespi wants husband David Crespi, who murdered their twin daughters, out of prison. Huffington Post 2012;Oct 3.

53 Counts G. Father who killed daughters in 2006 stops communication from prison. WSOC TV 2026;Jan 30.

54 Breggin PR. Judge agrees Prozac could have made teen a killer. Huffington Post 2011;Oct 3.

55 Secrets of the drugs trials: Transcript. BBC 2007;Jan 31.

56 Boseley S. Murder, suicide. A bitter aftertaste for the ‘wonder’ depression drug. Guardian 2011;June 11.

57 Carmichael D. In the Lindsay Clancy case, polypharmacy will be on trial. Mad in America 2026;July 17.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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Harvard Thinking: The perils of perfectionism

20,679 views Dec 17, 2025

Harvard Thinking Many people hold themselves to extremely high standards, but when the scales tip to the pursuit of perfection, it can result in anxiety, depression, and other serious mental health issues. In this episode, host Samantha Laine Perfas talks with journalist Jennifer Breheny Wallace, psychologist Ellen Hendriksen, and public health expert Michaela Kerrissey about when we’ve gone too far in trying to achieve our best.

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The Harvard Gazette: Perfectionism and being aware. Perfectionism has a dark side, says Ellen Hendriksen, a clinical psychologist and faculty member at Boston University, in her new book “How to Be Enough: Self-Acceptance for Self-Critics and Perfectionists.”

The lie that taints perfectionism

‘How to Be Enough’ author on the difference between admiration and acceptance, the power of ‘2 percent kinder,’ and why values should come before rules

Liz Mineo

Harvard Staff Writer

February 7, 2025 6 min read

Perfectionism has a dark side, says Ellen Hendriksen, a clinical psychologist and faculty member at Boston University, in her new book “How to Be Enough: Self-Acceptance for Self-Critics and Perfectionists.” In this edited conversation with the Gazette, Hendriksen, whose résumé includes a fellowship at Harvard Medical School,


When is perfectionism a healthy personality trait?

Perfectionism has a healthy heart because its core is conscientiousness, which is the tendency to be responsible and diligent, to do things well and thoroughly, to care deeply. Research has shown that conscientiousness is the No. 1 trait for both objective and subjective success in life. Those of us with perfectionist traits are often highly accomplished. It might manifest as excellent academics, job performance, sports, music, or things that we don’t usually think of as performance, like healthy eating, keeping our space organized, or always looking put together.

Book cover: "How to Be Enough."

How can perfectionism become unhealthy?

Unhealthy perfectionism encompasses over-evaluation, which is the conflation of worth and performance, and harsh self-criticism. It is also unhealthy when we strive to be perfect to try to earn belonging and acceptance. Perfectionism tells us a lie: that we can connect, belong, and be accepted by being good at things through performance. But it backfires because when we perform superbly, we might earn admiration, but that’s different than acceptance. When we’re admired, we’re put on a pedestal, but that means we’re alone.

According to the work of Roz Shafran, Zafra Cooper, and Christopher Fairburn, clinical perfectionism is when our self-worth is dependent on striving to meet personally demanding standards, and we evaluate whether or not we’ve reached those standards in an all-or-nothing way. And if we define failure as not meeting standards, ours or those of others, what will often happen is that we either get overwhelmed or intimidated, and we then avoid our task. Or we’ll try, but we’ll fail, not because we were incapable but because our standards were unrealistic. Either way, self-criticism comes in and leaves us feeling inadequate or not good enough. On the off chance that we pull out all the stops and reach our standards, we’ll decide that our standards were not demanding enough in the first place, and the cycle begins again.

What other manifestations of perfectionism can be problematic?

It also can manifest as a focus on rules, or as a preoccupation with mistakes — either trying to avoid future mistakes or criticizing ourselves for past mistakes. It can also manifest as procrastination because the prospect of meeting our unrealistic standards can be paralyzing. It manifests as social comparison; we’re trying to answer the question, “Am I good enough?” Finally, it manifests as feeling distant or isolated in relationships because we engage in what’s called perfectionistic self-presentation, where we talk about what’s going well and hide what’s going poorly, which makes us come off not only as performative but also unrelatable.

“When we perform superbly, we might earn admiration, but that’s different than acceptance. When we’re admired, we’re put on a pedestal, but that means we’re alone.”

Are there links between perfectionism and depression and anxiety?

If we define failure as not meeting our standards, and these are rigid and unrealistic, we’re going to rack up a lot of failures. Then, repeated over days, years, and potentially decades, we may start to feel like failures. Over time, the two pillars of depression, which are hopelessness (i.e., “This will never get better”) and helplessness (i.e., “Nothing I try works”) settle in.

Regarding anxiety, as we’re struggling with over-evaluation — conflating our performance and our worth — our worth is never a settled question. Every event becomes a referendum on our character: It could be every meeting at work where we expect ourselves to make erudite comments, or exams where we expect ourselves to get an A-plus, or a social event where we expect ourselves to be witty and articulate, or at least not awkward and weird. So, it makes sense that we anticipate every potential performance with trepidation, anxiety, and worry. Forgive my grammar, but it’s when “Did I do good?” means “Am I good? and “I did bad” means “I am bad.”

In your book, you offer specific steps to deal with perfectionism. Can you expand on that advice?

I take the subtitle of the book, “Self-Acceptance for Self-Critics and Perfectionists,” quite literally. By self-acceptance, I mean that we don’t have to change our self-criticism at all. Instead, we can change our relationship to self-criticism. What I suggest is that we can treat our self-critical thoughts like we treat the music at a coffee shop. It’s still there, but we don’t have to sing along. In perfectionism, the heart of which is conscientiousness, we take things seriously, including our own thoughts and feelings. What I suggest is that we can take our self-critical thoughts a little less seriously. We’ll still have them, but we don’t have to treat them as if they are true and literal. We can just let them float by or pass through our mind without getting yanked around.

Another way to overcome perfectionist tendencies is to focus on values rather than rules. Those of us with perfectionist traits like to follow rules, and if there are no rules, we make up personally demanding rules. Values are never coercive, so you freely choose to follow them, and you’re likely willing to tolerate some discomfort to do so. For instance, the value of giving back might mean that you’re willing to give up your Saturday morning to volunteer to pick up trash on the beach rather than spending that morning relaxing at the beach. If we start focusing on values rather than rules, we can choose what is meaningful and important to us rather than following unrealistic rules.

I want to emphasize that becoming less perfectionistic isn’t as laborious as it may appear. Those of us with some perfectionism usually default to gut renovations and total overhauls, but we don’t have to work that hard. Small tweaks are enough. We can aim for being 5 percent more understanding of ourselves, allowing 1 percent mistakes, being 2 percent kinder to ourselves, and that is often enough.

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Massimo: For more than 20 years, Norwegian neuroscientist Audrey van der Meer has investigated how handwriting shapes the human brain.

@Rainmaker1973

For more than 20 years, Norwegian neuroscientist Audrey van der Meer has investigated how handwriting shapes the human brain.

In a landmark 2024 study published in Frontiers in Psychology, her team used high-density EEG caps to monitor brain activity in students while they either wrote by hand with a digital pen or typed on a keyboard. The difference was dramatic.

Handwriting produced a powerful, synchronized burst of neural activity across widespread regions of the brain, linking areas involved in memory formation, sensory processing, and deep learning.

In contrast, typing the exact same content caused this rich cognitive network to largely shut down.

Because typing uses repetitive, uniform keystrokes, it demands little spatial or cognitive effort, leaving key learning centers quiet and disengaged. These neurological differences have a direct effect on how we process and remember information.

Earlier research by Pam Mueller and Daniel Oppenheimer at Princeton University reached similar conclusions. Students who took notes by hand consistently outperformed those using laptops on conceptual understanding tests.

Handwriting forces active listening, critical thinking, and real-time summarization, while typing often leads to verbatim transcription with minimal processing.

Our brains function as part of an embodied biological system. Replacing rich physical actions with effortless digital keystrokes may deliver short-term convenience, but it comes at the expense of deeper cognitive engagement. The solution is simple and timeless: pick up a pen.

[Van der Meer, A. L. H., et al. (2024). Handwriting versus typing: A neurophysiological comparison of brain activity during learning. Frontiers in Psychology, 15. DOI: 10.3389/fpsyg.2024.1234567]

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Elaine Mullally on X: Revenue sent my tax return back this year because apparently I answered one of the questions incorrectly… Question: “Do you have anyone dependent on you?”

@mullallyelaine

Revenue sent my tax return back this year because apparently I answered one of the questions incorrectly… Question: “Do you have anyone dependent on you?”

I wrote:

145,100 unemployed,

1.7 million on state benefits

33,000+ people in IPAS accommodation,

5,800 prisoners,

174 TDs,

60 Senators, an army of advisers, and consultants,

281,000 employed NGOs pushing the woke government agenda.

Around €1.8 BILLION a year going on overseas development aid…

464,000 public and civil servants …

plus a Government that seems to think the Irish taxpayer has an unlimited credit card.”

Revenue said my answer was “UNACCEPTABLE.” So I wrote back: “Why? WHO DID I LEAVE OUT???”

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DW: Lost at sea: Fighting low morale in the US Navy

Pablo Foley Elias8

Thousands of crew members aboard the USS Abraham Lincoln are on their way home, but their plight has highlighted morale issues that critics are blaming on the lack of US strategy in the war against Iran.

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Dr Phil Podcast: Lindsay Clancy: Dangerous Symptoms Postpartum Psychosis

63,558 views Aug 19, 2026 Dr. Phil Highlights

Dr. Phil examines the disturbing case of Lindsay Clancy, the Massachusetts mother charged with killing her three young children, and the critical question at the center of the case: Were warning signs of a severe postpartum mental health crisis missed? He breaks down postpartum psychosis, how it differs from postpartum depression and the “baby blues,” and the potentially dangerous symptoms including hallucinations, delusions, extreme insomnia, disorganized thinking, and loss of contact with reality. As the defense prepares to argue that postpartum psychosis and multiple psychiatric medications contributed to the tragedy, prosecutors are expected to point to Clancy’s alleged planning and coordination as evidence she understood her actions. His analysis focuses on the larger question beyond the courtroom: When a new mother shows escalating red flags, who is responsible for recognizing the danger and acting before it is too late?

Sponsored by Preserve Gold: Get up to $20,000 in FREE Gold & Silver with a qualified purchase. Text ASKPHIL to 50505 or visit https://DrPhilgold.com Sponsored by Chapter: Don’t wait! If you’re on Medicare or will be soon, reach out to Chapter: Call: (352)-845-0659 or go to https://askchapter.org to learn about your Medicare options and get help finding ways to save money. Experience a side of Dr. Phil McGraw you may have been missing as he provides critical information on some of the most important issues we face today. McGraw delves into the minds of the most exciting and accomplished people. From celebrities to ordinary people in extraordinary circumstances, to the world’s leading experts, every guest and topic is provocative, informative, and relevant. http://drphilpodcast.com Dr. Phil McGraw, one of the most well-known and trusted mental health professionals in the world, is the host of daytime TV’s top-rated program, Dr. Phil. This trailblazing and award-winning platform continues to provide the most comprehensive forum on mental health issues in the history of television. Dr. McGraw’s unique ability to take complicated and technical information and make it accessible and understandable to the general public has distinguished him both among viewers and within his profession. Follow for more Dr. Phil & The Dr. Phil Podcast: Dr. Phil Show –    / @drphil   Podcast – https://www.drphilpodcast.com/ YT –    / @drphilpodcast   Spotify – https://open.spotify.com/show/45Ek7SE… Apple Podcasts – https://search.itunes.apple.com/WebOb…

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Michael Smerconish: 35 Years Later, America’s Middle Class Is Still Losing. The Warning We Ignored

Aug 21, 2026

For free and unbiased Medicare help, dial 507-478-7579 to speak with my trusted partner, Chapter, or go to https://askchapter.org/smerconishPaid Partnership

Thirty-five years ago, Pulitzer Prize-winning investigative journalists Donald Barlett and James Steele published America: What Went Wrong?, a landmark investigation into the hollowing out of the American middle class. Now James Steele joins Michael Smerconish to revisit their warnings — and says the fundamental problems haven’t gone away. From disappearing pensions and factory closures to Wall Street, tax policy, corporate influence and the growing concentration of wealth, Steele explains how decisions made decades ago continue to shape the American economy today. Was the decline of the middle class inevitable? Could it have been stopped? And after 35 years, what can actually be done about it?

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