In the following excerpt from “A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives,” Kelly Brogan, M.D., discusses the long-lasting side effects of anti-depressants. This New York Times best-selling book is available now.

You might ask, “What if these drugs are in fact working some of the time for some people?” They still wouldn’t be worth the consequences for the placebo effect, particularly given their side effects, which are notoriously hidden from the lay public. I find it outrageous that drug companies can use any number of tactics to establish efficacy, including the suppression of data, and then use those tactics to legitimize long-term prescribing with no thought or attention to the real side effects over time.

When I lecture on the futility and perils of antidepressants, I like to employ the following analogy courtesy of Dr. David Healy, an internationally respected psychiatrist based in the UK: Let’s say you’re somebody who experiences a lot of social anxiety. You have a couple glasses of wine at a party as a pre-emptive strike. A sense of calmness washes over you and your symptoms evaporate. Through deductive reasoning, you could say, “Well, I must have an alcohol deficiency, so I should continue to consume alcohol every time I have this symptom, and I might want to drink regularly to prevent it altogether.” This analogy is emblematic of the practice of dishing out antidepressants without any consideration of their long-term consequences.

We’ve arrived at a place in psychiatry’s abuse of antidepressants where we have a half-baked theory in a vacuum of science that the pharmaceutical industry raced to fill. We have the illusion of short-term efficacy and assumptions about long-term safety. The potential emerging side effects are nothing short of horrifying, from suppressed libido and sexual dysfunction, abnormal bleeding, insomnia, migraine, weight gain, and blood sugar imbalances to risk of violent, irrational behavior and suicide. Before I get to the ugliest of side effects and withdrawal complications, let’s focus on how your ability to function long-term in the world with depression is significantly sabotaged by treating that first episode of depression with medication. This too has been expertly explored by Robert Whitaker, whose website is a virtual library of published data and thoughtful reviews of multiple long-term studies that have followed large groups of people taking antidepressants. Time and time again these studies demonstrate poor functional outcomes for people treated with antidepressants relative to those with minimal to no medication treatment. They are at greater risk for all the acute side effects I’ve already listed, as well as increased risk of relapse, cognitive impairment, secondary diagnosis and medication treatments (first a depression diagnosis followed by a bipolar one), and recurrent hospitalization.

A breathtaking 60 percent of patients are still diagnosed with depression one year into treatment, despite temporary improvement within the first three months. Two prospective studies in particular support a worse outcome in those prescribed medication. In one such British study, an unmedicated group experienced a 62 percent improvement by six months, whereas the drug-treated patients experienced only a 33 percent reduction in symptoms. And in another study of depressed patients conducted by the World Health Organization (WHO) in 15 cities across the UK, it was found that at the end of one year, those who weren’t exposed to psychotropic medications enjoyed much better “general health,” their depressive symptoms were much “milder,” and they were less likely to still be “mentally ill”!

Now let’s consider the more serious possible side effects of violent behavior, relapse, and crippling withdrawal among those who try to escape their grip. Antidepressants have a well-established history of causing violent side effects, including suicide and homicide.

In fact, five of the top 10 most violence-inducing drugs have been found to be antidepressants. Over the past three decades, there have been hundreds of mass shootings, murders and other violent episodes that have been committed by individuals on psychiatric drugs. Big Pharma spends around $2.4 billion a year on their direct-to-consumer television advertising for drugs like Zoloft, Prozac and Paxil. The networks can’t afford to run negative stories about prescription drugs, as they would lose tens of millions of dollars in ad revenue (no wonder the connection is habitually downplayed or ignored entirely). The Russian roulette of patients vulnerable to these “side effects” is only beginning to be known and may have something to do with how their bodies (and actions of their unique genetic code) metabolize these chemicals and pre-existing allostatic (stress) load. Healy has worked tirelessly to expose data implicating antidepressants in risk of suicide and violence, maintaining a database for reporting, writing and lecturing about cases of medication-induced death that could make your soul wince. And what about our most vulnerable: new mothers of helpless infants? I have countless patients like Kate in my practice who report never-before thoughts of suicide within weeks of starting an antidepressant for postpartum depression.

In a population where only a few randomized trials have examined the use of antidepressants for postpartum depression, I have grave concerns for women who are treated with drugs before more benign and effective interventions such as dietary modification, thyroid treatment, and addressing their sleep habits during this period when sleep deprivation runs high are explored. We already know that “low mood” is likely to resolve on its own within three months without any treatment, and upward of 70 percent of people will be free of depression without any medication whatsoever within a year. Yet we reflexively turn to these drugs and their unpredictable effects that can rob us of the ability to find permanent relief through the body’s own powerful systems, even though, by their own claims, they take six to eight weeks to “take effect.”

In 2004, the US Food and Drug Administration revised the labeling requirements for antidepressant medications with a warning: “Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.” The FDA was pushed to revise the labeling following a bevy of lawsuits in which pharmaceutical companies were forced to reveal previously undisclosed drug data.

You’d think such labeling would give people — and parents — pause. But since 2004, antidepressant use has only increased among both children and adults. I am routinely helping women who want to have a baby either avoid or taper from antidepressants, despite having been “specially trained” to prescribe for this population. For many of them, the first step is simply accepting the fact that they’ve been lied to about the value of antidepressants and their alleged benefits. Meanwhile, their downsides are not only downplayed but actively concealed.

All you have to do is spend a few minutes on SurvivingAntidepressants.org, BeyondMeds.com, or SSRIstories.org to appreciate that we have created a monster. Millions of men, women and children the world over are suffering side effects, including complicated withdrawal routinely dismissed by their prescribing clinicians. Contrary to what Big Pharma would have you believe, weaning off antidepressants is extremely difficult, so choosing to take them could be signing up for a lifetime of medication use that creates and sustains abnormal states in the brain and entire nervous system. As a clinician who once believed in these medications, I have been humbled by what they are capable of. In fact, even when I have tapered women off of Celexa at extremely low increments of .001mg a month, it can be hard to imagine another class of substances on Earth so potentially complicated to discontinue.

Kelly Brogan, MD, studied cognitive neuroscience at MIT before receiving her MD from Weill Cornell Medical College. Board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine, she is one of the only doctors in the nation with these qualification. She practices in Manhattan and is a mother of two young daughters.

A Mind of Your Own is available now.