Joanna Moncrieff

Joanna Moncrieff, professor of critical and social psychiatry at University College London, joins for a far-reaching discussion on depression, psychiatric diagnosis, antidepressants, the medical model of mental illness, and the expanding influence of psychiatry in contemporary society. Drawing on decades of clinical practice, research, and critical scholarship, Moncrieff challenges the assumption that mental disorders can be understood simply as underlying biological diseases and examines the evidence behind the widely repeated chemical imbalance theory of depression. The conversation explores the distinction between disease-centred and drug-centred approaches to psychiatric medication, the effectiveness and limitations of antidepressants, withdrawal, and the ways pharmaceutical interests have influenced psychiatric research and treatment. Moncrieff also considers the historical development of psychiatric interventions and the broader question of what happens when ordinary human experiences such as grief, distress, and social suffering become increasingly medicalised. The discussion moves beyond medication into questions of power, social control, and the changing boundaries of normality, drawing on Michel Foucault’s concept of biopower and examining why psychiatric diagnoses have become increasingly prominent in public life. Vigo and Moncrieff also discuss ADHD, autism, psychedelic-assisted therapy, and the political and cultural implications of expanding psychiatric categories. Throughout, the conversation asks whether psychiatry should be understood primarily as a branch of medicine or as a discipline shaped by social values, institutional power, and contested ideas about human behaviour. The episode offers a sustained examination of what psychiatric diagnosis means, what psychiatric drugs actually do, and how mental distress might be understood beyond the conventional medical framework.