Roger McFillin is a clinical psychologist and author of the Substack Radically Genuine, where I would recommend starting with What the Hell is Society Doing to Adolescent Girls?, The Medication Generation, and his piece about our last conversation, Losing the Language of Suffering.
Roger is uncompromising in his critiques of the mental health industry, and helps us remember what it means to be human. We had a pretty disturbing conversation about things I’ve felt for a while but he has seen first hand in his clinical practice. We spoke about the medicalisation of the female experience, the pathologisation of certain personalities, and how parents can protect their daughters.
Paid subscribers can access the full conversation, where we go on to discuss how therapy-speak and moral relativism make us easy to manipulate, somehow covering everything from Nazi Germany to Emma Watson’s latest podcast appearance. I hope you find it interesting as I did; I would love to hear your thoughts.
And please, subscribe to Roger here:
Freya India: Roger, as you know, I’m suspicious of the mental health industry. I’ve argued that therapy culture is actually worse for girls and young women, since we already tend to internalise our distress, and are now endlessly encouraged to do so. We are told to look inwards instead of outwards. And I’m amazed that this isn’t more of a feminist issue. Instead of labelling women as “hysterical”, now if they have a strong reaction to anything we say they are anxious, autistic, neurodivergent. In fact, we’ve got girls calling themselves that, declaring themselves sick and irrational for being thinking, feeling human beings.
“The mental health crisis is disproportionally impacting Generation Z girls,” you have written. “Doctors are more likely to pathologize the normal and expected emotional reactions that young girls and women experience during adolescence compared to previous generations. Girls are more likely to be prescribed powerful psychotropic drugs in response to these episodes. Girls are more likely to be psychiatrically labeled.” You warn that victims of sexual trauma are being diagnosed as bipolar or BPD, that girls suffering mood changes from contraception are met with more drugs, and that their experience of puberty itself is medicalised. Personality traits, too—you write that those who are sensitive, empathetic, experience emotions strongly, and are attuned to the feelings of others, are more likely to be pathologised and drugged. (Which is a little worrying, since that’s my entire personality…)
As you put it, “Seems like being female is under attack.” Can you expand on this? Should girls and young women be especially vigilant to the mental health industry, and how easily it can convince them they are sick? Parents of teenage girls read this Substack; what should they be watching for, and how can they protect their daughters?
Roger McFillin: You’re absolutely right: this is an attack on girls and women, but more fundamentally, it’s an attack on life itself.
We’ve created a medical model where emotional numbness equals mental health. The treatment goal is simple: feel less. The more disconnected from your inner life, the more “recovered” you are. This is emotional lobotomy disguised as care. A person who feels nothing isn’t mentally healthy. They’re barely alive. Yet that’s exactly what the system calls success.
Females and males are biologically different in how they process emotions, not as a flaw but as evolutionary design. Boys are more likely to externalize distress (dismissed as “boys being boys”), while girls internalize and express through tears and verbal processing (immediately labeled as symptoms). Female puberty’s complex hormonal cycles produce emotional range and responsiveness that psychiatry mislabels as instability rather than recognizing it as biological wisdom and developmental imperative.
Girls are also more likely to seek therapy, encouraged by a culture that tells them talking about feelings is healthy. They arrive ready to explore their inner worlds with rich emotional vocabularies. Yet psychiatry, which claims to be a medical science, has no blood tests, brain scans, or biological markers for its diagnoses. Instead, a girl’s words become her pathology. The more articulate she is about her pain, the more symptoms get documented. Her nuanced descriptions become diagnostic criteria. Her emotional vocabulary becomes evidence of severity. “She has such insight into her depression,” therapists note, not recognizing they’re witnessing emotional intelligence, not illness. Within sessions, she inadvertently provides all the ammunition needed for psychiatric labels and medication.
Boys who can’t or won’t articulate their distress fly under the radar. Girls who eloquently describe theirs get diagnosed and drugged. This is why females are medicated at more than double the rate of males. We’re punishing women for the very verbal intelligence that makes them exceptional at understanding and navigating emotional complexity.
My deepest concern is for adolescent girls, who deserve protection during their most vulnerable developmental years, not from their emotions, but from those who would medicate them away. When we pathologize female sensitivity and prescribe emotional blunting, we’re attacking capacities that only develop through direct experience. Girls need to feel these emotions fully, learn to understand their messages, and develop their own ways of navigating them. Adolescence is a crucial developmental stage when the brain undergoes massive reorganization. The emotional intensity and variability of female puberty isn’t random chaos; it’s necessary training.
Those sometimes overwhelming feelings teach them to track multiple emotional states simultaneously, read social micro-dynamics, and develop the sophisticated processing that allows adult women to later sense infant distress before symptoms appear and detect social tensions before they explode. By medicating these natural developmental surges, we’re interfering with millions of years of evolutionary programming. We’re disrupting nature’s design for creating emotionally sophisticated adults.
We intervene precisely when girls are navigating crucial developmental learning and label them as disordered if they happen to encounter the wrong clinician during a challenging life event. When a fifteen-year-old’s emotions are blunted by SSRIs, it disrupts the emotional development essential for healthy adulthood, with consequences that extend far into her future.
Critics will say “depression isn’t just sadness.” But by pathologizing emotions, we create depression. When we tell someone emotional distress is a “chemical imbalance,” we teach them to fear their emotions rather than read them as signals. They no longer recognize emotions as valuable information about their lives and relationships.
This is the ultimate invalidation: teaching a girl not to trust her own internal guidance system. Once she believes her feelings are symptoms rather than signals, she loses the ability to navigate life using her own emotional compass. That disconnection transforms temporary sadness into chronic fear and helplessness. A culture with language for heartbreak and rituals for grief produced resilient people. A culture that medicates every tear produces psychiatric patients.
The financial incentives are real. Every diagnosed girl is worth a fortune in lifetime pharmaceutical profits. But this goes deeper than money. This is spiritual warfare. A woman connected to her emotional power is independent and ungovernable. She is connected to a greater divine intelligence. A woman convinced she’s mentally ill never realizes her power and becomes a patient for life. We’re severing women’s connection to life force itself, breaking the bonds that hold communities together.
The ultimate expression of this antihuman agenda is what we’re doing to the unborn. We prescribe antidepressants to women of childbearing age at unprecedented rates, knowing these drugs cross the placental barrier when pregnancy occurs and permanently alter fetal brain development. Studies show increased autism risk, developmental delays, and neonatal withdrawal. Infants exposed in utero show altered stress responses and disrupted sleep patterns persisting into childhood. This withholding of informed consent isn’t accidental. It’s a systematic attack.
It’s always our most sensitive, creative, and emotionally gifted girls who get caught in the psychiatric web. The girl who feels deeply, who absorbs others’ pain isn’t sick. These are gifts that, when understood and nurtured, become her greatest strengths. Yet the earlier she gets caught in the hormonal birth control and SSRI trap, the more medications accumulate. What starts as one prescription at fourteen becomes three to five different drugs by the time she reaches adulthood.
The psychiatric system’s response to trauma, particularly sexual assault, represents its most egregious failure. A girl’s normal trauma responses (hypervigilance, rage, dissociation) are evidence of a functioning survival system. Yet psychiatry transforms these into “bipolar disorder” or “borderline personality.” The drugs don’t help process trauma. They prevent it. SSRIs blunt emotions that need feeling. Antipsychotics suppress rage that needs expression. Years later, the trauma remains unprocessed while she’s dependent on multiple drugs and convinced she’s broken rather than injured.
When a girl accepts any psychiatric label, she accepts a limited life. “I have anxiety” becomes her reason not to take risks. “I’m bipolar” becomes her explanation for every emotion, every enthusiasm dismissed as mania, every sadness as a depressive episode requiring medication adjustment. “I have borderline personality disorder” becomes her identity, teaching her that her very self is disordered, that her feelings are too intense, her relationships doomed to fail. “I have depression” becomes her story, and she stops believing happiness is even possible. These diagnoses don’t just describe temporary states; they colonize identity. She starts introducing herself by her disorders, planning her life around her limitations, choosing smaller dreams that won’t trigger her “symptoms.” These labels become prisons. She loses trust in her emotional responses, which for a woman is like losing her GPS system.
For Parents: Your daughter’s concept of “normal” is being deliberately shaped by forces that profit from her self-diagnosis. TikTok algorithms funded by therapy apps teach her every emotion is a symptom. Influencers normalize taking five drugs by twenty. School counselors trained by the mental health industry refer students for normal reactions.
Watch for these warning signs: She identifies AS a psychiatric diagnosis (”I have anxiety” not “I feel nervous”; “I am depressed” not “I feel sad”). She learns symptoms from social media and arrives at appointments already scripted. Doctors suggest drugs after fifteen minutes without asking about diet, lifestyle, the birth control pill or life circumstances. Schools refer her for crying about friends. She weaponizes therapy language to avoid challenges.
How to protect her: Guard her language. When she says “I’m depressed,” teach her to say what she actually feels. Be skeptical of hormonal birth control (it can triple suicide risk). Most importantly, teach her what every generation before us knew: difficult emotions are temporary visitors, not permanent residents. “This too shall pass” contains more wisdom than any diagnostic manual.
When she’s sobbing, don’t immediately suggest therapy. Sit with her. Share your own teenage struggles. Teach her what traditional cultures understood: adversity builds character. Emotions require witnessing, not fixing. Sometimes the bravest response is simply to endure. Previous generations called this resilience or grit. They knew that learning to tolerate discomfort without immediately seeking relief creates strength.
Help her see emotions as information, not illnesses. Sadness about a toxic friendship signals needed change. Anger at injustice fuels action. Anxiety before performance sharpens focus. These aren’t symptoms to suppress but messages to heed. After feeling them fully, she can return her attention to what matters: her goals, her values, her growth. This is ancient wisdom that therapy culture has forgotten: you don’t need to solve every feeling, sometimes you just need to outlast it.
Struggle clarifies everything: reveals real friends, shows what she values, teaches what she can survive. Every difficult emotion navigated without medication builds capacity for life’s challenges. Our ancestors knew this. They didn’t have therapists for heartbreak or pills for disappointment. They had community, ritual, and the understanding that suffering is part of becoming. The system is designed to catch sensitive, creative girls and turn them into psychiatric patients. Your job is to be the firewall.
I get the feeling, too, that conservative personality traits are pathologised in our liberal, secular culture. Those who want more from a relationship become anxiously attached. The reserved become repressed. The well-adjusted person is independent, progressive, extroverted, endlessly open to experience, never jealous, not insecure. Growing up, I definitely felt like the more conservative parts of my personality were deficiencies.
My worry is that when morality is relative, therapists become the new arbiters of right and wrong. Maybe you need to get over your discomfort with an open relationship. You don’t need a modest partner; you just have retroactive jealousy OCD. If you dislike your boyfriend watching porn, you are insecure; it’s a trauma response. Whatever you do, do not shame him. Be more tolerant, more open. We pathologise moral instincts and encourage girls to essentially regulate themselves out of them.
Even virtues become suspect. Selflessness is pathologised. Today the psychologically healthy person puts themselves first, prioritises their own needs, loves themselves above all. And so anyone who wrestles with this can feel unwell. In a society geared toward freedom and self-fulfilment, what becomes strange, pathological even, is a preference for stability, predictability, a sense of duty and self-sacrifice.
Part of this is probably ideological bias. Most therapists are liberal: 68% identify as liberal or very liberal, compared to 26% moderate and 6% conservative. Unsurprisingly, conservatives are also less likely to go to therapy, probably feeling that they will be misunderstood or maligned. Neutrality now means liberalism.
So I guess the deeper problem is that these labels reflect the dominant culture. We see this throughout history. In Nazi Vienna, Hans Asperger’s work on autism was influenced by whether children’s traits were useful to the Third Reich; if not they were “uneducable” and expendable. Even today, traits like avoiding eye contact are a symptom of autism in one culture, a sign of respect in another. The irony is that progressives insist everything is a social construct except mental health labels, which are treated as objective truths. But of course they are constructed, these attempts to describe complex feelings and behaviours. The suffering is real, but the categories constantly change.
Today our culture rewards being endlessly interested in and invested in yourself, being liberated from others. But as Erich Fromm warned in The Sane Society, “Many psychiatrists and psychologists refuse to entertain the idea that society as a whole may be lacking in sanity. They hold that the problem of mental health in a society is only that of a number of ‘unadjusted’ individuals, and not that of a possible unadjustment of the culture itself.” Fromm was concerned with the “pathology of normalcy.”
Does any of this resonate with your clinical experience? Or am I being biased here?