What Are Psychiatric Drugs Actually Doing to Your Brain? And Do They Help BPD? | Psychiatrist Dr Joanna Moncrieff

Is Medication the Best Solution for BPD?

In this episode, I sit down with Professor Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London and practising consultant psychiatrist, for a conversation that challenges some of the assumptions about mental health, psychiatric diagnosis and medication.

Joanna's work has challenged the idea that psychiatric drugs work by correcting an underlying “chemical imbalance” in the brain. So what does that mean for people with BPD?

Content note: This episode discusses psychiatric medication, depression, suicide, trauma and mental health diagnoses.

⚠️ This episode is for education and discussion, not medical advice. Please don't stop or change any medication without talking to your prescriber. Some medications can cause withdrawal effects if stopped suddenly.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

References

Moncrieff, J. (2025). Chemically imbalanced: The making and unmaking of the serotonin myth. The History Press.

Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2023). The serotonin theory of depression: A systematic umbrella review of the evidence. Molecular Psychiatry, 28(8), 3243–3256. https://doi.org/10.1038/s41380-022-01661-0

Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2024). Difficult lives explain depression better than broken brains. Molecular Psychiatry, 29(1), 206–209. https://doi.org/10.1038/s41380-024-02462-3

Stoffers-Winterling, J. M., Storebø, O. J., Pereira Ribeiro, J., Kongerslev, M. T., Völlm, B. A., Mattivi, J. T., Faltinsen, E., Todorovac, A., Jørgensen, M. S., Callesen, H. E., Sales, C. P., Schaug, J. P., Simonsen, E., & Lieb, K. (2022). Pharmacological interventions for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 2022(11), Article CD012956. https://doi.org/10.1002/14651858.CD012956.pub2

Streit, F., Awasthi, S., Hall, A. S. M., Braun, A., Niarchou, M., Marouli, E., Babajide, O., Frank, J., Zillich, L., Callies, C. M., Avetyan, D., Zillich, E., Naamanka, J., Gonzalez, J., Harder, A., Lu, Y., Aherrahrou, Z., Ahmad, Z.-U.-A., Ask, H., ... Witt, S. H. (2026). Genome-wide association analyses of borderline personality disorder identify 11 loci and highlight shared risk with mental and somatic disorders. Nature Genetics, 58(8), 1831–1844. https://doi.org/10.1038/s41588-026-02654-3