Dr Arnold Gilberg is on a mission to help people live happier and healthier lives without antidepressants.
Nearly 29 million Americans currently take antidepressant medication, but Gilberg believes these pills should be an absolute last resort.
And it seems his drug-free methods can work, with the doctor boasting a 70 percent success rate.
For Gilberg, a leading psychiatrist at Cedars-Sinai Hospital, deep dialogue is key in tackling the root cause of issues rather than opting for a quick chemical fix.
Exercise is also a nonnegotiable for his patients, and he insists that if they want him to be their psychiatrist, they must start working out.
‘I write prescriptions for gym memberships, not pills,’ Gilberg told the Daily Mail. He claimed nearly three-quarters of his patients have improved since beginning an exercise regimen.
‘The psychoanalytic way of thinking has always been that there were other approaches other than the use of medications,’ said Gilberg, who also helps A-list actors delve into the minds of their characters.
‘You get some benefit from the medication, but it does have a numbing effect… that’s why I’m very reluctant about them.’
Dr Arnold Gilberg (pictured) is a leading psychiatrist at Cedars-Sinai in Los Angeles and trained psychoanalyst who is reluctant to prescribe antidepressants
Gilberg’s method of treating patients with mild to severe anxiety and depression was shaped by the teachings of his mentor Franz Alexander, a psychoanalyst who learned the theories and techniques from Sigmund Freud himself.
Alexander, who is widely considered the father of psychosomatic medicine, instilled in Gilberg the importance of treating the whole person within the context of their life, not just a set of symptoms.
During a patient’s first 50-minute session at Gilberg’s office, the primary focus is delving into current crises they are experiencing rather than exclusively exploring more profound childhood trauma. This might be a divorce, bereavement, problems with a child or job stress, for example.
Gilberg is also a big fan of yoga, framing it as an ‘opportunity’ for patients to actively participate in their own healing.
‘I’m very holistic,’ he told the Daily Mail. ‘I encourage all my patients to do yoga and meditate, and there are all these modalities of care that we have available to us.’
Exercise acts as a powerful, natural antidepressant by increasing the brain’s production of endorphins and other mood-regulating neurotransmitters like serotonin and norepinephrine.
It also reduces the body’s stress hormones, such as cortisol and adrenaline, helping to alleviate both depression and anxiety.
Harvard researchers reported in 2019 that committing to a manageable bout of exercise, such as 15 minutes of brisk walking, can reduce the risk of depression by 26 percent.
This isn’t to say that Gilberg and other psychoanalysts have stopped rooting out trauma.
Instead they address the most immediate problem, such as a sudden loss, first.
‘We all have traumas in development. That’s just the way it goes,’ he said, describing a foundational Freudian concept.
‘And as a psychoanalyst, over time, you do explore those issues. But when a person’s going through an acute trauma, that’s not the time to start peeling away at the onion.’
So essentially, he seeks to put out the fire first and find the cause later.
Freud believed the mind was a fortress that guarded painful memories and secrets rooted in traumatic experiences, which the psyche buried deep in your subconscious.
Recent data indicates over 47 million American adults currently have or are being treated for depression, while statistics show over 21 million adults and five million adolescents experienced a depressive episode in the past year
Between 2009 and 2018, antidepressant use rose significantly among women, climbing from 13.8 percent to 18.6 percent. For men, however, the rate remained relatively stable, rising only slightly from 7.1 percent to 8.7 percent
He theorized that when these memories broke through the mind’s defenses, they manifested as symptoms like anxiety or dissociation from your body or surroundings.
The path to healing, in Freud’s view, was slow, deliberate work facing scarring memories head-on. The goal was to gently unearth this unconscious material and integrate it into a conscious narrative.
‘Today’s psychoanalytic thinking is different,’ said Gilberg, who is also the author of The Myth of Aging: A Prescription for Emotional and Physical Well-Being. ‘We’re not interested in going back to what happened when they were a child, but we want to stay on top of what’s going on now.
‘So we explore how badly he or she feels. We want to talk about what they’re doing to make things a bit better.’
Gilberg has not shunned antidepressants completely, and acknowledges they can be ‘worthwhile and good options’ for severe, biologically rooted conditions such as major depression or bipolar disorder.
But he worries that pills have gone from being just one facet of a mental health treatment plan, which typically includes regular therapy, to the default approach.
Uptake of antidepressants has risen steadily for decades, particularly since the 1987 release of Prozac, the world’s first selective serotonin reuptake inhibitor (SSRI).
Prescriptions of SSRIs and similar SNRIs (serotonin-norepinephrine reuptake inhibitors) soared in the years that followed. Americans filled 42 million prescriptions in 2010, a figure that rose 108 percent to more than 88 million by 2023.
In 2010, Americans filled 42 million SSRI or SNRI prescriptions – this number surged by 108 percent to more than 88 million by 2023
‘While I believe in antidepressants for major illnesses like bipolar and schizophrenia, I have been concerned about the use of antidepressants, which are dished out so easily, because of the impact they have on the individual,’ Gilberg told the Daily Mail.
He added that SSRIs have been used so widely that they have become not just the default treatment approach among many doctors but among patients as well – many of whom have been led to think they cannot solve internal conflicts through non-medical modes like psychotherapy, or that they will provide a quick fix.
‘I think that for myself, anyway, we have to be very discriminating about how we use the medications that we have available to us, because the medications themselves have side effects,’ he said.
Many patients taking the medications experience sexual dysfunction, including low libido, delayed orgasm or numbness, which can strain relationships and lower quality of life.
Other frequent complaints include weight gain, feeling detached or less responsive – known as emotional blunting – and digestive issues like nausea or constipation.
While not everyone is affected, he said these side effects are common enough for around a quarter of patients to stop taking their medication as a result.
You can pre-order Gilberg’s new book, The Myth of Aging: A Prescription for Emotional and Physical Well-Being, out on January 13, 2026.
