From Sensus Fidelium:
These questions are not foreign to me. I knew someone who took an SSRI, developed suicidal thoughts that frightened him, and flushed the pills down the toilet. Years ago, while driving for Uber, I met a veteran who told me that he took a pill, blacked out, and awoke in handcuffs. He later learned that he had wrecked his car and fought with police, but he remembered none of it. Those stories cannot establish what caused the reactions; I do not know the complete medical histories, diagnoses, dosages, or other substances involved. They are anecdotes, not clinical trials. Yet they explain why I cannot dismiss reports of sudden, frightening behavioral change as imaginary simply because they are unusual.
To explore these issues, I recently interviewed Dr. Josef Witt-Doerring, a board-certified psychiatrist and former medical officer in the FDA’s Division of Psychiatry who now works extensively with psychiatric-drug adverse effects and withdrawal. His perspective deserves a hearing, but it also needs to be placed within proper limits. He did not examine Lindsay Clancy, he was not her treating physician, and an interview cannot decide a criminal case. His value here is that he helps identify medical possibilities that toxicology numbers and outward appearances do not necessarily settle.
The prosecution in the Clancy case emphasized apparently organized behavior: she arranged for her husband to leave the house, acted while he was away, and took steps that can be described as planned. For many observers, planning seems to end the insanity question. A person capable of organizing means, they reason, must also understand the end toward which those means are directed.
Dr. Witt-Doerring challenged that assumption. A person experiencing psychosis may still speak coherently, perform household tasks, conceal disturbing thoughts, and appear outwardly composed. As he put it during our interview, a person can look “really put together” while being driven by “bizarre, delusional thoughts in the background.” The crucial distinction is between the ability to reason instrumentally and the ability to judge reality correctly. Someone may connect steps A, B, and C with terrible efficiency while beginning from a premise that is entirely false. (Read more.)



