The Challenge of Going Off Psychiatric Drugs
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The Challenge of Going Off Psychiatric Drugs
Millions of Americans have taken antidepressants for many years. What happens when it’s time to stop?
Released on 04/03/2019
Laura Delano was this sort of golden woman,
who had a really vibrant and charismatic presence.
She came from a wealthy background in Greenwich, Connecticut
and sort of was instilled with this idea
that she would be the best
and that anything less represented a failure.
She was 14 at this time, when she was increasingly aware
of the sense of fraudulence
or sort of being an imposter in her life.
She became very angry and she had started cutting herself,
and eventually, it was diagnosed as bipolar.
She was medicated at an age where she wasn't able
to understand maybe like the source
of what was really bothering her so much.
And she had been on psychiatric medications
for over 10 years.
I discovered Laura's blog and she had written in some detail
about the experience
of going off of psychiatric medications.
She wanted to sort of figure out what her experience
of the world was without them.
This sort of unexplored question in psychiatry
which is like there are these pills
that really do help people in their lives,
but what do we know about how long people are on them,
and how do we decide when to get off it?
And when they do get off,
do we know how to have them get off?
Allen Francis, one of the editors of the DSM,
he described it as a kind of public health experiment,
in which young people and old people are put
on medications for years and years
and there's just very little knowledge
about what happens after that.
We don't have longitudinal studies
about people on these medications for decades.
They get a very quick prescription of a pill,
and then there may not be an endpoint.
Laura got to Harvard, when she was 18.
She again, started to feel that same way,
where she didn't really know who she was,
and she felt depressed.
She had to perform at a debutante ball,
because her family had this tradition of it.
Her sisters described her as like fitting in seamlessly,
and sort of being part of this society world.
And Laura described feeling
like the symbolism was so literal
that she was supposed to be on this stage performing
as a person that she was not.
She just described that as the moment
that she felt like she needed to ask for help.
My first label was bipolar disorder,
and then I'd also be labeled with major depression,
social anxiety disorder, borderline personality disorder,
substance abuse disorder.
When you have a mental illness,
it causes you great suffering,
and when you're a normal person,
you can sort of cope with it better.
But for Laura, she was put on a lot of Prozac,
and she just kept taking more and more medications
and sort of feeling more and more removed
from society and more identified with this sick person
who was never gonna have a functioning life
and who was sort of chronically ill.
The word prescription cascade is used to describe
what happens when someone is prescribed a medication,
and there's a side effect of that medication.
And another medication is prescribed
to treat that side effect,
and then it keeps going like that.
You get put on one medication
and that causes maybe sexual dysfunction,
so you get put on Viagra.
Maybe the medication causes sleep difficulties,
so you get put on Ambien,
and then the Ambien is making you so groggy in the morning
that you get put on Adderall.
Laura felt lonely and isolated,
and she wanted meaningful relationships,
and medications were not gonna give her that.
Strangely, in the process of having these conversations
with her, more and more medical literature
kept being published about the difficulties
that people have going off of medications
and particularly antidepressants.
It is this growing awareness that there is this gap
that no one really knows how to get off of medications.
Laura started a website with advice for people
who want to taper off medication,
but don't have any infrastructure
or advice about how to do so,
a place where people could become more informed
about the medications they were taking
and what the experience would be like of going off of them.
Being free from over 10 years of psych drugs,
I'm just noticing how different things are.
On the forums where people are going off of medications,
they'll describe things like neuro-regret
or neuro-guilt, and it's this sense
that you're possessed by an emotion
that doesn't feel true.
Somehow, it feels chemical.
I would say like the most recurring experience
that people describe
that I find surprising was the sense of detachment.
One person said that when he hugged his wife,
he didn't feel love the way he used to feel love,
and it's just impossible to sort of know
where that comes from.
But for him, he was very positive that it was something new
that happened after going off the medications.
For Laura, it was validating to realize
that there were people noting that it's a peculiar
and sort of undescribed experience
of going off these medications.
Recovery, noun, to,
the action or process of regaining possession
or control of something stolen or lost.
There's been really interesting books written
about the ways in which antidepressants were described
as fixing the parts of women that sort of didn't fair well
in the workplace, like making them sort of spunkier
and more bold.
Then, there's a history before that of benzodiazepines,
which are anti-anxiety medications,
and this was in the 70s
when benzodiazepines were really popular
of those medications helping women feel more content
and calm and able to fulfill their domestic duties.
There's a long history, if you look at the way
that pharmaceuticals have been advertised
that it sort of targeted the needs for a woman
in a particular era.
But I don't think that explains all of it.
But I think that's worth looking at.
For Laura, she's had this way of articulating
how psychiatric language had sort of informed
her own understanding of herself in a way
that had sort of stood in for other forms of understanding,
and she felt like the diagnoses had
kinda become a self-fulfilling prophecy.
They're still holding on to the underlying belief
that there was something abnormal inside of me
that I needed to get better.
She believed so deeply that she was bipolar
that she read all of her activities and moods
within that framework.
There's sort of a feedback loop.
You're described as depressed,
and then you sort of feel like you have no reason
to hope for more.
She entered adulthood on so many medications
that it was hard to sort of figure out
what were natural weaknesses, what were natural passions,
everything was a little bit numb.
But right now, she's about to get married,
and she just bought a new house.
And so, her life is in a really good place.
And I can feel from the tips of my toes
to the top of my head, who I am today.
I can feel that I've finally recovered myself.
[Rachel] We think about medications
as like fixing some sort of chemical imbalance,
and that's a way simplified version
of what actually happens.
It's easy to ignore how many cultural
and social factors there are,
both in how we find our way to these drugs
and also how we experience them,
and why we continue to take them.
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