The Challenge of Going Off Psychiatric Drugs

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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.

[woman panting]

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.

[pills crashing]

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.

[chiming music]

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.