Summary: Laura Delano’s life changed when she was diagnosed with bipolar disorder as a teenager. Even after nineteen medications across a span of fourteen years, she felt deep emotional pain. This is her story of finding deeper, and more lasting healing – along with a happiness she could not have imagined possible.
This will be different than anything I’ve ever written. My intent is very simple: to tell a story that I believe many could benefit from in our faith community.
Why? Because Laura’s story is that of many Latter-day Saint teens and young adults growing up today – or at least it could be. Her story ends differently than many people you and I have known and loved – but that’s precisely the point. While many have started a story very similar to Laura’s, they haven’t yet found her ending (which is actually a new beginning – as Laura’s story continues today hopeful and vibrant).
I believe it’s possible that many of these we love could also find a similar change…if they became aware it was even possible. That’s why I’m writing today – to highlight this woman’s experience because I believe the trajectory of her heartening account could represent a path for many other Latter-day Saints with mental health challenges to find renewed hope and healing in their own lives.
What follows combines quotes from Laura’s other videos, and my own observations of her, with a condensed adaptation of a remarkable feature piece in the New Yorker last year. I supplement this narrative with some additional references to the larger context and some clarifying comments from her directly, having worked with her on a volunteer basis for the last couple of months in her important non-profit organization, Inner Compass Initiative and their signature effort, The Withdrawal Project. As a way to make this more accessible, I have necessarily shortened many parts of the story – and encourage you to review original sources to go deeper. I’ve also embedded here a shorter, recent video of Laura providing a more personal glimpse into her experience.
I find Laura delightful, encouraging, brave and inspiring – for so many reasons. You will see for yourself below why, and why I felt so compelled to share it. If, after reading this story, you would like to find out what it would take for you or someone you love to pursue a similar path, there is a weekly call on their Facebook page you can consider joining. I will also be hosting a Zoom call with Laura this fall dedicated to any questions you may have. If you’d like to support her non-profit’s efforts in any other way, we would also welcome your inquiry. You are welcome to email me at jzhess@gmail.com to sign-up for that call – or to learn more. At this point, I will turn exclusive attention to her – and allow her story to become the message.
The Beginning
Laura grew up in a stable, well-off family – and had pretty much everything going for her. Class president. Athletic skills. Great academic ability. Supportive parents. Three loving sisters. Even a pathway to Ivy League education.
“As a child I had a strong sense of who I was,” she said. “I was sensitive, happy and alive.” Yet at age 13, inner turmoil arose that was confusing. Looking in the mirror one day, “suddenly, the person looking back at me was a stranger – I realized, I didn’t really know who I was?” she said. Laura started to feel like she was living two separate lives and doubting whether she had a “real self underneath.”
“I began to think racing thoughts about death,” she said. “I’d escape these feelings by harming or starving my body, trying drugs, or drinking till I blacked out.” Understandably worried, her parents took her to a family therapist who eventually referred her to a psychiatrist. He diagnosed her with “bipolar disorder,” and prescribed Depakote, a mood stabilizer. Laura resisted this course, however, hiding pills in a jewelry box and then washing them down the sink.
After arriving at Harvard, she thought, “This is everything I’ve been working for. I’m finally here.” As her roommate described her, “Laura just blew me away—she was this golden girl, so vibrant and attentive and in tune with people.”
Yet her inner turmoil remained. Her mind continued racing and she wasn’t able to sleep. On a trip home, she told her family that she didn’t want to be alive – “I didn’t know who I was. I was trapped in the life of a stranger.” Before getting back to school, she was referred to another psychiatrist. This time, she recollected, “I remembered feeling a sense of hope” as she walked into the medical facility.
In his notes, the doctor described Laura as an “engaging, outgoing, and intelligent young woman,” who “grew up with high expectations for social conformity.” She told him, “I lie in my bed for hours at a time staring at the wall and wishing so much that I could be ‘normal.’”
She felt more receptive to the doctor’s recommendations this time. As Laura later put it, “The doctor had explained the story of who I was, and what I was feeling in a way that was more concrete than I had ever felt before. He told me I had bipolar disorder – a brain disease – I had always had it, but luckily there were medications to treat it.”
She continued, “I felt reborn – I walked back that hill to the bus top, a spring in my step, and prescription slips in my hand. Laura was relieved to hear more evidence that her distress arose from an illness. “It was like being told, It’s not your fault. You are not lazy. You are not irresponsible.”
“I have good news,” Laura told her father in a call afterwards. With tears streaming down her face, she said happily, “He’s figured out the problem.”
She began taking twenty milligrams of Prozac, an antidepressant – which was soon increased to forty milligrams, and then to sixty, when she still wasn’t feeling better. Each raised dose made her feel grateful for being heard. As she put it, “It was a way for me to mark to the world: this is how much pain I am in.”
Laura wasn’t sure whether Prozac actually lifted her mood—roughly a third of people taking antidepressants do not respond to them—but her classwork improved as her emotions felt less distracting and urgent. A friend from high school said, “I remember her carrying around this plastic pillbox with compartments for all the days of the week.”
The Cascade
During her junior year of college, Laura’s Prozac prescription was raised to eighty milligrams, the maximum recommended dose. Since the Prozac made her drowsy, she was also prescribed two hundred milligrams of Provigil, a drug for narcolepsy that helps soldiers and truck drivers stay awake during overnight shifts. This gave her seemingly boundless energy – “I was just a machine,” she recollects about her academic and athletics at the time.
Since this other drug made it hard for Laura to sleep, Ambien was added to the mix, which she took every night.
Despite following her doctor’s orders, as the years passed, Laura remember, “I got more and more disconnected – from myself, from friends and family, from creativity. I was told my illness was ‘progressing.’”
Two psychiatric drugs became three – three became four. This addition of a succession of medications has become common – including among young people – and is known as a “a prescription cascade.” What happens is the side effects of one medication become treated by another medication – even sometimes diagnosed as a new underlying condition. All this can create new unsettling emotional and physical phenomena not before seen or experienced in someone’s life.
In Laura’s case, for instance, her energy levels rose and fell so quickly that she was told she had a version of bipolar disorder called “rapid cycling.” And her subsequent life choices seemed undeniable confirmation of the same (including to herself). She would go to Nordstrom and buy two or three dresses – then come back and read in her own copy of the Diagnostic and Statistical Manual of Mental Disorders how this was “textbook behavior.”
In this state of mind, normal school stresses became paralyzing – so Laura opted out of spring semester at college. Going back to school brought such distress that she thought every day about dying. At her request, her family drove her to a hospital, where she was put on a new combination of pills: Lamictal, a mood stabilizer; Lexapro, an antidepressant; and Seroquel, an antipsychotic that she was told to use as a sleep aid. Her father recollected his feelings at the time – “I had no conviction that the drugs were helping. Or that they weren’t helping.”
Laura later returned to Harvard and managed to graduate, before holding a series of jobs. During this time, she felt herself interpreting “each moment of lethargy or disappointment as the start of a black mood that would never end.”
In response, over the next four years, her doctors tripled her antidepressant dosage. Her dosage of Lamictal quadrupled. She also began taking the benzodiazepine Klonopin.
The Anguish
Despite the continued attention from dedicated medical support and the increase in treatment, Laura was not feeling better – and certainly not herself. At this point, she was told what many people who struggle to find a benefit get told: “What I heard a lot was that I was ‘treatment-resistant.’” She came away feeling even more weighed down by this message – namely, that “something in me was so strong and so powerful that even these sophisticated medications couldn’t make it better.”
She remembers grappling with her “miserable existence” as she described it at the time. For a brief period, Laura saw a professional who raised questions about the trajectory she was on. He doubted her early bipolar diagnosis, writing that “many depressions are given a ‘medical’ name by a psychiatrist, ascribing the problem to ‘chemistry’ and neglecting the context and specificity of why someone is having those particular life problems at that particular time.” He reminded her of hatred she felt for herself at that time of her life. Laura decided that “he wasn’t legit” and stopped going to her appointments.
Rarely did Laura see any friends from high school or college anymore. As one later admitted, “At a certain point, it was just, Oh, goodness, Laura Delano—she’s ill.” Since her freshman year, Laura had also gained nearly forty pounds, connected in part to the medical side-effects. All this distance – and resistance to dating and socializing – was taken for granted as entirely a reflection of the illness.
Laura started this journey feeling estranged from herself. Now, when she looked in the mirror, she felt even less connection to her reflection. “All I ever want to do is lie in my bed, cuddle with my dog, and read” she wrote at the time.
She found another psychiatrist. “She could recount her psychic conflicts in a cool, clinical tone, taking pride in her psychiatric literacy,” as the New Yorker reports. “She saw her drugs as precision instruments that could eliminate her suffering, as soon as she and Dr. Roth found the right combination.”
She later recollected, “I medicated myself as though I were a finely calibrated machine, the most delicate error potentially throwing me off.” If she drank something that made her ‘too excited and talkative,” she thought, “Oh, no, I might be hypomanic right now.” If she woke up with racing thoughts, she thought, “My symptoms of anxiety are ramping up. I should watch out for this. If they last more than a day or two, Dr. Roth may have to increase my meds.”
The day before Thanksgiving in 2008, Laura drove to her grandparents’ house on the coast in Maine. She felt ashamed of her weight and noticed relatives treating her differently. “She seemed muted and tucked away,” one cousin later said. During the holiday, her parents took her into a private room and wept as they shared their worries that she seemed trapped. As Laura sat on a sofa with a view of the ocean, she nodded but didn’t really listen. What she kept thinking is: You’ve put everyone through enough.”
She went to her bedroom and poured eighty milligrams of Klonopin, eight hundred milligrams of Lexapro, and six thousand milligrams of Lamictal into a container – and headed out with her backpack. Laura told her sisters she was going outside to write. “She looked so dead in her eyes,” one sibling remembers – “There was no expression. There was nothing there, really.”
She walked down a trail to the ocean, sat on a rock and began writing, “I will not try to make this poetic, for it shouldn’t be. It is embarrassingly cliché to assume that one should write a letter to her loved ones upon ending her life.”
She swallowed a handful of pills at a time, until she found it increasingly hard to sit upright, and her vision began to blur. As she fell over and hit her head on a rock, she heard the sound but felt no pain.
When Laura hadn’t returned by dusk, her father walked along the shoreline with a flashlight until he found her. She was airlifted to a hospital, where doctors said they weren’t sure that she would ever regain consciousness. After two days in a medically induced coma, she woke up to her sisters and parents in the room. As she looked out and realized she was still alive, she started sobbing. Her first words to her family were, “Why am I still here?”
More Anguish
Laura was sad the suicide hadn’t work, but felt guilty for worrying her family. She had a black eye from hitting the rock, and felt weak, dizzy, sweating profusely, and anemic.
She started trying to work with the doctors again. “Her eye contact and social comportment were intact,” one wrote. Another doctor proposed that she had borderline personality disorder, a condition marked by unstable self-image and a chronic sense of emptiness and often used for people who didn’t fit into established illness categories. According to her medical records, Laura agreed. “Maybe I’m borderline?”
She was started on a new combination of medications: lithium, to stabilize her moods, and Ativan, a benzodiazepine, in addition to the antipsychotic Seroquel, which she had already been taking. Later, a second antipsychotic, Abilify, was added.
Shortly before leaving the hospital, Laura drafted a letter to the staff, “I truly don’t know where to begin in putting in words the appreciation I feel for what you’ve all done to help me. It’s been so many years since I’ve felt the positive emotions—hope, mostly—that have flooded over me.” Unpersuaded by what she was saying, she stopped the letter midsentence and never sent it.
After moving home, she spent evenings drinking with old friends. She told her psychiatrist, “I don’t feel grounded…. I am floating.” Her father encouraged her to “try to reach for one little tiny positive thought, so you can get a little bit of relief.” But she couldn’t – any positivity seemed out of reach.
She agreed to day-treatment for borderline patients. The director of the program told her, “So, you went to Harvard. I bet you didn’t think you’d end up at a place like this.” She immediately started crying – a response labeled as “emotional lability,” a symptom of the disorder.
After starting to drink heavily, Laura was persuaded to attend Alcoholics Anonymous meetings – where she felt hope in hearing stories of broken people who had somehow survived. Compared with the clinic, where she attended therapy every day, she found it refreshing that these meetings involved less self-absorption and constant turning inward.
At the time, she was also taking Effexor (an antidepressant), Lamictal, Seroquel, Abilify, Ativan, lithium, and Synthroid, a medication to treat hypothyroidism, a side effect of lithium. The combination of medications left her so sedated that she sometimes slept fourteen hours a night.
The Turning Point
In May of 2010, she wandered into a bookstore, even though she could rarely bring herself to read anymore. On the table of new releases was “Anatomy of an Epidemic,” by Robert Whitaker. As she described it, that cover “stopped me in my tracks… decorated with a long list of psychiatric drug names – almost all of which I had been on. My heart started pounding, I knew somehow that reading this book was very important.”
Laura remembers, “As I turned page after page, I felt like I had been hit with a ton of bricks. It showed scientific data that called into data everything I believed about myself.”
Whitaker’s book explores the question of why rates of mental illness have arisen, even while access to treatment for mental illness have also risen significantly. After reviewing the medical literature thoroughly, this award-winning journalist went on to argue that the combination of psychiatric medications, taken in heavy doses over the course of a lifetime, may be turning some disorders into chronic disabilities. [See here for clips of an interview I did with the author several years back; I have been impressed with his humility and thoughtfulness in my interactions].
For the first time, Laura was questioning whether she, in fact, had a “life-long chemical imbalance.” That wasn’t an easy thing to unsettle in her mind. As she recollected, “I felt defensive about my bipolar identity, outraged and confused all at once.
But amidst that internal chaos, an unfamiliar sensation was also emerging: hope. There was now the possibility of a different future.” She added, “I had no idea where the path was to get there – but it didn’t matter. All I needed was to know it was possible.”
Laura wrote Whitaker an e-mail listing the many drugs she had taken, and he agreed to meet. Whitaker said that she reminded him of many young people who had contacted him after reading the book. As he put it, “They’d been prescribed one drug, and then a second, and a third, and they are put on this other trajectory where their self-identity changes from being normal to abnormal—they are told that, basically, there is something wrong with their brain, and it isn’t temporary—and it changes their sense of resilience and the way they present themselves to others.”
Laura had always assumed that depression was caused by an enduring chemical imbalance – something she had never questioned. The more she read about this theory, however – she learned it had been heavily promoted by pharmaceutical companies and no longer had wide support among scientists today.
Over the following months, Laura began to question the story she had held onto for so many years, asking herself, “What if I stopped defining my emotional pain as ‘mental illness.’ What if I began to trust my inner compass, instead of looking to doctors as my only answer? What if I took back ownership of my mind and my body? Instead of suppressing my intense emotions, I began to sit with and feel the deep pain of being fully human?”
At her medical appointments, Laura started to raise the idea of tapering off her medications. She had used nineteen medications in fourteen years, and she wasn’t feeling better. “I never had a baseline sense of myself, of who I am, of what my capacities are,” she told the professional. Doctors at the clinic initially resisted her requests, but they did realize she needed a change.
The Taper
Following her pharmacologist’s advice, Laura first stopped Ativan, the benzodiazepine. A few weeks later, she went off Abilify, the antipsychotic. She began sweating so much that she could wear only black. If she turned her head quickly, she felt woozy. Her body ached, and occasionally she was overwhelmed by waves of nausea. Cystic acne broke out on her face and her neck. Her skin pulsed with a strange kind of energy. “I never felt quiet in my body,” she said. “It felt like there was a current of some kind under my skin, and I was trapped inside this encasing that was constantly buzzing.”
She later went off Effexor, the antidepressant. Her fear of people judging her became increasingly intense. She remembers going to the grocery store, and when the cashier said something, she was convinced that he was only pretending to be nice—that what he really wanted to say was “You are a repulsive, disgusting, pathetic human.” She was overstimulated by the colors of the cereal boxes in the store and by the grating sounds of people talking and moving. “I felt as if I couldn’t protect myself from all this life lived around me.”
She began to experience emotion that was out of context—it felt simultaneously all-consuming and artificial. “The emotions were occupying me and, on one level, I knew they were not me, but I felt possessed by them,” she said. Later, she found a community of people online who were struggling to withdraw from psychiatric medications, visited by thousands of people every week. She found others describing similarly heightened emotions – fear, anger, guilt, shame, regret – along with despair that one’s life has been futile.
For many people on the forum, it was impossible to put the experience into words. “The effects of these drugs come so close to your basic ‘poles of being’ that it’s really hard to describe them in any kind of reliable way,” one person wrote. Another wrote, “This withdrawal process has slowly been stripping me of everything I believed about myself and life. One by one, parts of ‘me’ have been falling away, leaving me completely empty of any sense of being someone.”
It took Laura five months to withdraw from five drugs, which she now considers in retrospect too quick of a process. (One of the keys in a successful taper that minimizes withdrawal effects is gradual, gentle decreases).
After living with various diagnoses with so many years as a “kind of career,” she also experienced fresh doubts about what she had been told by professionals all along – and confusion at what to do now. Previously, new symptoms of depression or hypomania had meant a predictable path she had trusted: remembering the details and telling her psychiatrist. Now she struggled to learn a new language and put her trust in new places – including her own intuition and “inner compass.” Laura looks back at her family’s support as crucial in this tapering process as well.
New Feelings
As part of the tapering process, Laura describes a kind of grieving process that happened – something common to many others – grieving the loss of many things missed during those fourteen years. The good news, though, is that many of those things slowly began to come back.
For instance, three months after Laura stopped all her medications, Laura was walking down the street in Boston and felt a flicker of sexual desire. “It was so uncomfortable and foreign to me that I didn’t know what to do with it,” she said. The sensation began to occur at random times of day, often in public and in the absence of an object of attraction. “It was as if that whole part of my body was coming online again, and I had no idea how to channel it.”
At the age of thirty-one, she started dating someone. “I felt like a newborn. I hadn’t ever figured out what my body was meant to be.” For years, Laura had been unable to have stable relationship – “On this very sensory, somatic level, I couldn’t bond with another human being.”
She always assumed this was a symptom of borderline personality disorder. “I honestly thought that, because I was mentally ill, the numbness was just part of me,” she said. She would look at beautiful romance in movies, “and it never crossed my mind that this was in the cards for me.”
Now she wondered how her medications could have influenced this all. Laura felt as if she were learning the contours of her adult self for the first time. For the first time, she started to practice feeling dread or despair – and not automatically interpreting it as a sign that her body was deficient and that the feeling would stay until she took a new pill.
It felt like a revelation, she said, to realize that “the objective in being alive isn’t the absence of pain.” She started to realize how reminiscent her mindset had been to a sad little bubble pictured in a popular advertisement for Zoloft. The bubble is moping around, crying and groaning, until it takes the medication and starts to bounce while birds sing. More and more, she began to realize her faith in the drugs’ potential had been misplaced. “I never felt helped by the drugs in the sense that I have meaning, I have purpose, I have relationships that matter to me,” she explained.
Previous professionals had been trying to help her – in the ways they knew. After years of this kind of medical support, people in Laura’s situation can reach a point where medication is the only form of help they are even willing to accept. But now, Laura was exploring other language to describe her emotions and moods, rather than automatically calling them symptoms. She remembers this as “unlearning” and “peeling off layers that have been imposed.”
She wrote several letters to former doctors requesting medical records, in hopes of better understanding how the doctor had made sense of her numbness and years of deterioration – with plans to ask, “I’m sitting in front of you and I’m off all these drugs, and I’ve never felt more vibrant and alive and capable, and yet we thought I had this serious mental illness for life. How do you make sense of that?”
The Work
Laura started writing and speaking about her experiences and began hearing from many people with similar stories – and looking for someone else to talk with for support. There is growing research attention to how to help people taper safely, including three reviews last year (Horowitz & Taylor, 2019; Mound, et al., 2019; Davies & Read, 2019) – all of which encourage more formalized guidance encouraging people to take the tapering process slower As of yet, this hasn’t translated into adequate support from the medical and treatment community to those who want to pursue this option. On the contrary, doctors will often “cut the dosage in half” and taper down in two or three weeks – far too quickly, and far more likely to trigger massive withdrawal effects (which are most often interpreted as a resurgence of the disorder – and further “proof” the person needs to stay on long-term treatment).
The absence of this kind of support is what makes peer-supported, community-based efforts like Laura’s so important. David Cope, a former engineer for the Navy, told me that Laura’s writings “helped keep me alive. I needed to know that someone else had gone through it and survived.” In the process of withdrawing from Paxil, Ativan, and Adderall, he felt detached from emotional reactions that had previously felt habitual. “The way I would explain it to my wife is, I know that I love her,” he told me. “I know that I care for her. I know that I would lay down my life for her. But I don’t feel love. There’s no emotional-physical response: the sense of comfort and tingly love when you smell your spouse’s hair—I don’t have that.”
Angela Peacock, a thirty-nine-year-old veteran of the war in Iraq, had been on medications for thirteen years, including the “P.T.S.D. cocktail,” as it has become known: the antidepressant Effexor, the antipsychotic Seroquel, and Prazosin, a drug used to alleviate nightmares. “I never processed the trauma of being a twenty-three-year-old at war, and how that changed my view of humanity,” she said.
In the absence of much professional support for those tapering off medications, this “layperson withdrawal community” has developed – a constellation of Web forums and Facebook groups where people tapering psychiatric medications get support. Along with connection and encouragement, these groups always advise slow tapers—they typically recommend that people reduce their doses by less than ten per cent each month.
One mother discovered Laura’s blog two years earlier and had e-mailed her right away. “I feel like I’m reading my daughter’s story,” she wrote. Her daughter Bianca had been on forty milligrams of Lexapro—double the recommended dose—for nearly nine years. She’d taken Abilify for six years. Now, after talking to Laura, Bianca’s father (also a doctor) had found a pharmacy that was able to compound decreasing quantities of her medication, dropping one milligram each month. She started to slowly decrease.
Like Laura, Bianca had always appreciated when her psychiatrists increased the dosage of her medications. She said, “It was like they were just matching my pain,” which she couldn’t otherwise express. About her first conversation with Laura, she said she started to feel understood: “I hadn’t felt hopeful in a very long time. Hopeful about what? I don’t know. Just hopeful, I think, because I felt that connection with someone.” She told Laura, “Knowing that you know there’s no words—that’s enough for me.”
In my own interviews with many individuals and families, I’ve noticed one striking pattern. Some of the same people who told me that starting medications made them “feel themselves again” and “brought them back to life” later tell me that tapering off medications did the same later on (after the medications were no longer so helpful) – helping them “feel themselves again” and start to “feel emotions they always wanted to feel.”
After consulting with people on the phone for nearly five years, Laura worked with Rob Wipond and a physician’s assistant named Nicole Lamberson to create an online guide for people who wanted to taper off their pills. There were few precedents. In the late nineties, Heather Ashton, a British psychopharmacologist, had drafted a set of guidelines known as the Ashton Manual, which has circulated widely among patients and includes individual tapering schedules for various benzodiazepines, along with a glossary of disorienting symptoms. “People who have had bad experiences have usually been withdrawn too quickly (often by doctors) and without any explanation of the symptoms,” she writes.
With the help of a grant from a small foundation, Laura launched in 2018 a new website called the Withdrawal Project – part of a nonprofit organization, Inner Compass Initiative, devoted to helping people make more informed choices about psychiatric treatment.
It can be risky to start or stop psychiatric drugs. And this website aims to help people navigate those decisions. As Laura explains it, “For those who decide withdrawal is right for them, we provide information on how to do so as safely as possible – and get support from doctors and family along the way.” The Web site helps people withdrawing from medications find others in the same city; it also offers information on computing the percentage of the dosage to drop, converting a pill into a liquid mixture by using a mortar and pestle, or using a special syringe to measure dosage reductions.
While others have made similar efforts to help the public navigate the complexities of psychiatric treatment (see Critical Think Rx), the Withdrawal Project is distinct in helping laying out hands-on, practical options for people considering tapering in a safe, mindful way.
That doesn’t mean everyone should consider this – at least not immediately, and not without sufficient support. But particularly if people are not feeling emotionally well on a course of psychiatric treatment, neither should this be an option minimized or overlooked. Said more directly, individuals and families should be more aware of this as a viable option, if the current treatment pathway has not led to deeper healing, peace and happiness.
In my own research, I’ve been struck at how much resistance there is to the possibility of tapering – starting with individuals themselves. As one woman I interviewed told me, “I’d really like to be off the meds, but the person off the meds is scary” – joking about being “locked up in the attic somewhere” if she didn’t have her medication.
So convinced have some people become that no emotional stability exists without medication that the possibility of tapering off is not even seriously considered. Part of that fear, of course, comes from the real turbulence that can arise when people experiment with tapering. As the New York Times reported in 2018, many people have found it surprisingly difficult to come off antidepressants – which can thus persuade them to stay on indefinitely.
Especially if that turbulence is interpreted as a “return of depression” rather than the expected withdrawal effects that everyone experiences when paring back a drug on which their brain has become reliant. All of this underscores the need for proper support, and a gentle, patient timeframe for tapering: precisely what the Withdrawal Project has helped tens of thousands around the world learn.
While it would be ideal to have professional medical supervision, many doctors remain resistant and even hostile to supporting such a course. Swapnil Gupta, an assistant professor at the Yale School of Medicine, said she is troubled that doctors have largely left this dilemma to patients to resolve. She and her colleagues have embarked on what she describes as an informal “de-prescribing” initiative. They routinely encounter patients who, like Laura, are on unnecessary combinations of psychiatric medications, for different reasons. Yet, when Gupta, who works at an outpatient clinic, raises the idea of tapering off patients’ medications, she said, some of them “worry they will lose their disability payments, because being on lots of meds has become a badge of illness. It is a loss of identity, a different way of living. Suddenly, everything that you are doing is yours—and not necessarily your medication.”
Gupta, too, is trying to recalibrate the way she understands her patients’ emotional lives. “We tend to see patients as fixed in time—we don’t see them as people who have ups and downs like we all do—and it can be really disconcerting when suddenly they are saying, ‘See, I’m crying. Put me back on my meds.’” She said, “I have to sit them down and say, ‘It’s O.K. to cry—normal people cry.’ Just today, someone asked me, ‘Do you cry?’ And I said, ‘Yes, I do.’”
A Bright Future
10 years to the day after Laura’s suicide attempt, Laura spent the Thanksgiving holiday with her family and a new boyfriend, Cooper Davis, and his four-year-old son. Cooper chose that same time to propose to Laura.
Cooper had been given Adderall for attention-deficit hyperactivity disorder at seventeen and had become addicted. As an adolescent, he said, he was made to believe “I am not set up for this world. I need tweaking, I need adjusting.”
Today, Laura is pregnant with their first child – and Laura is finishing her memoirs, which will be published next year.
If you look through several albums of childhood photographs, you will see Laura looking radically different from one year to the next.
Having spent hours with Laura over the last year personally, I will say that Laura has a remarkable luminosity, a grace, and a gift for teaching and articulating that I rarely find. Seeing her and Cooper together with their six-year-old in tow, while anticipating their baby is a joy. And what good they are doing in the world!
Marriage and a baby, of course, is not the end of her story. She agrees. “It’s not, like, ‘Laura has finally arrived,’ ” she said. “If anything, these trappings of whatever you want to call it—life?—have made things scarier.” She still felt overwhelmed by the tasks of daily life, like too many e-mails accumulating, and she often still gets extra emotional.
Although not now seeing a therapist—she felt exhausted from years of analyzing her most private thoughts—Laura continues a process of growth and development personally. While challenges still come, they are more workable.
Things are different – and more hopeful. As Bianca put it, the woman Laura was mentoring, “It’s like your darkness is still there, but it’s almost like it’s next to you as opposed to your totality of being.”
Laura agreed that she was experiencing “the stuff of being alive that I just had no idea was possible for me.” But, she said, “it’s not like I’m good to go. Literally every day, I am still wondering how to be an adult in this world.”
“If I could go back to that 13-year old girl looking in the mirror,” Laura says, “I’d tell her – “you’re not broken.” Rather than seeing emotional pain as entirely arising from “faulty brain chemistry,” she would reassure that girl, “It’s telling you something important about your relationship to yourself and to the world around you – and you need to listen. I’d tell her – your urge to die, is really an urge to live – just in an entirely different way than you know. I’d tell her – never stop trusting your inner compass.”
Credit to Rachel Aviv from her powerful piece in the New Yorker, The Challenge of Going Off Psychiatric Drugs (April 1, 2019), from which much of the foregoing has been adapted – as well as Ryan Wood and the Live Different project for the lovely video which I also drew upon. If you’d like to learn more about how to get involved personally – or find support for someone you love – email me (jzhess@gmail.com) and consider joining us for the Zoom call later this fall.
Laura’s story is my story, too.
I tapered myself, probably too quickly, but God kept his promise to help me as I promised to take the first leap of faith against everything friends/family/medical community said to me. All were ignorant, but not as ignorant as I was to accept going on medication the first time.
It’s time for the Saints to get off of their psychiatric medications.
It’s time to feel sad again; it’s time to feel happy again; it’s time to just feel again.
Never take medical advice from someone not licensed to practice, it’s beyond dangerous, especially with medications. Get a second opinion or a third but not from anyone who isn’t licensed
I’d love to hear more of your story, anon_somedaynot. Can you email me?
Robert, it can be difficult to find doctors with an awareness of these issues, unfortunately. So many people have needed to trust their intuition and other non-medical sources – including others, like Laura, who have had this experience. Ideally, yes – it is best to have medical support and supervision. But that’s not always possible. And in some cases, if you confine yourself to only what the doctors tell you, it’s unlikely many people will EVER be advised to go off (and not because that’s what is in their own best interest, according to the research literature). That’s just the reality.
I find the casualness with which medical professionals proscribe these kind of drugs appalling. I experienced this first hand when I was in the hospital after having a subsequent child. The OB that made the rounds was taking over from my vacationing OB. She I somehow mentioned that I had a really hard time feeling normal after having my first baby because of a lack of sleep. She started to write me a prescription for an anti-depressant after speaking with me for a minute or two. I declined and instead opted for getting help from family while I got some good sleep when I got home.
Pills don’t always fix everything. I think it is prudent to look for non-drug approaches as well and be more careful with taking drugs.
Licensing across professions does not carry identical weight.
It’s a huge shame that our culture has been convinced that psychiatry (as it’s currently practiced) is as authoritative in its own field as something like engineering – it just isn’t so, and I don’t believe it can be.
An engineer has licensing based on expertise rooted in principles based on physical law (deterministic). Psychiatrists do *not* have predictable physical and natural laws behind their diagnoses. They have probability-based (stochastic) ones at best, backed with some deterministic ones only at the molecular or biological level (maybe), but nothing at the level of a conscious, decision-making human being.
When something goes wrong mechanically or electrically, the problem can be known and usually a solution is straight forward: it’s predictable and repeatable. This is totally different than the stuff that goes on in psychiatry and other social-related sciences.
I think psychiatrists do the best they can with the tools they have, but I would never trust a licensed psychiatrist at the same level as an engineer, no matter how many years of experience or school they have. This difference is absolutely fundamental and I don’t believe it can ever be reconciled – they do not have the predictable tools to correctly solve a problem that is itself not predictable either, especially with human agency in the mix.
I’ve had a similar experience with psychiatric medications, and finally got tired of the cascading side effects and told my psychiatrist this past March that I had had enough of the medication. I don’t hold anything against them – I know my psychiatrist and primary care physician were trying their best to help me based on what they knew. I’ve been off meds for five months now, still struggling to find myself, but learning to live with the anxiety, pain, and discomfort of life, while also learning to find the laughs, smiles, and love that it also brings.
Not all psychiatrists prescribe medication, don’t lump them all together. I just don’t buy into the nonsense of you can out think your physical problems. Jacob wears glasses, why? Because he has to, a Dr told him that is the best solution. It does not have anything to do with faith or positive thinking . He needs glasses regardless. That’s life and that’s fine. Some people are bipolar and need medication otherwise the results can be deadly, it’s just how it is.
When I was pregnant with one of my children, a medical professional consistently tried to get me to drink tea, which this professional touted as having many positive benefits. However, I was unwilling to agree to follow this advice, as it would conflict with the Word of Wisdom.
On the other hand, I remember the hellish week I endured when several individuals in my family went off their respective meds, unbeknownst to me. There was a reason each of those individuals was being medicated. There was no noble plan to wean folks off medications that might be inhibiting their ability to experience life – rather, those who needed medications had neglected to refill their prescriptions or ask for help from adults who could have helped. Mass chaos.
On a vaguely similar vein, there are certain birth control medications that have the side effect of diminishing pleasure and desire related to intimacy. One approach to this would be to suggest that everyone cease taking birth control medication (after all, isn’t the primary purpose of companionate intimacy supposed to be desire and pleasure?)) But substantially increasing the probability of intimacy becoming procreative might not be what the individual wants.
Let each person own their person. If medication is warranted, great. If professionals demand medication be taken but the person finds this inappropriate, then they should own the consequences of disagreeing with professionals (such as finding a professional who is willing to help without the medication that is causing conflict with other professionals).
@Whizzbang
I am very glad you brought up an example with eye glasses – that is a very good case were the medical community can diagnose something based purely on deterministic physical laws (i.e. optics). And people are so much the better for it.
The same can never be said for something like bipolar disorder, which is frequently (usually?) misdiagnosed (e.g. instead of PTSD or childhood trauma). And the reason for this is because they are missing exactly what eye doctors have: predictable physical laws without human agency in the mix.
@Whizzbang
You reflect the intrinsic trust people tend to have in licensed medical professionals – unfortunately in my family we have found that there are some medical professionals who are drastically unworthy of that trust.
Actually, Meg most couples would be much better off without hormonal contraceptives. I’ve not used any for 14 of the 17 years I’ve been married. My kids are all appropriately spaced and I only have 5. Most of my friends don’t use birth control pills either. I think far more go without than you realize.
Jacob,
Once again, very well done. Thank you for sharing.
Two statements jumped out at me.
The first was from Laura Delano when she stated what a revelation it was when she understood that “the objective in being alive isn’t the absence of pain.”
We spend most of our lives and resources trying to avoid pain, don’t we? C.S. Lewis wrote a whole book on “The Problem of Pain”. Elder Holland spoke just yesterday on how life cannot be – should not be – without some pain and suffering.
I think the key is to not unnecessarily seek it out, or to master it and learn from it, or to manage it.
When Teddy Roosevelt said that “Comparison is the Thief of Joy”, he identified a source of pain that can be avoided.
The second statement that stood out to me was from Dr. Gupta’s revelation that many patients don’t want to drop their medications for fear of losing their disability payments. How sad it is that we have systems in place that incentivize pain and addiction.
biasedstatistician (love the name!),
I found your comments about licensing and the lack of deterministic science in the field of psychiatry to be dead on.
I once had a learned colleague, a well-known applied Statistician, who shared with me what various disciplines considered “significant” correlation in studying cause and effect relationships. This was many years ago, but by my recollection he stated that Mechanical Engineers would rarely accept anything below a 90% correlation, while Chemical Engineers would usually settle for 80%. Sociologists hoped for anything approaching 50%, and Psychiatry was lucky to find anything in the 30% range. While the numbers are general, I think it supports the principle you were explaining.
Cheers.