The Fragile Path of Going Off Psychiatric Drugs
Thousands of people who have been diagnosed with bipolar disorder, depression, social anxiety and other mental health conditions have been able to function better in daily life with the help of prescription drugs.
But the story of a young woman from a socially elite family, who went to Harvard and seemed to have a promising future is an eye-opening perspective on long-term use of multiple psychiatric medications.
Mental health issues began surfacing for Laura Delano at a debutante ball, where she felt like she was acting out a life onstage, not really living a life she felt was hers. Before the ball, she used cocaine and drank champagne, eventually ended up sobbing and being sent home. It was a moment of awakening that motivated Delano to start treatment and find her “real self.”
That awakening, however, led Delano through 14 years of treatment for varying and shifting diagnoses, including bipolar II disorder, which is marked by phases of mania and depression. She was also diagnosed with social anxiety, depression, and borderline personality disorder, which may be expressed as poor self-image, varying moods, impulsive behavior and problems with relationships.
During those 14 years, beginning in her late teens, Delano took 19 prescribed medications. Sometimes she was prescribed an antidepressant, then if she became drowsy, she was given a medication to keep her awake, then another to help her sleep.
The Decision to Taper Off Medications
In an in-depth article in The New Yorker, writer Rachel Aviv documents Delano’s years of psychiatric treatment and a “cascade of prescriptions” that eventually led the young woman to a slow and careful tapering off a multiple medications.
Delano had extensive emotional and financial support from her family, including treatment at McLean Hospital in Belmont, Massachusetts, one of the oldest and most respected mental health facilities in the nation. McLean has a history of treating celebrity patients, including Sylvia Plath, James Taylor and Anne Sexton.
While Delano respected and liked many of the psychiatrists who treated her along the way, and felt that they were prescribing drugs that would help her find a balance and a feeling of living an authentic life, the results of her medications over time let to physical and mental distress and confusion.
At attempted suicide during a family gathering put Delano on the brink of death, and into a medically-induced coma. Delano said she felt like she had put her family through “enough” so had tried to take her own life. She was taken back to McLean Hospital, seven years after her first treatment at that facility.
The Slide into Permanent ‘Illness’
When she was diagnosed with borderline personality disorder, Delano moved in with her aunt in Boston and began a day treatment program for that disorder. During that time, she happened to notice information about the book, Anatomy of an Epidemic, by Robert Whitaker.
“The drugs increase the likelihood that a person will become chronically ill, and induce new and more severe psychiatric symptoms in a significant percentage of patients.” Whitaker wrote about his research into the increasing use of prescription medications for mental health disorders.
In a review of Anatomy of an Epidemic in Scientific American, science journalist John Horgan writes, “Whitaker acknowledges that antidepressants and other psychiatric medications often provide short-term relief, which explains why so many physicians and patients believe so fervently in the drugs' benefits. But over time, Whitaker argues, drugs make many patients sicker than they would have been if they had never been medicated.”
Tapering Off Psychiatric Drugs
Laura Delano realized she didn’t know her “baseline self,” the person she was before all the medication. She wanted to know and feel that person. She began to talk with her pharmacologist about the idea of coming off drugs. Following her pharmacologist’s advice, Delano stopped one drug at a time, experiencing physical symptoms such as sweats and a constant feeling of “buzzing” in her body, as well as emotional symptoms, including fear and mistrust of others.
But as she was weaned off the drugs, Delano learned not to plan to go back on medications at the first sign of “dread or despair.” She accepted that life has ups and downs and she wanted to understand those tides of emotion, instead of covering them up with multiple medications.
Delano also found strength in support groups for people tapering off psychiatric medications. Her life stabilized and she became engaged to a man who works at an agency that supports people with psychiatric and addiction histories. Her fiance had himself been prescribed Adderall for attention deficit hyperactivity disorder, or ADHD, as a young teen and had become addicted.
Even though Delano has times when she admits she feels overwhelmed by the tasks of daily life, she has a perspective that allows her to recognize that and manage it.
Her view of life now, without drugs is: “Being alive isn’t the absence of pain.”
Bipolar II and the Challenge of Going Off Psychiatric Drugs, The New Yorker, April 8, 2019
Whitaker, Robert, “Anatomy of An Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America,” Ethical Human Psychology and Psychiatry, Spring 2005
Horgan, John, “Are Psychiatric Medications Making Us Sicker,” Scientific American, March 5, 2012