What the Mental Health Industry Doesn’t Tell You: Laura Delano

This system I had been turning to for help through all of these years that I had been assuming existed to take care of me, was actually a system of control. And I just hadn't seen it for what it was because I had never said no to it before. For 14 years, Laura Delano was a professional mental health patient, as she puts it, after being diagnosed with bipolar disorder when she was a teenager. Now, she believes the dominant, medicalized approach to mental illness is actually making us sicker as a society. 65 million American adults and 6 million American children are currently on psychiatric drugs. And there are zero off-ramps for getting them off these drugs safely within the mental health industry. Zero. She is the author of Unshrunk, a story of psychiatric treatment resistance. This is not about being pro or anti. This is about using straightforward, honest language to talk about what these drugs are and how they actually affect us, and then to let people make their own decisions from there based on their own life circumstances. This is American Thought Leaders, and I'm Jan Jekielek. Laura Delano, such a pleasure to have you on American Thought Leaders. Thanks for having me on. It's great to be here. What is it that we get wrong about the mental health system in America? I think at the heart of the problem is the fact that we've given a monopoly to this medicalized way of understanding ourselves, to this idea of having mental illness or of being mentally healthy. This whole framework, this medicalized framework, has taken on a monolithic status in our culture, such that all the other ways that we might make sense of the struggles that come with being human get pushed to the side. And when you're viewing your struggles through this medicalized lens, you have one logical next step to take, which is to get treatment, which is often pharmaceutical treatment. To me, it's about how much power and dominance and ubiquity the mental health industry has over our culture. That's really the heart of the problem. Just qualify for me, what does mental health industry mean exactly? That's kind of a whole compound of different groups? Yes, you could call it a mental health industrial complex if you wanted. I think for me, the word industry is an important one to use as opposed to system, I think, because it shines a light on the fact that this is about very powerful corporations between drug companies, the hospital industry, managed care, medical devices, the list goes on and on. I think naming that this is in large part about corporations who are selling products and services, I think, is why to me industry is the right word here. It's all built on this idea of mental illness and mental health. There seems to be a trend, especially online, people like to identify things that sometimes you might even consider personality traits or quirks or something like that as a particular disorder. For example, people self-diagnosing as ADHD and things like that. Is there a connection here? I think you hit the nail on the head. We've normalized pathologizing ourselves to such a degree that it's become just part of the cultural milieu. In the air that we all breathe, this idea of noticing a problem in oneself, some kind of discomfort, some kind of challenge, and instantly concluding, uh-oh, what if this is a symptom of a condition? I think because, in part, we have direct-to-consumer advertising where we are constantly being bombarded with this message that, you know, if you're having a hard time, maybe you could try XYZ treatment. In part, it's that. And I think in part, too, it's that because we have this monolithic mental health industry, it's kind of created this taken-for-granted assumption that struggles in life are problems to be diagnosed and treated. We've normalized it so much that we don't even realize it's actually a story, one story, of self. There are countless others as well. Two things. You're just reminding me. I remember someone recently was telling me about a situation where, in Kentucky, people were suing doctors for not prescribing them the pain medication which they wanted. Because these are consumer products that are being marketed and sold to people, they come in to their doctor's office knowing what they want. And so doctors are put in this difficult position where, if they are actually critical of the drugs they're prescribing, what do they do when their patient comes in wanting them? Because if it's not going to be them, it'll be someone else. So shouldn't it at least be them? Because they can at least help educate the patient about risks, about the lack of long-term outcomes, the negligible evidence base for long-term efficacy. So these critically-minded doctors, ironically, who don't want to be prescribing these drugs, often end up prescribing them because they know if they're not going to do it, another doctor who probably isn't critically-minded will. And so it is a real problem. It's only the US and New Zealand that actually allow for advertising of drugs on television. I haven't watched a lot of television in my life. I wasn't fully aware of it. In recent years, I've discovered just how much of it there is, and these very long ads that also list all these terrible side effects. I thought to myself, is it possible that people actually respond to these ads? Because the side effects don't sound so good. I think we've been so desensitized to that soporific voice listing the side effects at the end that people don't even hear it. They just glaze over. And what they absorb is the image of the depressed, gloomy woman who's now suddenly running on a beach, smiling. I think people are so desperate for relief. I think we live in a time where there's so much struggle. People are overwhelmed by anxiety, by despair, by a sense of meaninglessness, futility to change circumstances, that people want this quick-fix promise that is provided to them in these advertisements. And I do think people see these ads and believe what they're telling them because they are just desperate for change. And I was once the same way. I was so desperate for relief from this intense suffering that I'd spent so many years in that I was ready to believe anything I was told, especially by a doctor, because I was tired of trying to find the answer for myself. And of course, the book is your journey, indeed, with anecdotes and actually a lot of data and information on various illnesses and treatments. I mean, a fascinating structure, fascinating story. But just kind of give me a thumbnail of it very briefly. You've spent 14 years, I believe, in this mental health industry system. It's basically the story of my 14-year relationship to the diagnoses, the drugs, the mental health professionals, the hospitals, and then how I decided to end that relationship and what that looked like and why I ended it. At age 13 was my entry into a therapist's office. You know, I was an angry, intense, despairing, self-injuring teenage girl, and my terrified parents didn't know what else to do and I think felt immobilized themselves and not empowered to help me. So they did what so many loving American parents are taught to do. If your kid is struggling, you need to seek professional help. So that began my journey. A year later, I was sent to my first psychiatrist. I received a diagnosis within my first appointment with that psychiatrist. My whole life was basically reduced to, you know, what I was told was an incurable mental illness called bipolar disorder. And I was put right on meds and then spent a few years refusing to accept this diagnosis. Something in me knew that the struggles that I was experiencing were actually healthy responses to the environment that I was in, to the pressures I felt on my shoulders at school, sports. I was this very driven, perfectionist, perfectionistic kid. I knew that was the problem, not anything inside of my brain. But when you're a kid, you don't have power. You don't yet have a solid sense of self. So I eventually kind of lost touch with that knowing, and then spent the final 10 years in the mental health industry as a very compliant, obedient, deferential psychiatric patient. There's one chapter in your book which is kind of pivotal. For the first time, you decide not to comply, and you're faced with the fact that it's really not your choice. And that changes things. Just kind of tell me a little bit about that. Sure. I loved writing that chapter. So prior to this moment you're pointing out, I had been this compliant patient just so desperate for relief that I basically turned my entire life over to my doctors and eventually my seven-person treatment team and just said, just, you guys are the experts on me. Just tell me what to do. What meds to take? What therapy do I need to be in? What program do I need to sign up for? Because I just want to feel normal. I just want to feel like I belong here. And with every passing week, month, year of being this compliant patient, my life kept falling more and more apart. I kept getting physically sicker, chronic health issues, mentally and emotionally. I kept, you know, spinning out. My ability to care for myself just completely dissipated and I was completely dependent on my family. But I kept, every step of the way, turning my life over to these doctors. And so by 2010, at the age of 27, I had basically become a professional mental patient, as I like to put it. And it's a provocative phrase and I use it deliberately because I was the embodiment of this just crazy, unhinged, completely non-functioning, barely there human. And I was in a program, February 2010, I was 27, in a program going to the hospital every day from 9 to 5 for groups and therapy and all that. And a psychiatrist caught wind of the fact that I was maybe becoming suicidal, which I was, but I wasn't actually in that moment going to kill myself. And he said, you know, why don't you just check yourself in and just get taken care of? Go to the short-term unit. You'll feel more rooted. So I said, yeah, that's a great idea. I'm just going to go home and get my belongings. I'll come back later this afternoon. And he wouldn't let me leave to do that. Things escalated. I began raising my voice. He called security. And that was the moment that I realized that this system I had been turning to for help through all of these years, the most formative years of my life, that I'd been assuming existed to take care of me, to help me feel okay in my skin, was actually a system of control. And I just hadn't seen it for what it was because I had never said no to it before. And that changed everything for me. And it dislodged this faith that I had had through all those years and my doctors and the pills and the hospitals, just this unquestioning faith that these people were going to eventually help me feel okay. And suddenly in an instant, it all just blew up. And I suddenly was like, what have I been participating in? How did I not see this? When people are suicidal, the protocol is to prevent them from going through it. And they lose some of their ability to exercise their agency for their own good. That's how I understand it, right? And you had been suicidal before in earlier chapters. In those cases, you agreed to what was suggested to you as opposed to resisting. Doesn't it make sense that this doctor would do that? It's such a good question. And all these years later, when I look back, I completely understand his logic. He had no choice but to incarcerate me against my will because he was legally and ethically mandated to basically keep his patient alive. And so I think in many ways, we've put this profound responsibility on the shoulders of psychiatrists and other mental health professionals to prevent death and to see into the future. Because of course, part of what happens is that if a doctor senses that you are or might in the future become suicidal, they also feel obligated and are obligated to put your safety over anything else. And so we've given them this tremendous responsibility. And I don't think it's a fair one. I have to imagine that a lot of psychiatrists and the other psychologists who also have this power, if they didn't feel this terrifying liability issue looming over their shoulders, they might actually be willing to hang in there a bit longer with their patients, to ask more questions, to be curious, to be open to talking about suicide. But they don't have that opportunity. The way the whole mental health industry is set up and the legal power that we've given to doctors makes it impossible for them. And I think having now spent 15 years on the other side, outside of the mental health industry, having spent, I couldn't begin to count the number of hours with suicidal people, I have found that when someone is in that state, often what they need most is to be heard. They need to be able to talk about all the things that are making it such that they don't want to be alive anymore. They need to be able to talk about death and why it's calling to them. And it's when we shut down that space and we basically instantly kind of say, oh, panic mode, like incarcerate person, medicate person, I think ironically, it ends up making a lot of people more suicidal because they feel even more alone with their struggles. You said you're not a mental health professional, but in that role of Cleaning Up Saints, aren't you kind of taking on the role of being a mental health professional? It's an interesting question. And I think it actually gets to this monolithic power that the mental health industry has in our culture that we assume that helping someone in suicidal despair is acting like a mental health professional, that it's almost like we don't even know it's possible to do that, to be that role in someone's life as just a fellow human, as a fellow citizen, as a fellow lay person. And I think, obviously when I'm with friends or colleagues or people I'm working with who are feeling suicidal, they obviously know I'm not a mental health professional because I make clear that I'm not one, make clear that I'm a lay person and that it's my own personal experience with all of this that has led me to be in this place where I'm wanting to support other people. So I think, I know for a fact that a lot of people think that's dangerous and that for whatever reason, a non-professional sitting with someone who's in suicidal despair is gonna make it more likely that that person kills themselves. I would just say, I profoundly disagree. And having been a suicidal person through many, many years of my life, that's the one thing I never actually got. I never actually had anyone sitting with me and truly ready and kind of like brave enough to hear me talk about all the reasons why I didn't wanna be alive. I just never had that chance. I think it might've led me down a very different path because human beings have been helping each other through suicidal despair since probably the dawn of time. And yet in this final kind of, these final seconds of our evolution as a species, we now have kind of lost touch with the fact that you can be in so many different roles. You can be a family member, you can be a friend, you can be a pastor, you can be a rabbi, you can be a community leader and be with someone in suicidal despair. We have that power. We have that ability, everyone does, but we've just lost touch with it because of this kind of professionalized understanding so many of us have of what help means. How did you ultimately make this decision to, I guess, leave the system and all its manifestations? So after that forced hospitalization, I had two more encounters with this power that mental health professionals have to force and coerce. One was being made to take a medication that I didn't wanna take. And the other was having the police called on me when I was so tranquilized by that medication that I slept through a therapy appointment. So those three encounters with psychiatric power, really, just so blew up this faithful relationship that I'd had through all those years that I was in this kind of adrift space where I didn't know what to trust anymore, what was true, what wasn't, who to rely on, least of all myself, because I had gotten myself largely into this situation. And then in that state of questioning and rethinking, I happened upon a book that had this compelling cover with a phrenology head, a phrenology illustration on the cover, one of those old drawings where the human skull is kind of broken up into different compartments. And instead of the kind of now debunked, you know, oh, this region is for this personality type or that trait and this one's for that, it was each compartment had a different psychiatric drug name in it. And I was looking at this cover and it's like, I've been on that drug, I've been on that drug, I've been on that drug. Oh, I've been on almost all of these drugs. I wonder what this book is about. I'm gonna buy it. And I sat down to read it without even knowing what it was about. And the fact that I could even read it, I think was a miracle because I was on five medications at this point. I was on lithium, Lamictal, Abilify, Effexor and Ativan. So two mood stabilizers and antipsychotic and antidepressant and a benzodiazepine. And this is like a standard regimen for someone with a bipolar diagnosis. So reading anything, thinking, absorbing information was very hard, but I somehow took in the words. And the name of the book was Anatomy of an Epidemic by Robert Whitaker. And he set out to answer this curious question that he'd realized he had, which was why do long-term studies of people diagnosed with schizophrenia, why are the outcomes better in countries that don't have ubiquitous pharmaceutical treatments? Why are the outcomes worse in the US and other kind of developed countries that have access to all these amazing medications? This is such an interesting question. Why? So he went on this quest to figure out an answer and basically in a nutshell, realized that the story we've been told or sold about the safety and effectiveness of psychiatric drugs when used over the long-term is completely lacking in a strong evidence base. And that if you actually look at outcomes, there's a strong case to make that psychiatric drug use over the long-term is making us sicker, more disabled. There I was on five medications. My job through my 20s had been treatment, literally year after year after year of just progressively worsening dysfunction. Eventually to the point where I was declared so sick as to be treatment resistant because none of these drugs were helping me. I just kept getting worse. It's so tragic. Poor Laura's bipolar disorder is so severe. And I, after reading this idea, it just, and looking back on my life, I thought to myself, what if it hasn't been treatment resistant mental illness this whole time? What if it's been the treatment? In an instant, my faith in these drugs that I just never once had stepped back to question ever, literally from freshman year of college onwards, I had questioned them at the very beginning, but I'd forgotten that I wasn't even in touch with those instincts at that point. It blew up my faith in this kind of quick fix, the quick fix promises of the psychiatric drug paradigm. And now suddenly, what if there's another path for me? What if there's another way? What if it's not one of these two options? And I felt curious for the first time about my future, which I had had no opportunity to feel because I had believed for so many years in this life sentence of chemical imbalance in my brain. Oh, you can manage it with meds, but it's incurable. I mean, that's a hopeless story of self. And so that kind of began this journey I've been on ever since. And I knew in that moment I have to give myself a chance at figuring out who I might be beyond these drugs and beyond the diagnoses as well. Is bipolar in fact incurable? Well, it's a hard question to answer because you have to kind of sink to the deeper question, which is what is bipolar disorder in the first place? And what does it mean to cure a mental illness? And through my entire career as a patient, I took for granted that the DSM, the Diagnostic and Statistical Manual of Mental Disorders, which is copyrighted by the American Psychiatric Association and it's considered the Bible of psychiatry. It's where all the diagnoses live. I had just assumed that it was this scientific text. There must have been extensive, rigorous research behind the scenes over the APA, going into understanding, oh, schizophrenia and what it is and bipolar and major depression and social anxiety disorder. I just took for granted that these were discrete illnesses of the brain without ever once asking myself or any doctor, how do you know that? I just assumed, I just never questioned. And I learned that the DSM is really, all it really is, is this book that has been written and edited by a relatively small number of psychiatrists who kind of discuss in a very subjective way what they observe in their patients. And then they basically vote in and out which diagnoses they think should be in it or not. So for example, homosexuality was a mental illness until it was voted out in the third DSM. And so when I stepped back and thought about what this actually means for me, I realized I have been assuming that there's pathology inside of me without everyone's asking for proof. Sometimes I get accused of denying the reality of mental illness and I find that fascinating because so much of what I write about and speak about is about how hard it is to be alive and how intense and profound it is to struggle and how real it is. When you lose touch with reality and you are spinning out and you don't know up from down and you don't know what's true and what isn't, I mean, it's debilitating. Of course, it's real. These experiences are real. People hallucinate. People have delusions. People want to kill themselves. People have panic attacks. These are all real things. But this idea of them being symptoms of a brain disease, that's kind of the level that I'm critiquing here. And I think when you disentangle yourself from that very subjective level that so many of us take for granted as objective, then it opens up all this possibility for change. I've met the criteria for bipolar disorder for years. I was not misdiagnosed. I don't anymore. I would definitely meet the criteria for other DSM diagnoses like social anxiety disorder, for example, but I don't really care because it doesn't mean anything to me. A lot of the change for me in curing my bipolar disorder was about changing the way I was making sense of my experiences, what my experiences meant, and therefore what I needed to do about it. What did it mean to leave the mental health system? I mean, some of that is coming off of these five drugs that you were on. And I understand that is a very difficult process to do. People that have gone cold turkey have got all sorts of terrible side effects sometimes, or other people would say their illnesses are relapsing when that happens. I mean, how did you manage that without knowing the things you know now? I'm so glad you're bringing this up because the issue of coming off psychiatric drugs is a hugely important one. And as you said, it is an incredibly dangerous, risky thing to do. Another thing I'm often accused of is being dangerous, you know, that I'm dangerous because I talk about coming off these drugs. I talk about coming off of these drugs because I want to help people do it as safely as possible because it is so dangerous. I completely agree. And so I think what I didn't know in 2010 when I decided to come off those drugs was the fact that my central nervous system had become completely dependent in a physiological sense not in the addiction sense where I had cravings and would kind of seek out the drug despite it causing harm. That's kind of the conventional definition of addiction. This was purely physiological. My brain had completely re-acclimated itself, structure, how it functioned, as had my body because of these drugs that had been in my system for so many years. And so coming off of them, it doesn't just flip a switch and then your body goes back to how it was prior to you ever taking them. Coming off of them too quickly actually ironically disrupts the homeostasis that your body has developed to compensate for the presence of these drugs. So someone quitting any psychoactive drug, cold turkey, that they're dependent on will go through symptoms of withdrawal. What's challenging in the case of psychiatric drugs is that withdrawal symptoms mimic the symptoms of the very diagnoses, the reasons why they're taking these drugs in the first place. And so as you said, withdrawal symptoms often look like a relapse of an illness. And let's say you've been on an antidepressant for 15 years. For whatever reason, you've decided that you don't want to take it anymore. You come off, you feel horrible. Your anxiety is surging. You're not sleeping well. You're feeling exhausted and fatigued and unmotivated. And just your thoughts are racing about despairing things. And go to your doctor and you say this, your doctor will say, see, you're having a relapse of your illness. This is why you need to be on medication. You don't want to feel this way indefinitely, do you? And so people get stuck in this vicious cycle of thinking that who they are when they stop their meds is who they would always be. Therefore, they need to stay on them. So I didn't know any of this when I came off. I came off basically cold turkey. I came off five drugs in about half a year, which is very fast. And I went through an unspeakable pain. You know, just the struggles that I had on the drugs were just magnified, amplified, projectile vomiting, boils breaking out of my skin, debilitating migraines, light sensitivity, you know, panic responses at any kind of stimulus, paranoid racing thoughts, just utter fatigue. And then insomnia at night. I mean, just I could go on and on and on about how brutal withdrawal was. It was only as I started to recover from that, which took a lot of time, it began to click just how unsafely I'd come off them. And what also clicked for me was that I was able to survive cold turkey withdrawal in large part because I had a lot of resources at my disposal. I had a family who could take care of me. I didn't have to work. I didn't have kids. I didn't have to pay a mortgage. And so that was when I realized some people feel really helped by these medications. I totally respect that. But some people don't. And they should have the right to know how to come off of these drugs safely. And right now, it's almost unbelievable. 65 million American adults and 6 million American children are currently on psychiatric drugs. And there are zero off ramps for getting them off these drugs safely within the mental health industry. Zero. And when you say zero, I mean, I actually had a psychiatrist on recently that actually specializes in doing this. So it's not zero. Good point. So there are individual practitioners and what might be perceived as fringe resources cropping up around tapering. But the system itself, the official, whether it's the National Institute of Mental Health or the American Psychiatric Association or the American Academy of Child and Adolescent Psychiatry, none of the official bodies that are looked to for guidance, look to for guidelines, for protocols, for establishing standard of care. There's zero acknowledgment there. And there are zero off ramps there. And so it's forced those of us lay people who've had to figure out safe tapering for ourselves and then doctors like Josef Witt-Doring and the small handful of others who are kind of seeing this need and building resources for people at the outskirts. This is why we do what we do. I would love to not have to spend all day every day talking about safer psychiatric drug tapering because it's just so ubiquitous. The information is everywhere. Doctors inform you of this before starting a medication. The American Psychiatric Association acknowledges this. There are safe protocols on its website. The NIMH has a whole research arm focused on studying withdrawal and tapering. I would love for that all to exist so that I don't have to spend all my time shouting from the rooftops how dangerous it is to come off of these drugs. And just to be clear, what you just described is what you would like to see, not what exists. It's what I would like to see. None of it exists. It's my hope that these changes will take place in the coming years because we have a crisis on our hands. This epidemic of people on psychiatric medications, even if 5% of people out there decided they wanted to come off their meds, that's still a few million people. And they need a place to turn. They need reliable information. They need support and resources. And right now, besides those individual doctors like Josef Witt-Doring, it's literally only those of us laypeople who have built our own kind of mutual aid networks and figured out our own tapering protocols. We are all that exists right now. And that's a real problem. But thank goodness that laypeople are helping one another because otherwise people would have nothing. What are psychiatrists thinking when it comes to a plan for people coming off of large amounts of medication? You're saying they just don't think about it at all? It's another almost kind of unfair position that we've put psychiatrists in. If I put myself in the shoes of a psychiatrist who's seeing his patient once a month, it's very possible just for 15 minutes, maybe an hour, but that's pretty rare. And then that person who I see once a month comes in and she's on four medications or five medications and she says, doc, I want to come off. Of course that psychiatrist is going to instantly freak out. Well, what do you mean? Because that psychiatrist is set up to fail here. That psychiatrist doesn't have the time to properly support that person. Has the liability risks of operating outside the standard of care. Doesn't know the patient enough to even really know what their support system looks like, what their nutrition is like, what kinds of stressors are on their plate. So I get why psychiatrists are so terrified of helping their patients come off. I think another piece too is that psychiatrists often have in their mind the previous times their patients tried to come off and it didn't go well, which is usually cold turkey or rapid withdrawal. People think slow is a few weeks, a few months, maybe even a year. Oh, that's very slow. That's actually a year is fast for a lot of people, however shocking that sounds. And so I think doctors just, it's a combination of fear and then just how ill-equipped they are. And it's no fault of their own that this system around them has kind of set them up to fail in this way. And I think that's why the nonprofit that I founded in 2018, InterCompass Initiative, our mission is to help people make more informed choices about psychiatric drugs, about psychiatric diagnoses, and about safer tapering off these drugs. Our hope is that we are seen by the psychiatric profession as a relief, as a resource, as a partner, as a collaborator in this, because of all these poor psychiatrists who don't have the resources, the time, the bandwidth to properly help their patients come off. It takes a lot to come off of a psychiatric drug. It can. Certain percentage of people don't have problems. It's a mystery who is gonna have an easy experience and who isn't. For the people who have a hard time coming off, it might take years. How many people have the resources and support to do that successfully? Not many. I've looked at some of the criticisms of your, especially since you came out with your book, and some positive reviews, and some very critical reviews, but maybe one basket of criticism is that you're promoting hesitancy to use drugs which help people, which can actually make a real difference in people's lives. As a result, people may be harmed. How do you react to that? I am sharing my own personal story, and I'm sharing some basic facts that I learned for myself, too, after not knowing them for many, many years. That people hear that as me pushing an agenda that people stop their meds or don't take these drugs, I think speaks to the understandable fear of unknown terrain beyond the quick fix of pharmaceuticals that are so ubiquitous in our society. I get why people are threatened by my story. 15 years ago, had I read this book, I wouldn't, I mean, first of all, I wouldn't have been able to read it. I would have been so offended. And convinced that this was trying to push an agenda on me. When you have invested, whether it's for yourself in your own life, or for your child, or you're a psychiatrist, when you've invested years, money, time, attention in this medicalized story of mental illness, needing indefinite treatment, anything that calls that into question, it calls your whole worldview into threat. And so I wrote this book to start a conversation. I knew it would scare people because I would have been scared of it too. But my only agenda here is around informed choice. My story is a story of what happens when you do not have the information you need to make a meaningful choice for yourself about whether and how to engage with the mental health industry. I want people to have all of that information so that they can make whatever choice is right for them. Which might be to take these drugs. I'm not anti-psychiatric drug. I have friends who feel helped by these drugs. I think they can be helpful. It's about the stories that we tell ourselves about why these drugs are helpful that I think distorts our ability to make true choices about them. These drugs are not medications treating diseases. They're psychoactive drugs that are disrupting brain function. That disruption might feel helpful for you. The work of Joanna Moncrief, she's a British psychiatrist who herself gets called anti-medication all the time and she's very much not. I remember when I found her work many years ago, it helped me click right into the nuanced understanding that we need to have about these drugs. This is not about being pro or anti. This is about using straightforward, honest language to talk about what these drugs are, to talk about our limits of knowledge around what these drugs are and how they actually affect us. Then to let people make their own decisions from there based on their own life circumstances. If they decide they don't want to take these drugs, they should have the right to not take them and they should have options. They decide they do. I completely support that. What would you say is the most important information that you weren't given in your process? That you would want everyone to have when they're considering helping themselves using medications? I imagine there's millions upon millions of people that are considering this every day. When it comes to the drugs, I think what I was not told, what my parents were not told, is that these drugs are approved by the FDA on the basis of very short-term trials, six to eight weeks on average. There is zero evidence base for polypharmacy. These drugs have never been studied in combination with each other. Their safety and efficacy, I should say, have never been studied in combination with each other. Every single psychiatric drug across all the different drug classes is dependence-forming. Meaning, as I said earlier, if you take this drug for any length of time, your body may well completely alter itself to accommodate the presence of the drugs so that if you want to come off of it one day, you might have a really hard time doing that and you might need years of tapering. And I think especially for women, for girls and women who are teenagers or entering into their young adulthood, childbearing years, it should be a legal requirement that doctors tell us before we start these drugs that if you want to have a child one day, you need to build in a long-term exit strategy here so that you don't find yourself in a situation where you need to stop this drug abruptly and potentially cause harm, significant harm to yourself. So I think a lot of it is about just the straightforward facts about the evidence base upon which all of these drugs are prescribed. And I think part of my outrage that a lot of it is fueled by how in the dark so many of us are about what we actually know about these drugs. And what's wild is that it's all available right now. Don't take my word for anything I just said. You can go to the FDA website right now. Drugs at sign FDA. You will be taken to the website where you can search up. You can search for the drug label of any psychiatric drug you're on. You can read the whole thing. You can see the two or three trials that were used to approve the drug. You can see how long it lasted. You can see what they called effective, which you may or may not be surprised to know is often quite small. And then from there, decide what you want to do. Another one of the criticisms I've seen come up is that your story or your book or this approach will be used to actually cut back mental health services and offerings of help which are available to people at large. How do you respond to that? That's a big question. And what are the true causes here of this so-called mental health crisis that we're in? If it's not chemical imbalances in our brains or faulty brain pathology, which it isn't, there's no evidence base for any of that to this day. The NIMH acknowledges that. It's not too hard to kind of come to the conclusion that it's about our relationship to the world we live in. Of course, people need support and resources but do we need them in the arena of getting people more treatment, more diagnoses? Or do we need them actually where people's struggles emerge from, the circumstances of their lives? And if I would argue that's where funding needs to be directed to the community level, to neighborhoods, to helping people get their basic needs met. So I have yet to see my story actually be used by any policymaker as a justification. So I don't take that critique too seriously but I do think the deeper fears behind that critique are valid. I share them. I just don't think the solution is to fund more mental health treatment. I think it's to actually redirect funding to the circumstances of people's lives which is what leads them to have the struggles that get them diagnosed and medicated in the first place. And one quick additional point to that is as I found for myself, long-term mental health treatment was actually quite disabling for me in mind, body, and spirit. And I do think we have a crisis of psychiatric iatrogenesis. And for anyone not familiar with the term, iatrogenesis is basically harm caused by treatment, by doctors. I'm not saying they're doing this on purpose. I think these are well-meaning people who want to help but the mental health industry can have this paradoxical effect where it promotes itself as being this resource that will help people feel happier, feel more productive, feel more connected, capable and yet ends up producing the very opposite in people. And so I think we need to address that as well. We need to direct funding towards helping people recover from the harms that have been caused by their treatments which in turn I think will help people return to their lives and to meaningful work and meaningful connections and purpose and all of that. I know a number of people who strongly believe that they've been helped by these drugs and were able to come off them later. And I guess there was some plan for that. They didn't feel like there was a relapse. You're not against these drugs but everything you're telling me suggests that there's serious problems here with how we think about them, what we're told about them. What role is there for these drugs in people's lives in your view? I mean, human beings have been altering themselves with psychoactive chemicals for countless thousands of years. So I think it's natural for us as humans to disrupt our own consciousness for all kinds of reasons. And so, you know, psychiatric drugs are one of a vast array of other substances we turn to from coffee to alcohol to psilocybin and a long list of other psychoactive substances. So I think they can be helpful for people and used especially in the short term. I think these drugs can have a place in our society. I'm against them being forcibly used. But beyond that, yeah, I really think it's about changing the language that we use to talk about these drugs and our conceptual framing of what they are. I knew someone quite well who ended up becoming arrested for stabbing someone in a corner store and was out of his mind at the time. He was forcibly treated and in some interactions I had with him later, he seemed to be happy about that fact. But you can kind of imagine situations where people are really not in their mind and they need some kind of treatment that they would never consent to. How do you react to that? Well, I think seeing someone in a psychotic state in a public space, I mean, when someone's reached that point, basically every system has failed them. Every support, every resource or perhaps lack thereof. And so I think in those rare circumstances, if forcibly drugging someone is the solution that we have decided is the best thing to do as a society, let's at least just call it what it is, which is sedation. It's not actually treatment. And perhaps being on psychiatric drugs, stopping them abruptly, starting them, stopping them. People often end up forcibly drugged because they've tried to come off their drugs in the past and they did it cold turkey and it leads them to go crazy. But also being human, people lose it. We're violent. It's a part of being human as well. And so I think this idea that we could somehow get rid of violence is denying our nature. Obviously, I don't like violence. I wish it didn't happen. Well, and we incarcerate people and we remove them from society because of that, and I would argue very rightfully so. Yeah, and that brings up the issue of how a psychiatric diagnosis can strip people of responsibility for their actions. Because there's a big difference between someone who has not committed an act of violence and someone who has. So once an act of violence has been committed, if you're telling that person, oh, this happened because you're sick, it's not your fault, you need treatment. There are serious consequences to that message versus holding someone accountable for their actions. I think the insanity defense and this whole idea of absolving people of responsibility for their actions by telling them they're sick may end up creating more problems than we realize. For those people and then also just for our broader society. Well, perhaps I'll have a chance to invite you back on the show to talk about that. That's a very fascinating vantage point that I'd actually love to explore in the future. Before we finish up, tell me about the InterCompass Initiative and what you have built here. Our mission is to help people make more informed choices. We don't push any kind of agenda. We've been painted that way by certain media outlets recently. But really, we have a lot of free information on our website where people can learn about the history of the DSM, how psychiatric drugs are researched and brought to market, the rating scales that are used to diagnose people, how those rating scales come into being. Basically, all the information that we should be given prior to accepting a diagnosis and starting a psychiatric drug. We have a community of people at our InterCompass Exchange for anyone thinking critically about the mental health system. And it's all built on this idea of the power of lay people helping each other, of expertise, not through the institution, through the letters after your name, but through having lived it yourself. So there are support groups there. There are discussions happening. No one's telling each other what to do. No one's telling people that they should come off their meds or anything like that. It's just people sharing about their own experiences with one another and providing hope and support and basically filling the void that we all wish the mental health industry was doing a better job addressing around helping people who've decided for themselves they want to come off these drugs. And I think the other big piece of what we do is, and what we're really focusing more on in the coming months and years, is helping people's stories, the power of storytelling. You know, this information has been available all along about the DSM, about the drugs, about all of it. These FDA drug labels have been sitting on the internet since each of these drugs were approved. And yet here we are with an epidemic of people on these drugs. So clearly the data itself isn't going to change things. It's going to be our stories. It's going to be the power of identification, of seeing yourself in someone else's experiences that helps you kind of step back and rethink your life and make decisions that are actually true decisions for yourself. So we have a stories library that we're in the process of developing where we're going to help people tell their stories, engaging with the mental health industry, and then disseminating those stories more broadly. For anyone who feels something in them that's like wondering, like, is this the path that I want for myself? Are these drugs really my endgame here? Is there another way for me? Is there another way to make sense of my experiences? Well, Laura Delano, it's such a pleasure to have had you on. Thanks so much for having me on. It's been so great to chat with you and I'm grateful to be here. Thank you all for joining Laura Delano and me on this episode of American Thought Leaders. I'm your host, Jan Jekielek.