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

[FULL TRANSCRIPT BELOW] “This system I had been turning to for help through all of these years, through the most formative years of life, 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,” says Laura Delano, author of “Unshrunk: A Story of Psychiatric Treatment Resistance.”

For 14 years, Delano was a “professional mental patient,” as she puts it, after being diagnosed with bipolar disorder when she was a teenager.

Now she wonders whether the dominant, medicalized approach to mental illness is actually making us as a society sicker.

“Sixty-five 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 says. “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, and then to let people make their own decisions from there based on their own life circumstances.”

In this episode, we dive into Delano’s story and discuss the dangers of relying solely on medical treatments to treat mental health issues and of rapidly withdrawing from psychiatric drugs.

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

FULL TRANSCRIPT

Jan Jekielek:

Laura Delano, such a pleasure to have you on American Thought Leaders. 

Laura Delano:

Thanks for having me on. It’s great to be here. 

Mr. Jekielek:

What is wrong with the mental health system in America?

Ms. Delano:

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. 

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, dominance, and ubiquity the mental health industry has over our culture. That’s really the heart of the problem here.

Mr. Jekielek:

What does the mental health industry mean exactly? 

Ms. Delano:

Yes, you could call it a mental health industrial complex if you wanted to. The word industry is an important one to use as opposed to system because it shines a light on the fact that this is about very powerful corporations; drug companies, the hospital industry, managed care, medical devices, the list goes on and on. This is in large part about corporations who are selling products and services, so industry is the right word here. It’s all built on this idea of mental illness and mental health.

Mr. Jekielek:

There seems to be a trend of people identifying personality traits or quirks as a personality disorder, like people self-diagnosing as ADHD [Attention Deficit Hyperactivity Disorder]. Is there a connection here? 

Ms. Delano:

We have medicalized ourselves to such a degree that it’s become part of the cultural milieu, in the air that we all breathe. It is this idea of noticing a problem in oneself, some kind of discomfort, some kind of challenge, and instantly concluding, “What if this is a symptom of a condition?” In part, we have direct-to-consumer advertising, where we are constantly being bombarded with this message that if you’re having a hard time, maybe you could try XYZ treatment. It’s also that we have this monolithic mental health industry that has created this taken-for-granted assumption that struggles in life are problems to be diagnosed and treated. We have normalized it so much that we don’t even realize it’s actually a story of self. There are countless other stories as well.

Mr. Jekielek:

In Kentucky, people were suing doctors for not prescribing them the pain medication that they wanted.

Ms. Delano:

It is because these are consumer products that are being marketed and sold to people. They come into their doctor’s office knowing what they want. 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, you know, 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. It is a real problem.

Mr. Jekielek:

Only the U.S. and New Zealand allow for the advertising of drugs on television, with very long ads that also list all the terrible side effects. Do people actually respond to these ads?  

Ms. Delano:

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. 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. 

I do think people see these ads and believe them, because they are just so desperate for change. I was once the same way. I was once 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 by myself.

Mr. Jekielek:

The book is about your journey, with anecdotes, a lot of data, and information on various illnesses and treatments. It is a fascinating story. Please tell us about your 14 years in this mental health industry system.

Ms. Delano:

It’s the story of my 14-year relationship with the diagnoses, the drugs, mental health professionals, the hospitals. It’s the story of how I decided to end that relationship, what that looked like, and why I ended it. I was 13-years-old when I first entered a therapist’s office. I was an angry, intense, despairing, self-injuring teenage girl, and my terrified parents didn’t know what else to do. They felt immobilized and not empowered to help me. 

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 what I was told was an incurable mental illness called bipolar disorder. 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 and with sports. I was this very driven, 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. I eventually lost touch with that and then spent the final 10 years in the mental health industry as a very compliant, obedient, and deferential psychiatric patient.

Mr. Jekielek:

There is one chapter in your book which is pivotal. For the first time, you decide not to comply, and you’re faced with the fact that it’s really not your choice, which changes things. Please tell us about that.

Ms. Delano:

I loved writing that chapter. Prior to that moment, I had been this compliant patient, just so desperate for relief that I basically turned my entire life over to my doctors, and then eventually my seven-person treatment team. I said, “You guys are the experts. Just tell me what to do, what meds to take, what therapy to be in, and what program to sign up for, because I just want to feel normal. I just want to feel like I belong here.”  

With every passing week, month, year of being this compliant patient, my life kept falling more and more apart. I kept getting physically, mentally, and emotionally sick, with chronic health issues. I kept spinning out of control. My ability to care for myself just completely dissipated, and I was completely dependent on my family. But every step of the way, I kept turning my life over to these doctors. By 2010, at the age of 27, I had basically become a professional mental patient, as I like to put it. It’s a provocative phrase, and I use it deliberately, because I was the embodiment of a crazy, unhinged, and completely non-functioning human being. 

In February 2010, at age 27, I was in a program going to the hospital every day from nine to five for groups and therapy. A psychiatrist caught wind of the fact that I was maybe becoming suicidal, which I was. But at that moment, I wasn’t actually going to kill myself. He said, “Why don’t you just check yourself in and get taken care of? Go to the short-term unit. You’ll feel more rooted.”  I said, “That’s a great idea. I’m just going to go home and get my belongings and come back later this afternoon.” 

But he wouldn’t let me leave to do that, and things escalated. I began raising my voice. He called security. That was the moment that I realized that this system I had been turning to for help through all of these years, through the most formative years of my life, that I had been assuming existed to take care of me and help me was actually a system of control. I just hadn’t seen it for what it was, because I had never said no to it before. 

That changed everything for me. It dislodged this faith that I had had through all those years in my doctors, the pills, the hospitals—just this unquestioning faith that these people were going to eventually help me feel okay. Suddenly, in an instant, it just all blew up. I asked myself, “What have I been participating in? How did I not see this?”

Mr. Jekielek:

When people are suicidal, the protocol is to prevent them from going through with it, and they lose some of their ability to exercise their agency—for their own good. You had been suicidal earlier on, and you agreed to what was suggested, as opposed to resisting. Doesn’t it make sense that the doctor would recommend this?  

Ms. Delano: 

All these years later, as I now 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 keep his patient alive. 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 if a doctor senses that you are or might in the future become suicidal, they are obligated to put your safety over anything else. We’ve given them this tremendous responsibility, and I don’t think it’s a fair one. 

A lot of psychiatrists and psychologists who have this power, if they didn’t feel this terrifying liability issue looming over their shoulders, might actually be willing to hang in there a bit longer with their patients. They might be willing to ask more questions, to be curious, and 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 to do this. 

Having now spent 15 years on the other side, outside of the mental health industry, and having spent 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. When we shut down that space and say, “Panic mode,  incarcerate the person, medicate the person,” ironically, it ends up making a lot of people more suicidal, because they feel even more alone with their struggles. 

Mr. Jekielek:

You’re not a mental health professional, but in creating that space, aren’t you taking on the role of a mental health professional? 

Ms. Delano: 

This goes back to the monolithic power that the mental health industry has in our culture. We assume that helping someone in suicidal despair is acting like a mental health professional. It’s almost like we don’t even know it’s possible to have that role in someone’s life as a fellow human being. When I’m with friends, colleagues, or people I’m working with who are feeling suicidal, they obviously know I’m not a mental health professional because I make it clear that I’m a layperson. 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. 

I know for a fact that a lot of people think that is dangerous and that, for whatever reason, a non-professional sitting with someone who is in suicidal despair is going to make it more likely that that person kills themselves. I profoundly disagree. Having been a suicidal person through many years of my life, that is the one thing I never actually got. I never had anyone sitting with me and truly ready and brave enough to hear me talk about all the reasons why I didn’t want to be alive. I just never had that chance. I think it might have led me down a very different path. 

Because human beings have been helping each other through suicidal despair since the dawn of time. Yet, in these final seconds of our evolution as a species, we now have 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 you can be with someone in suicidal despair. We have that power. We have that ability. Everyone does. But we’ve lost touch with it, because of this professionalized understanding that so many of us have of what help is supposed to look like. 

Mr. Jekielek:

How did you ultimately make this decision to leave this mental health  system? 

Ms. Delano: 

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 want to take, and the other was having the police call on me when I was so tranquilized by that medication that I slept through a therapy appointment. Those three encounters with psychiatric power really just blew up this faithful relationship that I had through all those years, and I was in this adrift space where I didn’t know what to trust anymore and what was true, because I had largely gotten myself into this situation. 

In that state of questioning and rethinking, I happened upon a book that had this compelling cover with a phrenology illustration on the cover. It was one of those old drawings where the human skull is broken up into different compartments. Instead of the now debunked theory of this region is for this personality type and this one is for that, each compartment had a different psychiatric drug name in it. 

I was looking at this cover and thinking, “I’ve been on that drug. I’ve been on that drug. I’ve been on almost all of these drugs. I wonder what this book is about. I’m going to buy it.” I sat down to read it without even knowing what it was about. 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—two mood stabilizers, an antipsychotic, an antidepressant, and a benzodiazepine. This is a standard regimen for someone with a bipolar diagnosis. 

Reading anything, thinking, and absorbing information was very hard, but I somehow took in the words. The name of the book was “Anatomy of an Epidemic,” by Robert Whitaker. He set out to answer this curious question he had, which was, “Why do long-term studies of people diagnosed with schizophrenia have better outcomes in countries that don’t have ubiquitous pharmaceutical treatments? Why are the outcomes worse in the U.S. and other developed countries that have access to all these amazing medications?” 

This is such an interesting question. Why? He went on this quest to figure out an answer. In a nutshell, he 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. If you actually look at outcomes, there’s a strong case to be made that psychiatric drug use over the long term is making us sicker and more disabled. 

There I was on five medications. My job through my twenties 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. People said, “It’s so tragic. Poor Laura’s bipolar disorder is so severe.” 

After reading this idea and looking back on my life, I thought to myself, “What if it hasn’t been a treatment-resistant mental illness this whole time? What if it’s been the treatment?” In an instant, my faith in these drugs that I never once had stepped back to question from freshman year of college onward had now changed. I had questioned them at the very beginning, but I had forgotten about that. I wasn’t even in touch with those instincts at that point. But it blew up my faith in the quick fix promises of the psychiatric drug paradigm. 

Suddenly it was, “What if there’s another path for me? What if there’s another way? What if it’s not one of these two options?” I felt curious for the first time about my future. Before, there was no opportunity to feel anything, because I had believed for so many years in this life sentence of a chemical imbalance in my brain. They said, “You can manage it with meds, but it’s incurable.” That’s a hopeless story of self. 

That began this journey that I’ve been on ever since then. In that moment, I had to give myself a chance at figuring out who I might be beyond these drugs and beyond the diagnoses as well.

Mr. Jekielek:

Is bipolar disorder, in fact, curable? 

Ms. Delano:

It’s a hard question to answer, because you have to think about the deeper question, which is, what is bipolar disorder in the first place? And what does it mean to cure a mental illness? Throughout my entire career as a patient, I took for granted that the DSM [Diagnostic and Statistical Manual of Mental Disorders], which is copyrighted by the American Psychiatric Association [APA], is considered to be the Bible of psychiatry. It’s where all the diagnoses live. I just assumed that it was this scientific text. There must have been extensive, rigorous research behind the scenes over at the APA going into understanding schizophrenia, and also what is bipolar disorder, 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 and I never questioned. I learned that the DSM is really a book that has been written and edited by a relatively small number of psychiatrists who discuss in a very subjective way what they observe in their patients. Then they basically vote in and out which diagnoses they think should be included. 

For example, homosexuality was classified as a mental illness until it was voted out in the third DSM. When I stepped back and thought about what this actually means for me, I realized I had been assuming that there’s pathology inside of me without ever asking for proof. Sometimes I get accused of denying the reality of mental illness, and I find that fascinating because, you know, 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, 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 is the level that I’m critiquing here. When you disentangle yourself from that very subjective level that so many of us take for granted as objective, it opens up all this possibility for change. I met the criteria for bipolar disorder for years. I was not misdiagnosed. 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 made sense of my experiences, what my experiences meant, and therefore what I needed to do about it. 

Mr. Jekielek:

What did it mean to leave the mental health system? Some of that meant coming off the five drugs you were on. That is a very difficult thing to do. People who have gone cold turkey have terrible side effects and then say that their illnesses are relapsing. How did you manage to do that?

Ms. Delano: 

The issue of coming off psychiatric drugs is a hugely important one. It is an incredibly dangerous, risky thing to do. I’m often accused of being dangerous because I talk about coming off these drugs. I talk about coming off these drugs because I want to help people do it as safely as possible because it is so dangerous. I completely agree. 

What I didn’t know in 2010 when I decided to come off those drugs was that my central nervous system had become completely dependent in a physiological sense—not in the addiction sense where I had cravings and would seek out the drug despite it causing harm. That’s the conventional definition of addiction. This was purely physiological. My brain had completely reacclimated its structure and how it functioned, as had my body, because of the drugs that had been in my system for so many years. 

Coming off of them 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 disrupts the homeostasis that your body has developed to compensate for the presence of these drugs. 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. 

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, fatigued, and unmotivated. Your thoughts are racing about despairing things, and then you go to your doctor. 

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?” So people get stuck in this vicious cycle of thinking that who they are when they stop their meds is who they will always be. Therefore, they need to stay on them. 

I didn’t know any of this when I first came off these drugs. I basically came off cold turkey. I came off five drugs in about half-a-year, which is very fast. I went through unspeakable pain. The struggles that I had on the drugs were just amplified—projectile vomiting, boils breaking out of my skin, debilitating migraines, light sensitivity, panic responses to any kind of stimulus, paranoid racing thoughts, utter fatigue, and then insomnia at night. I could go on and on about how brutal withdrawal was. 

It was only as I started to recover from that, which took a lot of time, that it began to click just how unsafely I had come off them. 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. That was when I realized some people feel really helped by these medications. 

I totally respect that, but some people don’t. They should have the right to know how to come off these drugs safely. Right now, it’s almost unbelievable. There are 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.

Mr. Jekielek:

I had a psychiatrist on the show recently who specializes in this tapering process, so it’s not zero. 

Ms. Delano: 

That’s a good point. There are individual practitioners and what might be perceived as fringe resources cropping up around tapering off these drugs. But the official system itself, whether it’s the National Institute of Mental Health, or the American Psychiatric Association, or the American Academy of Child and Adolescent Psychiatry, these official bodies that are looked to for guidance, for guidelines, for protocols, and for establishing a standard of care, there is zero acknowledgement there. There are zero off-ramps there. 

It’s forced those of us lay people who’ve had to figure out safe tapering for ourselves. Then there are doctors like Yosef Witt-Doerring and a 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. 

It’s not like the information is everywhere, that doctors inform you of this before starting a medication, that the American Psychiatric Association acknowledges this, that there are safe protocols on its website, and that 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 about how dangerous it is to come off of these drugs.

Mr. Jekielek:

To be clear, this is what you would like to see, not what exists now.

Ms. Delano: 

It’s what I would like to see, but 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 percent of people out there decided they wanted to come off their meds, that’s still a few million people. They need a place to turn. They need reliable information. They need support and resources. 

Right now, besides those individual doctors like Yoseph Witt-Doerring, 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 lay people are helping one another because otherwise, people would have nothing. 

Mr. Jekielek:

What are psychiatrists saying about coming off of large amounts of medication? You’re saying they don’t think about it at all.

Ms. Delano: 

It’s another 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, very possibly just for 15 minutes, or maybe an hour, but that’s pretty rare. 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 these.” Of course, that psychiatrist is going to instantly freak out and say, “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, and 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. 

Another piece 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 means a few weeks, a few months, or that maybe even a year is very slow. Actually, a year is fast for a lot of people, however shocking that sounds. With doctors it’s a combination of fear and then just how ill-equipped they are. It’s no fault of their own that the system around them has set them up to fail in this way. 

That’s why the nonprofit that I founded in 2018, Inner Compass Initiative, has a mission 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, or the bandwidth to properly help their patients come off. 

It takes a lot to come off of a psychiatric drug. A certain percentage of people don’t have problems. It’s a mystery who is going to 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.

Mr. Jekielek:

Since you came out with your book, one criticism is that you’re promoting hesitancy to use drugs which help people and make a real difference in people’s lives, and as a result, people may be harmed. How do you react to that? 

Ms. Delano:

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 years. People hear that as me pushing an agenda that people should stop their meds and not take these drugs. That speaks to the understandable fear of unknown terrain beyond the quick fix of pharmaceuticals that are so ubiquitous in our society. I understand why people are threatened by my story. 

Fifteen years ago, had I [seen] this book, 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. Whether it’s for yourself in your own life, or for your child, or if you’re a psychiatrist, when you’ve invested years, money, time, and attention in this medicalized story of mental illness needing indefinite treatment, anything that calls that into question threatens your whole worldview. 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 indeed might be to take these drugs. I am not against antipsychotic drugs. 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 distorts our ability to make true choices about them. These drugs are not medications treating diseases. They are psychoactive drugs that are disrupting brain function. That disruption might feel helpful for you. 

Joanna Moncrieff is a British psychiatrist who gets called anti-medication all the time, but she’s 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-drug or anti-drug. 

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, how they actually affect us, and 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, but they should have options. If they decide to take them, I completely support that. 

Mr. Jekielek:

What is the most important information to have when considering medication? 

Ms. Delano: 

When it comes to the drugs, 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. Their safety and efficacy have never been studied in combination with each other. Every single psychiatric drug across all the different drug classes is dependence forming. Meaning that if you take this drug for any length of time, your body may well completely alter itself to accommodate the presence of the drugs. If you want to come off it one day, you might have a really hard time doing that, and you might need years of tapering. 

Especially for women, for girls and women who are teenagers or entering into their young adulthood or 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 significant harm to yourself. A lot of it is about just the straightforward facts about the evidence base upon which all of these drugs are prescribed. 

Part of my outrage is fueled by how in the dark so many of us are about what we actually know about these drugs. What is 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. Just Google, Drugs/FDA, and you will be taken to the website where you can search for the drug label of any psychiatric drug that you are taking. 

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. Then from there, you can decide what you want to do. 

Mr. Jekielek:

Another criticism is that your approach will cut back on mental health services that are available. What is your response? 

Ms. Delano: 

That’s a big question. 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 [National Institute of Mental Health] acknowledges that—it’s not too hard to 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? I would argue that’s where funding needs to be directed, to the community level, to neighborhoods, and to helping people get their basic needs met. I have yet to see my story actually be used by any policymaker as a justification. 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. 

One 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. We have a crisis of psychiatric iatrogenesis. For anyone not familiar with the term, iatrogenesis is basically harm caused by treatment from doctors. I’m not saying they are 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 a resource that will help people feel happier, feel more productive, feel more connected, capable, and yet ends up producing the very opposite in people, so 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, will help people return to their lives, to meaningful work, to meaningful connections, and to their life’s purpose. 

Mr. Jekielek:

A number of people strongly believe they have been helped by these drugs and were able to come off them later. They didn’t feel like there was a relapse. You’re not against these drugs, but everything you’re telling me suggests that there are serious problems with them. What is the role of these drugs in people’s lives, in your view?

Ms. Delano: 

Human beings have been altering themselves with psychoactive chemicals for countless thousands of years. It’s natural for us as humans to disrupt our own consciousness for all kinds of reasons. There are other substances we turn to, from coffee, to alcohol, to psilocybin, and to a long list of other psychoactive substances. 

They can be helpful for people and can be used in the short term. These drugs can have a place in our society, but I’m against them being forcibly used. Beyond that, it’s about changing the language that we use to talk about these drugs and our conceptual framing of what they are.

Mr. Jekielek:

There are situations where people are in a psychotic state and need a treatment that they would never readily consent to.  What are your thoughts?

Ms. Delano: 

Someone in a psychotic state in a public space, when someone’s reached that point, basically every system has failed them—every support and resource, or perhaps lack thereof. 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 call it what it is, which is sedation. It’s not actually a treatment. 

Perhaps being on psychiatric drugs, and then stopping them abruptly, people often end up forcibly drugged. Because they’ve tried to come off their drugs in the past and they did it cold turkey, which led them to go crazy. But also by just being human, people can lose it. We’re violent and that’s a part of being human as well. This idea that we could somehow get rid of violence is denying our nature. Obviously, I don’t like violence, and I wish it didn’t happen.

Mr. Jekielek:

We remove people from society and incarcerate them because of this violent behavior.

Ms. Delano: 

Yes, and this 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 committed an act of violence and someone who has not. Once an act of violence has been committed, if you’re telling that person, “This happened because you’re sick, it’s not your fault, you need treatment,” there are serious consequences to that message vs. holding someone accountable for their actions. 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 for our broader society.

Mr. Jekielek:

Please tell us about the Inner Compass Initiative and what you have created.

Ms. Delano: 

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 Inner Compass Exchange for anyone thinking critically about the mental health system. It’s all built on this idea of the power of lay people helping each other, of expertise, not through the institution or through the letters after your name, but through having lived it yourself. There are support groups there. Discussions are happening. No one is telling anyone what to do. No one is telling anyone 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. I think the other big piece of what we do, and what we’re really focusing more on in the coming months and years is telling people’s stories. It’s the power of storytelling. 

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 was approved. Yet, here we are with an epidemic of people on these drugs. Clearly, the data itself isn’t going to change things. It’s going to be our stories that change things. It’s going to be the power of identification, of seeing yourself in someone else’s experiences that helps you step back and rethink your life and make decisions that are actually true decisions for yourself. 

Wve a stories library that we’re in the process of developing where we’re going to help people tell their stories of engaging with the mental health industry and then disseminating those stories more broadly. This is for anyone wondering, “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?” 

Mr. Jekielek:

Laura Delano, it’s such a pleasure to have you on the show. 

Ms. Delano: 

Thanks so much for having me on. It’s been so great to chat with you, and I’m grateful to be here. 

 

This interview was edited for clarity and brevity.