Laura Delano’s memoir ‘Unshrunk’ takes aim at psychiatric medications - The Washington Post

Laura Delano’s “Unshrunk” is more than a memoir. It’s a treatise against psychiatric medications.

Review by Judith Warner

Laura Delano is a familiar type: a person with big mental or physical health problems who careens from solution to solution until, through sheer pluck and independent-minded ingenuity, she finds the one that confers not just comfort or cure but an ideology, an identity, a transformational reason for being. Other like-minded people are drawn to her, and she forms a community that practices and promotes — perhaps even sells — a lifestyle.

Such a person, however annoying her proselytizing, tends to be pretty harmless. But what if she starts giving out life-and-death medical advice? What if that person, who also happens to be supersmart, attractive and compelling, is handed a bullhorn just when her message aligns perfectly with our post-covid, “D.I.Y. health” zeitgeist? What if she publishes a book at the very moment when her anti-expert, anti-science — in this case, anti-psychiatry — perspective aligns with U.S. government policy?

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Delano has published that book. In “Unshrunk,” she uses her long and messy journey on and off psychotropic medications to discourage their use by others. In the current climate, where a not-inconsequential number of people feel, like Delano, that our “psychiatrized” culture is alienating us from our “primal nature,” this very personal memoir has the potential to become a potent political manifesto. If that sounds like rhetorical excess, think again.

In the past six months, Robert F. Kennedy Jr., now secretary of health and human services, has recycled disproven theories linking antidepressants to school shootings and said that coming off common antidepressants like Prozac can be harder than quitting heroin. (As a presidential candidate, he also suggested sending users of SSRIs and Adderall to rural “wellness farms” to “get reparented” alongside addicted users of illegal substances.) Last month, President Donald Trump issued an executive order declaring kids’ use of attention-deficit/hyperactivity disorder medications “a dire threat to the American people and our way of life.” Trump and Kennedy have since decimated the Substance Abuse and Mental Health Services Administration, the federal agency that supports states and cities in administering care and provides scientifically reviewed information to the public.

“Unshrunk” will give them even more ammunition.

It’s the story of a high-achieving, supremely privileged teenage girl and young woman — a nationally ranked squash player; a Harvard University early admit; a debutante and distant relative of Franklin Delano Roosevelt — who, at age 13, started to come apart. Drinking, cutting, screaming at her mother and sisters, and begging her parents for a way out of the pressures of her wealthy Greenwich, Connecticut, prep school community, she was instead sent to a psychiatrist, diagnosed in a single visit with bipolar disorder and immediately put on heavy-duty meds that can have hardcore side effects.

Delano at first resisted taking the drugs, hiding them in her jewelry box, self-medicating with alcohol and masking her symptoms behind consistent school success. But by the winter of her freshman year of college — a period of heavy drinking and self-harm that she categorizes as “a willful lurch toward self-annihilation” — her psychic pain was so great that she gave in, and over the next decade she cycled through 20-odd medications, multiple psychiatrists and at least three hospital programs, including one that helped her recover from a nearly fatal suicide attempt. Through her early and mid-20s, Delano continued fighting with her family, having paranoid outbursts with friends, engaging in drunken, meaningless sex and using alcohol to generally “obliterate” herself. “I was physically, sexually, and creatively numb,” she writes, “while simultaneously feeling like an emotional live wire, a rabid animal.”

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You might think that sounds like mental illness. For many years, Delano thought so, too. And for most of that time, she was an enthusiastic psychiatric patient, avidly applying her signature blend of intelligence and excess to achieving “top-level patient performance” and wholly embracing the idea that she suffered from an “incurable brain disease” that would require a lifetime of medication. She experienced the rituals of pill-taking and therapy as acts of near-religious devotion: “The squeeze and twist of the white cap, the soft weight of pills in palm, the bitterness of chemicals dissolving on tongue: all of this, my sacrament,” she writes. One psychiatrist, “Weinberg” — double-Ivy League educated, with bright red lipstick, cashmere sweaters, tailored slacks and stiletto pumps — was both mother figure and high priestess. Weinberg’s home office in a “giant shingled house on a quiet dead-end lane” near Harvard Square, Delano writes, brought her a “sense of safety” that she says she “felt nowhere else.”

It is perhaps axiomatic that adoration of this order will have to fall to equally high-volume derogation. Delano’s falling out with psychiatry was fast and furious. It came when she was trying for the first time to get and stay sober, attending for the first time a day program for borderline personality disorder (a number of her providers, it turned out, had had doubts over the years about her bipolar diagnosis) and in the care of a psychiatrist in the borderline program who was willing to scale down her meds.

Free from alcohol — and off the addictive benzodiazepines she’d been prescribed for many years — Delano was finally clear-minded enough to read. (Years of “cognitive impairment,” she writes, “had made it nearly impossible for me to fully absorb words, to piece together meaning, often to remember what I’d read at all.”) One of the first books she read was Robert Whitaker’s “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.” It is one of many works by journalists over the past 15-odd years that have waged war on the psychiatric profession, often by building on the logical fallacy that if rates of mental illness are increasing and use of mental health treatment is increasing, then the treatment itself must be causing the illness.

For Delano, encountering Whitaker’s argument was nothing less than an epiphany. “The room around me got instantly bright and clear and sharp,” she writes. A “distorting fog I hadn’t before realized I’d been stuck inside” lifted. She came to the conclusion that she had never been mentally ill; psychiatry had made her sick. “My experiences had never been about illness, health, or recovery,” she later reflected. “I, like so many fellow ex-patients, had surrendered my personal agency, misplaced my faith, and been indoctrinated into a compelling ideology.”

After more than a decade of treatment, Delano decided to go off all her meds, the “unspeakable” horrors of their cessation only deepening her conviction that they’d been toxic all along. She also stopped therapy. She even withdrew from Alcoholics Anonymous, which she’d not so long before celebrated as her ultimate safe space — “like this was where I had always belonged” — deeming A.A. another “ideology” that had been “translating” her “dark complexities into symptoms of a different incurable condition,” labeling her as “eternally defective, as needing an outside force to fix” her, when she was merely, in truth, “being human.”

Having ceased to be a “professional psychiatric patient,” Delano became a professional psychiatric naysayer, advancing quickly from blogging about her experiences on Whitaker’s “Mad in America” website; to corresponding with readers asking for advice on discontinuing their own or their family members’ medications; to charging a fee for those “psychiatric drug withdrawal consulting services,” incorporating herself as an LLC and founding a nonprofit dedicated to spreading the word about “deprescribing” with her husband, Cooper, another veteran of a childhood “prescription cascade.”

Delano didn’t get any additional training or education for doing this; her only professional experience was a short stint as a peer specialist in a state-funded Boston-area community mental health organization, which was not a good fit. The clients there weren’t interested, she found, in learning to “stand up against psychiatric coercion” or “spring themselves from locked wards,” or listening to how her story could inspire them to “get themselves off meds.” They were “desperate for help” and “typically uninterested in hearing about my own experience leaving psychiatric interventions behind.”

Delano’s description of her life off meds, liberated from the “mental health industry,” isn’t exactly a portrait of wellness. “The more I came back into my body in the wake of pharmaceuticals, the more it hurt to be alive,” she writes. This pain can overwhelm her when, for example, she sees an exhausted mother with a crying toddler or an “ancient tree slowly dying in the cement sidewalk.” Delano still experiences “intense emotional pain and paranoia and debilitating anxiety and unhelpful impulses,” too. To handle her “extremely sensitive” nature, she has learned to “sit with” herself. Now in her early 40s and a mother, she sometimes sits for an hour as the “waves of pain” wash over her. As she acknowledges, she’s fortunate to have the resources to spend so much time in this way.

Delano has considerable skill as a memoirist. Her early chapters describing the alienation of a smart, sensitive, hyperaware teenager in an emotionally inhospitable universe cover Holden Caulfield territory in a new and highly engaging way. Her fruitless years of polypharmacy combined with intensive therapy will be depressingly familiar to many families who go into debt paying for what they’ve been told is the best treatment money can buy, only to find it isn’t worth much. All too familiar, also, is the thrall that so-called top experts — endlessly concurring on treatments that accomplish a whole lot of nothing — hold over Delano, her parents and the local practitioners who defer to them.

Her account captures a number of ugly realities: Mental health care as we know it in America is pretty awful. The medications often don’t work and can have terrible side effects. Therapy, at best, is hit or miss. The setup of the system (largely dictated by insurance companies) is such that people travel through with mind, brain and below-the-neck body atomized; care that looks at a patient holistically, that works preventively, society-wide, is a pipe dream. And yet, as the latest volume in a more-than-half-century-old strain of anti-psychiatry literature, “Unshrunk” is limited and highly predictable.

There’s much more accurate information, and deeper insight, available in the work of other sophisticatedly critical yet less polemical authors: the social psychiatrist and psychoanalyst Eric Reinhart, for example, who wrote very effectively on Trump-era mental health policy and practice in the New Republic recently, or the neurologist and author Suzanne O’Sullivan, who relies on decades of clinical experience to balance critique with compassion in her new, less-strident-than-advertised book, “The Age of Diagnosis: How Our Obsession With Medical Labels Is Making Us Sicker.”

Like many mental health memoirs, “Unshrunk” suffers by sharing its author’s symptomology: In this case, it’s a study in black-and-white thinking.

Judith Warner’s most recent book is “And Then They Stopped Talking to Me: Making Sense of Middle School.”

Unshrunk

A Story of Psychiatric Treatment Resistance

By Laura Delano

Viking. 352 pp. $30

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