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WORK TITLE: Unshrunk
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WEBSITE: https://www.lauradelano.com/
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COUNTRY: United States
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PERSONAL
Married; children.
ADDRESS
CAREER
Writer, speaker, and mental health consultant. Inner Compass Initiative, founder; Recovering from Psychiatry, LLC, founder.
MEMBER:Board member of the International Society for Ethical Psychology and Psychiatry, and National Association for Rights Protection and Advocacy.
WRITINGS
SIDELIGHTS
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Laura Delano is an American writer, speaker, and consultant, providing support to and advocating for the rights of individuals with mental health disorders. She works for people in emergency rooms, psychiatric hospitals, and institutional group home settings, and for people seeking help during the psychiatric drug withdrawal process.
In 2025 Delano published her memoir, Unshrunk: A Story of Psychiatric Treatment Resistance, in which she chronicles her struggle with mental health, beginning with a diagnosis of bipolar disorder at the age of 14 and prescriptions for a mood stabilizer and an antidepressant. She was told she had an incurable, lifelong disease. Over the years she accumulated more diagnoses, was in and out of mental health institutions, was put on a cocktail of nineteen medications, felt demoralized and helpless, developed an eating disorder, and contemplated suicide. And she was only getting worse.
Delano explains how she studied the approach of Alcoholics Anonymous, with its focus on taking responsibility for your own life, and applied it to mental health. She left behind the medicalized, professionalized mental health industry to build something different. In 2018 she founded the Inner Compass Initiative, a nonprofit organization that helps patients understand their psychiatric diagnoses and drugs, and to build community outside of the mental health system. Now medication free, Delano is a writer and public speaker, sharing her experiences, and discussing the social and political issues around the mental health industry.
Speaking to Eric Maisel in an interview at Psychology Today, Delano explained that she was a “psychiatric liberation activist”: “When I was labeled ‘mentally ill’ as a child, I was stripped of my humanity, my bodily integrity, my connection to the oneness of the world, and my trust in myself. That is oppression, both external and internalized. And when I made the decision to leave that all behind, it was an act of liberation, especially of my own consciousness—I woke up to the fact that all the ‘mental health care’ I was getting were actually chains and prison bars disguised as pills and labels.”
Reviewing Unshrunk, a Kirkus Reviews critic commented: “A courageous, insightful, beautifully written book challenging major tenets of Big Pharma and mainstream psychiatry.” In New York Times Book Review, Casey Schwartz noted: “Delano’s story is compelling, important and even haunting, but plenty of readers will chafe at her lack of interest in those who have actually been helped by these medications—especially today, when they’re facing criticism from some quarters.”
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BIOCRIT
PERIODICALS
American Scholar, Spring 2025, Scott Stossel, “Who Would I Be Off My Meds,” review of Unshrunk: A Story of Psychiatric Treatment Resistance.
Commentary, June 2025, Sally Satel, “Keep on Pushing My Love Over the Borderline,” review of Unshrunk, p. 1c.
Kirkus Reviews, February 1, 2025, review of Unshrunk.
New York Times Book Review, April 13, 2025, Casey Schwartz, review of Unshrunk, p. 9.
ONLINE
Laura Delano homepage, https://www.lauradelano.com/ (August 1, 2025).
Psychology Today, https://www.psychologytoday.com/ (March 21, 2016), Eric Maisel, “Laura Delano on Psychiatric Liberation.”
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From Wikipedia, the free encyclopedia
Laura Delano is an American writer and consultant who is the founder of the Inner Compass Initiative, a nonprofit organization that helps patients understand their psychiatric diagnoses and drugs and to build community outside of the mental health system.[1][2][3][4]
Works
In March 2025, Delano published the memoir Unshrunk: A Story of Psychiatric Treatment Resistance. The book details her struggle with mental healthcare, beginning when she received a diagnosis of bipolar disorder at the age of 13. Following that diagnosis, she spent decades struggling with psychiatric diagnoses, a "cascade" of differing medications, mental health institutions, and thoughts of suicide. After coming across a meeting of Alcoholics Anonymous, she found the group's focus on responsibility for one's own self refreshing, starting a path of personal understanding that her struggles with mental health were rooted in the very psychiatric medications she had been prescribed.[5][6][7][8][9][10]
Laura Delano was fourteen when she saw her first psychiatrist.
At school, Laura was a good student, earning straight-As, a national squash ranking, and the distinction of class president; at home, however, she was angry, despairing, and self-injuring. At the end of her first psychiatric session, Laura was diagnosed with bipolar disorder, which she was told had no cure. Her doctor said she would need to take psychiatric medications for the rest of her life.
Fiery and defiant, Laura did not accept against her diagnosis. She hid her medicine, didn’t tell anyone what her psychiatrist had said, and continued as best she could through high school. Upon entering Harvard, however, Laura’s struggles intensified. She was self-destructive and afraid. Desperate for an explanation and the promise of relief, Laura returned to a psychiatrist and accepted that she was mentally ill.
For the next decade, Laura lived in the clutch of psychiatry, seeking treatment from the best psychiatrists and hospitals in the country, accumulating a long list of diagnoses - major depression, eating disorder NOS, substance abuse disorder, and borderline personality disorder. Her cabinet of medications grew to a total of nineteen over the years. Delano had questions about her diagnosis and treatment but, given her struggles and suicidal tendencies, adhered to the pharmaceutical regimen she’d been told was necessary to manage her “incurable, lifelong disease.” When her symptoms only worsened, doctors declared her condition “treatment resistant.” At twenty-seven, Laura attempted suicide (to hear more about Laura’s struggles with suicide, you can read this article and watch this video).
Despite all her care, Laura never got better. Demoralized by her circumstances and inability to get well, Delano went back to her lingering questions about her initial and subsequent diagnosis. . . . What if her life was falling apart not despite her treatment, but because of it? After years of being a faithful patient, Delano realized there was one thing she hadn’t tried—leaving behind the drugs and diagnoses. This decision would mean unlearning everything experts had told her about her body, mind, and self. It meant exploring the terrifying unknowns of an unmedicated life.
Since becoming an ex-patient, Laura has been writing and speaking about her experiences and the social and political issues sitting at the heart of mental illness and mental health. She has worked for a large community mental health organization, providing support to and advocating for the rights of individuals in emergency rooms, psychiatric hospitals, and institutional group home settings. She has also been consulting with individuals and families seeking help during the psychiatric drug withdrawal process, and educating psychiatrists and mental health professionals about safer tapering protocols.
In January 2018, Laura launched Inner Compass Initiative (ICI), a non-profit organization that helps people make more informed choices about psychiatric diagnoses, drugs, and drug withdrawal.
Read Laura’s December 2024 Washington Post op-ed on the 30th anniversary of Elizabeth Wurtzel’s Prozac Nation here.
Laura Delano
Founder
Laura is a writer, speaker, consultant, and our Founder. She is a leading voice in the international movement of people who’ve left behind the medicalized, professionalized mental health industry to build something different.
Founder
At age fourteen, Laura Delano saw her first psychiatrist, who immediately diagnosed her with bipolar disorder and started her on a mood stabilizer and an antidepressant. Her initial diagnosis marked the beginning of a life-altering saga and for the next thirteen years, she sought help from the best psychiatrists and hospitals in the country, accumulating a long list of diagnoses and a prescription cascade of nineteen drugs. After some resistance, Laura accepted her diagnosis and embraced the pharmaceutical regimen that she’d been told was necessary to manage her incurable, lifelong disease. But her symptoms only worsened. Eventually doctors declared her condition so severe as to be “treatment resistant.” A disturbing series of events left her demoralized, but sparked a last glimmer of possibility. . . What if her life was falling apart not in spite of her treatment, but because of it? After years of faithful psychiatric patienthood, Laura realized there was one thing she hadn’t tried—leaving behind the drugs and diagnoses.
Now, after successfully tapering off all psychiatric medication, Laura is a writer, speaker and consultant, as well as our Founder. As a result of this work, she is a leading voice in the international movement of people who’ve left behind the medicalized, professionalized mental health industry to build something different, working every day with individuals and families around the world who are seeking guidance and support for their withdrawal journey and life post-psychiatry. She lives in Connecticut with her husband and children.
You can find out more about Laura through her personal website, or her memoir, Unshrunk: A Story of Psychiatric Treatment Resistance.
Laura Delano on Psychiatric Liberation
On the future of mental health
Posted March 21, 2016
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THE BASICS
What Is Psychiatry?
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Eric Maisel
Source: Eric Maisel
The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
**
Interview with Laura Delano
EM: You write and speak about a post “mental health” world. What do you mean by that?
LD: A lot of critically-minded people talk about the problem of the medical model as though it’s solely about “mental illness,” problematizing how suffering, struggle, non-ordinary states of consciousness, and non-conforming behaviors are turned into “symptoms” of medical pathology needing “treatment.” But they don’t often critique its flipside, which is just as oppressive—if not more so—in my opinion: “mental health.”
This concept is really just a synonym for “normal,” and is often perpetuated by the message that you need to be balanced, “put together,” happy, free from emotional pain, productive and high-functioning in order to be “mentally healthy,” no matter what your life circumstances are, and that you shouldn’t feel satisfied or okay with yourself until you get there. But this desperate pursuit of “normal” is really fueled by broader interests that have trained people—through advertising, marketing, schooling and of course the health industry, among others—to feel insecure, ashamed, and afraid of their inner darkness and thus believe that they need to consume—whether it’s goods like clothes and cars or services like “therapy”—in order to feel better and “get mentally healthy.”
To be human is to feel darkness, and I believe we must build a society that embraces this, and celebrates it, and no longer uses the individualistic, decontextualized, depoliticized language of “mental health” and its pursuits as a way of disempowering people by keeping their focus on themselves as “the problem,” rather than the horribly dysfunctional and destructive world we live in. There is meaning in suffering and struggle that we must listen to if we’re to ever make our world a better place, and as long as we’re fixated on getting rid of that darkness within us, we’ll never feel empowered enough to act on the world and truly transform it.
EM: You call yourself a “psychiatric liberation activist.” Can you tell us a little bit about what you mean by that and what you do?
LD: The activism I do today through my writing, speaking, and organizing arises from the fourteen years I spent as a mental patient, which were entirely about oppression and control. When I was labeled “mentally ill” as a child, I was stripped of my humanity, my bodily integrity, my connection to the oneness of the world, and my trust in myself. That is oppression, both external and internalized. And when I made the decision to leave that all behind, it was an act of liberation, especially of my own consciousness—I woke up to the fact that all the “mental health care” I was getting were actually chains and prison bars disguised as pills and labels and psych wards and all of those experts I’d come to rely on.
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As an activist, I try to help raise consciousness around the fact that this is not about “illness” and “wellness” or “mental health challenge” and “recovery”—that language really gets my goat, actually! It’s about oppression and liberation. And as I mentioned in my first response, that liberation does not mean happiness and pink roses and smiles—it means liberation from the belief that those are the ideals one must obtain to be “normal.” It means embracing all the emotional pain that comes from being alive, leaning into it, listening to it, and defying those around you who tell you there’s something “wrong with” you because you feel it. Every day I feel great emotional pain—I cry, or I get overwhelmed, or I have dark thoughts in my head, for example—but I’m no longer afraid of this, or see this as something I must get rid of. This, to me, is psychiatric liberation, and it’s the message I try to convey through my activism.
EM: What are your thoughts on the ways that a person can engage in withdrawal from so-called psychiatric medications, if a person wanted to engage in that withdrawal?
LD: I could write a whole book on this, but I’ll offer what I see as the three most important starting points before beginning to come off. First, make time to educate oneself. Knowledge is power, and the more people understand what these drugs are—psychoactive chemicals—and how they act on the central nervous system (CNS)—by impairing it and forcing the CNS to acclimate in profound, long-lasting ways—the more informed people can be in the choices they make about how to then come off.
Second, make time to think through one’s life circumstances. Things like physical health, a support system (or lack thereof), nutrition, a relationship to one’s prescriber, work situation, etc., are really important factors in the withdrawal journey. Just because a person wants to come off doesn’t mean it’s necessarily the best time—and if it’s not the best time, trying to come off can actually lead to really horrible things like getting locked up and put on even more drugs than before—so it’s important to plan, think carefully about the reality of one’s situation, be really intentional about taking care of one’s body, and build in as much unconditional support as possible.
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Third, explore the why. Why is a person thinking about coming off? What is it she’s hoping to achieve, to move towards? I often call it one’s “beacon,” and I think it’s really important to have it in place prior to beginning the coming off process. It’s what guides a person through any difficult times that emerge along the way, and it’s important to keep it on the horizon.
Unfortunately, it’s very hard to find safe, reliable information on how to withdraw—I’m actually working on an initiative around this very issue at the moment—and even some well-intentioned doctors out there are ripping people off way too fast (by that I mean over a matter of weeks or months; “slow” can often mean a year or longer). I’m confident that increasingly more safe resources will come online over time, and I encourage people to connect with the online withdrawal community through social media and forums, and at my website.
EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?
LD: Questions like this are tough to answer, because they hint at the notion that distress requires something “needing to be done,” and that very belief system, I believe, is problematic.
With that being said, the first thing I’d suggest is to listen to the distress. Even if it’s horribly painful or scary or confusing or disorienting, it’s a part of you that’s very meaningful, and it’s a messenger trying to convey something to you. It doesn’t mean there’s something wrong with you; in fact, quite the opposite, for it shows you’re sensitive and in touch with your surroundings.
Perhaps you’re in a destructive relationship. Or you are struggling to pay bills. Or your housing is in jeopardy. Or you’ve been eating toxic food full of chemicals known to impair the central nervous system and mess up the gut. Or your job is meaningless, but you feel stuck there. Or your only social interactions involve alcohol, which leaves you feeling alienated. Or perhaps there’s no visible thing in your life that’s leading you to this distress—that still doesn’t mean there’s something “wrong with” you. Maybe you’re feeling the violence, destruction, and neglect rampant in our society at a deep, spiritual level!
I’m not suggesting that the only thing to do is listen; of course, as human beings, action is how we grow and evolve. And much of the action that needs to be done has nothing to do with us as individuals—it has to do with acting upon harmful sociopolitical and economic systems, which of course is not an easy task. In the meantime, I find that when my pain becomes too much to sit with and listen to, it can be helpful to start with simple things like asking, am I getting enough exercise? Am I getting outside? Am I spending too much time on my laptop? Am I getting enough sleep? How’s my nutrition? Usually, I find something to work on when I ask these things.
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And when it comes to taking other kinds of personal action, I’ll get out of my head by offering support to someone else, or channeling my pain into my writing. I still sometimes feel the need to escape, of course, and usually that means eating dark chocolate and watching South Park (best show ever). But I really do believe that emotional pain needs to be listened to and fully felt first in order to understand what kinds of actions (or non-actions) might help shift things, whether in your own life or in society at large. And while I certainly don’t encourage the message that we need to get rid of all of our distress, I do believe that the more one tries to avoid it or numb it out or push it down, the more unbearable and problematic it grows.
**
Laura Delano is an activist, writer, consultant, and community organizer living in the Boston area. She spent fourteen years in the mental health system before discovering that she needed to leave it behind if she stood a chance at reclaiming her life. Today, Laura works with individuals looking to free themselves from psychiatric labels and drugs, and communities seeking alternatives to the mental health system. She is the founder of Recovering from Psychiatry, LLC and serves on the boards of the International Society for Ethical Psychology and Psychiatry and the National Association for Rights Protection and Advocacy. More about Laura and her work can be found at her website, www.RecoveringfromPsychiatry.com.
Delano, Laura UNSHRUNK Viking (NonFiction None) $30.00 3, 18 ISBN: 9781984880482
Finding herself--off of meds.
At 13, Delano was put on her first too-potent psychiatric drug because she was experiencing what was (to her, in hindsight) mere teen angst. What followed were decades of psychiatric drugs that were given to counteract effects of other drugs, which were given to counteract effects of still other drugs: the classic "cascade of prescriptions." She quickly became one of the 80% of 59 million Americans on psychiatric meds long-term. Only after years of brain-fogging drugs-upon-drugs, punctuated by years of hospitalizations, did she stumble into an Alcoholics Anonymous group, which focused on taking responsibility for one's own life. That simple notion, along with the common fellowship of people helping each other without professionals--and without pharmaceuticals--led her to wonder if her worsening mental health was due not to her lack of response to drugs, but to the drugsthemselves. Against advice, she began tapering off all of them. As she did, she researched. She read Robert Whitaker'sAnatomy of an Epidemic, Viktor Frankl'sMan's Search for Meaning, John L. McKnight'sThe Careless Society, and Rainer Maria Rilke's poetry. "The words of these men ignited a fire in me to feel, to just sit and feel, for how beautifully they articulated the art of leaning into the darkness of being alive." She also began mentoring others. Off all drugs, she had a "holy shit" realization: Her problem really was "the meds" all along. She founded a nonprofit organization and now runs a psychiatric drug withdrawal consultancy. She concludes: "I don't need to 'figure myself out,' to force a change in my day-to-day reality. I trust fully in my own process--in this intelligence within me, within each and every one of us that sits deeper than thought, that knows where to take us each from here .We're built for tribes and villages and neighborhoods and potluck dinners. We're meant to feel it all, and bear it all, together."
A courageous, insightful, beautifully written book challenging major tenets of Big Pharma and mainstream psychiatry.
Copyright: COPYRIGHT 2025 Kirkus Media LLC
http://www.kirkusreviews.com/
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"Delano, Laura: UNSHRUNK." Kirkus Reviews, 1 Feb. 2025. Gale General OneFile, link.gale.com/apps/doc/A825128245/ITOF?u=schlager&sid=bookmark-ITOF&xid=bf303ea4. Accessed 29 June 2025.
In ''Unshrunk,'' Laura Delano chronicles her struggles with mental illness -- and the endless parade of pills meant to treat it.
UNSHRUNK: A Story of Psychiatric Treatment Resistance, by Laura Delano
Laura Delano was 13, a studious, budding squash champion in Greenwich, Conn., when she looked in the mirror one night and felt her world dissolve. The life of pressure and privilege to which she belonged -- she is related to Franklin Delano Roosevelt -- became unreal to her, meaningless, ''a performance.''
Lashing out at her parents, begging to be sent away, led to the first of many mental health professionals, then to her first psychiatric diagnosis: bipolar disorder. Soon after, she would swallow her first mind-altering prescription pill.
Though she went on to Harvard -- and made her debut at the Plaza in a floor-length white gown -- she did so while binge-drinking, cutting and burning her flesh and wrestling with her sense that her life was hollow.
After college, as her friends soared, her life became an endless round of psychiatrists, institutionalizations and outpatient programs. An incomplete list of the drugs she has been prescribed: Depakote, Prozac, Ambien, Abilify, Klonopin, Lamictal, Provigil, Lithium.
Delano was the subject of a 2019 profile in The New Yorker, on the cascading effects of prescription pills and the challenge of getting off them. In ''Unshrunk,'' she tells her own story, and she tells it powerfully. Her memoir evokes ''Girl, Interrupted'' for the age of the prescription pill, a time when more and more Americans are on at least one medication for their mental health, including millions of children and teenagers.
Delano nearly didn't live to tell this story: After years of treatment, she hid behind a boulder near the ocean in Maine and swallowed three bottles of pills. Somehow, miraculously, her father found her before it was too late.
Recently diagnosed with borderline personality disorder and being treated by a male psychiatrist whom she experienced as misogynistic and tyrannical, she had an epiphany.
In a bookstore, she ran across Robert Whitaker's ''Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.'' Although the meds she was on made her foggy and reading was a challenge, she bought it, and saw her own experience vividly and alarmingly reflected. ''I'd been confronted with something I'd never considered before: What if it wasn't treatment-resistant mental illness that had been sending me ever deeper into the depths of despair and dysfunction, but the treatment itself?'' she writes. There is a technical term for this, she tells us: ''iatrogenic harm.''
Delano's story is compelling, important and even haunting, but plenty of readers will chafe at her lack of interest in those who have actually been helped by these medications -- especially today, when they're facing criticism from some quarters. Writing about the effects of lithium, still considered the gold standard treatment for bipolar disorder, she analyzes the writer Jaime Lowe's powerful 2015 article ''I Don't Believe in God, but I Believe in Lithium.'' Lowe, living with bipolar disorder, wrote of the mania that came on when, feeling better, she experimented with coming off her lithium
But Delano sees this testimony through a different lens. Rather than take Lowe's story at face value, Delano instead wonders whether Lowe has ever asked herself if these manic episodes were actually brought on by lithium withdrawal, rather than by bipolar disorder itself.
One wonders about this assertion, and whether Delano is looking at the treatment of mental illness, and mental illness itself, through a particular lens, one that can feel reductionist in its own right, even as she accuses American psychiatry of doing the same.
But Delano becomes more and more unapologetic about her views. She meets Robert Whitaker and begins to write blog entries on his website, spurred by the emails she receives from readers describing similar experiences. When she writes about her suicide attempt, she definitively breaks from the Greenwich code of discretion and perfection, and her mother and sisters cut off contact.
By the end of the book, Delano has become an advocate for those hoping to get off their meds, speaking at conferences and helping to develop a schedule for safe withdrawal. She gets married and has a baby. She assures the reader from the outset that she is not against psychiatry, but that when it comes to the D.S.M., American psychiatry's diagnostic bible, ''I no longer view this textbook as a legitimate or relevant source of information about myself.''
She does not pretend to be cured; she does not claim that her mind is an easy or comfortable place to live. She knows that her immense privilege helped provide the scaffolding that ultimately enabled her to get off the medications.
But she makes a more universal point, one that bears repeating and applies not only to mental illness but to the struggles of daily life: ''We're built for tribes and villages and neighborhoods and potluck dinners. We're meant to feel it all and bear it all, together.''
UNSHRUNK: A Story of Psychiatric Treatment Resistance | By Laura Delano | Viking | 337 pp. | $30
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PHOTO: Laura Delano (PHOTOGRAPH BY MARIAH MAY) This article appeared in print on page BR9.
Copyright: COPYRIGHT 2025 The New York Times Company
http://www.nytimes.com
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MLA 9th Edition APA 7th Edition Chicago 17th Edition Harvard
Schwartz, Casey. "Lessons in Chemistry." The New York Times Book Review, 13 Apr. 2025, p. 9. Gale General OneFile, link.gale.com/apps/doc/A835274990/ITOF?u=schlager&sid=bookmark-ITOF&xid=07b69478. Accessed 29 June 2025.
JUNE 2025
AT THE START OF EIGHTH GRADE, SEEMINGLY OUT OF THE BLUE, LAURA Delano--class president, squash champion, and future debutante--sensed herself coming apart. Looking into the bathroom mirror as she brushed her teeth, she felt herself "disintegrate into a million pieces, floating, fuzzy, disembodied in space," she recalls feeling at the time. "I am nothing....Who am I?"
In bed that night, the 13-year-old ruminated about being a "fake" and a "fraud." She'd been "brainwashed" by her parents and teachers at the all-girl Greenwich Academy. "They controlled all the girls," she concluded. "They convince us we have to look a certain way, talk a certain way, perform a certain way."
Delano struggled to contain an inchoate rage. She cut her arms with razor blades, fought bitterly with her family, and complained of intense academic and social pressure. That former President Franklin Delano Roosevelt was part of her lineage couldn't have helped.
Delano's 14-year tenure as a "professional psychiatric patient" (her words) lasted through prep school, then Harvard (where she thought, early on, that she might become a psychiatrist-anthropologist), and into her late 20s. She received eight separate diagnoses and admitted herself to a psychiatric hospital on four occasions. At 25, she almost died after downing handfuls of pills with swigs of wine.
And then, two years later, Delano was done: "I decided to leave behind all the diagnoses, meds, and professionals and recover myself." Unshrunk is the memoir of her life under the influence of my profession and how she broke the spell.
The first psychiatrist Delano saw at age 14 wasted no time imposing a medicalized narrative on the teen. The doctor confidently diagnosed Delano with bipolar disorder and prescribed medication--a mood stabilizer (Depakote) and an antidepressant, Prozac. An error. More properly, the doctor should have gotten to know her young patient better before making a definitive diagnosis, prescribing medication, and, for good measure, warning Delano that she had a serious life-long condition and would always require medication.
Gradually, however, Delano warmed to having bipolar disorder and came to regard her myriad problems--an eating disorder, alcohol and cocaine abuse, suicidal fantasies, promiscuity--as proof that she suffered from an "incurable brain disease....I wasn't bad or lazy or a failure. I was sick."
Yet medication did little to treat that sickness. At one time or another, Delano's medicine chest housed antipsychotics (Seroquel, Geodon, Zyprexa, Risperdal, and Abilify); mood stabilizers (Depakote, Topamax, Lamictal, and lithium); antidepressants (Prozac, Effexor, Celexa, Cymbalta, Wellbutrin, and Lexapro); and anti-anxiety drugs (Klonopin and Ativan). For alcoholism, she tried Antabuse and naltrexone. Alone or in combination, these pharmaceuticals dampened the author's sexuality, blunted her emotions, and slowed her thinking.
Delano was also treated at the storied McLean Hospital, made famous by past residents such as Sylvia Path (The Bell Jar, 1963), Susanna Kaysen (Girl, Interrupted, 1993), and David Foster Wallace (Infinite Jest, 1996). To Delano's chagrin, psychiatrists at McLean changed her diagnosis to borderline personality disorder.
The diagnosis entails a host of features, such as problems regulating emotion, idealizing-then-rejecting personal relationships, unstable self-image, and impulsivity. Disavowal of personal agency is common, as are suicide attempts, chaotic romances, and substance abuse. In Delano's eyes, "being borderline" meant that people would see her as "annoying, impossible, attention-seeking, manipulative, needy. Huge slut"--things over which one might be expected to exert some control.
After graduation, she remained financially dependent on her weal-thy parents and lacked a sense of purpose. "I surrendered personal agency," she writes, attributing her troubled thoughts and erratic behaviors to a broken brain. Attending Alcoholics Anonymous at 26, however, stirred some hope and prompted a momentous question: "Who would I be off my meds ?"
Soon, an answer began to form as she read Robert Whitaker's 2010 Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. A vocal critic of the psychiatric establishment, and a reckless guide to the anatomy of mental illness, Whitaker argued that the long-term disability of schizophrenia is caused by the medications intended to treat the condition. As proof, he offers the less dire fate of schizophrenic patients in developing countries, where medication is not used. In reality, however, the afflicted were not schizophrenic; they suffered from an acute, rever-sible condition, likely viral encephalitis. "Love and food and understanding, not drugs," are the treatments he urges.
Delano, 27 at the time, was prim-ed to receive Whitaker's message. "Holy s--t. It's the f--ing meds," she thought. "What if it wasn't treatment-resistant mental illness that had been sending me ever deeper into the depths of despair and dysfunction, but the treatment itself?"
To discover who she would be off her meds, Delano endured many agonizing months of self-withdrawal. (At the time, about 15 years ago, psychiatrists underestimated the degree to which the body adapted to psychiatric meds and that tapering off of them might need to take place over many months.) She went cold turkey off psychotherapy, too, and eventually emerged to found a nonprofit, the Inner Compass Initiative, that coaches paying clients through the medication-withdrawal process. The Initiative website says its aim is to help people get "beyond psychiatric drugs and diagnoses."
No question, psychiatry has its weaknesses. Researchers and clinicians are still grappling with as basic an issue as the optimal way to diagnose patients, for example. Despite half a century of promises to the contrary, researchers have yet to map mental disorders onto abnormal brain mechanisms or genetic risk factors. We still lack clinically useful diagnostic tests, such as a signature pattern on a brain scan or EEG, or consistently good responses to medications that correspond to the disorders listed in the Diagnostic and Statistical Manual (DSM).
Because the clinical picture of each patient depends on a jumble of other factors, including childhood adversity, head trauma, life experience, and simple chance, two people with the same genetic predisposition to mental illness may manifest their conditions differently. Conversely, "mild depression," a formal designation within the DSM's fifth edition, could just as easily represent inchoate misery molded into a diagnostic shape by convention, social suggestion, or the emotional gratifications of the sick role.
So, while the manual offers a serviceable framework for organizing clinical phenomena, it does a poor job explaining their origins. To be fair, the DSM architects have been very candid about that. As new taxonomic schemes are under development, we can take some solace in knowing that our medications mainly, though not always, treat symptoms, not diagnoses.
Another problem is that we psychiatrists both under- and over-treat the population. Severely mentally ill individuals, generally considered those with psychotic disorders, do not get nearly enough clinical attention. Meanwhile, the distraught are pathologized and, too often, reflexively given prescriptions. I encounter this routinely in the methadone clinic in which I work. The vast majority of our patients do not have a mental illness. What they have are difficult lives, harrowing childhoods, poor impulse control, and weak problem-solving capacities.
When they speak of "depression," most of the time it's demoralization that ails them. Many claim to be bipolar. When I ask them, with genuine interest, "How did you get that diagnosis?" The predictable response is "Because I have 'mood swings.'" That is not bipolar. True bipolar disorder is a grave, though usually treatable, condition marked by manic states, paranoia, and delusional thinking alternating with immobilizing depression. If I had a Swiss franc for every patient who told me he had been diagnosed with bipolar disorder, but who is actually not afflicted, I could open a thermal spa in Zurich.
Laura Delano, now 42, is a skilled writer, and Unshrunk is a highly readable book. But the reader is dared (this reader, anyway) to disentangle the author's innate, troubled self from the iatrogenic effect of treatment. In short, how much of Delano's anguish was Delano, and how much was inflicted upon her by psychiatry? There is no pat answer: Few things in human psychology are linear and monocausal. The impact of experience, traumatic and otherwise, can have delayed effects. What's more, we may unwittingly elicit responses from others that make us feel victimized.
Nor is memoir, the most subjective literary form, an ideal way to get at unfiltered personal history. Still, it is clear that Delano was in considerable mental pain before her crisis of identity and authenticity hit one night as she readied for bed. For instance, the author had started cutting herself before her first appointment with the psychiatrist and berated herself as "Slut. Whore. Pathetic. Dirty. Disgusting. Trash. Ruined." During that appointment, her inner voice described her as an "ashamed, bewildered fourteen-year-old girl overwhelmed by painful emotion."
Feeling improperly loved and comforted as a girl is an insistent theme. When her mother handed her the Depakote and Prozac to take with her milk, Delano recalled how "a part of me wanted to collapse into [my mother's] arms, for her to hold me, rock me, for her to tell me all of this had been a big mistake." After a bad date with a boy and the soothing ministrations of her Greenwich Academy, she laments "how long it had been since I felt taken care of." As for the medication, it drowned out "all other emotions--sadness, loneliness, shame, grief."
Why those emotions had been surging through her in the first place, I can't know. But I do know that existential misery and profound self-reproach are not side effects of psychiatric medication.
In fairness, the author acknowledges "that many people feel helped by psychiatric drugs, especially when they're used in the short term." (Note the phrasing "feel" helped, as opposed to her saying they are helped.) In truth, medications are often essential in helping many people with severe, chronic mental illness live more rewarding and productive lives.
Nor are most people with psychiatric illness straining against the system. Delano learns this when she works briefly as a peer specialist in a state-funded Boston-area community mental-health organization. When she started, she said, "I imagined I'd be spending my days helping people stand up against psychiatric coercion, spring themselves from locked wards, and successfully get themselves off meds they'd decided they no longer wanted to take."
But she had no takers. As befit her worldview, she ascribed the patients' complacency to false consciousness borne of their dependence--psychic and material--on mental-health care and social-service systems.
Many of the patients in the Boston facility, it turned out, were very ill, unable to live full, independent lives. Yes, some of them, perhaps a lot, may have had potential when they first became ill--if they did take medication reliably. Sadly, many public clinics and hospitals lack sufficient and talented staff. They are drab and unimaginative spaces. Yet as heartbreaking as institutions can be, it never occurred to Delano that these patients still found some value in what psychiatrists and psychologists offered them. Part of that repertoire may well have been medication.
Delano wants to warn readers about psychiatric medications, but Unshrunk is not a reliable guide. The author, for example, lauds a 2022 analysis of the literature in Molecular Psychiatry that purported to upend the consensus that serotonin is involved in depression. Research is ongoing, and the serotonin story will almost surely evolve. But the author should have acknowledged the three dozen researchers who critiqued the methodology of the Molecular Psychiatry article.
Unshrunk and Whitaker's Anatomy of an Epidemic go on the same shelf. Both are written by smart, passionate people. Both highlight undeniable problems with the mental-health-care system. Yet, their flagrant biases could mislead readers and harm fragile and seriously ill readers who are convinced to stop their medications.
For many years, Laura Delano was vulnerable and suffering. She was drawn, as many are, to the exonerating power of a diagnosis. She could then blame her brain, in addition to her parents, her school, and, later, the psychiatric establishment. But perhaps the crowning irony is that psychiatry can explain a lot.
Recall Delano's first year at Harvard, when she rejected borderline personality disorder? The fact is, seen from afar and based solely on her own account, the designation appears to have fit her. For one thing, borderline personality disorder is a condition for which meds are not especially helpful--but where alcohol, cocaine, and other street drugs tend to be, at least in the short term. Second, it is typical for borderlines to receive many diagnoses over the course of their lives. Third, the personality disorder tends to remit over time, in the sense that patients no longer meet the diagnosis but often retain scattered symptoms, or what psychiatry might call symptoms, such as the ones Delano says she still has.
The married mother of two continues to experience "intense emotional pain and paranoia and debilitating anxiety and unhelpful impulses." Yet, overall, she has greater mastery of herself, knowing, at last, how to engage the "art of leaning into the darkness of being alive." Having a mission--trying to help people in pain--has surely helped. But being fueled, as she is, by the organizing power of an enemy, means that anyone contemplating her ministrations must do so with a strong dose of caution.
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by Sally Satel
Copyright: COPYRIGHT 2025 American Jewish Committee
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Satel, Sally. "Keep on Pushing My Love Over the Borderline: Review of 'Unshrunk' by Laura Delano." Commentary, vol. 159, no. 5, June 2025, pp. 1c+. Gale General OneFile, link.gale.com/apps/doc/A844498804/ITOF?u=schlager&sid=bookmark-ITOF&xid=6958fff8. Accessed 29 June 2025.
Unshrunk: A Story of Psychiatric Treatment Resistance by Laura Delano; Viking, 352 pp., $30
Some years ago, in a condition of acute emotional distress, I found myself in the office of the resident psychologist on a unit of a mental institution. Sitting in this psychologist's office on day four of my incarceration, I was wracked by a kind of psychic claustrophobia; I was miserable and scared and desperate to get out. Fueled by panic, I pleaded tearfully that I needed to go home.
The psychologist said that leaving in my present state would be a bad idea--and she wasn't wrong--but then she asked if I'd ever had a manic episode or been diagnosed with bipolar disorder. I had not, I told her, and I was not having one now. But she seemed determined to pin this diagnostic label on me. At that moment of distress, I had little confidence in my own judgment about anything, but I am pretty sure of this: though I have received a number of psychiatric diagnoses over the years (a passel of anxiety disorders, plus major depression) that apply with fluctuating degrees of aptness to the lumpy and mutable human personality that is me, I am not and have never been manic. Her insistence that I might be only made my anxious agitation worse--which in turn reinforced her conviction that I was indeed a bipolar patient in the throes of mania.
My reaction to all this was despair, because this woman, representing the institution to which I had entrusted my fragile mental health, seemed to have no idea what she was talking about, an impression she reinforced by riffling through the pages of the DSM-V--that is, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the so-called bible of psychiatry--trying to remind herself of the various symptoms of bipolar and other possible disorders that she believed might be afflicting me. This was like watching a pilot try to land a plane while consulting the aircraft's instruction manual. It did not, to put it mildly, bolster my confidence in her clinical judgment.
I tell this story not to indict the psychologist's acumen but because she was a particularly vivid distillation of an abiding reality: much of psychiatric diagnosis and treatment still consists of a bunch of blindfolded researchers and clinicians playing pin-the-tail-on-the-donkey. And yet millions today find themselves trapped in the psychiatric- pharmacological-industrial complex, guinea pigs subjected to the prevailing and then evanescing trends in mental health treatment.
Over the decades, these trends have ranged from bloodletting, to pulling teeth, to Freudian psychoanalysis, to inducing malaria fevers (via infected rat bites), to the prescription of heroin, to partial lobotomies, to insulin comas, to electroshock therapy, to the "miracle drugs" of the 1960s and '70s (the Thorazine-era antipsychotics and tricyclic antidepressants), to the "miracle drugs" of the 1990s (the Prozac-era profusion of SSRI antidepressants), to "atypical antipsychotics," to psychedelics, to transcranial magnetic stimulation, to ketamine infusions, to the numerous acronymed variants of psychodynamic psychotherapy--CBT, DBT, ACT, EMDR, etc. The efficacy of just about all of these treatments can be distilled to this: some treatments work some of the time. Most of them, in fact, work about a third of the time. Which happens also to be true of placebo treatments.
Revolutionary new theories about the roots of psychiatric disorders--"the serotonin hypothesis of depression" or "the chemical imbalance theory of mental illness"-- turn out to be, at best, grossly oversimplified and, at worst, faux-medicalized voodoo. "It remains difficult to refute a critique that psychiatry's most fundamental characteristic is its ignorance," declared a 2022 review in Neuron, which concluded that efforts to identify the underlying cause of mental illness "have been a litany of failures." A decade earlier, Tom Insel, then the head of the National Institute of Mental Health, had acknowledged that the DSM was hardly scientific and should perhaps be retired-- which is unlikely to happen because pharma and insurance companies rely on its classifications. And yet despite--or maybe because of--all this, some 60 million American adults, including about one in five American women, are now on psychiatric medications.
This is the medical and cultural context in which Laura Delano's bracing and heroic book, Unshrunk, arrives. Delano writes with the hard-won authority of the longtime patient. She provides a searing narrative of her descent into the hell of pharmacological imprisonment, and then her climb out of it to freedom from medication dependence and her ultimate rejection of the term mental illness. She impugns the overblown claims Big Pharma has made about how effectively psychiatric medications work, and she punctures the oversimplified explanations biological psychiatry has provided for why they ostensibly work. She writes insightfully, at times lyrically, about not just her own psychological condition but also our culture's:
I sometimes wonder if talk therapy has become a source of
absolution in the way that weekly confessional has historically
been for many churchgoers--and whether ... therapists have become
proxies for priests.... The doctor handing me my prescription note,
the soporific piano on the pharmacy hold line, the crunch of
stapled bag passed over the register, 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.
For many readers, Delano's book will provide useful revelations about the realities of biomedical psychiatry; other readers will find in Delano's tale a validation of their own experiences of immiseration by misprescribed psychiatric medications. For these reasons, among others, this is a valuable and important book. But I worry it is possibly also a slightly dangerous one. Because for all the controversy about psychiatric drugs, there is compelling evidence that the right psychiatric medication at the right time can save lives.
Delano's own story is harrowing and powerful. At age 13, she is undone by the pressure of high expectations and ends up in her first psychiatrist's office. For the next decade and a half, she becomes "a professional psychiatric patient." Diagnosed at various times with bipolar disorder, borderline personality disorder, substance use disorder, and an eating disorder, she cuts herself, drinks herself into blackouts, does repeated stints in psychiatric wards, and tries to commit suicide. She sees, by my count, at least a dozen psychiatrists whom she sketches with mostly sympathetic understanding but at times with deservedly savage irony. One (older, male) psychiatrist seems creepily preoccupied with her sex life, and at the end of the book she writes acidly that the psychiatrists' case reports she has quoted from are "best understood as works of imaginative historical fiction."
Over the years, she is prescribed a devil's apothecary of medications: Ambien, Prozac, Effexor, Lexapro, Provigil, lithium, Lamictal, Topamax, Seroquel, Ativan, Klonopin, Neurontin, Antabuse, Naltrexone, Abilify, Risperdal, Cymbalta, Wellbutrin, Celexa. This procession of medications begins with Depakote, a so-called mood stabilizer, prescribed to her in early high school for her (ostensible) bipolar disorder. When she resists taking it, her therapist says, sounding like some Disney movie witch-temptress, "You want to feel happier, Laura, don't you?"
Thus begins her journey into the heart of psychopharmacological darkness and, eventually, back out again. After initially resisting the diagnoses imposed on her and the pills thrust at her (she hides them in a jewelry box), she eventually accepts her status as a mentally ill person. But for Delano, as for so many others, the quest to treat a putative mental illness with medication becomes an Alice-in-Wonderland quest to mitigate or treat the ill effects of the previous medication by switching to, or augmenting with, a new one. When Delano becomes unable to "make it through a day without obliterating myself with alcohol," she ends up in Alcoholics Anonymous, which she says provided more relief than the psychiatric establishment ever had. "I felt new space open up in me, and in it, the arrival of an unsettling question: Who would I be off my meds?
Around this time, Delano picks up a book called Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (2010), by the journalist Robert Whitaker, who provides an aggressively skeptical look at the history of psychopharmacology as well as case vignettes of individuals who had suffered long-term damage from psychiatric medications. The book hits Delano with the force of revelation: "Holy shit. It's the fucking meds." Red pilled, as it were, by this book about pills, she suddenly perceives a new reality. "Is it possible that psychiatry's medication- based standard of care is actually causing people to become psychiatrically disabled?" she asks, building on Whitaker's (controversial) argument that medications like Prozac, Zoloft, and Lexapro are exacerbating or even causing the conditions they are designed to treat. "Is it possible, in other words, that the treatment is making people sick?"
Whitaker's book fuels Delano's determination to escape psychiatry's dominion. With tremendous effort and a lot of suffering, she weans herself off all medications. She connects directly with Whitaker and begins writing blog posts for his website, Mad in America, describing her misadventures in psychopharmacology. Eventually she goes on to found her own nonprofit organization, Inner Compass Initiative, which aims to help people get "beyond psychiatric drugs and diagnoses." Inner Compass Initiative provides information about the dangers of psychiatric medication, as well as critiques of biological psychiatry. This is--if taken with a grain of salt--useful information for someone contemplating a course of pharmacotherapy, or for those wanting to wean themselves off psychiatric medication. The step-by-step guidelines for how to taper medications safely and carefully are exceptionally valuable.
Delano is correct that until recently, physicians have been woefully ignorant of how difficult it can be to discontinue medication. Only when online communities of patients came together to share their stories, and advocacy groups publicized them, did doctors start to become aware of what their patients were going through. Even then, Delano writes, some psychiatrists didn't believe what their patients were telling them about the scope of their suffering--until they themselves went on medication for depressive episodes and then had to endure withdrawal.
The force of will Delano demonstrated to escape the yoke of not just medications but the whole epistemological framework on which they rest is heroic. "I decided to live beyond labels and categorical boxes," she writes, in a kind of Emersonian triumph of self-definition, "and to reject the dominant role that the American mental health industry has come to play in shaping the way we make sense of what it means to be human." And the story Delano tells of 20th-century psychiatry's effort to shed the witchcraft hokum of Freudian psychoanalysis by embracing biological psychiatry and "redefine themselves as legitimate medical authorities" is accurate. She's right, too, that a number of large studies over several decades have cast doubt on both the efficacy of SSRI antidepressants and the biochemical theories that underlie them.
But I worry that in her zeal to break free of all institutional fetters and diagnostic categories, she overstates the case against biomedical psychiatry in ways that, in this era of antiscience populism, could be dangerous. For instance, Delano puts a lot of analytical weight on a 2022 "umbrella review," published in Molecular Psychiatry, which supposedly analyzed all the relevant studies and found no connection between low levels of serotonin and depression. The paper's lead author, however, was one Joanna Moncrieff, a professor of psychiatry at University College London and a dissident psychiatrist whose antipsychiatry crusade has gained her some uncomfortable bedfellows, ranging from Tucker Carlson and Robert F. Kennedy Jr. to the National Rifle Association and the Church of Scientology. The company Moncrieff keeps doesn't necessarily mean that she, or Delano, is wrong. But it does merit the raising of a skeptical eyebrow. And in fact, a year after Moncrieff's study was published, Molecular Psychiatry published a response by 36 researchers pointing out methodological problems with her analysis, including oversimplification, selective reporting of data, and interpretive errors. Delano doesn't mention that.
The debate over the efficacy of psychiatric medication is complex--and distorted by professional and ideological turf wars. Delano is unquestionably correct that many drugs are grossly overprescribed. But a majority of clinicians, as well as the authors of many recent studies, would say that, for instance, antipsychotic medication for schizophrenics, or lithium for bipolar patients, can lead to significant remission of symptoms and improvements in quality of life. (A recent comprehensive review of the extant research on lithium reaffirms its status as the "gold standard" for treatment of bipolar. Delano, who dedicates a chapter to explaining how lithium is poison, would surely dispute that review as industry claptrap.) The debate over antidepressants is even more complicated and multifaceted, but some large, reputable analyses--such as a massive 2018 meta-review of 522 double-blind studies, published in The Lancet-- have found that antidepressants (modestly) outperform placebos. The crudely oversimplified theory of mental illness as a "chemical imbalance" that can be rectified with drugs has been thoroughly debunked--but the idea that some medications can be effective for some patients has not been. Psychiatry poisoned and immiserated Laura Delano, as it has many others. But many people say that psychiatry and psychopharmacology have saved their lives, or the lives of their patients. (They may have saved mine.) Amid all the conflicting data in the studies and meta-reviews of studies, we are each of us always only Ns of 1.
Delano's book is a valuable contribution to the literature on psychiatric hubris, and it will be a source of succor to the fellowship of the overprescribed. I am also grateful to Delano and Inner Compass Initiative for educating people on how to taper their prescribed drugs safely. There may well come a time when I, still reluctantly entangled in my own web of psychopharmacology, will need support, and I can think of no one more qualified to help me than Laura Delano.
Permission required for reprinting, reproducing, or other uses.
Scott Stossel is the national editor of The Atlantic and the author of My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind and Sarge: The life and Times of Sargent Shriver.
Caption: Tom Varco via Wikimedia Commons
Copyright: COPYRIGHT 2025 Phi Beta Kappa Society
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Stossel, Scott. "Who Would I Be Off My Meds: Can weaning oneself off pharmaceuticals ease the cycle of perpetual suffering?" The American Scholar, vol. 94, no. 2, spring 2025. Gale General OneFile, link.gale.com/apps/doc/A838393504/ITOF?u=schlager&sid=bookmark-ITOF&xid=8661e734. Accessed 29 June 2025.