In recovery — from antidepressants. How patients are helping each other withdraw.

Beth Greenfield
Senior Editor
From left: holistic psychiatrist Kelly Brogan, who will not write prescriptions; longtime antidepressant users Sheila Wojciechowski and Chase Twichell, both of whom are weaning themselves off their medications. (Collage by Quinn Lemmers for Yahoo Lifestyle)

When Sheila Wojciechowski was 21 years old and fresh out of college, she found that her new job — working at a school for kids with autism — made her feel increasingly depressed and anxious.

“I would go home and cry, and feel like I was no good at the job,” she says now, at 35, of her quick spiral downward. “I slowly became less and less functional. I couldn’t get out of bed.” After seeing several psychotherapists and “not clicking” with any, she was taken by her parents, with whom she lived at the time, to a psychiatrist.

“I went in, and after, like, 10 minutes, he said, ‘Clearly, you have major depression disorder with anxiety disorder,” Wojciechowski, of Queens, N.Y., tells Yahoo Lifestyle. The doctor, who was citing an official diagnosis, then wrote her a prescription for the antidepressant Lexapro, a selective serotonin reuptake inhibitor (SSRI). Sensing her wariness, he asked her, “If you had a headache, wouldn’t you take an Advil?”

To that, Wojciechowski recalls, “I said yes. It made sense, and I tried it — reluctantly. … I knew it was not right from that first pill, but you do what you can with the information you have at the time.”

For Wojciechowski, now a therapeutic child care provider with a collection of message-bearing tattoos on her arms — including “Sheila B” in script, for her grandmother, who used to tell her, “Don’t let the bastards get ya!” — that meant giving the Lexapro a chance.

“I remember a few days after I started, I felt hyped up, but not in a good way,” she says, “and my doctor was like, ‘Just increase it. Take double,’” which she did. And it seemed to help. “I was like, ‘I’m just someone who needs medication to help me function.’”

But that idea plagued her, so she tried going off the drug a year later, following her doctor’s advice to “just cut it in half for two weeks” and be done. That caused what she describes as “weird brain zaps” and increased anxiety, so she went back on — until it seemed to stop working altogether. She returned to her psychiatrist, who told her, “Your life seems fine. You don’t have any reason to be depressed, so you must be bipolar.” For that new mood-disorder diagnosis (which she believes now was incorrect), he opted to put her on Abilify — an antipsychotic that’s used so often and for so many disorders, including depression, that it was America’s top-selling drug of 2014.

Eighteen million Americans, or 7 percent of the population, have taken antidepressants for at least five years. (Image by Quinn Lemmers for Yahoo Lifestyle)

It proved disastrous — leaving Wojciechowski “flat” and “numb” and causing crazy mood swings and swift weight gain — so the doctor added the antidepressant Wellbutrin to the mix, at her request, as well as the anti-anxiety pill Klonopin. A 14-year long push-pull with her meds ensued, and a growing, ever-present desire: to be drug-free — putting a stop, hopefully, to side effects, and allowing her to get to know herself again.

“I had this gut feeling,” she says about needing to get off her drugs. “And then I was desperate.”

So she turned to the internet, where she found a whole world of people in her shoes.

*****

Wojciechowski is, according to federal data, just one of the 37 million Americans (13 percent of the population) taking antidepressants — drugs widely hailed by psychiatric practitioners and by the millions of patients who have used them and found relief.  

She’s also one of 18 million people (7 percent of the population) who have been  taking antidepressants for at least five years, a rate that has almost doubled since 2010, and which has more than tripled since 2000. This is despite the fact that the drugs were originally intended and approved for short-term use, to get someone through a six- to nine-month crisis. Later studies found that longer-term usage could keep depression at bay for some patients, but such studies of SSRIs have rarely lasted more than two years.

“Psychiatry is now training doctors to put people on psychiatric drugs and never take them off,” claims Peter Breggin, a Harvard-trained psychiatrist who has become a vocal critic of psychiatry and a prolific author, focused today on weaning patients from drugs. “Adults are commonly told they have a biochemical imbalance and they have to take the drugs forever. There’s no evidence for this at all.” 

Breggin is referring to the still-debated, never-proven “chemical imbalance theory,” which says that depression is caused by a deficiency of the brain chemical serotonin, and that SSRIs help by enhancing it. That contention, however, has been largely debunked. Even the American Psychiatric Association (APA) has no official position on the theory, according to a spokesperson, who referred Yahoo Lifestyle to Ronald Pies, MD, editor-in-chief emeritus of Psychiatric Times; he says the notion took hold in popular culture thanks to a “distorted or oversimplified” hypothesis.

“Psychiatry is now training doctors to put people on psychiatric drugs and never take them off,” psychiatrist Peter Breggin, author of Toxic Psychiatry, contends. (Photo courtesy of Peter Breggin; graphics by Quinn Lemmers for Yahoo Lifestyle)

It “held that certain brain chemicals, like serotonin, are involved in mood disorders,” Pies, professor emeritus of psychiatry at SUNY Upstate Medical University and clinical professor of psychiatry, tells Yahoo Lifestyle. Caricatures of this claim then circulated in drug company ads, magazines and “misinformed” websites, Pies notes, giving the hypothesis a validity that “few if any psychiatrists have ever held.” (Reputable critics assert that both the APA and the pharmaceutical companies have a history of promoting the idea.)

In truth, scientists aren’t quite sure how SSRIs function, just that they do: A massive and largely celebrated meta-analysis of studies, published in 2018 in the Lancet, showed that SSRIs were indeed more effective than placebos (although critics have pointed out that most of the studies were funded by the pharmaceutical industry). But while the science on antidepressants may be murky, there is no shortage of anecdotal evidence about how they can help people, and a steady clip of recent personal essays by grateful users has credited the drugs with everything from stopping panic attacks and restoring equilibrium to making life “worth living” and erasing thoughts of suicide

They don’t work in the same way for everyone, though, and today, while there are no official numbers on how many people, like Wojciechowski, are attempting to wean themselves off their drugs, a recent study of 1,829 users of antidepressants found that about 75 percent had tried, just over 30 percent of them quitting successfully; the others found the withdrawal symptoms too hard to bear.

This much is clear: Thousands, if not millions, of people who are on antidepressants want to get off them — for reasons that range from unwanted side effects (including sexual dysfunction, emotional numbing and weight gain) to a nagging desire to know who they are without them. Still others, told they had a serotonin deficiency, feel they were needlessly diagnosed and prescribed from the get-go, and now want to put that belief to the test.

Whatever the motivation, they are finding that withdrawing is no easy feat — especially considering this startling fact: There is absolutely no psychiatric protocol to guide them.

“To my knowledge, there is no ‘official,’ professionally endorsed, week-by-week protocol for safely tapering patients off antidepressants,” Pies tells Yahoo Lifestyle. “This is a serious gap in our knowledge base and practice guidelines.”

And it’s why many, like Wojciechowski, are taking matters into their own hands, through a collective effort that represents a burgeoning international movement.

 

Consisting largely of peer-led, online communities, the virtual spaces provide mutual support in people’s quest to become drug-free — sometimes after years or even decades of struggling, in some cases, with what are known as “iatrogenic effects,” meaning that the drugs seem to exacerbate the issues that made people take meds in the first place.

The grassroots support and advice forums run the gamut from strictly layperson-led guidance hubs like the Withdrawal Project, Surviving Antidepressants and Everything Matters Beyond Meds to the more structured counsel of “holistic” psychiatrists such as Breggin and Kelly Brogan, whose pricey Vital Mind Reset Program provides patients access to a private Facebook support group.

What the systems provide is twofold: communal support for a process that can bring excruciating and long-lasting mental and physical withdrawal symptoms, and practical advice and instructions about how, exactly, to taper off these meds. The reach of the grassroots groups is powerful — not only for the patients who rely on them, but for the clinicians who turn to them in the absence of formal protocols.

“I learned this entirely from my patients. Entirely,” says Brogan, an MIT-educated physician whose entire psychiatry practice is focused on helping patients get off their psychotropic medications, and who has not written a prescription since 2010. “These drugs are more habit-forming than any chemicals on the planet — more than alcohol, cocaine, crack, Oxycontin. I could taper someone off of an opiate in days, but sometimes, with these meds, you need years to come down sometimes by a milligram. This is, like, an international emergency.” (The question of “habit” is a point of contention; while studies have found that many patients do find their SSRIs addictive, the APA notes that antidepressants are “not habit-forming.”)

To learn about the safest, most effective ways to taper off, “I read every [tapering] blog and chat room there was,” Brogan says, “and I learned that there are millions of people doing this around the world on their own today, because they cannot find [doctors] like me who are willing to support their journey.”

That may be starting to shift ever so slightly, thanks to the efforts of people outside the profession, says Robert Whitaker, the investigative science journalist behind the psychiatric-history critique Anatomy of an Epidemic (which used reams of medical evidence to question the broad diagnostic criteria for mental illnesses, the promotion of the “chemical imbalance” theory and the often too cozy relationship between many leading lights in psychiatry and the pharmaceutical industry). He is also the founder of the website Mad in America, whose mission is to “serve as a catalyst for rethinking psychiatric care,” arguing that “the current drug-based paradigm of care has failed our society.”

Whitaker, who is widely revered in withdrawal communities, and whose book is basically seen as the bible of the movement, tells Yahoo Lifestyle, “For the longest time, people wanting to get off [meds] would so often not find any support from their prescribers. But that has changed now, and one reason, I think, is grassroots.”

Recent developments include the establishment of the International Institute for Psychiatric Drug Withdrawal — an international consortium of mental health professionals and other experts (including Whitaker) that hosts withdrawal workshops, including one on Jan. 19 in Norway — as well as a new “deprescribing” initiative at the Yale School of Medicine, which aims to teach aspiring psychiatrists lessons about withdrawal.

 

“We have to come up with guidelines, because there are no guidelines, and there are no [financial] incentives to create those guidelines,” Swapnil Gupta, the assistant professor of psychiatry behind Yale’s informal effort, tells Yahoo Lifestyle. She says that she, too, relies on consumer forums and patients to learn about withdrawal.

Gupta was stunned at what she saw as overprescribing — patients on four or five different psychotropic medications at a time “without any specific pharmacological rationale” — when she arrived in the United States from India for her residency several years ago. Since then, she has  focused on the topic of safe withdrawal, adding lectures to the Yale curriculum and co-writing several review articles. A forthcoming book that she co-authored with colleagues will join Breggin’s Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families in filling the void, providing details on how to cut back on prescriptions in every medication class, including antidepressants and benzodiazepines — anti-anxiety meds, such as Klonopin and Xanax, which are often prescribed alongside antidepressants, and are highly addictive and are frequently misused, according to a new report.

Also adding to the growing withdrawal conversation has been the October release, in the United Kingdom, of a major government-commissioned review in the journal Addictive Behaviors.  It analyzed 24 studies to create a more accurate portrait of the experience of withdrawal. The main objective was to examine the severity and duration of antidepressant withdrawal effects, and whether or not they matched the official U.S. and U.K. warnings given to patients — which say that effects are “self-limiting (typically resolving between 1 and 2 weeks)” and “usually mild,” according to APA guidelines as well as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Researchers, as it turns out, found major discrepancies.

“Current clinical guidelines are in urgent need of correction,” noted the researchers, John Read, a psychologist, and James Davies, a cultural anthropologist, who wrote about finding a much more bleak reality: “While in some people, such reactions may be mild, of short duration and manageable … in other people, even with slow withdrawal, these reactions are severe, long-lasting and can make normal functioning impossible. Typical AD [antidepressant] withdrawal reactions include increased anxiety, flulike symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. Dizziness, electric shock-like sensations, brain zaps, diarrhea, headaches, muscle spasms and tremors, agitation, hallucinations, confusion, malaise, sweating and irritability are also reported,” along with “mania and hypomania,” “emotional blunting and an inability to cry,” and “long-term or even permanent sexual dysfunction.”

The study, which Read tells Yahoo Lifestyle was inspired in part by the grassroots withdrawal community, also found this: that 64 percent of patients say their doctors never warned them about the risks or side effects of antidepressants.

“Most people try to come off their drugs and can’t, because they go into a withdrawal reaction and they become very confused, because the doctors don’t tell them about the withdrawal reaction — they tell them, ‘See? You need your drug,’” says Breggin, who does not share Whitaker’s optimism that the ethics of prescribing psychiatric drugs and weaning patients from them have been improved in recent years. “It’s only gotten worse. That’s why work by the laypeople, the consumers, is the work that’s going to change things, and I’ve been saying that for about 30 years,” he says. “It’s the only way.”

Learning from each other, not psychiatrists: ‘revolutionary’ 

A growing number of people wanting to withdraw from SSRIs are in firm agreement with Breggin — including about 30 who gathered in a bland, small conference room at a Connecticut Sheraton last spring. They had come to join a workshop, “Psychiatric Drug Withdrawal 101: A High-Level Overview of What a Risk-Reducing Medication Taper Plan Looks Like,” as part of a weekend conference by Advocacy Unlimited, a mental-health rights nonprofit.

Laura Delano, whose Withdrawal Project website is a hub for people wanting to come off antidepressants, in New York City last spring. (Photo: Casey Hollister for Yahoo Lifestyle)

Leading the workshop was Laura Delano, who has emerged as a guru in the global tapering community through her personal blog and popular year-old website, the Withdrawal Project. People flock to her for advice because she is an experienced layperson, not a medical professional, who has made it her passion to help others through the withdrawal journey after making it through herself. She says she became incapacitated, both physically and mentally, throughout much of the process, because she went about it too quickly, with no guidance.

But still, she was driven.

“Basically, when I was 27, I had this profound ‘Aha!’ moment, realizing that the previous 14 years of my life had gone down a very different track than I would have had I not been diagnosed and put on these medications,” Delano tells Yahoo Lifestyle, explaining that she was what she likes to call “psychiatrized” — given her first of what would be many diagnoses and prescriptions — at age 13. By the time she had her epiphany, in 2010, believing she was misdiagnosed and overprescribed, she had been steadily feeling worse and worse, both physically and emotionally, and was on a cocktail of five drugs, including mood stabilizers, antidepressants, the antipsychotic Abilify, and an anti-anxiety pill.

“I began to really question the medications I was on, the diagnoses I had — the whole medical model [of psychiatry] … and I realized I had no idea who I was. I had been medicated during the formative years of my life, and it was keeping me up at night, like: Who would I be off of these drugs?” Delano tells Yahoo Lifestyle. “Then I found Robert Whitaker’s work, which was a real catalyst. I was like, What if it’s been my treatment that’s been making my life so hard?” 

And so, though she had no support from her psychiatrist and “didn’t even know there was a such thing as withdrawal,” she went off her five drugs in five months, “basically cold turkey.” It was a horrendous experience, she says, racking her body with Exorcist-like side effects, from vomiting to boils (not to mention a roller coaster of emotional torment).

“It made me passionate,” she says, “about how not to do it.”

She started blogging about her experience for Mad in America, and then on her own site, Recovering From Psychiatry, inspiring emails from people all over the world who told her, “Oh my God, your story is my story.” Now she uses her experience of “psychiatric liberation” to teach that it is entirely possible to safely and successfully taper off and stay off psychiatric drugs with careful preparation and a slow-tapering regimen.

Delano, who is straightforward and down-to-earth, was raised in a Connecticut suburb and attended Harvard, but felt crushed by the pressure to succeed. “I would arrive in Harvard Square without a shred of self-worth beyond that which I felt from my grades, my athletic accomplishments, and the rest of my college application. And the message that I was ‘mentally ill’  — defective, abnormal, different, broken — would only serve to deepen my sense of emptiness and self-alienation…” she wrote in 2014. Delano attempted suicide; she soon had thoughts about going off her meds, and when she eventually did, was lucky to able to spend her withdrawal time living with relatives, just “tucked away, doing everything I needed while I healed.” Now she’s on a mission to pass on her hard-won wisdom. 

“What we’re covering here today really is revolutionary,” Delano told the spring workshop, “so I think it’s important to name that we are in a revolutionary space here.”

People took notes on the dense information she then doled out, which started with the advice that “The psych drug withdrawal journey doesn’t start with the taper — it starts with the preparation.” She talked about withdrawal in stages, and noted that how long the process will take varies greatly — from one week to 20 years, depending on the person.

“I’m seven years off these drugs, and I’m still healing from them,” Delano notes. “There’s a kind of power in letting the body call the shots. And this is about taking back our power, and realizing it’s up to us to educate ourselves. We don’t actually need these doctors to educate us.”

 

Delano, in fact, has been called upon to educate many physicians — giving keynote addresses and speaking on panels to psychiatrists all around the world, from London and Norway to Uruguay. In Brazil, she was hosted at a three-hour learning intensive for psychologists and psychiatrists at Brazil’s equivalent of the National Institutes of Health.

“Literally, last fall, I was at the World Psychiatric Association annual conference in Berlin, Germany,” she says, “standing in a room in front of like 200 conventional psychiatrists, on a panel, telling them, ‘This is what we’ve discovered in the layperson withdrawal community. These are our protocols that are helping people who have been on these drugs for 15 to 20 years come off them successfully, and you guys don’t know this information.’ I was wanting to pinch myself.”

Next on her agenda (along with crucial fundraising) is to teach a 10-week pilot withdrawal workshop that she hopes to turn into a model that can be replicated in other communities.

“I believe that access to information about these drugs and how to come off them as safely as possible should be a human right for all people that’s freely accessible,” she says, stressing that she’d never judge anyone’s decision to take psychiatric drugs or not.

“To me, it’s not about good or bad, or being anti- or pro- these drugs. It’s really about people’s rights to choose what they put in their body, and to make informed choices about the drugs,” she says, “and I don’t think that anybody is doing that, really — not the doctors, not those of us who take them — because the entire knowledge base that educates these doctors at medical school, and the journals and pamphlets, is biased and skewed.

“For example,” she continues, “people have the right to know that the average length for a drug trial for a psychiatric drug is 6 to 8 weeks,” she notes. “So these drugs are only looked at for a month and a half before they’re approved, and then you’re told you need to take this indefinitely. There is no evidence base for the long-term use of these drugs. People have the right to know that.”

The psychiatric profession, in general, has mixed feelings about Delano and the withdrawal community. The APA would not comment on the movement for Yahoo Lifestyle. And while Pies — who is viewed by many withdrawal activists as the face of the psychiatry establishment — confirmed the length of drug trials as noted by Delano, he has some criticisms.

“I think we need to distinguish between well-informed ‘grassroots’ movements aimed at improving psychiatric care — whose efforts I applaud — and broad-brushed ‘dissing’ of all psychiatric medications, with the aim of discouraging patients from using these medications, even when the patient is severely impaired,” he tells Yahoo Lifestyle. He faults Delano’s online tapering guidelines on “psychiatric drugs” for “inappropriately lumping together a variety of different agents, based on anecdotal data.” He takes issue with the idea that psychiatrists tell patients they must take these drugs “indefinitely,” noting that anyone being told that “may not be getting a good evaluation,” and pointing out that “most antidepressant prescription is not done by psychiatrists,” but by general practitioners and family doctors.

Pies, who believes alternatives to medication should always be considered, also stresses that, regarding the lack of long-term SSRI usage studies, “absence of evidence is not evidence of absence. That is, we should not conclude that because we don’t yet have the evidence in longer-term treatment that the treatment is not helpful or effective.” He adds, “While it is commendable to look for long-term evidence of antidepressant benefit, it is also critical to look at the risk of recurrent major depression [and realize that] up to 15 percent of individuals with recurrent MDD commit suicide.”

Still, overall, Delano sees her and others’ efforts to disrupt the narrative as a much bigger story. “It’s in part about the pharmaceutical industry, but also about the medicalization of everyday life — the very notion of what we call ‘disease’ and ‘illness.’ It’s really a philosophical dilemma that we all have to grapple with. Like, do we want to call obesity a disease and treat it like one? Or do we want to look at our society, and at poverty and at racism and at the food industry? Because that would make a lot of people with a lot of power not too happy.”

Learning from mistakes 

The power wielded by care providers, according to those who have attempted to taper off antidepressants and anti-anxiety meds — at least among the 15 people who shared their stories with Yahoo Lifestyle — can lead to a huge amount of frustration.

Lauren Omartian, left, and Nicole Dalcourt, right, took antidepressants for many years. (Collage by Quinn Lemmers for Yahoo Lifestyle)

“She said, ‘Lauren, if you don’t take the medication, I won’t work with you.’ It was like emotional hijacking. That effectively silenced me,” recalls Lauren Omartian, 57, of Boston, about her psychologist’s reaction to her wanting to go off Wellbutrin (an antidepressant) and Ativan (an anti-anxiety med) several years ago.

Her journey into the world of medication, Omartian tells Yahoo Lifestyle, began when her general practitioner put her on Xanax for stress, back in 1982 (although she never requested the drug). Not long after, she wound up having such obsessive suicidal thoughts that she landed in a psychiatric hospital. From that point on, she was prescribed a variety of pills, with a doctor finally landing on the duo of Ativan and Wellbutrin in the 1990s. Years into that, she decided, for a variety of reasons (including a pileup of physical ailments, from alarming weight loss to fibromyalgia), to try and get off the drugs, only to be met with the resistance from her therapist. And then she read Anatomy of an Epidemic.

“That book really turned my world upside down,” she says. “But I’ll be eternally grateful for it.” Today, Omartian is two years free of Ativan and in the midst of a difficult Wellbutrin taper, relying mainly on Facebook groups for support. “Just being off the medication is incredibly liberating,” she reports. “Friends have said it seems like I’m coming out of the fog, and that my personality is coming back.”

Upstate New York writer Chase Twichell, 67, has been on various meds for 32 years, including the antidepressant Paxil; the first time she tried tapering off of it was in 1992. She went too quickly, and wound up with “weakness, fainting, nausea, vomiting, disequilibrium, a weird feeling of electrical currents running through my body, shocklike feelings in my head.” At the ER, she was told she had the flu.

“It was the worst experience of my life,” she tells Yahoo Lifestyle. “I knew it was the Paxil, but no one would believe me.”

She went back on and tried weaning again in 2005, but the same thing happened. Now, for about nine months, she’s been giving it another, more informed go, using the specific recommendations on the Surviving Antidepressants forum. “The site is not run by medical professionals, but is very carefully and responsibly moderated,” she says. “I find it immensely helpful to compare notes with others.”

Also running into trouble with a Paxil taper was Nicole Dalcourt, 41, of Ontario, Canada, whose doctor tried weaning her off too quickly, causing symptoms severe enough, she tells Yahoo Lifestyle, “that I collected a multiple sclerosis diagnosis.” She went back on the drug and tried again; this time her doctor led her down “another wrong path” by prescribing a benzodiazepine to help ease withdrawal symptoms; she was left with immobility, panic attacks, hallucinations, tremors and blurry vision. Eventually, though, Dalcourt found relief by consulting various holistic health practitioners, and today is med-free and writing a book about her experience.

Tapering off antidepressants caused such severe withdrawal symptoms for one woman that she says she “collected a multiple sclerosis diagnosis.” (Image by Quinn Lemmers for Yahoo Lifestyle)

“We’re way ahead of the doctors,” Monica Cassani, who started the support and education website Everything Matters Beyond Meds 12 years ago based on her own experience, tells Yahoo Lifestyle. “I was there at the beginning, and it’s mushrooming now all over the world.”

Cassani, who says she was “forced” onto psychotropic meds after having an adverse reaction to hallucinogens while attending the University of California at Berkeley, eventually “cobbled together a support system” and figured out how to get off her drugs over a six-year period. She started her site — which gets up to 2,000 views daily without any social media presence — as a way to help others, and sees a recent shift in how long-term meds and withdrawal are viewed, pointing to an April 2018 New York Times story, “Many People Taking Antidepressants Discover They Cannot Quit,” as “indicative” of that. “It’s infiltrating society in a way that it wasn’t when I first started doing this. I’ve definitely seen a change in how it’s received publicly,” she says.

And while most of that is due to determined grassroots efforts and illuminating studies, Cassani also gives a nod to the rising number of holistic, or “green” psychiatrists, who complement the movement by making it their mission to support folks wanting off their meds — psychiatrists like Brogan, who started her career in the burgeoning field of reproductive psychiatry, writing prescriptions for pregnant women until she had a series of life-changing epiphanies (including reading Anatomy of an Epidemic).

“I think she’s part of it,” Cassani says of Brogan. “She’s wonderful for the movement, especially for people who require [her help in withdrawing]. It does, unfortunately, lend credibility.”

A psychiatrist who won’t prescribe 

Brogan does virtual one-on-one counseling for a handful of patients, but is focused these days on helping people taper off psychiatric meds through her books and programs. That includes a “reset” preparation that involves first making major dietary changes (no more dairy, wheat or sugar), getting a battery of blood tests (to rule out issues such as thyroid problems that could mimic depression), and making lifestyle shifts such as prioritizing sleep.

“I don’t taper a milligram before this 30-day reset is accomplished,” says Brogan, who stresses that people should “never ever ever ever just stop taking your meds” suddenly, and who adds that, while withdrawal is certainly possible, “It’s not for the faint of heart.” She describes her role in the support process as “basically like a home birth midwife,” explaining, “I’m there, I have total confidence that it’s going to be cool, and I’ll reflect that to you, like, ‘You’re rocking it out, keep going.’”

Her private patients — all women, as she believes “women, in particular, are sold a bill of goods around pharmaceuticals” — are typically in their 40s, having been medicated since their 20s, when going to college or other transitions caused distress.

“I meet with women, and they’re on three to five meds — and these are not women drooling in Bellevue, these are women who work [in New York City], who from the outside in look totally quote unquote ‘normal,’ and they feel unwell. They come to me unwell on medication, basically they’ve had enough, because their psychiatrist says, ‘Let’s just add this one on.’ … So then we have to create a new terrain. We have to figure out the why they were ever put on meds before we take them off — the real why.”

Brogan rejects not only the so-called chemical imbalance theory, blaming it on messaging gone awry due to unregulated direct-to-consumer marketing (“The FDA absolutely turns a blind eye,” she says). She also rejects the whole diagnosis of clinical depression. “I do not believe it’s a disease entity, and the reason is because there is not a shred of evidence that it is. Do I believe that it’s an experience? One hundred percent.” Learning to live diagnosis- and medication-free, she says, is difficult, and not helpful for everyone, because “it means that you have perhaps far less evidence [to explain] what you feel is still off or wrong inside you.”

That has been a difficult part of the withdrawal journey for Sheila Wojciechowski, who wound up finding Brogan’s book and signing on to her Vital Mind Reset program and some private sessions, and looking to the web forums of Cassani and Delano for support in her ongoing, determined effort to get off her medications.

“While I do struggle at times, there is a real sense of ‘I’ve got this,’ hope, and bright light at the end of the tunnel,” says Wojciechowski, who has been tapering off Lexapro for 17 months now, and is down to 2.5 mg after taking a dose of 20 mg for 15 years. And she wants to stick to it, despite having suffered bouts of withdrawal symptoms from anxiety and depressive waves to insomnia and body aches. “For me,” she says, “meds won’t ever be an option again.”

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