It’s hard for me to write about about Laura Delano’s new book Unshrunk: A Story of Psychiatric Treatment Resistance without getting personal because for much of the book I felt like I was reading my own story.

Longtime readers of this Substack know I have in the past dealt with what we politely call these days ‘mental health issues,’ a journey which involved a severe eating disorder, depression, and nearly a decade on antidepressants and anti-anxiety meds.

Laura dealt with all this and more. At age 14 she was diagnosed with bipolar disorder and so began her initiation into the world of psychiatric medicine. Medicated according to an ever-increasing cascade of prescriptions and repeatedly institutionalised, Laura became a full-time Patient. 

However, despite all these psychiatric drugs and interventions, Laura’s state did not improve.

Or, it finally dawned on Laura, because of all these psychiatric drugs and interventions, her state did not improve.

Eventually, Laura was able to taper off the drugs, find her feet, and leave her previous full-time Patient identity behind. Writer, speaker, consultant, wife, mother, Harvard graduate – Laura is many things, but most of all, she is herself.

Unshrunk is a compelling memoir threaded with close examination of the scientific evidence base for the drugs that Laura spent a decade and a half imbibing under the close direction of her various treating doctors.

Having had a family member who was similarly diagnosed and medicated for several decades before finally succeeding at their own suicide, I wish this book had been published earlier.

Anyone whose life has been touched by emotional, mental, and addiction struggles, particularly of the type that psychiatry has labels and medications for, and maybe of the type that proves ‘treatment resistant,’ will find comfort and insight in this book.

But also, Unshrunk serves as a powerful educational text for anyone scratching their head as to why, with all the psychiatric services and medications at our fingertips, we in the West are struggling more than ever before with mental health.

Fresh off the back of an interview with Tucker Carlson (which has been seen three million times on Twitter and over 390,000 times on YouTube) Laura joined me for a Q&A. I’m thrilled to share it with you:

RB: We met in person at a Brownstone event in Connecticut last year and got to swap stories, and my impression was that our experiences of mental health struggles had a Sliding Doors sort of duality. In my case, my religious upbringing centred on the moral and spiritual causes and cures for my troubles, which meant psychiatry and medication were not the first port of call in my ‘treatment.’ For you, it was straight to the psychiatrist, and then the prescription cascade. What was it about your family and social context that had you headed straight for the psychiatrist’s office – and to the prescription counter – at the first sign of teen troubles?

LD: Growing up, my family had unquestioning faith in medical authority. I had chronic ear infections as an infant and toddler, for example, and rather than step back to wonder what might have been happening in my body to set these off – this was the 1980s, and no one seemed to know anything about the microbiome, inflammation, et cetera – my parents took me to the doctor every few months and put me on a constant stream of antibiotics. I don’t blame them, of course; they were doing the best they could with the information they had available to them. We now know the hazards that come with overprescribing antibiotics – but back then, it was just how many American parents did things: Do what the doctor says.

I also grew up in a town built on the illusion of perfection. People appeared put together: happy, successful, high-functioning. Because of this, my parents and I felt convinced that the struggles I began having as a kid were unique, which made it easy to conclude that something was wrong with me, something bad. There were no support groups for struggling teens and there were no conversations about where to turn for help beyond doctors. So that, for my parents, seemed like the only path forward. They felt overwhelmed and scared, and they weren’t alone either. It’s been the default for parents for years, given the absence of other types of support.

RB: In Unshrunk, you take readers through the scientific evidence supporting many of the medications you were prescribed and we discover that the evidence base is shockingly thin. How do you account for this? Do you find that mental health professionals are aware of the lack of evidence for their prescribed medications, or are they somewhat oblivious?

LD: This is such a great question. Many mental health professionals are unaware of the evidence base – or lack thereof – for psychiatric drugs. Most rely on guild journals, but we know that those conclusions often distort the data and don’t accurately reflect the raw information. Professionals tend to look around, see the standard of care, observe what their colleagues are doing, and go along with it – assuming that the official recommendation must be safe and effective.

The reality is that understanding these medications takes immense effort. It’s taken me 15 years, and I’ve barely scratched the surface. Mental health professionals are caught in a challenging system: they’re overworked, drowning in paperwork, stressed, and often afraid of rocking the boat. It’s easier to follow the standard practice than to invest their limited free time in becoming experts on the drugs they prescribe.

Changing this requires courage. The more mental health professionals educate themselves on alternatives to the prescription-based psychiatric approach, the more likely we are to see meaningful change. When I meet professionals who’ve done the work of learning about these medications and their patient outcomes, I have profound respect for them.

The information manipulation in the medical/pharmaceutical industry is complex, and demands time and diligent research to fully understand, and a command of resources that most people simply don’t have.

RB: In the book, you challenge the disease/treatment model, offering an alternative perspective on many of the experiences and behaviours that are commonly labelled as mental illnesses. Can you expand on this?

LD: For years, I understood my struggles through a medical lens, believing I was “sick” with various “illnesses” that lived in my brain. This perspective taught me to reduce my experiences to clinical symptoms with a biological cause. I came to believe my brain had faulty chemistry that could never be cured, but only managed with lifelong psychopharmaceuticals. This, in turn, led me to give up on the idea that I could grow, change, evolve, transform – even that I could (or should) take responsibility for my problematic behaviors. If they were caused by a brain condition I had no control over, I came to believe, what was the point in trying?

After taking this for granted through the most formative years of my life, I eventually discovered that the medical model of mental illness is subjective, not scientific. And if this was the case, I realized that I could choose to let go of this story and make sense of my mental and emotional difficulties in a different way.

By medicalizing my experiences, I was preventing myself from understanding my pain. When I stopped doing that, I began to see my emotional struggles differently – as intelligent responses to life circumstances. My pain wasn’t a defect, but a wise reaction to challenging personal relationships, cultural experiences, and societal pressures. This change of perspective enabled me to address my difficulties in ways beyond medication.

We need to expand our understanding of human experiences. Professionals and prescriptions can be helpful sometimes, but they shouldn’t be the only path. We can also find our way through pain by rethinking relationships, addressing unhealed wounds from hard things that happen to us, and understanding ourselves in the broader social, economic, and political contexts of our lives. The key is recognizing that our struggles tell a story – and that story is far more nuanced than a diagnosis.

RB: After coming off your medications, you dedicated your life to helping others do the same, if they so choose, with your non-profit Inner Compass Initiative. Why is it necessary and what are you offering that the medical/psychiatric establishment does not?

LD: After coming off medications, I realized how complex the process of recovering from them can be. I recognized that I had significant advantages – family support, access to education, and the ability to research dense pharmacological information. So many people lack these resources when trying to navigate psychiatric medication and withdrawal.

This understanding led me to create Inner Compass Initiative (ICI), a charitable organization with a critical mission: helping people make informed choices about psychiatric drugs, diagnoses, and treatment. We provide comprehensive information about how medications are researched and brought to market, the history of psychiatric diagnoses, and what’s known (and not known) about antidepressants, benzodiazepines, antipsychotics, mood stabilizers, stimulants, and sleep aids.

We’re also a community. Inner Compass Exchange is our online, worldwide mutual aid network that operates similarly to a 12-step group, in the sense that we facilitate the growth of decentralized, nonhierarchical groups that are absent professional power dynamics or financial exchanges, and coalesced around a shared vision and purpose. Our focus is on human connection driven by empathy and personal experience. The capacity to be there for others emerges from our struggles, from surviving a medicated life and later withdrawal from it, and using that experience to assist others.

A key part of our work is addressing the gap in tapering resources. In the United States, there are no safe places to turn within the conventional mental health system for guidance on safely reducing psychiatric medications. The UK – and, to my understanding, Australia – is just beginning to incorporate safe tapering protocols pulled from the layperson withdrawal community. My hope is that the US follows suit.

Our self-directed tapering manual and community aim to fill this void. We aim to empower individuals to make informed choices about their relationships to psychiatric diagnoses and drugs.

I would love to live in a world where there’s no need for our organization: one where comprehensive, compassionate, trustworthy resources are readily available everywhere. Until then, ICI will continue supporting people, offering information, connection, and hope.

RB: Why is telling your own personal story important to this work?

LD: For decades, we’ve known about the unscientific underpinnings of the psychiatric diagnostic paradigm and the questionable evidence base for psychiatric medications. The flaws inherent to much psychiatric research have been documented, yet most people — patients, family members, mental health professionals, academics, and educators — remain uneducated about the psychiatric enterprise.

More data or scientific evidence won’t spark awareness or critical thinking. Instead, it’s the power of identification — reaching people at the heart level by sharing stories of individuals who sought help in the mental health system and were inadvertently harmed by well-meaning professionals.

For me, reading Robert Whitaker’s book Anatomy of an Epidemic was a transformative experience. It wasn’t just the extensive, rigorously researched data that impacted me, but the personal stories woven through the book. Hearing people describe how they started medications during difficult times, and then got worse taking them, while doctors told them they were getting sicker, sparked an “aha moment” in me.

These stories sparked anger, grief, outrage, and curiosity. Seeing myself reflected in their experiences, I couldn’t help but resonate with what they’d lived. It made me ready to learn and, more importantly, unlearn.

My story — which is far from unique — is a powerful tool for educating others. By being open, vulnerable, and authentic about my experiences, I increase the chances that others might recognize themselves and have their own moment of clarity.

I hope my book will inspire others and give them the courage to listen to their instincts and act accordingly – whatever choices that might mean. There’s nothing more threatening to the mental health industry than those of us who have found our way out and are now sharing our stories.

RB: I have seen some media coverage around the launch of your book, implying that you are putting people at risk by encouraging them to stop life-saving medications, both through the publication of Unshrunk and your work with ICI. However, I noted that in your book you explicitly state that you are not anti-medication. How do you respond to these sorts of implied accusations? What is your view on the utility of psychiatric medication?

LD: It never ceases to amaze me how, in sharing my personal story, I’m often accused of telling others what to do when it comes to medication and psychiatrization. 

This misunderstanding reflects a deeper societal pattern where discussions about mental health and pharmaceutical drugs are seen as exclusive territory for licensed professionals. But those of us who’ve taken psychiatric medications are arguably qualified to discuss them. Our experience counts for something.

I’m not anti-medication; I’m pro-informed choice. People need credible information to make decisions, especially when current pharmaceutical marketing often peddles scientifically invalid narratives like “chemical imbalance” or “depression as a disease.”

This issue is nuanced, but in a polarizing time where people feel drawn to jumping into “pro” or “anti” camps, people often miss this. Psychiatric drugs, especially when taken in acute situations, can feel helpful, but not for the reasons we’re told. They aren’t fixing a pathology; they are disrupting brain function in ways that might feel useful – for example, sedating agitation, numbing intensely painful emotions, or quieting down a racing mind. When people understand these drugs from this perspective, they can make informed choices about whether it makes sense to try them. My goal is simple: empower individuals with comprehensive information and options, so they can decide their next right step.

RB: In Australia, some GPs (equivalent to American PCP) can now diagnose ADHD and prescribe stimulants, and GPs prescribe more than 80% of antidepressants. The idea is to make diagnosis and treatments more accessible by reducing the need for lengthy wait times to see costly specialists. Are we heading in the right direction?

LD: We have a similar issue here in the US, with a significant percentage of psychiatric drug prescriptions written by general practitioners. And while the goal – making help more accessible – may be virtuous, we’ve mistakenly narrowed this down to mean: “write a prescription.”

The solution shouldn’t necessarily be to restrict doctors, but rather to expand the visible options for help on offer. We need community resources that offer alternatives to diagnoses and meds. People should have access to non-professional help, lifestyle interventions, spiritual exploration, and community connections – not just a waiting list for therapy or a quick prescription.

RB: If you could offer one insight to people experiencing mental health difficulties (and their families) before they enter the psychiatric system, what would it be?

LD: It’s that no one knows you better than you do. No one knows your child better than you do.

It doesn’t matter how many letters someone has after their name, or how many years they’ve spent in their clinical practice. You are the true expert on yourself, and you are the expert on your child.

That doesn’t mean you have to do this alone. Lean into the resources available, and the communities like the Inner Compass Exchange – because there are people going through something similar. And then (and this is the hard part)– try to make space to sit with the discomfort and the confusion and the fear, and be curious about what your (or your child’s) struggles mean.

You also need to know that the feelings you’re feeling don’t mean you have a broken brain, or some defective pathology. Your difficulties mean something. They’re telling you something about your life. And if you can hang in there and make that space to be curious, and never let anyone convince you out of your own trust in yourself, you’ll find your way.

RB: And to those wondering if their medications are making their conditions worse, not better, what would you suggest?

LD: If you’re questioning your medications, the most important next step, besides listening to that inner voice of uncertainty, is to educate yourself. Go to the FDA website and look at the label for the drug you’re wondering about. Visit the Inner Compass Initiative website for our guide on how to navigate these labels if you feel overwhelmed.

So few people take this step and read the fine print because they are told this drug or that drug – or maybe the combination of these drugs–will take their troubles away. But take a close look and learn about the evidence base behind the drug’s approval – about what is meant when someone says that Drug X is “effective.” Learn about the adverse effects, and possible drug interactions that could be problematic. And then seek out the stories of other people who’ve also come to question their relationship to meds.

The bottom line is that if something in you is saying “this might not be the right path for me,” listen to that, because that is your wisdom, your inner compass. It’s the thing that guides you toward your truth. I know how scary it can be. However, you are the expert on what you need, and there is information and a community available to help you.

RB: Finally, if you could change one thing about the way the psychiatry industry operates, what would it be?

LD: It’s so tough to point to just one thing, but in the context of this epidemic of psychiatric drug use, it would be to disentangle psychiatrists from their fears around liability: give them the freedom to do things differently. Many psychiatrists know in their hearts that the medication-based approach isn’t helping many people — and may even be causing some harm. If physicians weren’t afraid of being sued, ostracized by colleagues, fired, or of losing compensation, more prescribers might be open to alternative approaches. They might consider avoiding medications altogether, or supporting their patients in safely coming off their meds. This fear of liability in the United States creates a massive barrier to giving people real choices about psychiatric interventions.

https://brownstone.org/articles/surviving-psychiatry/