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.”
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