Informed Consent in the Land of Psychiatric Drugs

Laura Delano’s youth was shaped by the language of psychiatric diagnosis. Its meticulous “symptom lists and tidy categories” defined her teens and twenties. She believed that her “primary condition, bipolar disorder, was an incurable brain disease that would only worsen without medications, therapy, and the occasional stay on a psych ward.”

So Delano embraced, as millions of others have, “the promises of a psychopharmaceutical solution,” welcoming the regimen of pills she ingested in the hope that they’d bring her stability, reliability, functionality. That they’d maybe, one day, even provide her with the chance to feel something close to normal.

Delano took all this as an objective fact. Her parents had the financial means to get her ­top‑notch care from some of the nation’s best doctors and psychiatric hospitals, and they dove right in, desperate for answers, eager to get her needed relief. “We accepted the grave reality that came with a disease like bipolar disorder,” Delano writes, “the unpredictable ups and downs, the inability to take on too much stress or responsibility, the many impulsive mistakes and destructive behaviors I’d engage in during unmanageable episodes, the risk I’d kill myself.”

For fourteen years, Delano lived tethered to the belief that her brain was broken and redesigned her entire life around the singular purpose of fixing it. Essentially, Delano became a professional psychiatric patient between the ages of thirteen and ­ twenty‑seven. After more than a decade, she “decided to leave behind all the diagnoses, meds, and professionals” and recover on her own. “Decided” does a lot of heavy lifting in that sentence, however. The path out of psychiatric drug dependency is grueling, and by no means guaranteed.

That is the story that Laura Delano tells in Unshrunk: A Story of Psychiatric Treatment Resistance.

Unshrunk is about informed decision‑making: what it takes to make a true choice regarding psychiatric diagnoses and drugs, the repercussions when you don’t have the information necessary to do so, and what happens after you realize the choices you thought you’d been making were never really choices at all. While Delano is clear that she is not “anti medication” or “anti psychiatry,” and recognizes that many people have been helped by psychiatric drugs, she insists on informed consent. Delano made it out of psychiatric drug dependence; many others do not.

In the following excerpt, Delano describes the unknowns about one widely prescribed psychiatric drug, questioning its efficacy ...