Unshrunk: A Story of Psychiatric Treatment Resistance
By Laura Delano
Penguin Random House
A young girl with anger outbursts and unexpected shifts in behavior is taken to see a psychiatrist at age fourteen. In Unshrunk, author Laura Delano tells what happens next, taking readers on the harrowing roller-coaster ride of her own life. Honestly, it may be more apt to dub it a haunted house ride. She recounts the frightful experience she had over the course of the next thirteen years, bouncing from practitioner to practitioner, medication to medication and institution to institution in an endeavor to regain her sanity. I nervously wondered how she would fare in each chapter. Would she be able to return to school? Improve her insomnia? Find stability? Tame her disordered eating?
Trigger warning: this book depicts (rather graphically) self-harm, suicidal ideation and discomfiting sexual liaisons. I was tempted to set the book aside as it got darker, exploring the depths of mental illness progression. But I kept reading, and I’m glad I did. Delano has done her research, so while she gives us a window on the thought processes of a mental health patient, she also reveals important context and history on various medications and “treatments.”
“Treatments” is in quotes because Delano questions all of modern psychiatry’s conventional approaches. She cites University College London professor Joanna Moncrieff, who suggests that psychiatry is built on a faulty model. “If you are told that Prozac is an antidepressant you naturally might assume it ‘works’ by targeting and acting against underlying ‘symptoms’ of an ‘illness’ called ‘depression.’ The problem is that in the case of psychiatric diagnoses, there are no actual underlying pathologies. ‘Psychiatry adopted the disease-centered model of drug action because it bolstered the idea that psychiatric disorders were the same as other medical conditions, and could be managed and treated in the same sort of way. The model was never tested.’”
Nonetheless, medications remain the go-to treatment for mental imbalances. Here’s a sample of the prescriptions Delano went through during her first six years of “compliant psychiatric treatment”: Depakote, Seroquel, Prozac, Effexor, Provigil, Ambien, Lamictal, Klonopin and many more. She also explored (or should I say endured) inpatient and outpatient therapies and countless support groups. All with no improvement. Throughout the varied dosages, medications and therapy practices, Delano was continually riddled with self-doubt and hopelessness. Despite compliance with treatments and protocols, she couldn’t hold down a job. She was dependent on her family for financial support. She had no meaningful friendships.
One psychiatrist finally helped her understand why her mental illness had progressed. Like many diagnosed with a mental disorder, Delano had gone through a “prescription cascade,” with ever-worsening symptoms. He told her that patients who do not improve over time with meds are known as “treatment resistant.” It’s medical shorthand to suggest that it’s not the medication that it is the problem, it’s the patient.
Delano is not the only one who has found no lasting help from meds. As of 2020, she recounts, nearly thirty-nine million American adults were taking an antidepressant. The 50 percent who do improve still have “significant residual symptoms” that affect function. Only 20 to 40 percent of patients first treated for a major depressive episode “are expected to achieve a relatively asymptomatic state.”
In 1997—the year Delano’s parents were given prescriptions for their fourteen-year-old daughter—the first two drugs prescribed (Depakote and Prozac) had not even been approved by the FDA for psychiatric use in children. Apparently, in the psychiatric context, it is not uncommon for such drugs to be prescribed to children for “off-label” use.
Over time (and following a suicide attempt), Delano began to ask important questions. She had been classified as “treatment resistant”; maybe it was time to resist treatment. What if it was the treatment itself that was making her sick? She had taken antipsychotics, antidepressants, mood stabilizers, antianxiety drugs and insomnia meds. Along the way, she had acquired a number of physical issues (likely drug “side effects”), including Hashimoto’s disease (a thyroid condition), irritable bowel syndrome and loss of libido. She eventually succeeded in weaning herself off of all of the meds and unhelpful therapies. She realized that discomfort is not necessarily something to be fixed, numbed or run away from. She attended Alcoholics Anonymous groups and began to practice mindfulness. “Just sit with yourself, Laura. Just be here, with all of it.”
Read this book only if you are willing to sit, as well, with uncomfortable emotions, situations and the utter messiness and confusion that make up our lives. This book challenged me to do just that, and I give it a thumbs up.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Summer 2025
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