John Staight

Always compliant patient who trusted his doctors until benzo tolerance and withdrawal hit. Surviving the frightening wilderness of poly med tapering and WD.

[Mark Horowitz @markhoro.bsky.social @markhoro]

I would have said in years of working in psychiatric clinics and wards that I only saw psychiatric drug (antidepressant) withdrawal once before I experienced it myself. And so I understand why doctors say they don't see it very often - and the clinical and conceptual factors that makes that likely.

[Mark Horowitz @markhoro.bsky.social @markhoro]

Fantastic initiative from the true blue Aussie heroes at Adelaide University - the launch of the "Not Broken" project aiming to counter the harmful narrative of broken brains, chemical imbalances and lifelong mental illnesses that have been propagated by mental illness boosters and bring people's problems back into sensible, humanistic focus. Link below.

[Angie Peacock, MSW, CPC @angpeacock1111]

@RecoveryDoctor @markhoro @BadreNicolas @DavidJuurlink Charts showing patients who are online looking for support for withdrawal. They’ve had to do this because of the lack of understanding in mainstream. All of these groups are searchable and can be read if you’re interested in seeing the scope of the problem.

[Angie Peacock, MSW, CPC @angpeacock1111]

@goyalisroyal @chrisaikenmd @sanilrege @awaisaftab @JhunuDr Come sit with me for a day. I get all the people who don’t trust their doctors anymore because they don’t believe how bad their withdrawal is. They leave your practices once they realize you will just keep medicating them or don’t believe them.

[Laura Delano @LauraDelano]

The mental health industry has a near monopoly on defining what it means to be human today.

Which also means they have a near monopoly on what constitutes legitimate help.

When someone spirals into emotional distress or an altered state, most families only see one visible path in front of them.

The system leaves very little room to imagine forms of care beyond diagnosis, hospitalization, and psychiatric treatment.

@bretweinstein @thedarkhorsepod

[Andrew Zywiec, M.D. @AndrewZywiecMD]

My entire generation was drugged into oblivion. There is no putting the genie back in the bottle. It's only gotten worse.

There will be a reckoning, one way or another. Either doctors will wake up, fess up, and help, or they will deny it until there is collapse.

[Taylor 🌞 @taperingtay]

Patients who share their antidepressant withdrawal experiences get cast as fringe—anti-establishment types who always refused the medical system.

But the system spat us out.

Anyone who went on medication once trusted it deeply. That's why we're here.

[Angie Peacock, MSW, CPC @angpeacock1111]

@GKasioumi Many with off label use are experiencing much more than brain zaps - often severe and anxiety and depression they never had before. This hints that some of these “mental symptoms” that others using for on-label purposes is not relapse but withdrawal effects.

[Dr. Roger McFillin @DrMcFillin]

Psychiatry promised to solve the mental health crisis. Instead it created one.

More ADHD diagnoses, more prescriptions, more "awareness" — and more suffering than ever recorded.

When the solution consistently makes the problem worse, it's not a solution. It's the business model.

What would it take for you to question the system treating you?

AWAKEN.
@DrRyanSultan

[Mark Horowitz @markhoro.bsky.social @markhoro]

Yes, this has been my experience - if adverse reactions are downplayed, withdrawal effects are somewhat further down on the list, on the back page, if anywhere. My impression is that this is a very common reason for presentations to urgent services.

[Laura Delano @LauraDelano]

It’s only a matter of time before the distorting lens perceiving psychiatric medication withdrawal as relapse disintegrates and our culture is left, once and for all, to grapple with what’s happening here

[Mark Horowitz @markhoro.bsky.social @markhoro]

The people who contact me for help are often highly educated - researchers, doctors, lawyers, journalists, the occasional psychiatrist. I think these people have enough intellectual confidence to do their own research+ confront their doctor about mis-diagnosis, or having their concerns dismissed whereas many people will defer to their doctors.

[Mark Horowitz @markhoro.bsky.social @markhoro]

It is interesting to hear the internal debate of the APA here. I can see they are put in a difficult position. To agree that it is worthwhile for there to be official deprescribing guidelines (which is very hard to disagree with – disagreement involves the assumption that all psychiatric drugs should be given life-long, a claim even beyond the pale for even the most reductive biological psychiatrist) involves admitting guilt that this has not been done in 40 years of practice and that the government needed to step in.

The opposite option is to decry this as a radical step from a secretary of HHS who is known to hold other controversial views. This is made difficult as attempts to paint this as ‘the government coming for your drugs’ has been shown to be caricature of what is a sensible process to update guidelines and foster an ignored by important practice.

The canniest move on the chess board is the ‘fake fix’ – proffering a hastily put together deprescribing textbook by the pre-eminent architect of mass prescribing (Stephen Stahl) or a complex exercise in obfuscation by the ASCP in their deprescribing consensus statement, both of which minimise or ignore the major issues (minimise withdrawal, de-center tapering and re-iterate again and again that relapse is a major risk and people should not stop their drugs, ignoring all the obvious flaws with research that systematically mis-classified withdrawal as relapse) as evidence that they are already dealing with the problem. Never mind that these initiative both came out 40 years after these drugs came on the market, after these bodies have issued thousands of missives that have increased prescribing, and that Stahl’s book enshrines existing dogma (with very, very pretty but irrelevant diagrams) of reducing drugs in 4-8 weeks using existing tablets and readily diagnosing relapse or adding more drugs if unpleasant symptoms arise.

I certainly hope the more enlightened voices willing to face the reality of the problem rather than seek to take refuge in denial, minimisation or vilification of the messenger will prevail, but it seems like this may not be the case…

[Laura Delano @LauraDelano]

For decades, those of us speaking about the harms caused by taking and coming off psychiatric drugs have been ignored, denied or dismissed.

I’ve been labeled everything from “antipsychiatry,” “anti-science,” and “Scientologist,” to “right-wing fascist” and “anti-vax,” to simply “too mentally ill” to understand what was happening to me.

Now the APA’s own annual meeting is full of panels on deprescribing, overmedication, withdrawal, and psychiatrists openly admitting they regret not helping patients come off these drugs sooner.

The hundreds of thousands of personal stories of psychiatric iatrogenesis have become impossible to keep waving away as meaningless anecdotes.

I have deep compassion for how hard it must be to face the possibility that you’ve been inadvertently causing harm to patients you’ve been trying to help.

But fear is the master distorter of truth, and the only way out is through.

We are eager to build a big-tent coalition to begin work on these changes we all know are necessary. I hope you’ll join us.

[Laura Delano @LauraDelano]

The world’s leading experts on *safe* SSRI tapering are those of us who’ve taken/come off these drugs, ourselves.

This shouldn’t be seen as a threat— the word ‘expert’, after all, comes from the Latin word for “tried, proved, known thru experience”—but as an invitation. 🕊️🕊️🕊️

[Inner Compass Initiative @_innercompass]

🧵 Many people who are told they have “treatment-resistant” forms of psychiatric diagnoses are led to believe their suffering is a fixed state, that their brain simply doesn’t respond to the psychiatric drugs they are prescribed.

But what happens when they carefully and cautiously taper off the psychiatric drugs that preceded the "treatment-resistant" diagnosis?

For a surprising number—including our own founder—a very different picture emerges: what was called “treatment resistance” turns out to be treatment-induced.

Based on these experiences of those of you who've been in this position and found a way out of it, it's time to ask some questions about the concept of treatment resistance.

We’ve posed three here—all inspired by your (and our) lived experience and a growing understanding of how long-term psychiatric drug use can create tolerance, dependence, and adverse effects that so often get misattributed to the original diagnosis... 1/

[Mark Horowitz @markhoro.bsky.social @markhoro]

I think when doctors say they don’t see withdrawal it goes something like this.

- The average GP/PCP has 2000 patients under their care,
-200 on antidepressants (10% of pop),
-studies show 6% of people stop their AD each year (eveleigh, 2018) in regular practice so 12 people stop
-4 will have no major issues,
-4 will have moderate issues,
-4 severe issues.

Of the 8 with problems 6 or 7 will be told or think it is relapse and go back on meds (of course textbooks and training say relapse is very common, withdrawal is a minor concern so it would be a pretty rare physician to see what they haven’t been taught to see).

1 or 2 will say this doesn’t make sense, research it, try to work out what is going on and make a point about it to doctor (30% of people on social media groups for withdrawal have graduate degrees).

And so the doctor will say ‘I rarely if ever see this’ because drugs are rarely stopped and the correct diagnosis is rarely made. It takes a motivated, thoughtful patient to push the issue. There are currently about 200,000 such patients, and growing rapidly.

Given that most studies of withdrawal from relatively long term treatment show 60%+ of patients experience withdrawal syndromes of at least 4 withdrawal symptoms (Rosenbaum 1998) it is simply not plausible that most people are not having pronounced withdrawal effects.

And that's before we even talk about the plausibility of the concept of 'relapse'....

[Erika @katug05]

One of the deepest wounds many sufferers describe is not only the condition itself — but the pain of not being believed by the people they love most.

Some are fighting devastating physical, neurological, and emotional symptoms while also carrying the crushing loneliness of disbelief inside their own homes.

Many are told:
‘It’s anxiety.’
‘You’re imagining it.’
‘Just move on.’
‘The medication couldn’t have done this.

And slowly, isolation begins to consume them.

No human being should have to beg to be believed while already struggling to survive.

This is why awareness matters.
This is why compassionate listening matters.
And this is why proper support systems are urgently needed — not only for patients, but for families trying to understand what these conditions can do to a person.

We need physicians who listen.
Counselors trained to recognize medication-related harm.
Peer support networks.
And compassionate people willing to take suffering individuals by the hand instead of dismissing them.

Sometimes the greatest medicine begins with belief, empathy, and simply refusing to abandon someone in their darkest hour. 💛

#MoralMedicine #JusticeForHenryPetition #PFS #PSSD #MilanoProject #PharmaAccountability #IatrogenicAwareness”

[Cooper Davis @Cooperdavis]

Over the last two weeks, I am seeing many attempts to consolidate and identify a single driving force behind an emergent “mental health reform movement”, or append some overarching label, brand or banner on top of it

What anti-reformers are missing is that, due to the uniquely self-protective temperament of psychiatry as a field, it has not always done a great job of responding to perturbations from the outside.

It’s become a cultural trope that psychiatrists are dismissive and haughty.

This caricature is far from “MAHA propaganda”; open any issue of the New Yorker since 1980 and you’ll find cartoons lampooning the profession for being more out of touch than their patients.

Perhaps as a result of an entrained conviction of knowing us better than we know ourselves, they may lack an accurate taxonomy of who or what exactly is shouting at them from the sidelines, and why.

They may not know, for example, that the vigorous activists at PSSD Network and PSSD Institute are mostly disconnected from the Akathisia Alliance, who in turn are disconnected from the rather enormous & balkanized “withdrawal community”.

And certainly they may not know of the hundreds of thousands of others for whom their relationship to psychiatric treatment was effecting enough to make the fallout thereof a dominant issue in their lives, often years after the fact.

These are not small numbers, nor are these casual concerns.

They may not care that the left-liberatory psychiatric survivor movement and its modern descendants are largely disconnected from the vast numbers of online groups and activists who identify not as traumatized former mental patients or crusading Szasian ideologues, but as harmed consumers of pharmaceutical products that were administered within a framework that the psychiatric establishment has, at the very least, co-signed, and has thus far declined to modify with any urgency.

And then of course you have millions
Of “everyday Americans” who, while not animated by any particular grievance against psychiatry, have grown nonetheless skeptical and concerned about the mental health system broadly, due not to “misinformation”, but rather their own direct personal experiences.

As Robert Whitaker points out below in his rebuttal to @awaisaftab , to equate himself, @joannamoncrieff and @LauraDelano as adhering to a single set of ideas that can plausibly be described as “MAHA Psychiatry”, a term that literally didn’t exist two weeks ago, is the kind of thing can only do when all criticism sounds the same to you…

…which is perhaps inevitable if the defensive strategy the field has settled on is to ignore outside input unless it meets some particular standard of acceptability, leaving all the voices that fail to meet the mark to blend together into some distant, mildly annoying din.

For some reason, that din is now getting too loud to keep ignoring, and I’m very happy to report that a number of leaders within the psychiatric establishment have responded by reaching out with curiosity and a genuine desire to parse what the rabble are trying to communicate from down here on the ground.

Those who choose to look for opportunities to write us all off in one stroke might imagine they are keeping the party-crashers at bay, but maybe should be thinking about what happens if we end up with invites of our own.

“The second problem with his opening is that he links all three of us—Moncrieff, Whitaker, Delano—into one lump, as though we all share a common critique.  In fact, we took different paths to arrive at our criticisms of psychiatry, and there is no reason to think we all share the same criticisms.”

[Anders Sørensen @_AndersSorensen]

Why do SSRI tapering and deprescribing provoke so much pushback?

Because if withdrawal can be this severe and mimic relapse this closely - and take years of tapering to avoid - then many people told they “needed the drug” may actually have been in withdrawal rather than "relapse".

If that's true, the case for long-term treatment begins to crack. And with that, much of mainstream psychiatry's legitimacy.

But paradigms resist before they change = hence the pushback.

Conclusion: this community matters.

Come join. You’ll meet the best of people.