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A Sane Approach to Psychiatric Drugs: The Revised Harm Reduction Guide to Coming Off Psychiatric Drugs

By       Message Bruce E. Levine     Permalink
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Millions of people believe that psychiatric medications have saved their lives, while millions of others report that their psychiatric medications were unhelpful or made things worse. All this can result in mutual disrespect for different choices.   I can think of no better antidote for this polarization than the recently revised, se cond edition Harm Reduction Guide to Coming Off Psychiatric Drugs. This 52-page guide, published by the Icarus Project and Freedom Center, is   now available FREE ONLINE in English as well as in Spanish , German , and Greek .   

 

Harm reduction is pragmatic and recognizes that there is no single solution for every person. Instead, as the guide states, "Harm reduction accepts where people are at and educates them to make informed choices and calculated trade-offs that reduce risk and increase wellness." Harm reduction is about providing information, options, resources and support so that people can make choices that fit their situation and who they are.

I wish the Harm Reduction Guide to Coming Off Psychiatric Drugs had been in existence for my entire career as a clinical psychologist. It would have been especially helpful for one particular couple whom I saw several years ago for marital counseling. Cathy and Jim (not their real names) met during their psychiatric hospitalization, both having been diagnosed with serious psychiatric illnesses. After their hospitalization, they dated, moved in together, and married.

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Cathy told me, "Jim is an intellectual, smarter than anyone I have ever met in my life"; to which Jim blushed and responded, "Bruce, sometimes it's good to have a wife who is a little delusional." Jim then told me that "Cathy is the most beautiful woman in the world"; to which Cathy laughed and said, "Sometimes I worry that Jim is hallucinating about another woman."

 

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After a year of marriage, their marital bliss began to erode over the issue of psychiatric medications. One day, Jim quit taking his antipsychotic Zyprexa. Cathy, who continued to take her antipsychotic Risperdal, was worried that Jim, without Zyprexa, would become agitated, do something "crazy," and would be forced to return to the hospital. Jim said, "Even if Cathy is right that I am increasing my chances of going nuts again--and I don't know that she is right here--the reality is that with Zyprexa I can't take a decent crap and I can't concentrate when I read, and books--besides Cathy--are the most important thing in the world to me." And then Jim added that he was worried about the short-term and long-term adverse effects of Risperdal on Cathy, and that he wished she would stop taking it.

 

Ultimately, and quite beautifully, both Cathy and Jim came to see that risk in life was unavoidable, and they learned to respect each other's choices and risks with respect to psychiatric medications. Both would have appreciated the Harm Reduction Guide to Coming Off Psychiatric Drugs , which is all about informed choice that allows one to take the risks that make most sense given one's situation.

 

Will Hall, the primary author of the guide, is a former psychiatric patient and is passionate about informed choice when it comes to psychiatric medications. Hall, no anti-drug ideologue, begins by pointing out that in U.S. society there are confusing messages about drugs, and this results in a great deal of fear:

 

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Drugs become demons or angels. We need to stay on them at all costs, or get off them at all costs. We look only at the risks, or we're too frightened to look at the risks at all. There is no compromise: it's black and white, all or nothing. It's easy to fall into absolutist thinking when it comes to psychiatric drugs. Pro-drug advocates focus on the risks of extreme emotional states, while anti-drug advocates focus on the risks of taking drugs. But it is the belief of this guide, and the philosophy of our pro-choice work at the Freedom Center and the Icarus Project, that either-or thinking around drugs is a big part of the problem.

 

Hall's serious emotional suffering included "multiple suicide attempts, hearing persecutory voices, extreme mistrust, bizarre experiences, hiding alone in my apartment, unable to take care of myself." The psychotherapy that he received hadn't worked, and no one provided him with any other options besides medication. Hall writes, "I was under pressure to see my problems as "biologi -cally based' and "needing' medication, instead of looking at medication as one option among many."

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