After Wonder Drugs: An Ethnography of Psychiatric Medication Withdrawal
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Online communities
Psychiatry
Psychopharmaceuticals
Science and technology studies
Withdrawal
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Abstract
Prescriptions of psychopharmaceuticals have exploded in recent decades, and at least one in six Americans takes a psychiatric drug. Antidepressants, the most common psychiatric medications, have been widely hailed as safe, effective, and non-addictive, and psychiatric consensus has maintained that antidepressant withdrawal symptoms are mild and short-lived. Despite this consensus, some people find that stopping their medications can be nearly impossible: they experience intense and sometimes-debilitating symptoms when they try to stop or reduce, and these symptoms can persist over the course of months or years. Unable to find support or guidance from mainstream medicine, these patients are gathering in web forums and support groups, seeking out and creating alternative resources for expertise and care. This dissertation is an ethnography of this “withdrawal community” of people struggling to get off (or dealing with the aftermath of stopping) psychiatric drugs. Drawing on eighteen months of online, multi-sited fieldwork, and over one hundred interviews with patients, researchers, clinicians, and activists, I take the problem of withdrawal as an ethnographic object, setting up shop in the opening between accepted medical commonsense about these medications and the severe experiences that some people report when stopping them.Exploring withdrawal as a kind of contested, sometimes-disabling, chronic illness (or injury), I show how biomedicine’s refusal to see or acknowledge withdrawal shifts the burdens of research, experimentation, and care onto patients themselves. Charting the phenomenology of people’s symptoms; the technical practices and modes of experimentation they engage in as they taper; and the social worlds and alternative forms of knowledge they build; I ask how these experiences, taken together, transform people’s understandings of themselves, the nature of mental illness, and the trustworthiness of medicine more broadly. Situated at the intersection of medical anthropology, disability studies, and science and technology studies, this dissertation asks how experiences with medication and withdrawal transform people’s bodies and lives, shedding light on the promises and blind spots of contemporary biomedical psychiatry; the plasticity of the body and the capacity of medical interventions to transform us; and what happens when mainstream medicine leaves people behind.