Welcome to the Mad in America podcast. My name is Brooke Siem, and I am the author of the award-winning memoir on antidepressant withdrawal, May Cause Side Effects. Today, I’m with Marsha Zaritsky, and I am very interested to talk to her because we don’t spend a lot of time talking about women who are prescribed psychiatric drugs as part of menopause, and we don’t talk a lot about it when it comes to the older adult population.

Marsha is a survivor of being prescribed Klonopin for sleep when going through menopause. She said she was never told what class of drugs she was put on, and it wasn’t until years later, when she became ill with severe digestive issues, that she figured out she was on a benzo and that it could be the root of all her health issues. Marsha is also a licensed mental health therapist certified in Internal Family Systems therapy.

The reason this is so interesting is that when we have people in the mental health field who have had experience with psychiatry and psychiatric drug withdrawal, that can sometimes change and inform how they practice.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Brooke Siem: I am very excited to have you here, Marsha, and to hear what you’ve been through and where you’re at now, because even just seeing you on the screen, I can tell how much radiance and joy there is there. We need a lot of hope in this space. I’m glad to be here with you.

Marsha Zaritsky: Thanks for giving me this opportunity to talk about it and share what I’ve been through and what I’ve learned.

Siem: Right before we started recording, you mentioned to me something very interesting, and that is that you have been through and recovered from a protracted withdrawal injury, and also, currently, you are hyperbolic tapering. Those are two things we often don’t see together. If you can just take us back a little bit and tell us how this all started and what was going on in your life at the time.

Zaritsky: Sleep has always been somewhat of an issue for me. I was travelling a lot for fun and using Ambien when I was travelling for sleep. At some point, my doctor said, “Oh, this is not a good drug for you to be on”, and she gave me Klonopin for sleep, but I didn’t ask any questions, a big mistake. I thought she was giving me something non-addictive, and then menopause hit, and sleep got even worse. It was something I used on and off for probably over a decade through menopause. Menopause can go on for quite a while.

I started to have severe digestive issues. I went to the ER in the beginning because I was in so much pain, and I spent probably a year and a half spending thousands upon thousands of dollars seeing naturopaths around digestive issues. Then I finally figured out that I was on a benzodiazepine.

For some reason, we had some Xanax in the house, and I took it one day, and my stomach stopped hurting. I asked my doctor could you give me a few of these because sometimes it’s so hard to eat. She says, “I can’t do that. You’re on a benzo.” That’s when things started to click. I was in tolerance on it and having really bad and severe symptoms—basically, I was in withdrawal. I increased the dose up to 0.5 mg and felt better for a few weeks. Then I saw the writing on the wall. My body was not tolerating the drug anymore. So I went into rehab to get off of it, which I would never recommend; that’s where I was poly-drugged.

Siem: A tale as old as time.

Zaritsky: Yes. Basically, I was taken off cold turkey, and then there were years of a protracted injury.

Siem: From the benzo?

Zaritsky: Yes. Another interesting thing in my story was that, with all my digestive problems going on, I got into programs like Primal Trust and DNRS, which are brain retraining programs. I couldn’t be on the forums much, so I was running solo.

Siem: Yeah. So was I.

Zaritsky: Yeah. I was there just winging it.

Siem: Which I’m glad for in hindsight, because I was so susceptible. I could have incepted myself with so many things just by reading other people’s experiences.

Zaritsky: Yeah, same. I knew they were out there, and then I would get so triggered. When I came out of rehab, I think I had that first year, and I got off three other medications. I did not hyperbolically taper, but in some ways, I’m glad because I got off them fast. I was so miserable. I couldn’t even tell if anything was making me more miserable.

Siem: So you went into rehab on one drug and came out on how many?

Zaritsky: I did start a couple. When things really started falling apart, I started Zoloft again, thinking I’m having anxiety that is really triggered by menopause or something. I knew the benzo was a problem, but I thought something could make the transition off it easier, which I don’t now believe is a true statement at all. Then, as things weren’t working and falling apart, they started me on gabapentin too.

Then I’m like, “This is crazy.” I remember saying to the psychiatric nurse practitioner, I’m not comfortable. I’m on three things now. I’ve never been on anything. Her response is kind of like, well, I don’t understand, Marsha. Lots of my patients are on three or more drugs.

Siem: It’s like I got lots of friends on these. It’s fine. How is that science?

Zaritsky: Yeah.

Siem: It’s the fact that I even have to say this out loud. You come out of the psych hospital—where you went to get off the benzos—on other things. Now you’re the Zoloft. Again, this was all prescribed around menopause. Okay. We are off the Klonopin now, but the Zoloft is still—

Zaritsky: I wasn’t in a psych ward, I was in drug rehab. It’s all somewhat of a blur, as you can imagine. Then I was on Zoloft, and I was out of my mind because I was taken off the drug in four days, and I got Zyprexa added in. They put me on two things to get me to sleep. I was awake for a week. So that first year, when I came out, I had to get off of mirtazapine, which is something I’m hyperbolically tapering now because I had to go back on it, but the Zyprexa and that other gabapentin sort of medication that I don’t even remember the name of, which is fine with me.

Siem: What was the genesis of your starting to learn about hyperbolic tapering, and how were you also healing from protracted withdrawal at the same time?

Zaritsky: After that first year of cleaning it up and then just being on Zoloft and mirtazapine, I just realized I had no capacity to do anything more. But two years off, in my protracted injury, I did try to get off the Zoloft, doing a linear taper because I was doing great for a few months. I had nice windows. I do tell people that lack of windows does not mean anything about healing in my opinion, because I had a very long injury.

It is so hard to comprehend, if you haven’t been through it, how really debilitating these symptoms are, right? I fought it for a long time, and I was confused. I knew I was in withdrawal, but I didn’t understand protracted withdrawal. Unfortunately, I think I gaslit myself a lot because, being a therapist, I felt a tremendous amount of shame that somehow I was on a benzo, and I didn’t know it.

I really think I carried that through the whole injury in some ways. On a day-to-day basis, I always tried to have some structure to my day because time was so hard to fill. I did push, I didn’t travel in planes, but we had a van, and we did a lot of trips in that. I’ve relocated now, and now I’m in Boise, but I lived in Washington then, and we would come here to visit my grandkids and my daughter. So I pushed myself to do things, which was good. A lot of times, doing different things would bring on a window, which I always find so interesting.

A couple of years into it, or maybe even the third year, is where it became spiritual and where I feel like things started to switch. It’s just like “I hate this, but this is the journey life has taken me on, and I get to experience this. I get to experience this pain. I get to experience this loss.” I started doing a lot of gentle restorative yoga. I found a really beautiful yoga studio I started going to it. All along, I was kind of meditating and doing these brain retraining visualizations and things like that. I just created this little spiritual bubble for myself. That’s where I think the healing really began. I was fighting it for quite a while.

Then the second part of your question, when I decided to hyperbolic taper, the first year that I was feeling better, I didn’t even think of it. I gave myself permission that if I have to be on these drugs for the rest of my life, that was great. But then things started to shift.

I left a home of 30 years, and it was right around the time of the move that I found Angie Peacock and found Mad in America and started listening to these interviews. It was one interview, actually, you did with a therapist. I was like, there’s this therapist talking about his withdrawal, and he was still working. It was like my blanket of shame just dissolved listening to this interview. Then I decided to get educated.

I did an interview with Angie Peacock, and then I started putting my story out on Instagram. That’s been another part of the healing. I told myself, if I’m going to try to get off these antidepressants, I cannot have my head in the sand as I did with the benzos. If I can’t handle reading these other stories, or what’s really happening to people, then I’m not ready to taper.

Siem: What do you think the difference is between healing from this as an older adult rather than being 20 or 25?

Zaritsky: I think one of the big things that fed the fear of never getting better was that we know the brain is different when you age. I really felt fear that I’m at an age where maybe healing isn’t possible. I know everybody, no matter what age you are, when you’re in a protracted injury, everybody has that fear. I’ve never met a person who doesn’t.

When I think back to it, it was very easy to isolate myself at this part of my life. I’m an introvert. It was easy to hide, which, for a while, wasn’t even a bad thing. I wasn’t working quite as much and didn’t live in the same town as my family, my daughter and grandkids, so it was easy to hide. I think you have to be careful in a protracted withdrawal, how much you stop doing. It was easy to stop doing a lot.

Siem: I’ve had a number of encounters with people who I would say were in their 50s or 60s, and even occasionally in their early 70s. One of the things that I hear from them is literally the words, it’s too late for me. I’m too old to go through this. I’m not that age yet, and I’m not in their experience. I’ve never really known what to say to that. I think there’s a part of me that understands that maybe there gets to be a point where you don’t want to upset the apple cart too much. But at the same time, these people are reaching out to me. I’ve had grandparents say, “I can’t connect with my grandchildren.” How did you approach that?

Zaritsky: What made me decide at my age to the hyperbolic tapering is that I don’t want these side effects. There is a choice in my hyperbolic tapering because the way I’m having some side effects is nothing like what I was experiencing with the benzo. But I came to a point where I want to feel life. I hate not knowing if I could be feeling more in this moment. I hate not knowing because I’m feeling tired today. Is it just because I’m getting older? Or is it because I’m on the meds? I hate that. I have to accept that I don’t know that right now. I just want off. It’s an interesting thought I have about aging lately, I think it’s like I want to meet death unmedicated.

Brooke Siem: Oh, that gave me chills.

Zaritsky: I know. I almost feel teary. I want to meet death unmedicated. That’s a huge experience. I don’t know if I’ll get there, I’ve been hyperbolic tapering for six months, and I’m sure it’ll be another four to five years. If it gets too hard, I might stay on a small dose. I don’t want to do another couple of years of a protracted injury. But people can get off these meds with minimal symptoms if they’re listening to their body. So I’m hopeful. But I really do. I want to meet this part of life unmedicated.

Siem: That hits me in a very deep way because you’re really talking about what, for most people, is the ultimate fear. To have the bravery to say that I recognize I want to hit that and feel it with all the force it’s got is quite a thing to say out loud.

Zaritsky: Well, one thing people get a lot when they’re near the end of their life is a benzo, so that’s never going to happen for me. My daughter is a nurse; she has all the instructions already. I feel fortunate that I wasn’t medicated young. I had a lot of life unmedicated, but I want to have the rest of it unmedicated if I can, and I’m willing to give it a shot.

Siem: How has this experience with withdrawal changed the way you practice?

Zaritsky: I did work through my injury, and sometimes that was hard. I would say I feel like I’m a better therapist probably than I’ve ever been in my career from the experience. When people talk about wanting to start meds, it’s just a whole different discussion now, and I ask way more questions than I would have used to. The majority of my clients are female. It’s interesting, the thing I see is that women have this pressure. They really don’t need to be medicated, but they want to perform at such a high level, right? Or they think the stressors they’re dealing with, somehow, they’re not handling it well because it’s uncomfortable.

I really ask a lot more questions, and then I talk about informed consent. I tell them they probably will not get it from their doctor, and they need to understand how these things really work. I’m starting to tell some clients what I’ve been through. I’m at the end of my career, so one thing I love about aging is that I just take a little more liberties than I used to.

Siem: I’ve always found that to be so perplexing in this space where I understand that in a professional therapeutic environment, the clinician is not supposed to share anything about their own life. I don’t know, for me it’s like if you know the brakes on a car aren’t working, are you going to tell someone to drive towards a wall?

Zaritsky: I know I would feel neglectful if a client was starting a med and they had any experience like mine, even for a day or two. This is horrific stuff. I have a young woman who probably won’t be able to get off her meds, but I know she wants to get pregnant in a couple of years. I’m starting the conversation with her about medication. I don’t think I would have been tuned into that previously. She’s really appreciative of that.

Siem: It allows people more agency to choose the right direction in their lives. If I could wave a magic wand and have these drugs never be on the earth, I’d do it. But I can’t, and people are going to have such a wide variety of experiences, and they’re going to need to go their own way on this. You can’t know what way to go or even how to start strategizing that if you don’t know what your options are.

Zaritsky: Brooke, the hardest thing I find in all of this talking about it with anyone, you can use the word withdrawal, and people think “what’s withdrawal? A month or two of feeling uncomfortable?” But I’ll tell you, the level of discomfort. I was in rehab with these women who were struggling with heroin, they’re like oh, my God, a benzo, this is the worst thing. They had so much empathy for me because they knew it was worse than any street drug.

People don’t get it when we talk about withdrawal, the amount of suffering, what it’s like to be in a body stuck in an adrenaline loop, stuck in terror, not being able to sleep, not being able to regulate at all. I mean, I wasn’t able to feel connected to things in my life. But God, could I cry? I felt so depressed and just did not want to be alive because it’s like your body is not working.

Siem: I’ve been doing Mad in America interviews all morning, and I’ve had three of you guys so far, and the identical words out of your mouths has been, you cannot know what this is like unless you’ve been through it. I forget that sometimes because I’m out of the world. It’s been 10 years for me, and I’m not actively in it anymore, thank God. But I’m having this feeling of kind of connecting on a deeper level because I’m being reminded that this is a very real thing that if you know, you know, and if you don’t, you don’t.

I just hope that whoever’s listening to this can get that. There are two people here talking about this experience, and we’re both saying this is something you will never ever experience in any other way. The people around you who haven’t been through it won’t get it. But we’re also two people sitting here who have recovered, and you’re still in the middle of it, but you’re doing well. I’m fully recovered. It’s like you said, there’s so many mistakes that are made, and yet at the same time, I see people heal every day.

Zaritsky: Right. I mean, that’s the one gift I wish I could give people. I’m an Internal Family Systems therapist, and this is the self-energy that is talked about. That’s holding on and grounding yourself a little bit through this horrific experience. The fear for me of not getting better whenever that would really come in, every symptom was a hundred times worse.

Siem: That’s interesting. There’s an element of withdrawal that I find to be quite curious. I think it probably extends to other ailments as well, but it seems particularly sensitive to withdrawal, where it’s this almost unconscious ability to create symptoms or make them worse. Is that something you run into?

I need to be careful in my wording there because people are going to think “I’m not creating this,” and then they’re going to feel attacked, right? But that’s why I wanted to talk to you about it, because you probably have more eloquence around this.

Zaritsky: Well, I think when you’re in a protracted injury, it’s become chronic. Then we get stuck in that loop of being focused on our symptoms. It’s just a natural way, the human nature of the body, how biology works. We do have to learn how to kind of become aware of that, and it is hard. I learned to be with symptoms and kind of be neutral and not react, and it’s a big order.

I think in the acute phase of withdrawal, for me, and I think for a lot of people, it was impossible. My symptoms were intense for a long time, but like there was a phase where I just felt worn down and more hopeless. Then there’s this phase where, like, I’m rising back up. I’ve got to fight this. I just had to be honest, I’m not going to take my life, so I have to survive this. The fighting was surrendering.

I do think when we focus on those symptoms or have the fear thought, there would be a rush of adrenaline, and symptoms would get worse. There were occasions when I would do the things I used to do, like yoga nidra, and there’d be times I’d lie down to do it so symptomatic, and I would just listen and do the guided meditation, and I would find calm. I couldn’t reproduce it the next day. There were times when I would go to a restorative yoga class agitated and not even knowing how I’d get through it. But by the end, my system got regulated. I do think when I would go into those things with the intention to regulate it really didn’t work. It was more going in with the surrender.

Siem: Oh, fascinating.

Zaritsky: For years, I was doing a lot of practices, which are good for the nervous system, but you have to release the agenda. That’s a huge premise, retraining our brains.

Siem: Right, non-attachment to outcome.

Zaritsky: Yeah, exactly.

Siem: What are your thoughts on doing therapy? I guess we’ll go specifically to IFS because that’s your speciality, while in a wave or a window?

Zaritsky: I was in therapy the whole time. I mean, I needed the support. I needed someone, but like, I didn’t do it every week because that felt like a lot. I think it’s a really individual choice. I don’t think it’s useful if your therapist doesn’t really believe you or get it, or you don’t have somebody who’s willing to understand it. I think you need someone who maybe understands that maybe some days all you need is co-regulation. You really can’t do the deeper work when you’re in a big wave. It’s like you’re sitting there in your trauma, being traumatized. I think having a therapist who gets that needs to be more somatic, so just some co-regulation.

I think it’s finding the right person, and you just have to listen to your own body. But I think at a certain point, therapy to process what you’ve been through, because this is an extremely traumatic experience, is really important.

Siem: Yeah, that’s kind of where I’ve landed, too. I do think it’s highly person-dependent. I did a therapy similar to IFS, but not exactly the same. I never wanted to be there. It was never pleasant. But I did recognize that even if I didn’t feel better right away, I usually felt better a little bit the next day or two. But for me, there was something about giving voice to the experience as it was happening that, because of the type of therapy, was not about rumination.

That’s why I think IFS and similar therapies can be such a game changer for something like this, because it’s not just putting a spotlight on what’s going on and letting you talk about it for 45 minutes and then sending you back out into the world. It’s actively using the power of your own mind and body to transform what you’re experiencing in the moment. At the same time, I’ve encountered people or work with folks where it’s just like, now is not the time to go digging.

Zaritsky: Right. I laugh when you say it. I still see an IFS therapist every couple of weeks. I’m still like, damn, why didn’t I cancel that stuff, and every time I don’t know why.

Siem: I can’t figure out why I hate it so much, given how much it’s helped me. It’s very odd.

Zaritsky: I know it’s funny. I’m a therapist, and I feel the same way.

Siem: As we’re winding down here, I think the two final questions I have for you, one is I would love to just know your professional thoughts on what you would hope other therapists could learn from your experience and how they can better interact with their patients who are considering going both on and off drugs.

Zaritsky: I wish I could get the attention of other therapists. I have tried. I should keep trying. I’m on some pretty big Facebook groups, and, occasionally I’ll post something you wrote or something else and it just gets buried. There’s no interest. I would hope they would get interested.

It’s not our job, we don’t prescribe medications, and we get no training about it, but we are on the front lines, and I would hope they would start to realize that and start to become aware of how people are being overmedicated. They’re medicating for mild anxiety and depression; it’s just like that’s just life. I would hope they would get interested and start wanting to understand this and realize that it is part of our job to understand it.

Siem: Then my last question is, what can you leave with the older adults here who are considering going off their medication or who are having experiences of menopause, and they’re going to go to their doctor, who’s just going to try to give them a bunch of drugs? What would you say to those folks going through this?

Zaritsky: Well, I would say if we’re going through menopause, it’s a trend right now to do like hormone replacement therapies. But I would definitely explore that before going on a psychiatric medication. There are a lot of other options to try, and like to really understand that these medications are strong. They change our brain structure. So think about, is that really something you want going into this next phase of your life, which is there’s a lot of wonderful things to experience, getting to work less and do the things you’ve been putting off, and it’s just a great thing to be unmedicated for.

But I also want to say to anyone on medication, it is a really personal choice. It’s a hard journey getting off of some of these meds, but I do want to give people hope. I really do feel recovered from an injury. I really am hyperbolic tapering with success and not having symptoms interfering with my life. I’m living a full, joyful life.

Like really, I would say my life is better than it’s ever been because this experience changed me, and I see this with a lot of people who I’m now getting to know now that I’m out about it. This changes us, and it’s really hard, and we don’t want to go through it. But we make good things come out of it. It can be done, and we’re never too old. It’s never too late if you want it.

Siem: Well, Marsha, I can’t remember the last time I smiled so much talking about such a horrible thing. Thank you so much. Your joy and lightness and perspective through this just comes through so loud and clear. While I hate that you had to go through this, I love that you’re using it to help other people. I think you’re making a huge difference.

Zaritsky: Oh, that means so much to me because really, if you saw me when I was going through it, I was, oh my God, crying all the time.

Siem: Yep, same. But here we are.

Zaritsky: Yeah. Here we are.

Siem: Well, thank you so much. If you could, where can the world find you since you are out and talking about this?

Zaritsky: Yeah. I don’t have a website, but I am on Instagram, and I have an account, and it’s called @gracefullyunmedicatingme.

Siem: Wonderful. I hope you get some folks following you over there, and I just want to thank you. Thank you for all your work.

Zaritsky: Oh, thank you. Thank you for what you do and for this great opportunity to talk with you. It was lovely.

***

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The post Meeting Life Unmedicated: Aging, Protracted Withdrawal and Healing—A Conversation With Marsha Zaritsky appeared first on Mad In America.

 

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