This report was first published on Mad in America on October 9th 2024
When Brooke Siem was 15 years old, her father died. Her mother, Dee Barbash, sought help for her daughter that led to a prescription for a psychiatric drug. In this interview, they look back on that fateful decision.
In this interview, Brooke Siem, who is the author of a memoir on antidepressant withdrawal, May Cause Side Effects, interviews her mother, Dee Barbash, to discuss the circumstances that led to Brooke being prescribed a cocktail of antidepressants at the age of 15. Today, her mother is a therapist who helps her clients taper from psychiatric medications—a profession that she took up after she came to understand the harms that Brooke suffered from having been prescribed these drugs for 15 years.
The transcript below has been edited for length and clarity. Listen to the audio of the interview here.
Brooke Siem: Today’s interview is a little different because I am at my kitchen table with my mother, who’s rolling her eyes at me as I introduce her. The reason Mad in America wanted to bring her on the show is because, so often in the world of psychiatric drug withdrawal or medication, we don’t spend a lot of time talking about what happens when a parent decides to medicate a child. Especially in my case, because I was 15 and had some agency.
Hi Mom, welcome to the show.
Dee Barbash: Hi, sweetie.
Siem: I spend a lot of time talking about my story and how it felt to me, but let’s talk about how it felt to you. My father—your husband—passed away when I was 15, and within a year, I was on two antidepressants and another four drugs to counter the side effects of the antidepressants. From my perspective, it didn’t feel like a big deal. We just went to a doctor but it changed the course of my life. How did it look for you?
Barbash: Well, from my perspective, I suddenly lost my husband, and you, Brooke, suddenly lost your father. You are an only child, and I was left a single parent. When a parent is suddenly thrust into a situation where you’re the only parent and you’re grieving yourself, it feels like an immense responsibility. The person that I used to discuss you with was gone. When you started to struggle—and of course, it’s expected that you would struggle with the loss of your dad—my fear probably became exaggerated. I started to see some things that really terrified me, things that looked like an eating disorder, and that made me very, very anxious.
At the same time, it didn’t seem like you were grieving in a way that I would have expected.
I went to a couple of friends who had degrees in psychology and asked for advice, and they both suggested that I take you to a child psychologist. If listeners have read her book, you know how that went. You went to the child psychologist. You did not get along with the child psychologist. You refused to cooperate, but I didn’t know that.
This is the first situation that parents can get into, especially parents of teens, when the child psychologist doesn’t want to share what’s going on with your child. There are good reasons for that because if the child knew that whatever was being discussed in that session was going to get back to the parents, it’s very possible the child wouldn’t be honest with the psychologist.
But in my case, the child psychologist called me and said that I was wasting my money, that she couldn’t tell me what was going on in the session, but that she was diagnosing you with an anxiety and depressive disorder and that I should take you to a psychiatrist. At this point, without having any other input, that was the decision I made.
Siem: We’re seeing this in schools. There was a law that was just passed in California that prohibits school districts from requiring staff to disclose to parents information related to a student’s sexual orientation or gender identity. Abigail Shrier talks about this in Bad Therapy, about how schools and counselors are keeping mental health information from parents. It was a little different for me because I was 15. But did it occur to you that you should have known what was going on?
Barbash: At that time, I just accepted it as a given because of HIPAA laws and because this professional had a Ph.D. in psychology. I don’t know what would have happened if I had challenged it. When you’re dealing with a teenager, you’re at a point with a parent where it’s a delicate balancing act between taking care of that child and letting that child have some autonomy. Lots of times, parents don’t have a lot of choice there. You certainly weren’t going to talk to me at that time.
Siem: For me, there’s just this fuzzy memory of being in the psychologist’s office for the last time, and then sometime later, a fuzzy memory of being in front of some psychiatrist.
Barbash: You weren’t offering any objections or opinions. You were pretty much doing what I said. The psychologist said you need to go to a psychiatrist, so I made an appointment, and you acquiesced. Had you pushed back a little bit, I probably would have backed off. I don’t think either of us understood what we were getting into. No one told us what might happen or how long you might be on these medications.
Siem: Were you in the room with me for the first psychiatry appointment?
Barbash: Not that I recall. And then when you started to take the meds and had bad reactions to the first two or three, they just switched you to something else until we got something that you seemed to tolerate. It seemed okay. You didn’t complain about it. You didn’t say it made you feel any sort of way. You were still very functional at school. I don’t recall that you started eating more.
Just knowing that you were on the drug—as terrible as this sounds right now—knowing that you were on the drug made me feel somehow supported, like someone else was taking care of you too. It was almost more for me than for you and that is what I think is the real problem. When kids are placed on anxiety meds or ADHD meds or a lot of these different meds—especially when they’re very young—it’s for the convenience of the parents, the school, and the teacher. Looking back, knowing you were on it somehow made me feel safe because I thought you were going down a bad trajectory. This seemed to interrupt that, and I felt like I had done something.
Siem: But did it actually interrupt it, or was it just the placebo effect?
Barbash: I think it was a placebo in my mind. Bottom line, you were medicated because I was afraid. That was it. If there’s a message I’d like to give to parents, that’s it. We need to look at what this medication is doing for us, the parents, and ask whether that’s really what’s needed.
Siem: Do you recall any level of informed consent?
Barbash: I certainly don’t recall the psychiatrist saying, “These are the risks. These are the side effects. This is how hard it is to take and to get off it. This is what we expect. This is what you could expect to see.”
Siem: There was no plan.
Barbash: There was no plan. I didn’t know what you’d been talking or not talking about to the psychologist. I just had to believe what she said. Then here’s this other professional, the psychiatrist, who seemed to concur and gave you medication. I’m like, okay, well, I’ll pay for it. Then by the time you went off to college, it was completely out of my control. At that point, you were seeing the psychiatrist yourself. You were deciding for yourself whether you wanted to continue on the meds or not. I was only in peripheral control for a couple of years.
Siem: Sometime around my 16th birthday is when the medication happened. Then there was the parade of doctors—endocrinologists and gastroenterologists—and that went on for years. It became normal for us to defer to medical professionals.
Barbash: We had no clue that all of these symptoms you were having were a side effect of the antidepressants. All of a sudden, all of these medical problems arose, and we were dealing with them one at a time. No one—not the gastroenterologist, the endocrinologist, or anyone else—ever said, “Hmm, she’s on Effexor and Wellbutrin. I wonder if…” We never connected the dots.
Siem: They tried to take out my gallbladder.
Barbash: They also tried to do another big gastro surgery that luckily we did not do.
Siem: I had an endoscopy and a colonoscopy at 19.
Barbash: You had thyroid problems. You couldn’t eat anything. You were in constant pain. You were having hot flashes. Your hair was falling out.
Siem: Those symptoms were delayed enough that it didn’t make it obvious that it was the antidepressants. When did you start to have a hunch that maybe the antidepressants were part of the problem?
Barbash: You weren’t getting better. If anything, you were getting worse in terms of the depression. You were lethargic, withdrawn, immovable, and had very little enthusiasm. Every night you would call me, and I would hear the flatness in your voice and the lack of life. Then you came home one day, crawled into bed with me, and started talking about how you thought there was something permanently wrong with you. I knew that wasn’t true. I know this child. I carried this child. I knew there wasn’t something permanently wrong with you, and the only difference was these drugs. But when I brought it up to you, you told me I was wrong and shut me down.
Siem: It just felt like anybody who’s been in that level of depression knows how frustrating and patronizing it can feel when someone dares suggest that maybe the problem is you.
Barbash: But I wasn’t saying the problem was you. I was saying the problem was the drugs.
Siem: You were saying the problem was the drugs, but I was so protective of them because I thought that if I feel this way on antidepressants, it’s going to be so much worse without them.
Barbash: You had no initiative in any way, even though when I tried to encourage you by supporting all of your various endeavors, whether they were educational or career-oriented, I always tried to support you, but the initiative was largely lacking.
Siem: I don’t know if I would have ever gotten off the drugs if I hadn’t had some cosmic interventions. I turned 30, got an opportunity to travel around the world for a year, and logistically couldn’t carry that amount of drugs in my suitcase. It was also starting to sink in that I shouldn’t be so depressed if the antidepressants were working. Do you remember when I told you I wanted to get off the antidepressants?
Barbash: I know it was over the phone, and I remember I was 100% supportive. I also remember when you started to come off the Effexor and the withdrawal began. I just wanted you to stick with it because I could hear the life coming back.
Siem: What do you recall from the first couple of conversations I had when I was in withdrawal? I don’t remember them.
Barbash: I was still in the mode I’d been in since you were 15, where I only knew what I’d been told. Every bit of information I got was either through a psychiatrist, a psychologist, or you. Initially, I might have had a few misgivings about going off the drugs, but if you decided to do this, I was going to support you. But then when we got a few days in, and the withdrawal symptoms started to hit, you called up a panic because you were worried about the intrusive thoughts and horrific visions going through your head.
Siem: What did I tell you? Because I don’t think I told you the extent of what was going on.
Barbash: No, but I could feel it. By listening to you, I could feel the terror in you, the repulsion in you, and how you were struggling. I could feel it. But at the same time, I could hear and feel the life starting to… like the blood started to run through you again. You were starting to sound more like the kid I remembered, even though you were in early withdrawal. I just wanted to hold space for you and help you get through. Of course, I didn’t know how long that horrible period was going to last either.
Siem: I always say that the thing that got me through is that when I called, you picked up the phone. I needed an anchor point, and you were it.
Barbash: Now, I have a practice where I work with people coming off of psychiatric drugs. Most people I work with need an anchor point. What they don’t need is their mother (or whoever that anchor point is) saying, “Well, you could always reinstate and go back on the drugs.” That is not what these people need. These people need to hear, “This is temporary. You’re going to make it. Let’s get through the next hour, the next day. I’m proud of you.” That’s what they need to hear. Because again, I think that when one of my clients complains to their mother about how much they’re suffering with withdrawal and the mother says, “Well, you could go back on the meds, maybe you just need them or you used to do so well on them,” this is a convenience for the mother, not the best thing for the person who has made a rational decision to get off these drugs.
Siem: I feel like people can be put on these drugs in such a flippant, irrational, thoughtless way. But nobody comes off them that way. It’s always intentional, with a reason, or a lot of rational thought. When people comment on my Instagram or TikTok videos, some people say, “I’m so scared to come off these drugs because of withdrawal.” It’s a double-edged sword because part of the reason why I think I did as “well” as I did in withdrawal, even though it was so horrible I got a book deal out of it, was because I was naive.
Barbash: It was also good that you were not living with me. By the time you came home, enough time had gone by that you were not reinstating. By that time, you were also working with a counselor and that was real support for me.
Siem: Was there ever a point in the process where you were worried that I wasn’t going to make it out or that something had gone wrong? It just lasted so long.
Barbash: Deep in my soul I knew you were going to be okay. I never worried that you weren’t going to make it out. At the same time, it’s hard for a mother to watch their child suffer. I think that is another reason why so many mothers of my clients come back with, “Well, you could always go back on the drugs,” because it’s so hard to hold your child while they cry. I truly understand that. But once they get through it, they have their life back. If we can hold steady for our kids as they come through it, it’s so worth it.
Siem: It took about a year for me to get through the severe withdrawal and another year with occasional windows and waves, but it was a period of figuring out how to be an adult, even though I was 32.
Barbash: That’s probably one of my major objections to medicating people, especially young people. When they’re seven or eight and you put them on these meds, they don’t learn coping skills and they don’t learn any kind of resilience. Then you expect them, at 25, to come off the meds and understand how to do life. They’ve never had a chance to do that. It’s incredibly unfair to medicate a child or a young adult and not allow them those precious years of learning. To give them the sense that something’s wrong with them and that they can’t live without medication…
Siem: Even if you don’t say that with words, you say it with action.
Barbash: Absolutely, that is the message. Every client I’ve ever had has faced that. To figure out who they are after years and years of being medicated is an amazing adventure. But it’s really scary for them because they’re not sure who’s in there, so it’s a terrifying place to be. My clients are angry because they were put on meds at a young age and now they’ve lost all of their 20s, maybe half of their 30s. It’s delayed them in every possible way—forming relationships, creating a career, getting an education. And if you’re 50 when you’re ready to come off? Then it almost feels like it’s too late. It’s just such a big decision to medicate a child and parents need a lot more information than they’re given.
Siem: Because parents aren’t being given information, what questions can parents ask to get the information they need?
Barbash: If you have a child that’s exhibiting some sort of unwanted behavior—like the child doesn’t want to be in school, the child throws giant tantrums when mommy leaves, or they’re overly attached to mom, or there are certain situations where a child of this age should be able to function, but the child is not functioning—I think the parent needs to try to figure out why that kid is acting like this. It is not about what’s wrong with the child. It’s about what happened to the child or what is happening to the child. It’s a painful thing to do, but sometimes you need to look at your own parenting skills, your own situation in your home, and what might be going on in the home that’s affecting the child. Look at all of those things, and then put yourself in therapy.
If you need to put yourself in therapy, talk about how this is affecting you and why this child’s behavior is getting under your skin to this extent. So much of the time, it’s about the parent and not about the child, and that was very true of me. If I had put myself in therapy about grieving, being a single parent, and having a kid that isn’t eating, and if I had realized so much of this was about me needing help and someone to hold on to instead of making Brooke the patient, I think we could have avoided a lot of things.
Siem: If a parent ends up in a pediatrician’s office and the pediatrician is suggesting medication, or maybe the parent is considering because they feel like they’ve tried everything, what specific questions would you have them ask a doctor before they make this call?
Barbash: I would want to know everything I could about the particular drug that was being proposed. What kind of tests have been done on that drug? What does the research say about this drug? What are the long-term effects of this drug? How often or how long is it proposed that this child would be on the drug? What are the side effects of the drug? If a child has been on the drug for 10 years, what effects are we seeing in kids who’ve been on that drug for 10 years? But before I ever got to that point, I would be looking at the circumstances around this child.
I’ll give you one example that I came across recently. There was a child whose pediatrician and school personnel told the mother that this little girl, eight years old, should be put on ADHD meds. The mother was actually a foster mother and this particular little girl had been abandoned twice by her biological mother and ended up in foster care, twice, by the time she was eight years old. At eight years old, the school nurse, the pediatrician, the principal of the school, the teacher—everybody—was telling this mother, “This kid is behind in school, is a problem in school, and needs to be medicated.” The mother resisted.
Several months later, when the adoption of that child came through—I actually went to court with the mother—the child was formally adopted by the foster mother and all the problems that had been happening in school magically disappeared. That child was never medicated, and this child is perfect in school now. What we need to look at is what is causing these difficulties with the child. Medication should be an absolutely last, last resort, and if it’s used, it should be extremely short term.
Siem: Some good Googling should probably be done in addition to talking to a doctor, because the doctor is going to say these things are safe, they’re therapeutic doses, and they’re not going to know anything about the latest research. They’re not going to know anything about taking people off. A pediatrician is not going to know what happens to some kid 10 years down the line. You have to become the child’s advocate.
You and I also have the rare benefit of having a strong relationship that’s weathered all of this. What advice you would have for a parent whose kid won’t listen to them, or who has a difficult relationship with their child?
Barbash: If you have that unfortunate situation, it might be important to find an adult that your child will relate to, whether that is a relative, a friend, or even a very trusted therapist. That kid probably needs someone to talk to. I would say also to the parent, “Hold on. The way your child relates to you at 15 or even 20 can be so different from the way they relate to you at 25. I promise you that if you hold on, one day when they’re 25 or 26, you’ll pick up the phone, and your child will say, “I called to apologize because you were right all along.” It will happen, parents. It will happen. You just have to hold on. But in the meantime, they need somebody to talk to, someone that you trust but that they trust also.
Siem: It’s been eight years since I stopped taking my last antidepressant. Both of our lives have changed because of this very casual decision we made when I was 15.
Barbash: Yes.
Siem: Knowing what we know now, what would you have done differently? Where would the first intervention have been?
Barbash: Knowing what I know now, which is an impossible situation, I might have gotten a second opinion when that psychologist said, “I’m diagnosing her with an anxiety and depressive disorder.” I might have—I don’t know if you would have told me at that time—but I might have said, “What do you think of that psychologist?” Maybe you would have told me what you really thought. But I think parents should get a second opinion and a third opinion. If it doesn’t feel right or it doesn’t hit you right in the gut, keep looking for help. If your psychiatrist is giving you trouble about coming off drugs, in my opinion, that’s not the right psychiatrist.
Siem: You have been working with people in withdrawal and who are tapering. What are a couple of the takeaways you’ve learned now that you’ve graduated multiple people through their taper?
Barbash: It’s just so important, I think, to maintain an encouraging and positive outlook. It’s so easy for people to get discouraged. At the same time, if you’re going through a taper, there’s a certain amount of required acceptance. You have to be willing to be uncomfortable to get what you want. You have to be a little stubborn and have a long-term perspective. Ultimately, you’re going to make it. If you hold out long enough, you’re going to make it. Everybody makes it if you hold out long enough.
Siem: I’m currently supporting someone who’s tapering and when they’re in a deep wave, even though I’ve been there and they know I’ve been there, there’s nothing that seems to pull them out of that. People who have been through it all say the same thing: that there’s this level of radical acceptance that has to happen. I don’t know how to teach that. I don’t know if it’s something you can teach, or if it’s just something you learn after getting so tired from fighting. You deal with clients who are in that level of a deep wave all the time. I think any advice for people who are in deep waves right now would be possibly very useful.
Barbash: For many of my clients, the emotional torture that they’re going through is far worse than the physical torture. This isn’t always true, but I would say that 75% of the time, my clients will report that the intrusive thoughts, the fear, the panic, the emotional stuff is much worse than all of the physical symptoms. They’re able to cope with the headaches, the shaking, the fatigue, the gastro stuff, or whatever much more than the emotional stuff. Along with that, I think one of the worst parts of it for most of my clients is the fear that it will never end and that they will never be better.
Many of them have reported to me that they feel like the only way out is death, because it’s so intense and so terrible. They need me to say, “You’re getting better.” They need me to be able to point out, “Six months ago, you told me this, this, and this. Six months ago, you couldn’t do that, that, and that. Now look at you.”
Also, another thing that helps with my clients is I have them keep a calendar where they write down every day whether it’s a red day (that would be like a deep wave), a yellow day (which is like, it’s not a great day but it’s a tolerable day), or a green day (that would be a window). I make them track it. When they’re in a bad wave, we go back, and we say, “Look, 40% of the time, you’re in a green day. Another 20% of the time, you have yellow, so 60% of the time you’re doing okay, you just have to get through it.”
But if it’s really a bad day, and if they’re having trouble physically as well as emotionally, I find often that a guided meditation session, a hypnosis session, things like that, can give them an hour of relief. I provide tapes for my clients, and at night they play them during the night. If they’re having trouble sleeping, it just relaxes them enough to get through it. We’ve just got to get through it, a day at a time.
Siem: Thank you so much for talking with Mad in America. I’ve been so excited to introduce you to the world, whether or not you wanted it. People email me about the book and talk to me about it and say, “My god, your mother, she’s just such an angel, such a hero.” It’s true, so I’m really happy to introduce you to even more people.
Barbash: If anybody out there is in the middle of this, keep going. Just know that it’s temporary, and you’ll get through it. Just keep going. Get the support you need if you need it but keep going.
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