Mental Health, Medication, and Informed Choice: My Holistic and Integrative Approach
In short: I don't assume mental health struggles are automatically a brain chemical problem, and that's not to say anyone's suffering is any less real. Life, habits, health, relationships, and difficult circumstances can all contribute to how someone feels. People deserve accurate information and informed choice about psychiatric medication, including what starting and stopping it can actually involve. You're welcome here whether you want medication, you're already taking medication, or you'd rather avoid it.
How I Think About This
As a licensed clinical social worker, I was trained to look at the whole picture, someone's biology, psychology, relationships, environment, and life experiences, not just symptoms in isolation.
That can include working with a medical provider to look at whether physical factors like thyroid problems, blood sugar changes, or hormonal changes might be part of the picture, since these can sometimes look psychiatric. It can also mean paying attention to sleep, nutrition, movement, and daylight, since our brains need steady energy and nutrients just like the rest of the body.
Of course life circumstances and relationships shape how a person feels, and trauma greatly impacts them too. None of that necessarily means there's a chemical problem to fix.
Sometimes Life Is Just Really Hard
It's to be expected that someone would be greatly impacted by a breakup, a job loss, a move, the death of someone they love, or trauma. There are also things that are just part of life and still genuinely hard. Caring for an aging parent, feeling lonely, or being stuck in a sense that life doesn't feel good and you don't know why.
None of that needs a medical explanation to be taken seriously. Feelings serve a purpose. Sadness, anger, fear, and grief can sometimes be important information about how we're living or the circumstances we're in.
Emotions can also feel completely overwhelming, so much so that people don't always have the capacity to feel them, and they learn to override what they're feeling instead. Part of my work is helping someone build that capacity, so they can be with their emotions rather than push them away, and hear what both the body and the mind are telling them.
If someone has been chronically unhappy, anxious, or irritable, for example, that's important to attend to rather than move past too quickly. Maybe they are living in ways that don't fit their values anymore. Maybe they are staying in a relationship, job, or situation that isn't working for them. Maybe they have become isolated, or fear has kept them from doing things they want to do, or there are experiences from the past that their mind and body are still responding to.
Moving too quickly to quiet a feeling can mean missing what it's pointing to. Someone may still decide medication would be helpful during a difficult period. I want that to be an informed choice rather than an automatic response to distress.
What About the Chemical Imbalance Explanation?
Part of informed choice is having accurate information about what we know and what we don't know.
People with depression are often told they have a chemical imbalance or too little serotonin in their brain. Research has not established depression as a serotonin-deficiency condition. In 2022, psychiatrist Joanna Moncrieff and colleagues published a systematic umbrella review examining the major areas of research on serotonin and depression, and concluded that the research they reviewed did not support the idea that depression is caused by low serotonin.
We know that some people have a positive experience with antidepressants, although we don't fully understand why they help some people and not others. Some people don't find them helpful, and others have a negative reaction. We don't have a clear explanation for those different responses.
That uncertainty is part of what informed choice means to me. People deserve to know what the research does and doesn't show, rather than a tidy explanation that isn't fully true.
Why I Think About Mental Health This Way
I'm Amy Hagerstrom, a licensed therapist and Somatic Experiencing Practitioner. My graduate training had a strong emphasis on infant and early childhood development. My somatic trauma training added another layer. Together they gave me a foundation for the very human lens I bring to this work, one that takes early life experience and the nervous system seriously. My approach as a therapist is holistic, somatic, and integrative, in part because of that training, and in part because of my own experiences.
For a long time, I did talk therapy and took psychiatric medications, carrying diagnostic labels that carried real weight. Instead of getting better, I got worse. Eventually I found body-based practices and Somatic Experiencing, and began doing the work myself as a client. Understanding how much my earlier experiences had shaped my sense of safety helped me make sense of myself with a lot more compassion. But it was working directly with what was happening in my body and nervous system that finally made the difference. My mental health improved significantly in a way I was able to sustain, and I never needed to return to psychiatric medication.
I also started paying attention to the basics I had been neglecting, especially nutrition, along with movement and sunlight, and I could see how much they were affecting how I felt mentally and emotionally.
Much later, I came across Laura Delano's work and her book, and it helped me see how much I had been treated as a diagnosis to manage rather than as a whole person, adding another dimension to how I understood my own story.
I understand myself very differently today, and I live a much fuller life than I knew was possible during those years.
Informed Choice Includes Knowing What It May Be Like to Stop
I'm not a prescriber, and I don't determine anyone's tapering schedule. My graduate training included some education about psychiatric medication, but it wasn't an area of deep study. I've chosen to go much further into this on my own, and I want to be a resource who can help you think through questions worth bringing to whoever prescribes for you.
If someone is considering psychiatric medication, I think it's worth knowing the potential benefits, possible side effects, what we know and don't know, and what discontinuing it may involve, before starting. That last part is particularly important to me because it wasn't something I understood when I first started taking medication.
When we take a psychiatric medication regularly, the brain and body can adapt to its presence, and coming off it isn't always as simple as just stopping, or even cutting the pills in half or tapering over a few weeks. For some people that's manageable. For others, it takes a much slower taper, sometimes over months or even more than a year. UK clinical guidance has recognized this for some time. In the US, this conversation is beginning to change. In 2026, the Department of Health and Human Services launched an initiative addressing psychiatric overprescribing and calling for greater attention to informed consent, shared decision-making, and deprescribing when clinically appropriate.
Understanding that this process isn't just physical can be really important. Many people assume that emotional or mental symptoms showing up mean their depression or anxiety is back, or that they need to increase their medication again. That's not necessarily the case. These symptoms might actually be part of withdrawal.
After reading Delano's work and doing further research of my own, I've come to wonder whether my own on-again, off-again pattern with medication, and the symptoms that kept reemerging, may have actually been withdrawal, rather than a sign that I needed to go back on medication.
I recommend Anders Sørensen's book Crossing Zero as a resource, and I also use it to help someone think through questions to take to their prescriber. As a therapist, I can also offer emotional, mental, and nervous system support through this process, and help someone track what they're experiencing along the way, including changes that may be worth discussing with their prescriber as possible withdrawal symptoms.
I Don't Decide For You
I've had people come to me after reaching a standstill with a previous therapist, because they didn't want to take medication and felt their therapist saw it as the next step. I've also worked with people who have had difficult experiences with psychiatric medication or withdrawal. And I've worked with people who take medication and feel it helps them, including clients who decided to start while we were working together. We're all different in our biology, histories, relationships, circumstances, and needs. When medication is part of what someone's working through, I believe in bodily autonomy and informed choice, and I'm there to help them understand themselves more fully and make their own choices, not to decide for them.
I Believe People Make Sense
One of the beliefs underneath my work is that people make sense. Our emotions and behaviors can become painful or create problems in our lives, but when we become curious enough about them, there is often something understandable underneath: fear, protection, grief, unmet needs, what they've lived through, physical factors, exhaustion, disconnection, or a life that no longer fits.
My work is about getting curious about all of it, including what is happening in both mind and body. Sometimes that means processing experiences from the past or looking at what may need to change in someone's life now. We may look at sleep, nutrition, movement, and other parts of daily life. Someone may need to reconnect with friends, lean more on family or other people in their life, spend more time outside their home, or find ways to feel less isolated. Medical care may be part of the picture too, and for some people, medication may be a choice they want to make.
Because I am a somatic therapist, a significant part of my work is also about the nervous system: increasing felt safety, recognizing fight-or-flight earlier, coming out of chronic patterns of freeze or shutdown, and helping the body recognize when the threat it learned to respond to is no longer happening now. As someone develops more capacity, there can be more room to feel emotions without becoming overwhelmed, stay connected during difficult moments, make clearer choices, and engage more fully in life.
Usually there isn't just one thing that needs attention. That's why I work in a way that includes the mind, the body, and the larger context of someone's life.
Looking for a Therapist Who Will Respect Your Choices About Medication?
If you've felt pressured to take psychiatric medication when you didn't want to, had a hard time with medication or withdrawal, or simply want a therapist who looks at the bigger picture with you, you are welcome in my practice.
I provide online somatic therapy for adults in Florida and Illinois. My work integrates Somatic Experiencing with a broader look at the factors that can affect how you feel, including your history, relationships, physical health, and daily life.
You don't need to share my history or make the same choices I have. I will respect yours.
If this approach feels like what you've been looking for, you can schedule a 10-minute consultation to learn more about working together.
Sources and Further Reading
Moncrieff, J., Cooper, R. E., Stockmann, T., et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular Psychiatry, 2022.
National Institute for Health and Care Excellence (NICE). Medicines associated with dependence or withdrawal symptoms. 2022.
Goldberg, J. F., McIntyre, R. S., Swartz, H. A., et al. Recommendations for the Deprescribing of Psychotropic Medications: A Consensus Statement From the American Society of Clinical Psychopharmacology Task Force. JAMA Network Open, 2026.
Horowitz, M. & Taylor, D. The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs. Wiley-Blackwell, 2024.
Sørensen, Anders. Crossing Zero: The Art and Science of Coming Off — and Staying Off — Psychiatric Drugs. 2025.
Delano, Laura. Unshrunk: A Story of Psychiatric Treatment Resistance. Spiegel & Grau, 2025.