Brooke Siem, MAY CAUSE SIDE EFFECTS
Award-winning chef, author, and speaker Brooke Siem joins Zibby to talk about her debut memoir, May Cause Side Effects, which tells the story of her withdrawal after fifteen years on antidepressants. The two discuss how Brooke’s experience affected her memories—including when she won Food Network’s Chopped competition—as well as how her support network helped her reframe her outlook on life. Brooke also shares how her antidepressant journey impacted her relationship with food, who she hopes will read her book, and which author shaped her writing journey the most.
Transcript:
Zibby Owens: Welcome, Brooke.
Brooke Siem: Thank you.
Zibby: Thanks for coming to this in-person podcast, which, clearly, I haven’t done in a while, as I was unprepared. I was somewhat ready. My family’s all over. It’s a mess. This is life.
Brooke: It’s very welcoming.
Zibby: This is actually exactly where, last night, we watched your episode of Chopped, which was amazing. Even though I know you won and they knew you won, I wasn’t going to give it away, and so there was still somehow some suspense, which was wonderful.
Brooke: It’s an entertaining forty-five minutes of television. I didn’t make it obvious or easy for myself or anyone else.
Zibby: It was so funny because I had already read it, so I was like, “You guys, she might look calm here, but she was so nervous.” Then I was straining to see. I’m like, do I see the pustules on her arms? Are they out in this scene?
Brooke: I don’t know if you could’ve seen those obviously.
Zibby: First of all, your book, May Cause Side Effects, was so good. So, so good. I loved it. You’re a really great writer. I don’t always say that, just so you know. You probably are aware. Your words, your turn of phrase was so amazing that I kept underlining and dogearing and screenshotting and all of it, even the way — there was some way you described an X-ray machine which stuck out to me, something like a thousand — I’ll find it later. I love how you write.
Brooke: Thank you.
Zibby: You wrote that this took you a long time to write, this book, and that the act of writing it took a long time. Tell listeners a little bit about what your book is about and the backstory.
Brooke: My book, it didn’t start off as the book it became. The book is now about my experience with antidepressant withdrawal. The long story is I was a child of fifteen when my father suddenly died. I was put on antidepressants right away because it was 2001. That’s what was starting to happen then. That’s still what happens a lot now. I was still a kid. I just was doing what the adults were telling me to do. Fifteen years later, I’m still on these same drugs. Nothing had been changed. They’d been really poorly monitored. I just realized that maybe it was time to see what I was like as an unmedicated adult. I saw a psychiatrist and started to get off them. Basically, my whole life exploded. I entered into severe antidepressant withdrawal, which was not something I’d even heard of. I didn’t know what it was. I didn’t know if I was having a psychotic break or what was happening. It took a long time to get out of that, almost a year.
In the meantime, I had gotten this opportunity to travel around the world for a year. I decided I was going to take that opportunity no matter what, thinking that I’d be stable by the time it was time to go. I wasn’t. I got on a one-way ticket to Malaysia and started traveling around the world still experiencing antidepressant withdrawal trying to figure out who I was without these drugs, literally getting to know myself from the bottom up again. That’s effectively what the book is about. It actually started because my literary agent at the time for a previous book, because I’d written a cookbook for my bakery, had heard a little bit about my travels and said, “You should try writing a book. Pitch it. See how it goes.” I was like, okay. I’d been doing a long-term project of saying yes to things, and so I just said yes. It started off more as a travel memoir. It was pretty bad. Eventually, I realized the real story was about the antidepressant withdrawal. That took a long time to unpack and start to write and figure out what had actually happened to me because I didn’t actually really know until I started writing and researching.
Zibby: Then you also did the piece on the grandmothers cooking along the way.
Brooke: Yes. What happened was, I’d been working in restaurants in New York. Then I owned a bakery in New York City. We wrote a book for that. When I decided to start traveling, I was really burnt out. I hated the industry. I was really resentful because I had loved cooking so much. The years just beat it out of me. When I started traveling, I said, okay, I need to feel love in some capacity. Cooking was always such a source of love for me. Then it was gone. That made me so sad that I said, when I travel, I’m going to avoid restaurants as much as possible, at least the fancy ones. I’ve been in that world. I worked in that world. I don’t need to do that. I said, I want to spend as much time with the people who are cooking everyday food as I can, and old recipes and old styles. I decided to seek out grandmothers all around the world. I ended up getting invited into fourteen different homes in ten countries, four continents. I’d spend sometimes days with these women learning old recipes from all around the world. We just would talk, sometimes through a translator, sometimes with points because we didn’t have one. Sometimes they spoke English, and we could actually really chat. It was a really interesting way of healing throughout this process of antidepressant withdrawal in a way that was very personal to me. The two things were happening at once. I didn’t really write about it too much in this book because in a way, it just really felt like it was for me. I kept it a little out of there, but I’ve since written about it. Still in touch with some of my grandmothers over Instagram. It’s great.
Zibby: I love that. You could’ve made that into a book.
Brooke: I thought about that. Once I got into it, the story was really about antidepressant withdrawal and how so many people go through this and don’t know that they’re going through this. It wasn’t even so much about, I’m a patient, let me write a book for other patients. I wanted to write a book to help clinicians and prescribers understand what this experience is like and to help family members because all they see is someone who quite literally looks like they’re having a psychotic break. You need to know that that’s not what it is in order to help support that person through. I basically wrote the book I wish I’d had, and it wasn’t about cooking.
Zibby: You talked, though, at the end about, if you had known better, you would have done a more hyperbolic tapering versus the doctor who you saw who — it made me think, again, how is it possible that you can just go out and find any doctor? They can do anything. They can give you all the worst advice, and it’s okay. There are no checks and balances to the whole thing.
Brooke: I wish I had a better answer for you. I just don’t. I hear this story. I’ve heard it hundreds of times at this point starting to publicly talk about this. I think there’s a thousand reasons why this is happening, everything from the broken health care system to doctors only being able to take patients and get reimbursed for insurance if there’s a diagnosis, to not having enough tools, to people wanting a quick fix, to people like me who were medicated for a reason at a certain time and have never been guided on safe tapering or even given an indication that getting off these drugs at some point would be possible. I was just under the impression that I was broken. I was given the line about having a chemical imbalance, and this will fix it. Especially when you’re a child and you’re told that, you imprint that onto your soul. That becomes part of who you are. To start unraveling that means to unravel your entire identity and everything you’ve been told about your life.
Zibby: Not to mention that you were grieving.
Brooke: And I was grieving.
Zibby: That alone presents as a mental illness.
Brooke: Literally. The symptoms are identical. Now we have prolonged grief disorder, so now it is a mental illness.
Zibby: Yes. I wish I had known that when everybody was like, you’ve been grieving too long. Pick yourself up. I’m like, well…
Brooke: In the bathtub.
Zibby: I’m in a bathtub in Malaysia with a man I’ve never seen before.
Brooke: Talking to ghosts.
Zibby: Talking about a monster or whatever. I was like, yeah, that is pretty crazy.
Brooke: I guess on the outside it did look like I had it totally together while I was on all these drugs. For me, it felt more like I was just continuing to act out the roles that I had established for myself and been given. It wasn’t even conscious. I just did it. I didn’t feel like I was putting on a mask every morning and taking it off every night. I was just going through the motions. Then I was also going on a downward trajectory. I was continuing to get more depressed and also more suicidal despite the fact that I was on all these antidepressants. The math wasn’t working out in my head. I finally had this light-bulb moment. I was also having a lot of memory problems at the time. My short-term memory was getting bad enough to where my business partner and I were getting in fights because she’d tell me something, and I’d forget. We started to think maybe it has to do with all these psychiatric drugs. When I got this opportunity to travel, I was like, I don’t want to forget it. That was one of the big reasons why I decided to get off of them. Then once I started to get into antidepressant withdrawal, what happens, and what happens to a lot of people, is that there are all these hugely negative side effects, so physical, psycho-emotional, mental, hormonal. Everything’s going crazy. At the time, I was having these little moments of feeling like the lights turned on. Colors got brighter. I’d feel creative or curious about something. These were things I hadn’t felt in fifteen years, my entire twenties. I never felt that. Those little moments, for me, were so important because I started to realize, wait a second, there’s a part of me in here that I didn’t know existed. I want to know more about that person. I’m curious about that.
Even though the vast majority of the experience was really awful and it was a struggle to keep going and to not just go back on the drugs, there was a big part of me that was desperate to figure out, can I experience joy? Is this possible? I just needed to know. It got to a point where I started to lose hope in being able to experience that joy for more than just a moment because it had been going on for months. That’s when we found Allen, who was kind of an unconventional counselor. He blended Eastern and Western modalities into his own little thing. It was all self-compassion based. For me, the reason why it was really effective is, because I had had so much memory loss, I had difficulty in traditional talk therapy going back to the time when I was an eight-year-old and had experienced something. I literally couldn’t remember. I couldn’t connect, especially all the trauma around my dad being gone so fast. The memories were just gone. Allen’s technique allowed me to tap into metaphor or subconscious or a past life or whatever, God, universe, whatever you want to call it. It allowed me to work with things in a very abstract way, which, for me, was the only way I was actually able to start processing the trauma and the emotions and also to get through the withdrawal itself and to start separating, okay, what was me? What was because I didn’t have this chemical in my body anymore? Also, who was I? What did I want? His process allowed me to do that. It’s very difficult to explain. I hope I do a decent job in the book.
Zibby: You did a good job, yes. You did a good job.
Brooke: I almost don’t want to try and explain what it’s like in person because it just won’t make sense.
Zibby: You’ll have to read it. It was great because you always alternated the thought and what it meant and then what you said.
Brooke: There was a lot of parroting back and forth. The takeaway from it from my perspective is that it took a long time for me to find a modality that worked for me. It wasn’t traditional. Once I found it, it clicked. Almost, I started to feel the healing happen pretty fast. I’m really grateful that I had the ability. It was my mom who brought him to me. I was able to just say, okay, I’ll take whatever help anyone’s offering me right now.
Zibby: Then your dad also had all those tapes that you found. That was amazing.
Brooke: That literally happened towards the end of my first draft. My mom just was standing there with a Ziploc bag one day. Guess what I found?
Zibby: I was so impressed you even had a tape player.
Brooke: Oh, I had to find it. I think I looked through a few of them. They didn’t work. I ended up with this old Walkman. It was scratchy. Then half of them had some radio show taped over them, which was so frustrating.
Zibby: So funny. We always did that with even our VHS tapes. How many times did I record shows? We couldn’t just buy another? How much were they? We must have recorded over it a hundred times.
Brooke: Then you’d have some memory that you really wanted, and someone would come record Jeopardy.
Zibby: I was like, okay, I didn’t need my sixth birthday party. Here’s Little House on the Prairie again. Oh, well. One of the side effects you had that was particularly acute was the sensory overload stuff. Had you had any of that before you went on the meds? Do you continue to have it now? I know you reference sometimes you have to get out of the busy city and just move to the desert if you don’t want to deal with the cars type of thing.
Brooke: I’ve always been very sensitive, but I don’t remember having these extreme reactions to pretty much all sensory. When I first started to get off the drugs, every one of my five senses, it was like the intensity was turned up. I struggled with lights being too bright, audio input.
Zibby: Should I turn it down?
Brooke: No, I’m okay now. Audio input was and still is the only thing that kind of lingers. I have a lot of trouble hearing different sounds at once and also just actual noise. I got custom earplugs made. In the first couple years while I was still readjusting to an unmedicated life, I’d have to wear them in the airport because even just the din of noise around me was too much coming in. That’s really been the longest one to come back. I don’t have the emotional triggers anymore, which is great. Leaf blowers are the bane of my existence. I cannot stand them because they set something off in me that is very emotional as well as just drilling into my ears. I’m happy to say that I can go past some landscape now and not burst into tears. That’s growth. That’s healing.
Zibby: It was so funny because on your episode of Chopped, you were so sure — you were like, I feel like I did a great job. It’s good. They were like, we really like your confidence. I was like, confidence? I’m reading your book. I’m like, this is so ironic. This is not at all the way you present here. Do you feel like, even despite all the turmoil and whatever’s going on and how you had to get through weaning all of the stuff and physical manifestations and all of it, that you can still feel really great about certain areas of your life regardless of how you feel about the other parts? Do you know what I mean? Can you compartmentalize like that? Is that easy for you?
Brooke: You mean when I think back on my experience with Chopped?
Zibby: No, just anything. Can you be like, I feel like I want to take this chair and break it into a thousand pieces and scream in the street and do all these things, but I’m an awesome baker? Sometimes it’s hard to hold those two things. Some people, it’s more like, I’m depressed. I’m bad at everything. Everything is terrible. There’s nothing — but it feels like, no.
Brooke: When I was in the depression and also medicated, everything was flat in a way where nothing was ever good enough. It didn’t even matter if I was better than average at something because it still wasn’t as good as somebody else. I knew that I was phoning it in half the time. I just brushed it off that everything was just blah. When I was in serious withdrawal when it was very, very emotional, I was completely consumed by the emotional swing of it all. The best way I can describe it is like a second puberty, if you just imagine what it was like when you were thirteen, but now you’re thirty. It’s worse. What’s happened now as an adult — this is a place where when people ask me for advice, I tell them that this is where I think the goal is, is where you can be having an emotional breakdown or you can be really angry and at the same time, you can still hold gratitude. It’s when you can have the duality that I think is the key that you’ve done something right in your recovery, in your healing.
To me, it’s very odd. I almost feel like maybe my higher self or whatever you want to call it is almost observing the emotional. It feels a little disorienting because you’re very aware that you’re hitting a pillow and you’re breaking a chair in half. You’re like, maybe that’s not great, but it’s in a nonjudgmental way. Then I feel like I also allow myself to do that. I also trust that this is going to end. I can kind of feel the emotion leaving me. At the same time, I’m also very calm in the background. It’s going to pass. Let it out, honey. Let it out. It’s very odd to have it both happening. I’ve now experienced this in grief. I’ve had lots of having this incredibly emotional reaction to grief and still holding gratitude for being able to experience grief in a cozy bed. I had a dog run away. That was awful. I remember sobbing but also being just so grateful to even be alive to experience it. That’s where I’m at now. That’s what I tell people is more of the goal. It’s not to necessarily stop the emotion or to never have these swings, especially if you’re an intense person or a sensitive person. It’s just to —
Zibby: — Feel them.
Brooke: Feel them. Be aware that you’re feeling them, which is different than being consumed by it.
Zibby: Yes. I like that. I just wanted to read a couple passages quickly because they were so pretty. Let’s see. Let me read this. This is how you didn’t cry at first when your father passed away. You sort of held it in until later. You said, “I didn’t cry when my mother and I both shrunk into five-feet-tall figures of hips and bones subsisting on nothing but deviled eggs my grandmother delivered by the dozen. I wanted to run to my mother and run away from her. I wanted to press fast-forward or rewind and send us forward or back. It didn’t matter, as long as we weren’t there. When I saw my mother’s red and swollen eyes, I knew I was powerless to help her, so we danced around each other, coexisting in a haze of involuntary life. Sometimes my mother slept all day, and sometimes she didn’t sleep at all. Sometimes we hugged each other in the hallway. Sometimes we didn’t acknowledge each other. Mostly, she was out of the house dealing with the logistics of sudden death.” Then you talk about the collection agency. Then you say, “I didn’t cry until one fall afternoon when I pulled a knife out of my flesh. It bored so deep into the fleshy space between my thumb and forefinger that when I lifted my hand from the apple I’d been steadying, the knife held its place like a sixth appendage.” Ouch.
Brooke: It didn’t hurt at the time.
Zibby: You talk more about how you thought you had an eating disorder and how the doctor you told dismissed it, which I could not believe too. That was amazing and terrible. Then let’s see. Oh, the remote, the fact that you’re at your computer and the way you procrastinate is applying to totally unlikely things and the fact that you got Chopped and remote year at the same time and then had to go do them.
Brooke: What better way to pretend you don’t live your life than to try and be somebody else’s life?
Zibby: Now I feel like those were not the best passages. I promise, they were really great. Wait, maybe I have another one from this part of the book. You had so many great sentences. I’ll just read them later or something. How about this one? “My heart beats faster, each breath shallower than the one before. I hope for relief when I walk into the gym, but the bubble tarp serving as the roof provides no protection from the beating sun or the cacophony of construction.” Cacophony of construction, that’s really awesome.
Brooke: I like alliteration.
Zibby: I like alliteration too. “It is only when my skin begins to tickle with sticky heat.” That’s another good one. Anyway, whatever. I really like the way you write. Everything is very visual.
Brooke: Thank you. Yeah, it’s very visual and visceral. I don’t understand people who can — like the Dickens of the world who — these long sentences. That’s not how my brain works. I just need to get to the point but make you feel it.
Zibby: I get that. Do you still have the diving mask? Where is it?
Brooke: I do still have the diving mask. It’s in my drawer right now. I have a diving drawer. It’s got snorkel and my skins and everything. I’ve used it multiple times. Every time I use it, I take a picture and send it to Martin. He’s in Indonesia now. I really want to go down there with a book and give it to him because he doesn’t know how much of an influence he was on my healing in that part of my life.
Zibby: Are you at all worried about big pharma in general with this book coming out?
Brooke: Am I worried about big pharma? Not really. This is just one experience. I don’t really own anything, so there’s nothing to take. I’m a writer. We’re not known for our riches.
Zibby: You live in Reno now, right?
Brooke: I live in Reno. I went back home mid-pandemic. Getting family time in after all my years in New York.
Zibby: Amazing. What are you up to aside from writing and now having to market this book and everything?
Brooke: We’re doing book marketing. That is weird, especially nowadays. It’s not like people are being sent on book tours, really, anymore. In some ways, it feels like nothing has changed. I still spend a lot of time on Zoom, but it’s just for a different topic. I also still very much work in the food industry. I really enjoy having both. I do research and development for startups. Then I also work with elite athletes, like Major League Baseball athletes, to help feed them and make sure they’re eating what they need to perform really well. I’m basically like a personal HelloFresh.
Zibby: Nice.
Brooke: It’s really nice. I really love it. I love the balance because cooking, luckily again, it’s something that brings me a sense of peace. To be able to do that and then also talk about this heavy topic, it’s a really nice balance to talk about antidepressant withdrawal and then go make cookies. It’s great.
Zibby: I think that the main issue with antidepressants and coming off of them after a long time is, like what you point out in the book, how do you know who you are underneath all of that, if you actually need to be medicated or if it’s withdrawal symptoms? Maybe you’re the person who needs to go right back on, but maybe you’re not. How do you know? What if you wait a year and something terrible happens? What if it gets worse?
Brooke: The tricky part about this is that even though we’re starting to see a lot more research now about withdrawal specifically and also about the long-term effects of these drugs — most of these drugs, there’s no long-term studies. Most of the studies to approve these drugs and all drugs, they’re six, eight, ten weeks, maybe. We’re only now starting to get to a point where people have been medicated for decades. We’re only now starting to be able to see the effects of that in not a small amount of people. There are certainly people who thrive on these drugs, and that’s what we hear about because it’s a nice bow. People who do well on things tend to talk about them. People who don’t have any positive or negative response tend not to say anything. People who are having a negative response are debilitated. They’re just debilitated. There are a lot of people like that. The rough numbers are, around fifty percent of people experience withdrawal symptoms. About half of those experience severe symptoms. It’s a huge amount of people given how many tens of millions of people are on these drugs.
For me, it’s like, look, I’m not a doctor. I’m not here to tell people what to do with their health or, get on them, stay off them, whatever. It’s everybody’s individual business. What I think is a real problem and a real shame is the fact that when we recommend these drugs, when we put people on them, there’s never a plan to take them off. There’s never any sort of discussion about what the ideal timeline is for these things. They’ve only been studied for six months to two years, so why are we putting kids on them and then fifteen years later, we haven’t taken them off? That’s not how these drugs were designed. It’s not how they were studied. There are consequences to that. I hope that my story and this book just further expands the conversation. I hope it helps people have more informed conversations with their doctors. I hope it helps legitimize the experience that so many people have. I hope it really helps stop overprescription and also overdiagnosis. As I said at the end of my book, had I gone to the wrong doctor at any point during this year, I could’ve been diagnosed with bipolar, schizophrenia, or — shoot, what was the other one? I can’t quite remember. Basically, there was three major diagnoses that could’ve led to even stronger drugs or institutionalized for an illness that I never really had.
That happens to people all the time. They end up getting diagnosed with something that they don’t have. I just listened to the “Cost of Living” podcast, so I was thinking on that one. That ends up being a strain on an entire social security system. It ends up being a strain on family members. Also, people who really need help and really have serious mental illness that aren’t iatrogenic, they’re not caused by some of these drugs, they’re not necessarily getting the help either because the system is overwhelmed. All in all, this is avoidable. Bottom line is this is avoidable. We’re starting to learn how best to deprescribe, but we don’t necessarily have the tools. 37.5 milligrams of Effexor is the smallest amount you can get from a pharmacy. When you go from that to zero, it’s a huge amount of stress on the body. You can’t go to a pharmacy right now and get smaller dosages. You have to literally get a drug scale in your home, open them up, and count the beads. That’s what people are doing to get off of these drugs safely. Even just the knowledge of that, whether or not that’s from your clinician or you as a patient, that helps a lot of people avoid unnecessary suffering and also just helps them become more in tune with who they are because not everybody wants to spend their whole life on these drugs. We should be able to take people off them in a safe way that doesn’t destroy their lives.
Zibby: What are you most worried about with this book coming out?
Brooke: I feel lucky, in a way. This book took six years to gestate and get born. I hope at this point I’ve kind of already experienced the gamut. I’ve gotten the nasty comments. I’ve been told I’m dangerous, which doesn’t make any sense. I’ve been rejected just because somebody has a good experience. I think I’m not so much worried about public perception anymore because, also, the great majority of the information and contact I get from people is people who have similar stories. I know that the work matters. That’s helped me through. I don’t know if we’re fully ready to accept the personal responsibility in healing from some of these illnesses, disorders, or just whatever you want to call them. I don’t even like calling them that. I think we’re in a hard time where there’s a lot of things that are wrong in world. There’s a lot of things that are having a deep effect on people’s mental health. We don’t have the tools to fix them. If we don’t rely on these drugs, what do we do? I don’t have an answer for that. I hope that people understand that it’s not about wanting people to suffer or telling people they’re bad for taking them. It’s not about that. It’s just learning to follow your own compass, find what works for you, take control of your life, and to cultivate deep, deep self-awareness and discover the balls you have in order to make changes where changes need to be made. I think that that’s what a lot of people need to do in order to improve their circumstances. That’s really hard when you have to cut out family or you’re in deep financial situations. I don’t know. I don’t have the answers. That’s the problem.
Zibby: It’s okay.
Brooke: I’m okay to talk about it. Maybe that’s the biggest worry, is that people will think I’m trying to say one thing about this. I’m not. The whole point is that this is messy and complicated.
Zibby: It’s your experience.
Brooke: Yeah, but the conversation needs to be broader.
Zibby: Your story is amazing. The way you write so openly and honesty and beautifully, it’s great.
Brooke: Thank you.
Zibby: If anything, it’s a good read. You’ll entertain people for a couple hours, so there you go.
Brooke: I’m really glad to hear that. I was worried about that because there’s such a tendency in so-called misery memoirs to just word vomit all over the page about how terrible your life is. That’s not always fun for people to read, so I really tried to not do that. I don’t know how it comes off to other people.
Zibby: Last question. What advice would you have to aspiring authors?
Brooke: Get help. By that I mean, my book would not have happened — three major editors helped me along the way.
Zibby: You worked with Laura Munson, right?
Brooke: I did. Do you know Laura?
Zibby: Oh, my gosh. Yeah, I know her. I’ve gotten to know her through the podcast. We did an event together. We email a lot.
Brooke: I love Laura.
Zibby: I read her book, two books. She’s amazing.
Brooke: Laura was my lighthouse in the fog. I just found her writing retreat online. I raised some money through grants funded by my state and was able to go. That’s the advice. I recently did a calculation on how much this book cost for me to write. It was a lot of money.
Zibby: Of course, you did.
Brooke: What I realized was that the reason why it happened is because I asked for help. I knew I needed it, and I took it. I think that’s the biggest thing. Most authors, unless you’re really experienced, just cannot see the forest for the trees. You don’t really know what the story is. You need somebody else to do it. It helps to pay a professional whose job it is to do that as opposed to a friend who wants to tell you what you want to hear or something. I’d say just get help, whether or not that’s taking a class or finding a good writing group or finding a way to hire an editor early on. It hurts. It hurts to be told your work needs help, but that’s what makes good books.
Zibby: Amazing. Brooke, thank you so much. Thanks for coming on “Moms Don’t Have Time to Read Books” and for sharing your story.
Brooke: Thank you. Thank you so much, Zibby.