In yesterday’s newsletter, I announced the arrival of two new resources at Mad in America: a section on psychiatric drugs managed by Robert Whitaker, and one on psychiatric drug withdrawal, which I’ll be curating. Each of these can be found on the menu bar of our home page under ‘Drug Info’, or in our righthand column under ‘MIA’s Sunshine Campaign’ (which you’ll be hearing more about in the near future, in case you’ve been wondering about it!)
Before I describe MIA’s new withdrawal resource, I’d first like to thank those in the online withdrawal community who provided me feedback and offered ideas about resources as I worked on this endeavor—you know who you are. I am also deeply grateful for the voices of hope, inspiration, and wisdom that you’ll find housed in this new section in various forms of media.
I know from firsthand experience how hard it can be to read a simple sentence about withdrawal when on or coming off psychiatric drugs, let alone to feel clear-headed enough to track down information on the internet, sift through it all, decide what’s trustworthy and reliable and what should be ignored, and make a safe and responsible plan. The purpose of our psychiatric drug withdrawal section is to make it easier, clearer, and more accessible for those in our community to get informed about coming off psychiatric drugs. In this new section, you will currently find:
- information on adverse effects and long-term outcomes of psychiatric drugs
- books, manuals and guides on psychiatric drug withdrawal
- videos and radio interviews about withdrawal
- personal stories of withdrawal
- resources for family members and friends of people in withdrawal
- hope, helpful tips and techniques for getting through withdrawal
Some of you may remember Mad in America’s directory of practitioners and places that support drug withdrawal; this is currently offline while we rebuild the platform to make it more streamlined and helpful.
We would like to make clear that Mad in America does not endorse any particular methodology, organization, or resource we list, nor are we stating an opinion about the very personal choice to take or withdraw from psychiatric drugs. Rather, we see this section as an informational resource for those who are thinking about tapering from psychiatric drugs, as well as doctors and others who want to support withdrawal efforts.
We encourage feedback from you on the resources we’ve gathered for this section, and in the next few days, we’ll be putting up a feedback submission form. Eventually, we hope to open the feedback channel up publicly, so that people can post directly about the resources that have been helpful (or not helpful) to them. We also envision this section one day expanding into an interactive online community—one with safety, security, and privacy at its core—so that people can find one another, connect, exchange ideas and support one another. But as MIA has very limited resources, and we are made up of a small team, this remains a vision for the time being.
Going forward, we hope others will contribute to this effort by submitting resources, sharing personal stories of withdrawal, and providing us feedback and suggestions so that this section can continue to grow in safe and beneficial ways, and reach as many people out there as possible. It is very meaningful for me as both an ex-mental patient and a part of the Mad in America team to be curating this section, and it’s exciting to think about what might grow out of this new community endeavor: personal and collective empowerment, grassroots connections, increased opportunities for online and in-person mutual aid, dialogue and exchange about withdrawal, and perhaps even withdrawal research projects. We look forward to expanding this resource in partnership with many others who share our mission of rethinking all things “mental health.”
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
fabulous – how great it would be if people set up psyche drug withdrawal groups with this resource as an aid
People who set up psyche drug withdrawal groups would have be very careful about legal issues at least in the US and to make sure they were protected from any potential lawsuits in case someone had adverse reactions from withdrawing from meds in the group.
Yes, indeed, a very real fear. In my life outside of MIA (i.e. something totally unaffiliated with MIA), I started a mutual support group almost two years ago for people thinking about/in the process of coming off psychiatric drugs and though we have a very clear disclaimer that it isn’t therapy, counseling, medical or clinical advice, and the group is structured in way that tries to ensure no one tells anyone else to do, it is, of course, a real fear nonetheless. But regardless, in my opinion we must force open these kinds of spaces in society, otherwise, how will people support one another and make change happen? Haha, wouldn’t it be great if we had a team of international lawyers who could help every group make sure they were structuring themselves safely?
Miss Laura, it’s absolutely amazing what your doing. I hope your including in the ‘withdrawal’ section for benzo’s you include the severe ‘cold turkey’ withdrawals which can be deadly. My mental health care workers informed me it was ‘just fine’ to stop my Klonopin after a 10 year addiction and I there isn’t enough space here for me to inform you of the mental torture I endured and then my Mental Health workers denied the 50 horrific symptoms what I experienced! They never uttered ONE word to me about possible withdrawal symptoms. Or provided any support what so ever. I was left to endure that withdrawal at home, completely alone.
I am so sorry to hear about the terrifying and painful experience you had as the direct result of not being properly informed about safe drug tapering! I hope you are hanging in there OK on your healing journey.
It is certainly our intention to house information pertaining to safe psychiatric drug tapering so that people out there can make better informed choices around how to come off psych drugs, and not have to go through the experience you’ve had to go through. Thank you so much for sharing a bit of your story here.
Interesting. Has there been lawsuits by people who feel they have received poor advice from support groups? Or lawsuits against groups saying they are practicing medicine without a license?
Whats crazy is…if your doctor says you shouldn’t go off the meds…but you want to and need additionaly supports…where can you go? The only main places for this type of work has been online support groups of people who actually have gone through this process. (And a few good NPs, Docs and NDs).
And yes I get that there could be erroneous or conflicting advice which indeed makes it a bit like the Wild West- but this is because the medical community has not acknowleged the dangers and suffering in discontinuation- or created effective protocols for people who are tapering.
No lawsuits to my knowledge… And I hope it stays that way! I completely, totally agree that given the inflexibility and close-mindedness of the conventional system it’s especially critical to build spaces at the grassroots level for people to support one another. And though I certainly think it’s important for doctors and therapists to get educated about safe tapering (even more fundamentally, for proper research to be conducted on withdrawal in the first place, and for the voices of those of us who’ve come of ourselves to be heard and listened to, especially by professionals), I also think it’s important to emphasize that people can and do successfully come off without the support and guidance of doctors and the mental health system. Of course, it’s much easier to have the support of a knowledgeable doctor (and one is necessary to write prescriptions), but people every day are coming off on their own and with the support of each other, family, and friends, and this is a message that people need to hear.
I’m curious, Jonathan– how many colleagues do you have who are both supportive of withdrawal, and have a sense of safe tapering protocols?
Glad to be connected here!
Yes- I agree that a lot of folks are doing this on their own with groups of supportive peers who really understand the work… without true support from the medical establishment… and they are figuring out much safer ways to do this.
As to colleagues who understand this stuff?
Sadly very few. Tapering is a complex and very unique process and though a general caveat of going slow is helpful, each person must find their own way in terms of when to hold, when to taper, how quickly, what supportive techniques work best, etc. It really is a unique process.
Most therapists I know have very little understanding of this. Or they may have a general understanding and want to put that in the hands of a doctor- as it is “outside their purview” or “practicing medicine”, etc.
Here in Portland, there are a few good therapists, NDs and NPs who do understand this- but even with them it can be complicated.
It can easily become complex when family members don’t understand the length of time tapering can take, or feel that the iatrogenic injury is made up and couldn’t be that bad. This leads to strong family dynamics tension which causes further deepening issues.
Tapering and iatrogenic injury don’t just affect the individual- they affect the whole family and the extended network of friends and allies the person is in contact with. These are complicated problems that are easily brushed off in the medical system.
Anyways- again I thank you for this very important work Laura. I’m spreading the news in my circles…
Those “meds” are keeping you sick ! Go ahead, sue me for saying that.
It’s OK to yell fire in a crowded theater when it really IS burning.
I went to AA for a wile and bashed psychiatry and “meds” with the truth and some people suggested I stop so I did it more.
Ah, yes… During our era of all things terrorism, we must constantly live with the fear of being attacked by armies of lawyers in powdery wigs (i.e. the Litigious Extremists.) No wonder I’m anxious…
Yes, that’s exactly the kind of thing we’re imagining! Great idea.
Good. I was thinking of setting one up when I was involved with Speak Out Against Psychiatry as we had a few people who came off and were sectioned pretty quickly afterwards.
It was stressful to deal with and these people hated the services where they were forced to take drugs they did not like.
Drug withdrawal advice and support is only one part of what is need for people who feel trapped in the system but an important part and setting up alternatives is a valid campaign tactic.
Wow- amazing! Thank you so much for the hard work in putting this together.
Thanks so much, Jonathan!
I think this is a great project. I escaped being drugged because my childhood spent in the system was so long ago. But in the past couple of years I have been educated by a lot of people and groups that have had to struggle with this, and I really admire and respect people who have made the choice to get off these poisons. I think it takes a lot of courage and strength of character to do this, and I also think that people who have gone through this can be leaders in our human rights movement, and of course, some of them are already.
So thanks to MIA for doing this. It will be a wonderful service for people.
Hi. I hope this becomes a significant resource for people. Just last night, I listened to a person’s story about negative withdrawal symptoms. The speaker seemed to feel uninformed, afraid, and alone. In an act of desperation, this person opted to simply go back on the meds. And while it seemed that the speaker was utterly heartbroken about being stuck on the insidious, gerbil wheel of meds, most of the group members could only offer comforting reassurance, “Yes, going back on the meds was probably the best option.”
That is heartbreaking…
Indeed, it’s like there’s an entire realm of potential dialogue, engagement, exploration, and discussion that’s being left unspoken in society, and even worse, is totally invisible to many. In all the years I was on psychiatric drugs, it never once crossed my mind that I could perhaps find a way to live my life off of them, bought into the medical model as I was. So there are plenty of folks out there who don’t even know it’s possible. And for many people today who do in fact think and wonder about withdrawal, just mentioning the word can be dangerous and alienating (losing friends, family support, and of course potentially one’s freedom if their doctor doesn’t like the idea.) So the stakes are high, and it’s kind of like the “wild, wild west” out there much of the time for those who try to forge a path on their own.
The message that there is life after psychiatric drugs, and that there are safe ways to get there for those who so choose, is still largely invisible to the greater world. (This of course is both due to fear and lack of access to information, and also to greater forces of industry– Pharma/Psychiatric/etc.– that intentionally try to keep these message silenced.) The more we all speak out about this, and force open spaces online and in person, the greater the chance that people like the person you heard speak last night will feel like they have a chance at another way, and can get empowered through information and support to try getting there.
Thanks so much for commenting.
For the countless lives that will be forever changed; and the many that will be literally saved –
Thanks for your support, Duane. Great to reconnect here. It’s been a while, my friend!
Did I miss seeing http://survivingantidepressants.org/index.php?/index listed as this site in my opinion is very helpful regarding withdrawal issues? I know you had individual posts from the site but not a direct link as far as I could tell.
There is some good advice there but there is also sometimes bad advice, and privacy concerns.
-The admin and moderators are dogmatic and sometimes pushy when a struggling member wants to try another drug to get them through a crisis.
-They claim they are not giving medical advice, but they advise on dosing. I just looked and saw a guy being told that he should up-dose from 5mg to 10mg of drug to alleviate withdrawal symptoms. He did it, and started have worse symptoms plus chest pain. He’s only 22.
-Very personal posts are listed individually by google.
-Members are accepted if they tell a convincing story, but non-members can read almost every post they make.
-No one is allowed to delete posts or close their accounts
It is a good place in many ways, but I advise caution about joining and posting because of privacy concerns. I’d be very careful about taking medical advice there.
Robert Whitaker put up a comment further down in this thread addressing your inquiry here (dated morning of May 23rd).
Thanks Laura, this is a great initiative.
The anxiety can be dreadful on withdrawal. CBT and Mindfulness might sound like catch phrases, but they work.
Yes, isn’t it amazing how options that on the surface might sound so simple– too simple it feels like, when in the throes of serious withdrawal struggle, to really have an impact– actually end up making a huge difference, even if it’s just a short-term respite from the storm? I found needlepointing and doing Sudoku and crossword puzzles to be absolute life-savers for me in the worst times of anxiety and akathisia. Who would’ve thought!
For me it was computer games! A few years back there was some research suggesting that focusing on highly engaging visual-spatial tasks can prevent the symptoms of PTSD, makes sense that it would help with anxiety too: https://www.scientificamerican.com/article/tetris-shown-to-lessen-ptsd-and-flashbacks/
Wow, this is historic. The one thing I tell people about when they want to release their medication and do natural healing is that their deepest core stuff, which has been all this time suppressed by the drugs, will come up for shifting. To me, that was the hardest part, but of course, the most rewarding, and where authentic transformation resides. Even after the physical symptoms of withdrawal subsided, after a few years, those issues begged for clearing as I went along.
Certainly a multi-dimensional process that really grows one’s awareness beyond imagination. Safe and trustworthy support is so vital, of course. I look forward to seeing how this endeavor unfolds. It could really change lives.
I agree- in my personal experience I too found that there was a tremendous amount of internal work to be done (especially in regards to the “issues” that got me into the “mental health” system in the first place as a 13-year old, which of course I’d never really had a chance to truly address once I was labeled and put on psychiatric drugs). For me, this inner work happened entirely outside of the realm of “mental health” and far away from any “professional”, and only really began once I got through the serious impairments I had in the first part of my withdrawal journey. That work is what really allowed me to change my life, and reconnect with an authentic sense of self.
Thanks for your supportive words about our new initiative!
Laura, re sense of self–indeed, and how important is this in activism? I could not have fought my way through the system, legal mediation, corrupt social services and legal advocacy, and even just telling my story over the years so publically, without a sense of self. One has to expect a variety of diverse reactions when we challenge others like this, especially with the politics of it, and all the personal stuff it brings up in everyone, that can so easily be projected all over the place. Without a solid sense of self, I would have thrown in the towel a million times. Every time, I’m so happy I persevered. Self is intact—well, most of the time, I guess, being human and all!
You’re right about the underlying stuff. I found that what worked for withdrawal, worked for this as well.
Fiachra, what I think is cool is that there are so many ways to mix and match safe, effective tools of our choosing, to design our own path of healing and personal growth. Like, sooooo many, via a variety of media, often free and accessible to anyone. I listen to so many different teachers online, compare their information, how it sits with me, etc. So much info about alternative perspectives online. Since doing this to help support getting myself back together, it’s pretty much become a way of life now. So many ways to teach and guide ourselves as we go along, without committing to a potentially unsafe relationship, especially with internet, YouTube, etc.
Learning chakras and how to use these as healing tools is what helped me the most, bar none. Carolyn Myss, Anatomy of the Spirit. This guided me through that, initially.
Also, I did a three year program of self-healing, learning psychic and subtle energy focus, etc, and came out on the other side transformed and well on my way to 100%. Although I still had some work to do, which was more than anything being out there in real life and applying it all in my relationships as I moved forward professionally—establishing boundaries, thinking in a self-respecting way, knowing the red flags with toxic people and environments, etc. It’s really a fascinating process to re-build one’s psyche from the ground up, especially as I was in my late 40s. Transformative in every way. I was hand to mouth on disability, but still could scrounge part of the tuition, but I also did volunteer work as trade, everything was negotiable, I made it work.
Lots online about chakras. I really can’t stress enough the plethora of perspectives and tools of healing support that are online, that are pretty easy and extremely effective. For getting off medication, learning to GROUND was vital and more relevant than anything. I spent years practicing grounding, this self-nourishing connection to the Earth, and it was a life-changer to know this. Natural healing all around us. Time to tap into it, as it is abundant and FREE.
There’s a fantastic amount of good information for free online. I’m going to read up on the Grounding.
You and Robert are providing a wonderful, and much needed, service. Let’s hope the medical community starts weaning people off these toxic drugs.
I was just reading my journals from the time right after I’d stopped the drugs, and I described the joy of getting back my peace of mind.
Let’s hope that the medical community will start to recognize the signs of tolerance withdrawal and wrap their minds around PAWS.
Heck, let’s hope the *do no harm* medical community quits handing out pills like candy…
Thanks for this new feature. It’s very much needed and I predict it will become a basic part of MiA…
Thanks so much, humanbeing!
And yes, recognizing and validating the reality that for many, getting off psych drugs means an extended period of serious impairment of basic day-to-day living, is a crucial step to be taken in the medical community, and of course, in society at large. The intolerance, cruelty, coldness, and lack of support and validation that people in withdrawal, and especially those in lengthy withdrawals, experience on a daily basis is simply unacceptable. There are some great videos and pieces of writing in our section that talk about this.
Hi Someone Else,
Oh, that’s so cool you kept journals during that time. I bet it’s a powerful experience to go back and read them. What a meaningful, valuable documentation of your journey those words are!
It is interesting, I was afraid to read them for years. But as I’m reading them, I realize I wasn’t actually crazy, other than I’d had crazy “voices” pumped into my head via neuroleptic induced anticholinergic intoxication syndrome (called “bipolar”). Thankfully, the “voices” went away after I was weaned from the drugs. Thanks for all you do, Laura.
I just read a recent post about the “dangers of withdrawal” on Healthline.  (Well, I read it after all the banner ads for medication finished loading…) Their “information” is quite interesting. I felt compelled to provide them with some feedback:
“Your concluding sentence is the best: ‘…don’t gamble on your health and wellness.’ I belly-laughed at the irony. This ‘article’ is nothing but advertising full of scare tactics. You should be ashamed of yourselves. See you in Hell.”
Quite a mixed up article. This, too:
“Antidepressants help return a balance to mood-influencing chemicals in the brain.”
Chemical imbalance, that old chestmut!
It is horrible the medical community is still propagandizing about the chemical imbalance theory.
And antidepressant discontinuation syndrome, caused by a doctor abruptly taking me off what she called a “safe smoking cessation med,” are the exact symptoms that were later misdiagnosed as “bipolar” in my case. What a sick joke the medical community has made of itself. All they seem to know, is how to be dangerous, and make people sick for profit. One has to wonder how long the medical community will continue to be considered a respectable profession.
Oh, and I’ve heard that psychiatrists never promoted it and it’s a strawman argument to accuse them of that… Weird.
I never had a real problem getting off psych drugs. It was the doctors who wanted to keep me on, but I didn’t like the stuff, and I thought it wasn’t worth the averse effects. I thought with averse effects like that it can’t possibly be good for me. Learning about how bad they actually are only justified my instinctual rejection of such chemicals. I was lucky. I had never spent as much as a year, and sometimes more, that some people I know have endured in the state hospital without, need I add, psych drug abstinence being an option. Then there are the people who have been on such drugs for 10, 20, 30 years and more. You just can’t tell them to stop taking the drugs without offering some kind of guidance.
This is a really big, Laura. The more people there are out there telling people that they don’t have to take psycho-poisons for life, the better. My fingers are crossed. Sooner or later, the message is going to reach my neck of the swamp. Of course, it may require a little help from me. and so I will do what I can to let people know your resource is there. Thanks.
Thanks, Frank, and yes, I too hope these resources and narratives re: psychiatric drug withdrawal begin to reach more and more people, too! Thanks for helping get the word out, and I’m so glad you were able to listen to your instincts back when you were on psych drugs.
Wow – this is amazing. I wonder if you would be willing to add a question/answer place where specific questions could be asked , and then people with experience could answer if it was something they were familiar with?
There are the forums, if that helps..
That’s a great idea, and the kind of thing we’re thinking through as this section grows and becomes more interactive. I’m keeping a list of suggestions we’re getting and I will add this to it!
Thanks so much for your input 🙂
This is a wonderful resource and very inspiring for me since we plan to start a Learning Community Project with the aim to learn and encourage professionals and “ordinary people” how to support people who want to taper drugs. In Sweden as in many other places all over there is such a lack of available knowledge and experience re how to support/ encourage/ provide knowledge based on research and ´humanistic/ therapeutic practice
Not to take away from the wonderful work Laura has done but again, I wanted to urge anyone who is looking for an excellent resources on tapering off of psych meds to please visit http://survivingantidepressants.org/index.php?/index. Don’t be fooled by the title as there is information on tapering other psych meds besides antidepressants.
By the way, just so folks know, I don’t make any money from recommending this site. 🙂 But because for some reason, it was not listed as a direct link in the resource section, I wanted to make sure folks were aware of it because in my opinion, it is excellent.
Thank you AA!!
We are of course aware of the surviving antidepressants website, and admire it as a very good resource. However, the owner of that site asked that MIA not link to it, and so that is why we left it off.
Thanks for responding Bob and letting me know what happened. Please disregard the request I sent in to have it be added obviously.
Do you know why?
Well done Laura.
I wonder if somehow this information could be made available to people on the 3 biggest online mental health forums I’ve found:
Reddit’s many subreddits devoted to mental health/”illness”.
I relate to what others write about the legal concerns from giving this type of information out. When I’ve written about this topice I say that people should always consult with a psychiatrist before making any decision about drugs. It’s ironic because, if followed, more often than not this advice (to see a psychiatrist) will result in things becoming worse rather than better.
In my own case, over a period of several weeks and against my psychiatrist’s advice, I unilaterally withdrew from all psych meds (an antidepressant, an antianxiety, and an antipsychotic). It worked great and I never looked back. But, I understand that I am in the minority of people who could stop drugs quickly without any severe withdrawal effects.
MIND – UK based charity, used to advise people to talk to thier Dr’s before withdrawing but after some research which showed people were no more likely to succeed with or without Dr’s support they withdrew that advice.
Laura, you da woman! This looks great, and I can’t wait to dig in! This kind of information, forum and dialogue is so desperately needed. I happen to think it’s the most needed of anything in the “mental health” domain. Unfortunately, it may be that not everyone who has been debilitated by psych drugs will be able to successfully taper completely off…but they sure have the right to try, with as much support as possible–and to at least reduce them as much as possible. As you know, there is precious little support for that among medical professionals with prescribing power. Thanks for your valiant efforts to help others achieve the freedom you’ve been enjoying since getting off your own toxic psych med cocktail. Your life is a great testimonial and inspiration to me, and I’m sure many, many others!
So this is what you’ve been doing lately!
It would be good eventually to develop a sub-section here which provides up-to-date info and scientific studies which are no doubt scattered throughout the MIA archives and elsewhere, categorized by drug and accompanied by a deconstruction of the most frequent arguments by prescribing physicians for each one’s use. This would be a helpful tool for demystifying the issue in the eyes of the public, and would provide a resource to which journalists, etc. could be referred when they question our credibility.
The subject of official retaliation has been broached here already, and should be seriously prepared for. Whenever a significant amount of folks begin withdrawing from their poisons, maybe even before, the pharmaceutical industry and its corporate/psychiatric/government cronies will begin spreading horror stories and smear propaganda. Someone who has withdrawn from their “meds” and then has some sort of serious emotional setback will be paraded up & down as being an example of this outrageous new trend of “self-treatment” and MIA will be scapegoated as being responsible. I think this is pretty predictable. The answer is to have the legal backup ready and waiting, and to have the MIA community prepared and ready to defend Bob W & Laura with letters, contributions or whatever.
Excellent. Keep up the good work.
Didn’t see this mentioned above, but it’s important:
Whatever drugs, – or alcohol, etc., that a person takes, takes up space in their life.
Sure, you can just stop, or quit, or even slowly taper. But there’s a hole left behind.
So remember it’s not enough to just NOT take some substance – you also need to
replace that substance with something else more healthy.
For example, one reason the 12 Steps of A.A. recovery work so well, is that they help the person
find, create, and maintain something else in their lives, besides alcohol or any drugs.
It’s a simple concept, but it bears repeating.
Thank you for what you are doing. I am ready to contribute knowledge of all the tools in my toolbox that I know are useful. Some would appear magical at first glance to an outside observer. The proof is always in the pudding . It either works or it doesn’t. I’ve touched on them in my many posts here at MIA but am able to go into more detail. Best really is in advising an individual after hearing their story and customizing the info for them. I’ve also been trained in Traditional Naturopathy and energy healing http://www.YuenMethod.com by two of the most amazing healers I could ever have imagined to meet.
Another thing I have found is that some of what works in helping someone come off the psych drugs is the same stuff with or without modification that can help someone going through their initial or subsequent extreme states and help them from getting caught or returned to psychiatric coercion giving them more time to figure out whats going on.
Best of wishes to you in your nobel efforts.
Awesome news :). Thank you.
Thanks for all your efforts, Laura. I found myself dependent on benzodiazepines, and in a hellish withdrawal what some doctors wouldn’t think of as a very high dose. Yet, here I am, nearly housebound, exhausted, with daily panic attacks, and horrible looping thoughts. It feels like it’ll never end. Most of the doctors I’ve seen never acknowledged this is a withdrawal, and once who did, would have put my health at risk with their crazy rapid taper. Things look, hopeless and bleak and every day is a challenge. Dealing with stressful events in life feels like climbing Mt. Everest. I’ve had some predisposition to feeling anxious and mildly depressed throughout my life, but those feelings were bliss and happiness, considering what I am dealing with now. I didn’t even know this sort of reality existed until late last year when I was misdiagnosed with other illnesses. I am keeping myself from going to ER, psych wards or detox center, because they have no idea how to deal with benzo dependence.