It took Adam Jacobs one convincing phone call: a call that weeks later, would lead him to curiously ascend two flights of stairs into a stranger’s colorful Victorian-style home in Newton, Massachusetts. On the outside, one may have expected to see all kinds of plants, a small garden with a 4-foot wooden bridge, metal flowers beaming from the ground, the occasional gargoyle and a set of deer statues. It wasn’t the monotonously sterile kind of welcome most doctor’s offices gave— with pristinely cut bushes and brown waiting room chairs. Jacobs liked the old feel of the place. It was charming. Figurines of owls and other art within the home would reflect the familiar eclectic remnants of the outside.

At 47, he’d walk up these stairs with the same sense of exhaustion that permeated throughout his past 20 years, in an uphill struggle trying to wean off of medications with seemingly no end. When he reached the last step, he’d walk into Dr. Judy Tsafrir’s office, where the course of his struggle would change through an untraditional means.

Tsafrir has practiced homeopathic psychiatry for over 20 years. She is a board-certified adult and child psychiatrist and psychoanalyst, is on the faculty of Harvard Medical School and the Boston Psychoanalytic Institute, and teaches and supervises at the Cambridge Health Alliance. She’s the author of “Sacred Psychiatry,” and consistently works with patients to wean them off of psychotropic drugs.

While her training is conventional, her approach is not. She advertises that her practice “is dedicated to healing through integration of heart, mind, body, soul and the biosphere and Cosmos.”

After Jacobs engaged in several attempts to try to wean off of anxiety-prescribed medications, with consistent relapses and little luck, he found Tsafrir right after the pandemic. Like many first-time clients, he initially approached her practice with skepticism, especially after seeing that she also specialized in astrology.

"I'm like well, this, it's just like a hocus pocus kind of because I was never really into that sort of thing… but then the other side of what she did seemed so appealing to me so I decided to give it a try.”

When they connected on the phone, she took the time to get to know him and all of his history, as opposed to many other doctors he’d come across.

As his mom sent him to counselors, he found himself mentally checked out, unwilling to talk, “like Matt Damon’s character in Good Will Hunting,” he jokes. Jacobs buried things, like the fact that his family was struggling financially and didn’t have life insurance. On paper, he was a straight A student, and never experimented with any drugs. But apart from these checked boxes, he became more quiet and isolated— developing a social anxiety that seeped into his band concerts and friendships. It was an anxiety that would soon reappear after college, at one of the most exciting parts of his career.

As Jacobs was living out a Boston Wolf-of-Wall Street lifestyle as a post-grad institutional bond trader, it was an unexpected time for these unsettling feelings. “I was getting, you know, taken out by all these brokers and going out for steak dinners all the time,” Jacobs said. “And I'm like 24 years old at this point.”

He voiced concerns about his anxiety spikes to his primary care doctor, and in turn, was given a prescription for Zoloft, and eventually Wellbutrin within a 30 minute conversation.

That is not uncommon in many patients. Roxanne Chavalier and Brooke Holder, patients who were prescribed higher doses of psychotropic medications after voicing concerns about side effects, were also initially diagnosed and prescribed within a 15-30 minute conversation by their primary care physicians.

Those who prescribed their medications were not specialized in psychiatry, which isn’t an anomaly. Nearly 80% of nationwide prescriptions for psychotropic drugs come from holistic physicians, who have a limited training in treating mental health, as opposed to psychiatrists. A 2011 study showed that misdiagnosis in these kinds of primary care settings reaches 65.9% for major depressive disorder, 92.7% for bipolar disorder, and 71.0% for anxiety disorder.

“I told them many times that I didn’t think [the medication] was working for me, because there were these continuing suicidal thoughts,” said Holder, now a college senior in Boston. “I would tell them I’d still have these moments of uncontrollable sadness, which I didn’t understand was bipolar at the time, and instead of changing my meds or trying to figure it out, they would always just prescribe more or double it.”

For Jacobs, six months of being on the drugs seemed to have a promising effect, and life was running a smooth course. He proposed to his sweetheart Nicole, and the newly engaged couple would make a move out to North Carolina for his work. But the sexual side effects of the medication led him to stop taking it cold turkey, which led to a massive crash.

“It turns out my body is very sensitive to these things. And I had sort of a mental breakdown, and then got in front of a psychiatrist down in North Carolina. And he immediately gives me Klonopin for some immediate relief.”

Klonopin is in the benzodiazepine class, and functions as a long-acting tranquilizer, where it is also given to people before undergoing surgery. Known for being highly addictive, doctors are advised to limit the prescription to 2-4 weeks.

Jacobs was going through a withdrawal from the past medication, without realizing what it was, and was given the Klonopin prescription with little guidance.

“Take them as needed,” he recalls his doctor saying.

“And so the solution, you know, probably shouldn't have been giving me another drug. It's like, all right, I just shouldn't have stopped these other meds cold turkey.”

Jacobs says there is a crisis lurking after opioids, and it is “the Benzo crisis”.  Benzodiazepines are among the most commonly prescribed psychiatric medications, with more than 1 in 20 people in the U.S. filling a prescription each year. They are also the third most commonly misused illicit or prescription substance among adults and adolescents in the U.S.

“There are millions of people on these drugs and the anecdotes and the stories that you will hear is that these drugs are harder to get off than heroin,” he said. “The difference is that you can still function, unlike if you're on heroin and you're totally high and strung out,”

When trying to stop Klonopin, withdrawal symptoms completely took over any sense of control for Jacobs, and often led him to relapse into depressive and physically straining cycles— something that would continue for twenty years.

His withdrawal symptoms ranged from the commonly referred “head zaps”, to physical pain in the bones, muscles, and teeth, to restless leg syndrome.

“Imagine something where your entire body cannot sit still, can't sleep, can't focus, can't do anything,” he said. “It’s like you’re in this purgatory/hell while you're saying ‘this it, it might last half an hour it might last three four five hours,’ and you're in such agony with this that you literally can’t find any sort of relief or rest.”

Many patients are led to increase their doses over time from the tolerance withdrawal, which makes the drug less effective.

“So like the Klonopin that I take now, I don't feel anything,” Jacobs said. There is no relief from it. There is no benefit. There's no high. Nothing. Like it's just my whole central nervous system at this point is only just addicted to it.”

While being in a perpetual state of physical and mental unpredictability, Jacobs grew a team at a wealth management firm in Boston with over $2 billion in client assets, where he manages 13 advisors and 10 client service managers.

He loves his job, has a beautiful house, and is married to a loving wife with two kids. His life embodies the American dream on the outside.

“And so I was getting myself a little bit lower, and going to different support groups and so on,” he said. “And I'm just like, this is, it's a living hell. I’m having suicidal thoughts. I can't go on. The only thing that kept me going was my wife and kids that I love so much.”

Jacobs even bought extra life insurance because he didn’t know what was going to happen to him.

“I used to have thoughts about, you know,” Jacobs said. “There's a period of time called an incontestable period where if you get life insurance, you can't, if you commit suicide within two years, they won't pay out a claim. Um, but I, in my mind was like, if I can get through these two years, I could check out, and my family financially would be okay.”

After trying to sever a reliance for 20 years with a medication he believed he shouldn’t have been on in the first place, he would only find success once he started Tsafrir’s protocols.

“And she goes, ‘if I feel comfortable with you, then I will take over prescribing your medication,’” he said. “So she wasn't even going to take over my medication at first. It was going to be my primary care and that's what we were going to do unless she felt that I was somebody that was willing to follow her instructions, not just sit there and talk once a week. I told her ‘yeah, I’d do anything.’”

As he began his sessions, his protocol consisted of an anti-inflammatory keto-based diet, a Gupta meditation program, sunlight, time outside and occasional Ketamine sessions. His diet also involved taking sugar pills with a Klonopin base to slowly taper off.

Dr. Tsafrir says that in addition to nutrition, part of the routine consists of 40 minutes a day of practice doing guided meditations; they’re what she calls “brain retraining exercises.”

“If a person is too depressed to participate, or they just say, ‘oh, like I've done meditation before, I don't want to do that,’ You know, I just can't help them,” she said. “And I don’t want to waste their time and money.”

It's been over a year since Jacob’s started the protocols, and now 49, he says he couldn’t have ever imagined the mental place he’d be in.

“And not only that, I'm still tapering through these medications. I'm still having a drug that most people can't ever get off, that people say is harder to get off than heroin. But here I am, more physically active, more present than I've ever been with my family, my work. It's unbelievable. And I sit down, I'm like, wow. Even my thought processes are so different.”

Jacobs and Dr. Tsafrir expect the final stages of tapering to take place in March.

Matthew Smith, who has a doctorate in Medical History, and is a professor and historian in social psychology and pharmacology at the University of Strathclyde in Glasgow, says that the prescribing practices that affected Holder, Chavalier, and Jacobs, are all too common in the U.S., partly due to the healthcare system— where 65.4% Americans rely on private insurance.

“And so private providers are not interested in paying for, you know, hours and hours of psychotherapy, they're very willing to pay for a drug, because it's cheaper, it's easier,” he said. “And it also, you know, it's also something that the drug companies are interested in as well.”

Immediately putting individuals on pharmaceutical drugs is often the first resort, rather than the last, Smith says. He also says that the rise in psycho-pharmacology and the demise in psychoanalysis has led to the failure of addressing the role that poverty, inequality, and other socioeconomic factors also play in people’s mental health.

Jacobs says he is lucky to be where he is now, and partly credits Dr. Tsafrir for saving his life.

“If I knew how I would feel right now, when we first started, I would have paid anything,” he said. “My wife and I would have sold the freaking house if we were assured that I'd be where I am now. Oh my God. We wouldn’t even have to think about it.. You don't realize, unless you experience it—that if you don't have your health, you have nothing.”

Jacobs even bought extra life insurance because he didn’t know what was going to happen to him.

“I used to have thoughts about, you know,” Jacobs said. “There's a period of time called an incontestable period where if you get life insurance, you can't, if you commit suicide within two years, they won't pay out a claim. Um, but I, in my mind was like, if I can get through these two years, I could check out, and my family financially would be okay.”

During this period, he began searching for unorthodox approaches— leading him to Dr. Judy Tsafrir, a board-certified adult and child psychiatrist and psychoanalyst, and a Harvard Medical School faculty member who has practiced homeopathic psychiatry for over 20 years.

The field of homeopathic psychiatry approaches mental health through a focus on environmental conditions integrated with many different aspects of the mind and body. Homeopathic psychiatrists, like Tsafrir, consistently work with patients to wean them off of psychotropic drugs.

At first, Jacobs was skeptical of her approach. But soon enough, he’d be in her office, and she’d spend a few sessions getting to know him and his history before any intervention.

As he began his sessions, his protocol consisted of an anti-inflammatory keto-based diet, a Gupta meditation program, sunlight, time outside and occasional Ketamine sessions. His diet also involved taking sugar pills with a Klonopin base to slowly taper off.

Tsafrir says that in addition to nutrition, guided meditations provide what she calls a “brain re-training exercise.”

“If a person is too depressed to participate, or they just say, ‘oh, like I've done meditation before, I don't want to do that,’ You know, I just can't help them,” Tsafrir said. “And I don’t want to waste their time and money.”

Jacobs is currently at the end of his tapering stages after a 20-year battle, and says he is lucky to be where he is now. He partly credits Tsafrir for saving his life.

“If I knew how I would feel right now, when we first started, I would have paid anything,” he said. “My wife and I would have sold the freaking house if we were assured that I'd be where I am now. Oh my God. We wouldn’t even have to think about it.. But you don't realize, unless you experience it—that if you don't have your health, you have nothing.”