By Kaitlin Bell Barnett, author of Dosed: The Medication Generation Grows Up (Beacon Press, September 2014)
As the number of young people treated with psychiatric medications has risen sharply over the past couple of decades, the issue of treating kids has become a hot-button issue.
A growing chorus of critics point fingers at doctors who are allegedly too quick to pathologize ordinary childhood struggles as mental illness, and at parents allegedly too quick to medicate their children—all in the absence of scientific evidence about the drugs’ long-term effects. Mental health advocacy groups counter with anti-stigma campaigns urging people to seek help, and big pharma continues to aggressively push its drugs for more and more pediatric indications.
As in many culture wars, though, the people whose fates are being debated have largely been submerged under the sea of rhetoric.
I wrote Dosed: The Medication Generation Grows Up, to move past simplistic polemicizing by telling the stories of some of these medicated kids themselves—and by exploring the internal and external variables that shape young people’s real-life experiences of medication.
A member of this “medication generation” myself, I knew there wasn’t going to be a simple answer. At first, I had considered my own experience taking antidepressants starting at 17 to have been comparatively straightforward. Yet, the more I reflected on it, the more I realized that my relationship and attitude toward medication had changed as I matured, as I encountered new life situations and stressors; experienced new symptoms; tried new drug regimens; saw different doctors and therapists—and reassessed the past from my present vantage point.
And that was just my story. Examining the experiences of young people from diverse backgrounds, who suffered from different types of problems, and who took a range of medications combined with various other therapies, would certainly complicate the picture.
There are few straightforward answers to be found in the limited body of scientific, medical and psychological research involving young people and psychotropics. Virtually no studies exist that examine how various drugs—antidepressants, ADHD and antianxiety medications, antipsychotics and mood stabilizers—impact developing brains and psyches over the long term. And only a few examine a given drug’s short and long-term effects on kids’ physical development, social relationships, academic achievement, encounters with the law, propensity for substance abuse and overall life trajectories.
With all this in mind, I have sought in Dosed to accept ambiguity and also to dissect it. The book explores the myriad, often-changing factors that influence young people’s experiences with psychotropic medication during their formative years.
Dosed is not by any means a rigorously controlled scientific study; rather, it follow five young people from initial diagnosis through the present day, using in-depth interviews to construct detailed individual “medication narratives.”
I deliberately chose five young people from different types of family and geographic backgrounds, with different psychiatric diagnoses, and different types of medication. Now in their 20s and 30s, they represent the first wave of children and teens to be medicated starting at a young age.
Dosed captures the nuances and complexities of individual experiences, but it also contextualizes and analyzes them. It compares the five main subjects’ experiences with each other, with my own experience, and those of several dozen others of their “medicated peers.”
The book also situates these medication narratives within a cultural, historical, and scientific context. It traces the forces that led to an increasing recognition of childhood mental illness and a growing reliance on prescription medication to treat kids’ emotional and behavioral problems. And it surveys the clinical, epidemiological, psychological and sociological literature on young people and psychiatric medications—limited as that research is.
Undoubtedly, our understanding of how psychotropics impact developing minds, brains and bodies will evolve with new scientific studies and with time. As more kids are diagnosed and treated for emotional and behavioral problems, though, we need to consider how the treatments affect their lives, and shape their life trajectories. Dosed begins a conversation that needs to continue both in and out of the classroom.
Kaitlin Bell Barnett is a freelance writer whose articles have appeared in numerous national and regional outlets, including the Boston Globe, New York Observer, Parents, and Prevention. She lives in New York City with her husband.