I stayed up late the last few nights reading Jeffrey Eugenides’ The Marriage Plot, engrossed in large part by the subplot involving Leonard Bankhead, who suffers from bipolar disorder and what might be called a typically complicated relationship with both his manic phases and his medication.

The book is set in the early 1980s, which gives Leonard few viable options for pharmaceutical treatment. Now doctors often prescribe anticonvulsants such as Tegretol and Depakote, and atypical antipsychotics, but back then lithium was more or less the only choice.

Leonard began to experience depressions early in high school but wasn’t diagnosed or treated until his freshman year of college, when he began taking a low dose of lithium apparently without incident.

But as college graduation nears, he begins to chafe at the idea of taking the medication at all, which sets him on a terrible merry-go-round of breakdowns, high doses to get him back on track, side effects from the high doses and then rebellions against the side effects, followed by more breakdowns.

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In the ever-fraught public discussion of kids and psychiatric medication, the proper role of school administrators and teachers often comes up. What teachers should or shouldn’t say to parents about medication treatment for their students is an understandably touchy subject.

Many parents are wary of being told to medicate their child because an overwhelmed teacher “can’t deal” or because medication would be cheaper than providing special services.

Teachers and administrators, though, are are in their own bind. They may have opinions about what would be best for the kid – going on a drug for the first time, adjusting a dosage, trying a new out-of-school therapy – but they are also wary of meddling.

The subject is so delicate that at one point about a decade ago, a number of states even passed resolutions seeking to ban teachers from mentioning medications to parents.

Ten years later, the landscape has shifted a little, partly because of the demographics of the teacher workforce. Many of today’s young teachers were yesterday’s medicated kids.

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This reader’s story about her experience with medication seems especially timely, given the recent analysis of studies analyzing suicidal ideation and antidepressants. She says she experienced such suicidal thoughts in the initial weeks of treatment, but that the thoughts passed.

For patients, especially young people, who do experience this kind of suicidal ideation after beginning an antidepressant, it is usually early in the course of treatment. The reader, who didn’t want to use her name, doesn’t elaborate on her response to this suicidal ideation, or whether a doctor told her to expect it.

However, if she’d be willing to take questions in the comments section, I, for one, would be very curious to hear more about how she interpreted these thoughts, whether they scared her, whether she was able to brush them off because she knew they were “drug-induced,” etc.

I’d also like to hear why she was so resistant to taking meds in the first place and whether there was going on in her life that was particularly stressful and that she thinks helped set off her depression at that particular time.

Her initial resistance is interesting to me, because it seemed to surface again during the time she she either forgot to take her medications or decided to go off it and concluded that she “deserved” her misery. From interviews I’ve conducted and research I’ve done, that seems a very common attitude in others, especially in depressives. I don’t think it’s necessarily unique to being young, but I would be curious to hear readers’ thoughts about why this mindset is so persistent.

Incidentally, on the topic of suicidal ideation, I’d like to point readers to a very thoughtful critique of the Archives of General Psychiatry study by Dr. David Healy, a psychopharmacologist and one of the most prominent and earliest crusaders seeking to draw attention to the link between antidepressants and suicidal behaviors and thoughts. I’m not sure I understand everything he says in the column, but it’s an interesting read, nonetheless.

And now, the reader’s account of her experience with meds, in her own words. I invite further personal stories about medication, in any format you like and on any aspect of your experience – don’t feel bound by the prompts I gave. Email me at kaitlin.b.barnett [at] gmail.com. Try to include your diagnoses and what medications you took.

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A new, important study published in the prestigious Archives of General Psychiatry found that antidepressants decrease the risk of suicidal thoughts and behavior in adults and have no effect on the risk in children.

This is big news, since in 2004 the FDA slapped a black box warning on antidepressants, cautioning that they could cause suicidal tendencies in people under 18. In 2007, the agency extended that warning to young adults under age 25.

I’ve read the study and news accounts about it, including PsychCentral’s, but I’m still left with a lingering question. Perhaps some astute readers who know more about statistics than I can weigh in.

Based on the studies findings, can we conclude that there is really no association between antidepressant use and the risk of suicidal thoughts and behaviors in kids? Or did the kids who grew more suicidal while taking antidepressants and the kids who got less suicidal taking the medications just cancel each other out?

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Many people – most, I would venture to say – don’t have simple, uncomplicated relationships with their medication. One reader who has generously shared her story of taking medication demonstrates how conflicted one can be about long-term drug treatment, and yet how one can feel unready or unable to end it.

Among many interesting issues Kristy touches on, I’m struck by how little the doctor explained to her at the outset. In interviewing other young people who began medication as children or teens, I have found this substantially complicates their relationship with medication, often creating confusion, resentment and a lack of commitment to long-term treatment.

Their reaction is understandable. Would you want to continue taking a drug if you didn’t perceive a major positive change, and if you received very little feedback and guidance from the adults in your life as to what to expect and how to interpret what you experienced?

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Trying to get one’s medication regimen just right proves an ongoing challenge for many people. Over the years, I’ve learned that if you need to change something about your meds, it’s best to alter just once thing at a time.

Tweak too many things at once and neither you nor your doctor will be able to tell which new drug, altered dosage, or medication interaction is to blame.

I say this, but I still regularly ignore my own advice. Suffering from a migraine today, I did it again, demonstrating just how difficult it is to practice good self care, even when you’ve had years of experience.

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This reader’s story presents an interesting perspective, because he took antidepressants 30 years ago, before many of the current psychotropics were on the market, before psychiatric drugs were as commonly prescribed as they are now and, especially, before they were prescribed as often to children and teens.

It’s also interesting because he was hospitalized fairly soon after his symptoms showed up. He’s agreed to take questions in the comments section.

Again, I invite readers to share any aspect of their experience taking medication by emailing me at kaitlin.b.barnett [at] gmail.com. You don’t have to respond to my prompts – you can discuss any aspects of taking medication as it pertains to growing up, childhood, adolescence, forming an identity, etc.

1) How did you start taking medication in the first place? At the time, did you think you needed medication?

At age 17, I woke up one morning with my face wet, and my pillow soaked. I was very confused, but focused on getting ready for school, and didn’t give it any thought. Into the bathroom, get ready, and tears start coursing down my face. I wasn’t thinking anything upsetting, wasn’t feeling upset. I realized I had cried in my sleep….apparently a lot, based on how wet my pillow was.

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A reader, whom I’ll call ES, has generously provided the following account of her experience with antipsychotic drugs, starting when she was 13. I think she provides a very nuanced perspective.

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This is a blog about young people’s experiences with medications, and I’m always looking to broaden the scope of stories I tell.

I’ve really appreciated people sharing their personal experiences in the comments section, but if anyone would like to elaborate in a guest post, or by getting in touch with me and then having me write up a short account of their experience, please get in touch in the comments section and we can go from there.

Full names aren’t necessary for those concerned about confidentiality.

I am particularly interested in hearing from those who began taking medication as children or teens. You can highlight any aspect of the experience that stands out to you, but here are a few ideas to get you thinking. You don’t have to address all of them!

1) How did you start taking medication in the first place? At the time, did you think you needed medication?

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In my last post, I asked what it means for your “illness identity” when you take a medication that manages your psychiatric problems so that they go away or are no longer problematic. “Does a formerly “severe” mental illness become “mild” or “moderate”?” I asked “Does it disappear entirely?”

It’s often said that these disorders can’t be cured – they can just be managed. Medications are one way of managing them. But the fact is, few people like taking psychiatric drugs. They have unpleasant side effects, they get us deemed “weak” or make us feel like we’re leaning on a crutch, they even change our identity and sense of self.

Therefore, we need a reason to keep taking what we’ve been prescribed. A diagnosis and, more specifically, the presence of troubling symptoms, serve as the justification. The irony, though, is that once these troubling symptoms go away, it’s hard to see why the drugs are still warranted.

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