When I first started writing about psychiatric meds, I thought there was a simple dichotomy between the drugs people took for psychiatric conditions, and the drugs they took for physical problems.

I’ve since learned there’s considerably more blurring of the lines. Drugs developed as antidepressants are used to treat conditions involving chronic pain, for example, and drugs developed as anti-seizure medications are used to treat anxiety.

I’m curious to know, then: How does this affect people’s views of psychiatric meds? Is a drug more or less acceptable when employed for a mental condition than for a bodily one?

In an age of unscrupulous social-media-mediated personal revelations, I’m not particularly big on self-sharing. So I try to write about myself only when I think it adds to the discussion.

I wish it weren’t, but today is one of those days. After more than a decade of taking newer antidepressants for depression and anxiety, I’ve begun taking a drug developed before I was born – the tricyclic antidepressant nortriptaline, or Pamelor.

I’m doing this not for mood issues, but because I’ve been suffering from chronic migraines for nine months, and a litany of other drugs have done nothing to prevent them. But my decision to substitute Pamelor for Prozac – my doctors didn’t want me taking both, in addition to Wellbutrin, my other antidepressant – is significant because I’m a child of the SSRI era who had a miracle turnaround when I first began Prozac over a decade ago.

If weren’t for the headaches, you can bet I wouldn’t go anywhere near a tricyclic. The SSRIs and their  cousins, the SNRI antidepressants, of which Wellbutrin is one, have worked too well, and the rumored side effects of the tricyclics have scared me off.

This is the second time that the migraines have induced me to do what neither intense anxiety or unrelenting depression could: get me to try a psychotropic I was otherwise opposed to trying.

Once you start following the debate about young people and psychotropic drugs, you see the word “overmedicated” bandied around a lot.

I’ve argued before that deeming kids overmedicated without saying what constitutes properly medicated doesn’t make a lot of sense. Still, at least we have some idea of approximately what percentage of kids in the United States – and, to a lesser extent, in other countries – take various kinds of psychiatric meds. What we don’t know is how long the kids continue to take these medications.

This is a frustrating knowledge gap if, like me, you’re interested in the long-term “psychosocial” effects of taking meds – that is, how the experience shapes kids’ outlooks and identities.

A reader raised an interesting point regarding my previous post about what kids reveal to their parents about suicidal urges – and what parents are willing to accept.

I had written that I can only imagine how painful it must be to acknowledge that a child one has “created and raised with such effort and sacrifice” wants to die. The reader called me out, saying that the real problem was a parent adopting this put-upon attitude.

Such an approach to child-rearing would send the child careening into depression, she argued.

It seems like a fitting bookend to follow my last post, which discussed a documentary about a teen who killed himself a few months after he went off his mood stabilizers, with one about a documentary suggesting that meds – not the lack of them – are to blame for suicidal thoughts and actions.

The film Prescription: Suicide?, which a medication-critical reader was kind enough to send me, profiles families whose children killed themselves or experienced suicidal thoughts after they began taking SSRI antidepressants.

I tweeted earlier this week that I can’t get the PBS documentary Boy Interrupted out of my head, and that’s still true several days and a second viewing later.

Creative Commons License image credit: mnapoleon/Flickr

The documentary retraces the life, psychiatric illness and eventual suicide of Evan Perry, medicated from age 7 and diagnosed with bipolar disorder age 10. At 15, Evan killed himself by jumping out the window of the bedroom he shared with his little brother. He had been stabilized on lithium for years, but tapered off the drug a few months before he died.

The film represents an attempt of Evan Perry’s filmmaker parents to fathom the unfathomable – why their son decided, finally, to take his own life.