Since there is not much to do, from a layman’s perspective, except wait until June for the Supreme Court to hand down its decision on the Patient Protection and Affordable Care Act (PPACA), I thought I would share some thoughts on how it pertains to young people with chronic mental health problems – the ones who look healthy but actually have considerable healthcare needs.

This is a group that you can define variously depending on what you think constitutes “chronic mental health problems.” I’m going to define it more broadly than traditional definitions of serious mental illness and simply include young adults who have mental health problems so troubling that they seek out long-term mental health services, whether it be medication or any sort of therapy.

I think it’s important to highlight this group because Supreme Court Justice Antonin Scalia (among many others) has argued that the individual mandate forcing everyone to buy insurance is unjust in part because young, healthy people have better things to do with their money besides spending it on health insurance.

I just wrote a book arguing that taking psychiatric medication from a young age has a profound effect on people’s lives and identities, far more profound than most – including those who take the medications in question – even realize.

But sometimes it’s possible to go too far with this view, to see everything through the prism of mental illness and medication. It’s can be unfair, even dangerous, to assume that just because someone has a history of psychiatric problems and medication use, that that’s the cause of their present problems.

I was reminded of this myself over the weekend.

In my last post I blogged about the decision whether or not to disclose to a significant other that you are taking medication. For this post, I said I would write about when both members of a couple are taking meds – but when one is an old hand and one is a relative newbie.

To my knowledge, there are no studies explicitly looking at this topic, but I think it would certainly make for an interesting line of research to look at the differing effects on identity. If I were a researcher, the central question I’d ask would be: Do people who begin taking meds at younger age feel that the drugs are more integral to their sense of self than those who begin them when their identities are already fully formed?

A reader’s story about taking meds has spurred me to address a topic I’ve been mulling about for some time now: the ways in which people do or don’t discuss their medications with their significant others.

The reader, a 21-year-old who wanted to go only by “CJ” was plagued by several concerns about taking medication long-term. Among them was the possibility of “meeting someone” and then needing to disclose having a psychiatric diagnosis and a regimen of psychopharmaceuticals, without which, CJ, said “I’m a different person, a scary person.”

I found it sad and poignant that this was among this young person’s top concerns concerning medication. But for better or worse, taking psychiatric medication is a very private act, something we must decide whether or not to disclose to others.

The decision to do so or not to do so takes on outsize importance as young people navigate their first serious relationships.

A little while back, I asked readers to share their experiences with medication. CJ, who first took medication at age 12 and is now 21, was kind enough to write in. At 12, CJ had self-harmed and was suicidal, which was the initial impetus for drug treatment.

Some medications have helped with those tendencies, some only exacerbated them – a controversial topic I’ve addressed in previous posts.

Eight years later, mood swings and sleep continue to be problematic, and antidepressant and antipsychotic medications that help with these issues are ones CJ considers to work. Forgetting the drugs for even a day has alarming results, and CJ sees medication as necessary for living a “normal” life.

Despite reservations about lifelong medication treatment, CJ fears that doctors will think the medications have cured the disorders and stop drug therapy, triggering a frightening breakdown. Another lingering worry – and one I found particularly poignant – concerns meeting someone and falling in love, only to have the person leave upon finding out about CJ’s diagnoses and medications. Even with a team of doctors, therapists and other mental health professionals and a cocktail of medications, this young person sees a long road ahead to recovery and many obstacles ahead.

If you would like to share any aspect of your experience taking medication from a young age, please feel free to email me at kaitlin.b.barnett [@] gmail.com. And now, in CJ’s words:

I try to keep up with books and movies that deal with young people and medications, even as minor theme. To that end, I just finished reading and watching the movie version of Ned Vizzini’s It’s Kind of a Funny Story, about an overachieving, depressed and very stressed-out teenager named Craig who checks himself into a psychiatric ward after quitting  Zoloft.

During his stay, Craig restarts his medication, and, more importantly to the larger message of the story, finds some much-needed inner peace.

The book takes a vaguely pro-medication stance (don’t stop taking your meds cold turkey or you might end up in a psychiatric hospital), but it got me thinking about a couple of more interesting questions along the way: Can people who have never experienced serious psychiatric problems understand those who have? And, by extension, can those who have never taken psychiatric medication understand what it is like to take one?