Archives for August, 2012
People who take psychiatric medications long-term are no strangers to stigma, or the threat of it. We perennially face, for example, the question of whether it's worth risking others' judgment and the potential negative repercussions of disclosing our conditions -- and the fact that we take medication for them. But you can commit to taking medications long-term and still perpetuate or further the stigma associated with meds. And I don't just mean that in the sense of keeping your medication regimen secret. Most of us do so in another way altogether that we're largely unaware of. The fact is, most people have some kind of internal barometer when it comes to medications - which ones they are willing to take, and which ones they're not.
This weekend a mother published a New York Times column about how her son came to be diagnosed with ADHD and became a member of the ballooning "Ritalin Generation." "Just a little medication," the teacher told the boy's mother, "could really turn things around" for the boy, who was having trouble focusing on class worksheets and lining up quietly for transitions between classes. When the mother firmly responded that she and her husband weren't going to medicate their son, the teacher backtracked, sounding mock-horrified. She wasn't explicitly suggesting medication, she said. The law prohibited such a thing. She just didn't want him to fall through the cracks - and thus was was merely suggesting the boy's parents have him evaluated by a psychologist. The boy was evaluated, and sure enough, he ended up on Ritalin for a short-time, though he quit it on his own a year later, matured out of his former inattentiveness, and eventually ended up a well-adjusted, school-loving honor-roll student - and medication-free. Such stories are commonly invoked as cautionary tales about the alleged over-diagnosis of ADHD and other behavior disorders and over-prescribing of drugs like Ritalin to keep children's behavior in check. Teachers recommending meds for disruptive students often feature prominently. In fact, the debate over school involvement in medicating disruptive children showed up as early as the early 1970s.
Psychiatric medications have a lot of potential hidden costs. We don't know, for example, how taking them from a young age affects long-term brain and psychological development in kids. They have myriad of side effects, some serious, like diabetes, high cholesterol, neurological impairment and birth defects when taken in pregnancy. They carry stigma, both from others and self-imposed. But I'm not talking metaphorically about costs here. I'm talking straight-up financial outlays. Taking psychiatric medications can really add up, even for those who have health insurance, and even when they can take generic instead of brand-name drugs. One big reason is the so-called "medication merry-go-round."
With all the attention on the misuse of psychiatric drugs, I think it's worth taking a look at how the increased scrutiny affects people who have a diagnosis and a legitimate prescription. I don't mean to suggest that just because someone has been diagnosed and a doctor has seen fit to prescribe her medication that she necessarily needs the meds - or even that she "should" be on them. Plenty of people have unjustified diagnoses and unneeded prescriptions. But for those who do benefit from treatment, you've got to wonder how all the media attention affects their experience.