Part of the cringe-inducing delight of watching Girls is hearing Hannah say things and do things she knows she shouldn’t. And part of what’s refreshing about Dunham herself are her irreverent, indecorous comments and self-revelations, whether on Twitter, New Yorker essays, or interviews.
So I was especially curious to hear what Dunham had to say about her obsessive-compulsive disorder and medication use in a just-released Rolling Stone cover story. Especially since it was titled Girl on Top: How Lena Dunham Turned a Life of Anxiety, Bad Sex, and Countless Psychiatric Meds into the Funniest Show on TV.
Today is World Mental Health Day, and I’ve been thinking a lot about the terms “mental health” and “mental illness” ever since reading a recent post post on the topic by blogger Natasha Tracy.
Natasha contends that using the politically-correct, cheerier-sounding term “mental health” trivializes psychiatric disorders and ends up shortchanging those who suffer from mental illness. That got me thinking again about a question I’ve often pondered: Can long-term, maintenance treatment with psychiatric medication take someone with a “mental illness” and restore him or her to “mental health?”
The answer isn’t as obvious as it might seem.
Today I’m featuring the story of Allie, a 21-year-old college senior in Wisconsin who was ultimately diagnosed with bipolar disorder. Allie kept her unhappiness a secret and didn’t begin taking medication when she was old enough to ask for it without her parents finding out.
Allie’s story is interesting, because it shows how kids can suffer from severe depression from a very young age. It also shows how in a culture where psychiatric drugs seem ubiquitous kids can come to focus on medication as a source of salvation.
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.
In a recent post, I explored the question of whether meds can help reduce bullying behavior in kids with psychiatric conditions, since they are more likely to bully peers than kids without such problems.
But research shows that kids with psychiatric problems are also more likely to be bullied – and that those who are bullied are at elevated risk of suffering from psychiatric disorders later on.
In my own research for my book on young adults who grew up taking psychiatric meds, I was struck that almost everyone I interviewed reported having been bullied during childhood or adolescence (some also reported bullying other kids).
So how does taking psychiatric meds affect the likelihood of kids being bullied? Do the drugs enhance kids’ self-esteem and behavior so that they’re less likely to be picked on? Or do kids get teased because they take meds?
In recent years, there has been a huge increase in the prescribing of psychiatric medication to treat aggression in children.
Specifically, atypical antipsychotic and mood stabilizing drugs, originally developed for schizophrenia and bipolar disorder in adults, are now routinely prescribed to treat the aggression that occurs in a variety of childhood psychiatric disorders.
Prescriptions for atypical antipsychotics increased sixfold between 1993 and 2002, and the majority were prescribed to treat non-psychotic aggression, according to a task force that recently published guidelines on how to treat aggression in kids.
But these drugs carry the risk of serious side effects, notably severe weight gain and metabolic changes that can lead to Type 2 diabetes. Critics, including many in the medical community, have said they are over-prescribed.
At the same time, we’re in the midst of a collective national hand-wringing over how to reduce childhood bullying. Might drugs that curb aggression be the answer?
What are the issues involved in taking stimulant medications for ADHD from early elementary school onward? And what happens when someone who has done this decides to quit the drugs in college – only to find her motivation and academic capabilities diminish without the meds, and to suffer a crisis of identity and mood problems upon resuming them?
Two recent guest posts from a reader raised these questions and prompted ample discussion and comments from readers. In those posts, I let the young woman in question speak for herself. Now, I’d like to highlight some of the larger issues her story illustrates.
Yesterday, I published the first part of a guest post from a young woman, now 20 years old, who had spent the majority of her life – pretty much as long as she can remember, she says – taking medications for ADHD.
After working hard in high school and getting into her top-choice college, she decided she wanted to see what she was like without medication. She wanted to prove to her parents – and to herself – that she could function well in school and in life without the drugs she’d been taking for so long.
The summer before beginning college, she stopped taking her medication. Here, in her words, is what happened afterwards, and how it changed her view of herself and her need for the drugs.
So often when we talk about psychiatric meds, we discuss it only on the most superficial level. But when people have a chance to really open up about the ways they think long-term medication has impacted them, I believe they can share some valuable insights and lessons.
I try to provide that kind of in-depth storytelling in my new book, Dosed: The Medication Generation Grows Up, but with so many medications, so many psychiatric disorders, and infinite life experiences accompanying them, there are many more stories out there to tell.
I was intrigued and pleased, then, when a young woman, a 20-year-old incoming college junior who grew up in Georgia, wrote me to say that she wanted to tell her story of taking medications for ADHD “for as long as I can remember.”
On this blog and in my new book, Dosed: The Medication Generation Grows Up, I explore young people’s experiences with medication. And oftentimes, by exposing their ambivalence, even their resentment, toward their treatment from an early age, I end up implicitly questioning the value of early intervention for mental illness.
So in honor of the American Psychological Association’s Mental Health Month Blog Party Day, I want to address the question of whether I think early intervention is worth it.