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.

How many kids take medications for mental health problems in the U.S. these days?

It’s a simple question, and one I’ve been getting asked a lot lately as I’ve been interviewed about my new book, Dosed: The Medication Generation Grows Up, about coming of age on psychiatric drugs.

And I’ve been embarrassed to hem and haw and not to have a single, easy answer.

Because here’s the thing: There are a lot of piecemeal stats from a lot of different sources, but they vary wildly, and there’s no single, unassailable source.

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?

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.

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?

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.

What does it feel like to grow up taking psychiatric meds? That’s the question that has occupied me for the past couple of years. Naturally, it feels different to different people, but overall I’ve found that meds seem to introduce a lot of extra uncertainty into the process of coming of age.

There are a lot of ways that meds make growing up more complicated, and I’ll explore those in future posts. But one big factor has to do with the lack of info, from a scientific perspective, about meds’ effect on developing brains and bodies.

Preparing to write this post, I started to survey the media coverage of the latest report from pharmacy giant Medco on how many Americans are taking psychiatric medications. The straight news coverage was okay, but many others simply used the report as a chance to declare - again -that Americans are “overmedicated.”

I don’t see how you can you honestly declare that a whole country, or even any particular group, is “overmedicated” unless you can also determine what number would constitute “appropriately medicated.” Not surprisingly, few people sounding off on either this report or the larger issue are willing to make such a call.