How closely does a writer’s work mimic her life experiences? It’s a perennial question made all the more irresistible as it pertains to Lena Dunham, the 26-year-old creator of one of TV’s most talked-about shows, and her recently-revealed history of Obsessive-Compulsive Disorder.
In the first season of HBO’s Girls, Dunham stirred up debate by, among other things, repeatedly revealing her less-than-perfect body while playing the show’s main character, Hannah Horvath. What got people talking as the second season progressed, though, was how serious the show seemed to be getting, especially with its depiction of Hannah coping with a resurgence of her OCD symptoms.
Critics, fans, mental illness activists and patients have largely praised the Girls’ depiction of OCD, which they’ve hailed as convincing and nuanced, but agonizing to watch. One hollywood.com writer and self-described former OCD patient called it “some of the darkest, most difficult material with which Girls has wrestled to date,” lauding the show for avoiding the temptation to turn OCD into a mere joke.
The fact that Dunham revealed in a March cover story for Rolling Stone that she’s struggled with OCD since childhood – and taken medication for it on and off – gave the topic more buzz. (I discussed what she revealed-and what she didn’t-here).
In a HBO behind-the-scenes look at one of the episodes, Dunham disclosed a little more about the connection between her experience and the show’s representation of Hannah’s OCD – though she didn’t go into specifics.
For those looking for a more direct comparison, here’s a look about what Dunham has said about her own experiences with OCD symptoms and treatment – and how they compare to Hannah’s.
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.
Ever have a hard time remembering to take your meds regularly? Now try tallying up all the psychiatric meds you’ve ever taken, their dosages and side effects. It’s harder than you might assume – especially as time goes on.
When I was interviewing my peers for my book about growing up taking psychiatric meds, I started with what I thought was a basic question: Can you give me your medication history – which meds you’ve taken in the past, and for how long?
I was shocked at how many people couldn’t answer the question with any confidence.
With the explosion of mobile apps and websites such as PatientsLikeMe, which help people chart symptoms, medications and side effects, we’ve entered a new era of unprecedented medical self-monitoring.
Is this a good thing when it comes to psychiatric medications and mental health?
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.
To recognize World Suicide Prevention Day, I wanted to post again about the topic of medications, suicide and young people.
First, the sad statistics: Worldwide, suicide is the second-leading cause of death among young people ages 15 to 19. In the United States, according to the CDC, suicide was the third-leading cause of death in 2009 for people ages 10-14, 15-19 and 20-24. It was the second-leading cause of death for people ages 25 to 34.
The vast majority of people who commit suicide have a mental illness. But for nearly a decade doctors and researchers have been debating whether certain classes of medications used to treat mental illness increase or decrease the risk of suicide – as well as suicidal thoughts and behaviors – in young people.
In 2004, the FDA placed a black-box warning on all antidepressants, warning that they increase the risk of suicidal thinking and behavior (called “suicidality”) in children and teens.
An FDA analysis had found that one type of antidepressants in particular, the SSRIs, which include Prozac, Zoloft, Paxil, Lexapro and others, doubled the risk of suicidality in young people from 2% to 4%. But it found no completed suicides in the studies it looked at, which included some 2,200 children.
In 2005, the European medications regulatory authority urged European countries to put strong warnings about using either SSRI antidepressants, or SNRI antidepressants, such as Effexor and Cymbalta, for children or teens. The warning was based on the drugs’ potential to induce suicidality and hostile or aggressive behavior.
Also in 2005, the UK’s National Health Service issued guidelines urging doctors to avoid prescribing antidepressants to kids under 18 unless other therapies for depression didn’t work.
In 2007, the FDA expanded its black box warning on antidepressants to include all young people under age 25. The risk is greatest in the first month or two of treatment, the FDA warned.
After the U.S. and European warnings went into effect, prescribing of antidepressants to children and teens decreased. At the same time, some …
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.
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.
For years, researchers and health policy experts have been charging that psychiatric medications aren’t adequately tested in children – and a new study gives some powerful ammunition to that critique.
The study, from Pediatrics, looked at clinical drug trials between 2006 and 2011, involving five conditions that cause the greatest “disease burden” for children, as measured by a rating that counts the total years of healthy life lost to disability.
In high-income countries like the United States, three of the five conditions with the highest disease burden among kids were psychiatric disorders: depression, bipolar disorder and schizophrenia.
But of the drug studies to treat those conditions, disproportionately few involved children.
The lack of trials is troubling because children and adults don’t necessarily respond to medication in the same way. With psychiatric drugs, that’s a potential problem both for physical reasons – and for psychological and developmental ones.