Pediatrician and author Claudia Gold recently published a column about my book, Dosed: The Medication Generation Grows Up, over at The Boston Globe in which she highlighted an issue I’ve been meaning to address here for some time: Young people and medications’ sexual side effects.

The drugs most famous for interfering in the sexual realm are the SSRI antidepressants, like Prozac and Zoloft, which can cause loss of libido and problems with sexual arousal and orgasm. But mood stabilizers, such as Tegretol and Depakote, which are commonly used to treat bipolar disorder, also cause sexual side effects for many people

Both classes of drugs have been increasingly used in young people over the past couple of decades. But if these young people experience sexual side effects from the medications, what are the effects on their psychosexual development? Should we be worried?

In this blog, I have been writing about different facets of “the experience of medication” in young people who take psychiatric drugs for a variety of conditions.

I’m going to continue to do that, because there are many more topics I want to discuss (please feel free, as always, to make suggestions in the comments section if there are particular subjects you’d like me to write about).

However, if you’d like to read an account of what got me interested in this subject in the first place, you might want to check out the excerpt from my new book, Dosed: The Medication Generation Grows Up, which is over at Salon.com.

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?

I stayed up late the last few nights reading Jeffrey Eugenides’ The Marriage Plot, engrossed in large part by the subplot involving Leonard Bankhead, who suffers from bipolar disorder and what might be called a typically complicated relationship with both his manic phases and his medication.

The book is set in the early 1980s, which gives Leonard few viable options for pharmaceutical treatment. Now doctors often prescribe anticonvulsants such as Tegretol and Depakote, and atypical antipsychotics, but back then lithium was more or less the only choice.

Leonard began to experience depressions early in high school but wasn’t diagnosed or treated until his freshman year of college, when he began taking a low dose of lithium apparently without incident.

But as college graduation nears, he begins to chafe at the idea of taking the medication at all, which sets him on a terrible merry-go-round of breakdowns, high doses to get him back on track, side effects from the high doses and then rebellions against the side effects, followed by more breakdowns.

This reader’s story about her experience with medication seems especially timely, given the recent analysis of studies analyzing suicidal ideation and antidepressants. She says she experienced such suicidal thoughts in the initial weeks of treatment, but that the thoughts passed.

For patients, especially young people, who do experience this kind of suicidal ideation after beginning an antidepressant, it is usually early in the course of treatment. The reader, who didn’t want to use her name, doesn’t elaborate on her response to this suicidal ideation, or whether a doctor told her to expect it.

However, if she’d be willing to take questions in the comments section, I, for one, would be very curious to hear more about how she interpreted these thoughts, whether they scared her, whether she was able to brush them off because she knew they were “drug-induced,” etc.

I’d also like to hear why she was so resistant to taking meds in the first place and whether there was going on in her life that was particularly stressful and that she thinks helped set off her depression at that particular time.

Her initial resistance is interesting to me, because it seemed to surface again during the time she she either forgot to take her medications or decided to go off it and concluded that she “deserved” her misery. From interviews I’ve conducted and research I’ve done, that seems a very common attitude in others, especially in depressives. I don’t think it’s necessarily unique to being young, but I would be curious to hear readers’ thoughts about why this mindset is so persistent.

Incidentally, on the topic of suicidal ideation, I’d like to point readers to a very thoughtful critique of the Archives of General Psychiatry study by Dr. David Healy, a psychopharmacologist and one of the most prominent and earliest crusaders seeking to draw attention to the link between antidepressants and suicidal behaviors and thoughts. I’m not sure I understand everything he says in the column, but it’s an interesting read, nonetheless.

And now, the reader’s account of her experience with meds, in her own words. I invite further personal stories about medication, in any format you like and on any aspect of your experience – don’t feel bound by the prompts I gave. Email me at kaitlin.b.barnett [at] gmail.com. Try to include your diagnoses and what medications you took.

Many people – most, I would venture to say – don’t have simple, uncomplicated relationships with their medication. One reader who has generously shared her story of taking medication demonstrates how conflicted one can be about long-term drug treatment, and yet how one can feel unready or unable to end it.

Among many interesting issues Kristy touches on, I’m struck by how little the doctor explained to her at the outset. In interviewing other young people who began medication as children or teens, I have found this substantially complicates their relationship with medication, often creating confusion, resentment and a lack of commitment to long-term treatment.

Their reaction is understandable. Would you want to continue taking a drug if you didn’t perceive a major positive change, and if you received very little feedback and guidance from the adults in your life as to what to expect and how to interpret what you experienced?