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.
Here’s the background: I’ve been feeling glum lately. When I was in high school and middle school I suffered from low-level depression (dysthymia), but I have been taking antidepressants for more than a decade which have kept it pretty well in check.
However, a few months ago I had decided to go off one antidepressant and reduce the dosage of another because I’ve been taking so many prescription meds for my migraines and I was trying to simplify my medication regimen a bit. My psychiatrist and I, as well as my therapist, had all assumed I was depressed because I’d reduced my meds. Seems logical, right?
Then, in one of my occasional fits of self-diagnostic paranoia, I was motivated over the weekend to start researching the side effects for one of the drugs I take for migraine-associated nausea. Turns out one of these side effects is depression, and the drug is contraindicated in people with a history of the condition. This either escaped the noticed of both my psychiatrist and my neurologist, or it’s an obscure enough side effect that they didn’t consider it a problem.
I’m not saying my recent unhappiness is necessarily a result of this migraine medication. It could also be a result of Topamax, another migraine drug I’m taking – or it could come from something else altogether, perhaps having nothing to do with pharmaceuticals. The point is that for weeks I went along assuming that I was feeling depressed because I’d reduced the dose of my antidepressants. Somehow, when you take psychiatric medications, it’s tempting to view everything through that prism.
One of the young women whose stories I tell in depth in my book experienced a much more dramatic example of this phenomenon. She had been diagnosed and treated with medications for depression and ADHD starting at age 14; later, she began to experience symptoms of anxiety and insomnia and was prescribed benzodiazepines and sleeping medications.
But gradually, from college onward, her anxiety and agitation got more and more extreme. Doctor after doctor attributed this to a mood disorder. She was 28 before they discovered she had an autoimmune condition that had likely been causing the most extreme symptoms.
This didn’t mean that she’d necessarily been misdiagnosed at age 14, or that she never should have received psychiatric medication. It simply means that doctors kept chalking up these particular, scary symptoms she was having to her psychiatric problems, and rejiggering her psychiatric meds when at some point they should have stopped to consider if something else was at play. They kept doing this even when she suspected her problems were not mental in nature, and begged them to look elsewhere.
Her history of medication, however, gave the doctors something to latch on to – and something to experiment with in terms of changing doses and adding and subtracting drugs when they could and should have been pursuing other diagnostic avenues.
This young woman’s story is an extreme case. I don’t mean to suggest that every young person who takes psychiatric medication and is faring poorly should assume some rare physical disease is to blame. But I do think we should all be cautious about letting their history of medication stand in as an explanation for everything that goes wrong in our lives.
What about you? Have you ever had your psychiatric history, or history of medication cloud your judgment, or cloud someone else’s judgment, when it came to a problem you were having?