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?
The book answers the first question about understanding mental illness with a ‘no’ by implying that the people on Craig’s psych ward have an inherent, natural camaraderie and that those outside – including Craig’s family – can’t really understand what he, or the rest of the patients, are going through.
I happen to think this paints an overly rosy picture of psychological distress, since when you are truly suffering, you often have little or no capacity to love or empathize with others. I also think it assumes a lot of similarities between psychiatric disorders that are vastly different in their symptoms, their degree of dysfunction and in the extent to which they impact insight and grasp on reality.
But I’ll move on to the question of whether people who have never taken medication can understand those who do, since this blog focuses on the experience of psychopharmaceuticals. This, in turns, raises a few follow-up questions.
1) Does taking medication in and of itself make somebody ‘different,’ and give them a substantially altered worldview?
I’m talking here about people who take medication long-term because either they or their doctors think that it does something for their psychiatric symptoms. In other words, I’m not referring to people who try, say, an antidepressant, notice no change, and quit after a few weeks.
I would argue that there is no one, single “medicated experience,” or even a single way to experience a particular drug, and that even though there are many subtle ways that taking psychiatric medication does mark people as different, they are not always aware of these differences, or at least they’re not aware of them until prompted to consider them.
The relevant differences are the ones they perceive, and in terms of other people understanding their experience, what matters is how well they can communicate what they are going through – what they felt before they began taking the medication and what they feel now that they are taking it. That, in turns, begs the question:
2) Can people who take medication adequately and accurately articulate how they feel different now that they are taking the drug, compared to how they felt before?
As somebody who’s written a book about the many subtle effects of medications, I’d very much like to believe that they can. On the other hand, having interviewed many people and hit a lot of roadblocks, I can say that a lot of people don’t really know how to describe their altered sense of self. They’re simply not used to discussing their experience of medication, because in our society it’s not a topic of detailed discussion – it’s something we talk about in passing, if at all.
People will maybe complain about side effects – dry mouth, low libido, fatigue – or they’ll say they felt “more like myself” or “drugged up,” but you usually have to ask many follow-up questions to discover what they really mean by these vague statements. It’s a bit of a Catch-22. You have to have some familiarity with the subject to ask the right questions, but in order to get familiarity with the subject in the first place without firsthand experience, you need to be able to ask the right questions.
3) Can adults understand what it’s like to take medication for children and teens, who can’t or won’t fully disclose the texture and nature of their inner lives?
This is an important question, because adults – parents and doctors – are very often the ones making the decisions about whether or not children should take the drugs in the first place. If they can’t understand what it’s like, is it ethical for them to be making these decisions? On the other hand, if they can’t understand what these drugs feel like, who should make the decision to medicate a child?
On a more fundamental philosophical level, how does anyone know what constitutes understanding someone else’s perspective? I’ve often wondered about this in the case of prescribing doctors. They can’t “try” every psychiatric drug they prescribe, and even if they did, if would do any good – each drug works differently on each person. A doctor can only use his or her best clinical judgment to guess at how a drug is affecting a given patient.
So what’s the answer? The best any of us can do, I think, in trying to understand anyone else’s experience, with medications, with mental illness, or with anything in life, is to be ready to listen, to ask considerate and thoughtful questions, and to use our empathy and our imagination.
What do you think? What does your own experience with medication, or interacting with others who take medication, tell you about this dynamic?
photo credit: Heather F