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.
Some people do take medication for just a year or two, begin to feel like to their “old self” again, and successfully taper off the medication without a recurrence of symptoms.
But many others – myself included – end up on psych meds for the long haul, either because their symptoms reoccur when they quit the meds, or because they are too frightened of that possibility even to consider abandoning medication.
Indeed, psychiatrists and other mental health professionals often emphasize that psychotropic drugs are “a treatment, not a cure.” They may help get some people through temporary emotional rough patches, but for those with chronic mental illness – the people Natasha Tracy is concerned about – the drug treatment effects don’t last once you’ve quit them.
This is a grave shortcoming when it comes to the drug treatment of mental illness because it potentially involves decades of treatment from early in life: Unlike many other chronic health problems, psychiatric disorders manifest early.
Half of all mental illnesses begin by age 14, according to the National Institute of Mental Health. Accordingly, a major health policy goal, as National Institutes of Mental Health director Thomas Insel has often explained, is early intervention. Mental illnesses, Insel said recently, are “the chronic disorders of children” – with potentially serious long-term repercussions if left untreated.
That intervention needn’t necessarily take the form of drug treatment. But for myriad reasons, many of them financial, the choice often comes down to medication or no treatment at all.
For young people whose suffering is severe and/or intractable, I believe medication is far better than no treatment. But, as I detail in my recent book about young people who grew up taking psychiatric meds, drug treatment from a young age brings its own set of challenges – psychological, physical, social, familial.
Not least among these challenges is the perennial question of how long to continue taking meds. For people who began psychotropic treatment at a young age, it’s not unreasonable to think that they might have outgrown their old problems. On the other hand, as I can attest myself, it’s sobering – even traumatizing – to attempt to abandon medication only to rapidly spiral downward and feel you have no other viable choice except to restart treatment.
Journalist Robert Whitaker makes the provocative claim in his book Anatomy of an Epidemic that psychotropic drugs cause lasting changes in the brain that practically guarantee the return of symptoms once the drugs are withdrawn. He declares it a tragedy for a generation of young people to be chained to drug treatment, facing a return of symptoms – or even worse symptoms than they had in the first place – if they were to quit.
If this is true, it would represent the dark side to the often-made claim that psychotropics are “neuroprotective” – that taking them prevents more frequent and more severe breakdowns.
Regardless of what the larger truth turns out to be, for now, individuals still face the same haunting question. When you have been mentally ill and are restored to normal or near-normal functioning by medications, are you well? Or are you just buying time?