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?
At first glance, the expanded opportunities for medical self-monitoring would seem helpful for both doctors and patients.
Without physiological tests to gauge how meds are working, doctors make treatment decisions largely on patients’ self-reported symptoms and drug side effects. But relying on memory can have its pitfalls For example, the effects of drugs that take weeks to kick in, such as antidepressants, are notoriously hard to gauge for many patients because they set in so gradually.
Not being sure how – or whether – a medication is working can not only be frustrating for the doctor but also troubling for the patient. It’s hard to keep adhering to a medication regimen when you’re not sure whether the drugs are providing relief, or whether they might even be making things worse.
If patients can, with a few finger swipes or keystrokes, look back and see how they fared after changing medications, adding a new medication or adjusting a dosage, it may well help them and their prescribing doctor see how effective their pharmaceutical treatment is.
Some professionals also think charting symptoms and side effects can be good for mental health in and of itself. It can help people avoid triggers for troubling moods or behaviors and provide motivation for engaging in activities or strategies that seem to have improved psychological wellbeing in the past.
Mostly, I think tools – high-tech or not – that let people take charge of their own mental health and medication treatment are a great boon. But a tiny part of me wonders: Is there such as thing as being too aware of your mental health and your meds?
This might seem like a bit of a strange question coming from me. This spring, I published a book, Dosed: The Medication Generation Grows Up, in which I argue that taking psychiatric medications starting at a formative age adds many extra layers of complexity to the process of growing up and “finding yourself.”
Part of the answer to this tangle of figuring out what’s you, what are your symptoms of mental illness, and what are the effects and side effects of your medication, I argue in the book, is encouraging young people to be more self-aware and involved in their treatment.
Kids and teenagers tend to have a better relationship with their medication, I found, when they have opportunities to think and talk with their family, friends, doctors, and other mental health professionals about why they are taking the drugs and how they feel about taking them. And part of making an informed and educated decision about the latter involves being aware of how they affect various aspects of your physical and emotional health.
But I do sometimes wonder if there’s a downside to constant self-scrutiny, especially for people are already prone to ruminating or obsessing.
From interviewing my peers who take medication, I know I’m not the only one who can drive herself crazy (crazier?) trying to parse the effects of medication.
Consider the possibilities if I’m feeling particularly anxious. Maybe my meds have stopped working and I need a new dosage or a new drug. Or perhaps I’m experiencing side effects from meds (some antidepressants can exacerbate anxiety, while some anti-anxiety drugs, like Xanax and Klonopin, can cause rebound anxiety when they wear off).
Or perhaps there’s something situationally very stressful about my life that I need to remedy. Or maybe I’m just not exercising or sleeping enough.
That is, even if I’ve kept a careful record of my medication changes and doses, what foods I’m eating, how much I’m sleeping or exercising, etc., there may be too many variable to attribute my anxiety to any one cause.
Alternatively, a number of therapists I’ve interviewed worry that too much focusing on symptoms and medication side effects – especially from a young age – can lead patients to see everything through that lens.
In this scenario, young people, especially, may learn to see normal emotions as symptoms of their disorders – an indication the meds aren’t working, say, instead of an indication that they might need to change something in their attitude, habits, or behavior.
What do you think? Does encouraging kids – or adults, for that matter – to tune into effects and side effects of their medication promote a healthy sense of involvement in their treatment? Are apps and websites that help do this useful tools?
Or is there such a thing as too much monitoring of one’s meds and moods?