In the past couple decades, prescribing psychotropic medications for children and adolescents has pretty much become business as usual. Dosed: The Medication Generation Grows Up, by journalist/blogger Kaitlin Bell Barnett, “takes a nuanced look at the issue as she weaves together stories from members of this ‘medication generation,’ exploring how drugs informed their experiences at home, in school, and with the mental health professions.” Notably, the author herself is part of the story, as she started taking antidepressants in her teens.
Claudia M. Gold, MD, author of Keeping Your Child in Mind: “Dosed is a fascinating, well-researched, and very important book. After reading it, I hope that no parent, pediatrician or psychiatrist will give psychiatric medication to a child or adolescent without very careful consideration of the potential long-term consequences. Bell Barnett shows that these medications are often not a ‘quick fix,’ but rather have deep, lasting impact, not only on physical and emotional health, but also on a person’s core sense of self.”
From the description of “The Medication Generation,” more about the effects on these kids:
The questions we all ask growing up—’Who am I?’ and ‘What can I achieve?’—take on extra layers of complexity for kids who spend their formative years on medication. As Barnett shows, parents’ fears that ‘labeling’ kids will hurt their self-esteem means that many young children don’t understand why they take pills at all, or what the drugs are supposed to accomplish. Teens must try to figure out whether intense emotions and risk-taking behaviors fall within the spectrum of normal adolescent angst, or whether they represent new symptoms or drug side effects. Young adults negotiate schoolwork, relationships, and the workplace, while struggling to find the right medication, dealing with breakdowns and relapses, and trying to decide whether they still need pharmaceutical treatment at all. And for some young people, what seemed like a quick fix turns into a saga of different diagnoses, symptoms, and a changing cocktail of medications.
All of the above has occurred within a changing treatment model that often makes the meds overly accessible and inadequately monitored. An excerpt from the book (for use in Salon):
As psychiatrists switched from forty-five-minute visits with time for psychotherapy to fifteen-minute ‘med checks,’ prescriptions often came with little continuing discussion about how kids felt about taking medication, or how it was affecting them. That was fine by some, but not by others. One young woman I interviewed, who received her prescriptions from time-crunched psychiatrists who scheduled fifteen-minute appointments they often cut short, wished there had been time to ‘talk about feelings, not just symptoms.’ One young man told me that even though psychiatric medication is ‘so much a part of our culture,’ he could ‘probably count on one hand’ the conversations he’d had about his medication use, or anyone else’s.
In a Huffington Post article, Barnett advocates, among other helpful suggestions, that parents seek a therapist for their kids if they’re on medications:
Many studies have shown that the combination of therapy and medication beats either treatment alone. But beyond that fact, I recommend trying to find a therapist who’s open to discussing not just feelings, relationships, thoughts and other traditional therapy topics, but also kids’ opinions and attitudes about being on medication. Taking psychiatric drugs can be stressful and confusing, and often children and teens don’t have anyone with whom they feel comfortable discussing their concerns. If the child is open to it, therapy can be an ideal venue.
But what about the kids whose parents aren’t actually available, whether to offer guidance on such matters or otherwise? A very recent post by Barnett takes on “one relatively small but prominent group,” our country’s foster children, who evidently are significantly more likely than other kids to be put on drugs. Although this problem is currently being tackled in various ways, Barnett singles out a brand new resource from the federal Children’s Bureau for its fresh and needed approach:
‘Making healthy choices: a guide on psychotropic medications for youth in foster care’ aims to give foster children the information necessary to look out for their own best interests when it comes to mental health treatment. The guide, appealingly illustrated and written in plain, accessible language for pre-teens and teenagers, can’t magically fix the systemic problems that contribute to such high rates of psychotropic prescribing. Nor is it likely to help children who are too young or too disturbed to absorb its advice. But it is a wise and much-needed step toward molding troubled and vulnerable kids into well-informed self-advocates.