Growing up on medication

Most parents know that the topic of psychotropic medication is charged with emotion.  Everyone from your friends to the anchor on the evening news seems to have not just an opinion, but a judgment.  This month a new book, Dosed: The Medication Generation Grows Up hit the bookstores.  Kaitlin Bell Barnett, the author, argues that American society needs to start listening to the people with the most credibility — the generation who grew up taking these medications.  She says we need “to stop bickering about whether or not kids were “overmedicated” and should, instead, listen to the people best positioned to comment on the subject – the generation of young adults now in their 20s and 30s who spent their formative years taking the controversial drugs in question.”

For her book, Ms. Barnett interviewed several young people in their 20s and 30s.  She tells their stories and explores some of the issues they face, including the impact of medication on a developing child’s sense of self and the toll taken by medication trials and side effects.  Some felt they had little input into the process of deciding to use medication or weren’t told why they were being given a particular pill.  Some grew up to reject medications while others continued taking them.  There is no single experience and there is no consensus.  However, there is a strong, compelling voice added to the debate whether the benefits of medication outweigh the negatives.

Several of the points made in Dosed reminded me of the 2008 PPAL study on psychotropic medication.  While we were going to survey only parents on this topic, we were also able to survey almost 70 youth and hold three youth focus groups.  These young people were 12 to 19 years old, younger than the group interviewed by Ms. Barnett.  But some of their worries about side effects and frustration with unclear information were very similar.  Parents who were surveyed also reported that their insurance was more likely to cover med checks (76%) than therapy visits (53%).  Ms. Barnett also makes this point.  She says that Medicaid and private insurance are “both eager to keep costs down, and therefore preferred relatively cheap psychiatric drugs to long-term talk therapy (despite a growing medical consensus that the most effective treatment for most psychiatric conditions was a combination of medication and therapy).”

For the first time, there are millions of young adults who took one or more psychotropic medication during their growing up years.  In the 9 years between 1987 and 1996, the number of youth under 20 taking at least one such drug tripled, going from 2% to 6% — an increase of at least one million children nationwide.  In 2009, 25% of college students were taking psychotropic meds, up from 20% in 2003, 17% in 2000, and just 9% in 1994.

Many parents report that their children vacillate from opposing meds, to reluctantly trying them, to seeing the positives and negatives and then back again.  Parents, too, often have mixed emotions.  They seldom make the decision to use psychotropic medication for treatment in a neutral, stress-free environment.  They receive conflicting messages not only from their children, but from their extended families, schools and society at large. 

Kaitlin Bell Barnett offers advice to parents, garnered from her own experience and observations. Strong, clear communication is essential, she writes.  Even more essential is taking the time to listen to your child’s feelings and thoughts about medication.  She urges parents to explain why the medications are needed and include them in decision making as much as possible.  She counsels parents to listen to their children’s worries and attitudes about medications and find a therapist who is willing to talk about this topic.  She notes that resisting or rejecting medication is common but parents can mitigate it by having a trusting relationship with their children.

I’ve often said that the most important thing parents of a child with mental health needs can do is nurture and value the relationship they have with their children.  In our medication study, youth told us that while they like speaking directly to their prescribing doctor, they relied on their parents for information and a better understanding about medication. It’s still a highly charged subject.  The best thing we can do is to listen to each other.

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9 Responses to Growing up on medication

  1. Alice says:

    I do understand that there are many children and young adults that require medication but, I also feel that we have become a country that often chooses medication before reviewing other solutions. Today, sadly most mothers have to work and children spend there days in day cares. We also have a great deal of broken homes where there is only one parent. We have also become a county that parents and teachers are fearful to discipline our children and when I say that I don’t mean abuse. Children long for discipline and direction they need roll models, people in there life to look up to, sadly again we fall as a Nation. I am not saying that we must do away with medication but, I am saying we need to focus on the families and encourage loving relationships with our young married couples. Children learn how to be adults by watching their parents interact this is also a big part of childrens mental health. I don’t have the answer but I do see what is happening around me.

  2. Nancy says:

    Thank you for this one. I have noticed that over my 20+ years of doing this, talking about it has become easier. It used to be that most children did not want to take medications because they didn’t want to be “different.” However, now for some children who already feel quite “different” medication helps them feel more “normal.” Lisa, I agree, the best thing we can do is to keep talking about it and to listen.

  3. Judith R. Knight R.N. says:

    It is good to see attention being paid to this subject and to have the percentage of young people taking psychotropic medication documented. This is a beginning of a more informed public discussion about this important subject.

  4. Marie says:

    I agree this is a very emotional subject. Of course many parents want their child less medicated. This is evident by the open conversations at venues from Seminars to the park. 20+ years ago, with my older son, many parents weren’t as educated and let’s face it We didn’t have the internet to comb through, day after day, reading side effects and emotional statements. ADHD medication caused for many VERY Heated conversations. Those without a child who couldn’t enjoy his/her life because of the constant bouncing around, were very judgmental.

    We didn’t know about the value of Talk Therapy and “Sensory Diets” It was give your kid this pill or don’t. My older son did not take meds, but definitely would have had a much calmer body if I knew about pressure, brushing etc. He chose on his own to attend Anger Management in High School and those tools have helped immensely.

    In the fall, my 13 y.o. who is on a handful of psych. meds, Chose to go off everything by holding and spitting. Thinking it would make him feel better. He wound up in a psych. hosp. for 3 weeks. There, his meds were drastically changed and he is doing better.

    What does a mother make of that, you trust a doctor and research your brains out only to have another change everything, with great results. O.T. specialists suggest therapy after therapy. We don’t just read an article, many of us are up half the night researching. Then there is the cost. The things that make the most impact on his life carry price tags of $10,000 for summer camp – $1800 for a program to help him focus. Even Social Skills is $50 an hour and upward. NO ONE helps you pay for these, over 80% of us are single parents. The fight alone costs $$$-for the right help at school, DMH..
    I have talked to men, 27 and 30 years old who state ‘those drugs really messed me up’ and it makes me lay awake nights, what am I doing to my child, I research and fight all day and am exhausted and angry by the time my boy gets home, and THAT’s not fair to him. Care for a 5’9″ 170lb child doesn’t exist – so no work, no money. and then mom gets a pill– because insurance covers it.

  5. Dede Ketover says:

    Thanks to Lisa Lambert & PPAL for putting this important conversation out there.

  6. Bree says:

    This topic has been on my mind for years, watching my nephew go from Ritalin to cocaine abuse as an adult; a grandaughter whose been diagnosed, misdiagnosed and rediagnosed since she was four. She’s sixteen now and in and out of group homes. They’ve had her on every medication known to man – she has become a living science experiment – a “lab rat”. My nephew has been in an out of prison since he was 19. He’s in his thirties now and still experimenting with drugs. He now has a toddler with ADD – he’s on meds.

    During all the years that have passed, I have witnessed countless examples like these. Seeing just the side effects of some of these psychotropic medications was enough to make a lasting impression on me. Their faces have been tattooed in my mind. If any parent out there is contemplating medicating their ADD/ADHD child, please read the warnings and possible side effects that are listed with the prescription BEFORE administering it to their child. Do research and ask questions of parents and professionals alike. Never take only one person’s opinion. Be an advocate for your child. You are all he/she has got.

    And just in case you’re wondering, I also have two boys that the public schools have been pressuring me to medicate for about a year now. My fifteen year old was diagnosed with ADHD in his Freshman year of high school. I am taking him three times per week for neurotherapy treatments that I am hopeful will work. It takes money and patience, but also has about an 80% success rate to eradicate ADD/ADHD symptoms for good. I’m praying he’s in the 80th percentile.

    My younger son, currently in middle school, had been diagnosed with a Communication Disability in fourth grade. This year I have been pressured (by school) to have him evaluated for ADHD. I did and the results were conclusive: he DOES NOT have ADD. He does have a Communication Disability, just like the elementary school had determined three years ago. There seems to be a very strong educational push in this country to medicate our babies. It should be noted that in most of the industrialized world does not do the same. In fact, in many countries psychotropic drugs are illegal to be administered to anyone under 18. This is a big enough red flag for this mom. I will continue to look for healthier alternatives for my children because I have to be the one to protect them. And if these medications require a label that prevents anyone under 18 from purchasing them, and they do, and they are classified in the same drug category as Cocaine, then I wouldn’t want to ingest them myself! Why would I give them to my children??

    I’m sorry if I’ve offended anyone out there. I based my personal decision on research and facts printed in black & white. I prefer to make informed decisions based on data and my observances, not the opinion of one or two doctors. Knowlege is power. Without knowlege, what do we have?

  7. kendra edmonds says:

    I have a child who was born with a birth defect. He had excellent care at a Shriner’s Hospital. At this place, with a slew of experts in many different areas, they had a philosophy that we as a family adopted, and it went something like this: while acknowledging that a problem exists, the care is delivered from a conservative approach of least restrictive to most restrictive. Procedures often were lengthy and sometimes didn’t yield great results, but they did the least harm. We learned to be patient, we learned to co-join with the helpers, to accept help in areas we needed help, to inform the care when we felt we knew our child best and together we all were on the same page to optimize care for our child. This same child began the special ed. process in first grade. We resisted meds and labelling from 1st grade through 5th, despite a somewhat bumpy educational ride as a result. The advisorial stanch of the school and our feeling of disrespect for the needs of our child, set us all up for a dysfunctional relationship that, in the end, did more harm for our child. Eventually, our son did try meds, with limited success, and sporatic usuage. As soon as he turned 18, he signed himself out of special ed and graduated without special ed +/or meds. He continues to be ambivilant about the use of meds, +/or any label that exposes him to the potential need for psychotropic meds (because I think in large part, when he was about 16 and frustrated and angry as a teen, the psychiatrist, in a 15 minute med review, decided to add mood disorder to his profile and prescribed depakote, which he refused to take). He has always been open to “talk therapy,” whether with us, his parents, a guidance counselor, or a therapist. We have always been there for him, but the others were harder to access. It seems it is easier to just “take a pill,” and that became a more universal call, despite, in my opinion, the belief that psychotropic medication is a more restrictive approach. Easier is not the same as least restrictive. I wish we as a society could be more cognizant of this.

  8. Marcy says:

    Thank you Lisa for beginning this conversation. If we truly want to integrate mental health with physical health – or reattach the head to the body as some say – we need to think about treatment the same way. The two are integrally intertwined. There are those doctors whose first line of intervention for any disease is medication; and there are those who encourage behavior change or alternative strategies. I applaud parents who seek out alternatives before starting psychiatric medications. Ultimately though, medication may be the right intervention – and similar to other medical conditions, not necessarily forever. My son has been unfortunate to have a chronic medical disease (diagnosed at age 8) as well as emotional difficulties. Consequently, we explained the need for psychiatric medication as parallel to the need for his colitis medication. Both are medical conditions that need medication. And just as the medical condition changes over time, and the need for that medication changes over time so does the need for psychiatric medication. We have always talked openly and listened to our son’s thoughts and feelings about his medications and he knows we take his opinions seriously. His intense desire to be off the psych meds has contributed greatly to his motivation to learn and utilize other skills to manage his symptoms and behaviors – something we have encouraged. And he now is nearly medication-free. Again, this is a process parallel to other medical conditions – if you exercise and watch what you eat, you may be able to reduce or stop your blood pressure medication. Keep up the discussion – we are our children’s best advocates.