Furious Seasons links today to an interesting piece by Richard Friedman in the NY Times . Both raise interesting and important points and should be read.
Friedman asks this, arising from one of his patients , now 31 who has been on SSRIs since she was 14--
"But now she was raising an equally fundamental question: how the drugs might have affected her psychological development and core identity."
Indeed, how might they? And why is this question only now being asked? And even more broadly, what does it mean to have depression as a primary element of one's identity, as if it were as immutable and permanent as height or eye color? Is her sadness or anger or ambition hers or is it her depression or her medication? And how could she ever tell? Who might she be had it not formed such a huge part of her life and development?
These are enormous questions and will or should be raised more often as we face the coming of age of countless numbers of children who have been medicated with one or another or several psychotropic drugs since childhood. I remain haunted by the girl in the Frontline episode who could not tell if her moodiness, something quite ordinary in adolescents, were indicative of a need to increase her medication *because* she has no sense of unmedicated moods. She has no idea what it is to feel happy or sad or angry or full of angst over being a teenager without medication, without holding in front of her in first place her "illness". In many ways, she, her unmedicated self, developed only to the point where the medication was begun and should she go off it, it seems she might well have to go through the process of learning to manage and understand her moods in the same way that all of us, the unmedicated, do as we grow up.
And these same questions come to mind as I read Friedman's article. One of the things I have heard again and again from people I know who have taken SSRIs is that their emotional range is blunted; they don't feel depressed but they don't feel much of anything, either up or down. And one of the things I remember vividly about being an adolescent was how intensely I could feel things -- enthusiasms, sadness, outrage, delight. How can someone who has been medicated so long even know what that feels like? And how likely is it that if and when they come off the medication, they interpret ordinary ups and downs, which they have not experienced, as indicative of their "illness" and thus necessitating medication again? How can I know what it is like to be an ordinary human being with the usual range of emotions and reactions if I have never experienced them? Might that be like having as a palette for experiencing life all the colors but none of them saturated?
Oh, and anywhere in this, was therapy even considered as an option?