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When the Kids Grow Up: A Book Review


 

Kaitlin Bell Barnett’s first book, Dosed: The Medication Generation Grows Up is a series of case studies of young people who have been taking psychotropic medications since childhood or adolescence. It’s also a look at how being on medication has affected them – not just in terms of how it treated their illnesses or modified their symptoms – but also in terms of how it altered their perceptions of themselves, their personal growth, their relationships with others, and their ability to feel confident about their standing in the world.

I’d first heard about the book from the author’s Kickstarter campaign to raise funds, and before the book was published, I’d e-mailed the author and knew she had spent dozens of hours with each of her interview subjects, and she assured me that this wouldn’t be an anti-psychiatry tirade, but rather an honest look at how this “first generation” of medicated young adults saw themselves.

I knew just a little about the author from her website and a posted video: She is young, attractive, articulate, and motivated enough to be writing a book on a complex subject. She holds degrees from Dartmouth and Columbia, and she’s been on antidepressants for a decade.

My first thought – and this is admittedly a bit shallow because I know nothing of her suffering or what dark places she may have been – was that the author didn’t seem any worse for the wear because of her own experiences with psychotropics.

I expected the book to be more narrowly focused on the emotional lives of the young people whose stories are told, and oddly enough, I was hoping the manuscript would yield some definitive answers! A bit naive a wish for an experienced psychiatrist, but I can hope for such things, right?

Ms. Barnett tells the stories of five young people who have been treated with medications for the long haul, and she intersperses her own experiences into the narrative. None of the patients suffered from severe psychotic disorders, and she recreates their stories from their own perspectives, as well as from information she has gotten from family members. The narratives, however, are not the meat of the book – the author uses them as springboards to lead into discussions of all the issues that come up around the use of medications in children.

She does an impressive job of going into depth on every issue one might consider when prescribing medications to children – including metabolic concerns, black box warnings, what factors improve compliance, and how the foster care system uses these treatments, to name just a few.

And while I mentioned that the emotional lives of the patients aren’t the entire focus of the book, she does a good job of exploring how being on medicine influences how these patients attribute the events in their lives – where their responsibility for their feelings and behaviors may interplay with facets of illness and medication. She presents their stories with balance, some occasional healthy skepticism, and she skips the sensationalist tone that journalists usually take when talking about children and psychiatric medications.

Usually, when I read a psychiatry book that is written by someone other than a psychiatrist, no matter how good the book is, at some point, I have the sense that there are aspects of illness or treatment that the author just doesn’t fully understand; there may be something that is portrayed with simplicity or the use of borrowed terms. This book was the exception: Kaitlin Bell Barnett “gets it” and she fully understands the issues she discusses about child and adolescent psychiatry. Had there been an “M.D.” after her name, I would have read this book believing she was a child psychiatrist. Her level of sophistication and her comfort with psychiatric jargon was such that I wondered if the lay reader – a teenager or a parent considering medication for their child – would fully understand. For the nuanced reader, however, and certainly for everyone prescribing to children, this book is a tremendous contribution.

I had two criticisms of the book that I want to expand on from my own experience. The author talks in detail about how taking medications influences children’s views of themselves and their experience of the world, and how people are often secretive and alone in this endeavor. There were moments when I felt like she was talking about the issues related to medication in a vacuum, but the children she portrays are not playing on a level field with children who don’t have psychiatric problems. They start out with tangible suffering, described quite poignantly, and the question of how medications influence the young person’s worldview is a difficult one.

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