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Popping Pills: Mental Illness Medications in YA and Why They Matter

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About a year ago, I was in the hospital.

I remember hoping I’d be out by the 4th of July so my family could celebrate the holiday at home, instead of staying in some cramped hotel room near the psych ward so they could visit me. Through group therapy and visits with the ward’s psychiatrist, I was on best behavior. (I was, in fact, out by the 4th.) I remember the overwhelming guilt and shame I felt at ending up in the hospital in the first place. If I’d been strong, I wouldn’t have needed help. If I’d been strong, I could have made the horrible thoughts of hurting myself, and hurting others, go away. If I’d been strong, I wouldn’t have needed the medications that the nurses handed me with little Dixie cups full of water twice daily. If I’d been strong.

My bipolar I disorder, and my obsessive-compulsive disorder: before my fateful two-hour drive to the emergency room in the closest big city with a psych ward, I believed these things were weaknesses to be eliminated by sheer force of will. Pills were for pussies, I told myself. Which was why, prior to the hospital stay, I had slowly been reducing my dose of Risperdal, the primary medication that managed my terrifying manic highs, without telling anyone, until I was hardly taking anything at all. The two or three months I managed to get by on the reduced dose were enough to convince me: My psychiatrist is lying. I don’t need medication. I’m fine. I can beat this. Until, of course, I couldn’t.

It’s taken me months to get my medications stabilized, but it’s happened, and I’m happier and healthier now than I’ve been since I was fifteen years old. But, looking back, I can’t help but wish that I’d been able to come to terms with the “weakness” of taking the medication I need to be well sooner. And it’s hard not to lay some of the blame for my attitudes at the feet of the books I love.

Minor spoilers for Revolution by Jennifer Donnelly, Bleeding Violet by Dia Reeves, and Silver Linings Playbook to follow.

Though there are countless others, two of my favorite YA novels, in particular—Revolution by Jennifer Donnelly and Bleeding Violet by Dia Reeves—are unfortunately guilty of the same mental illness trope: that someone is “just not themselves” on medication, that they feel like they’re swimming through syrup, or that they are somehow buying into the “system.” In both cases, the protagonists—one severely depressed and one schizophrenic, respectively—end up tossing out their pills as part of their character arc, liberating themselves from the negative effects of their mental illness in the process.

Contrast this with the movie Silver Linings Playbook, in which Pat, the bipolar protagonist, initially makes similar arguments—that he’s bloated and dull on medication—but by the end of the movie, reaches health and happiness by taking medication and making life changes. Why can’t we see more of this in YA?

It’s frustrating to see mental illness treated as just one more way to stick it to the establishment, instead of as the very real spectrum of disorders that it is. Attitudes can’t change until writers with mental illness make their voices heard, and write their own stories. When we do, it will change lives.



About Author

Maggie Tiede is a teenaged writer and book blogger out to change the world, one word at a time. She was diagnosed with bipolar I and obsessive-compulsive disorder when she was seventeen. She lives in northern Minnesota, United States, North America, Planet Earth, where she is currently at work on a novel; and probably would like to be your friend.

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25 Comments

  1. You make a really good point about medication. In my manuscript, part of my main character’s journey to remission of her clinical depression is her medication. For her, it’s an essential part of her improvement. It’s important for teens to see that sometimes meds are necessary, and they’re not shameful.

  2. Great post! I agree with you completely. It’s total BS and really irresponsible to romanticize the idea that someone with a mental illness can get better by freeing themselves of medications. And I HATE the stereotype that meds change your personality or ruin every waking moment. Having been saved several times throughout my life by anti-depressants and anti-anxiety meds, I really believe there should be more realistic portrayals of treatment for mental illness in YA. Thanks for writing about this.

    • Meds certainly aren’t all shiny and rosy–I’ve struggled with weight gain and extreme fatigue, etc.–but along with therapy, they play such an essential role in getting better, and it’s just not represented at all. I hope that changes in the future!

  3. Pingback: Magnets, Marines, Melancholy, Music and Medication: Mental Health Monday | A Way With Words

  4. Amen!

    Having my struggles with depression and anxiety disorder in real life, I hate being told that there’s something wrong with needing medications. It’s not helpful, and it’s not realistic.

    I fear that some people have bought into this notion and sell it from a position of profound ignorance, heedless of the damage it can do.

  5. Well said! It’s not just in YA books, either. It’s in TV shows, movies, etc, including those made for adults. It’s one of my “pet peeves.” Having experienced not only being happier, but feeling so much more ME on my meds, it irks me a lot when it’s bungled so badly in pop culture.

    • I didn’t mean to imply that it exists solely in YA, but on the whole I’ve seen more diverse portrayals of mental illness in adult media, bad with the good. I think it’s because the teen experience with mental illness tends to be very different–more stigmatized by peers, especially. I hope we’ll see more acceptance within the coming years, and better portrayals in pop culture are definitely a part of that.

  6. I second what Lisa says — it’s everywhere. It drives me batty. I think there are good points to be made about what meds can take away from mentally ill people, but what you say is exactly how I feel — it’s a spectrum, and experiences of mental illness and of taking medication vary so so widely. I’m tired of simplistic depictions of the question of meds one way or the other. It’s frequently a hard decision to take meds (though I am glad I have mine), and it’s frequently a hard decision to not take meds. It would be great if it were a simple decision but it’s often not.

    • Oh, certainly. It’s definitely a struggle for me to take my meds–when we were still getting the dosage right, they DID make me groggy and I’m still struggling with weight control and appetite. I don’t want the pendulum to swing the other way and portray meds as the only solution, either, which I think is your point. It would just be nice to see an end to their demonization in pop culture.

      • I agree. Meds can be a struggle – I’ve been on meds for almost 10 years now, and I’ve lost track of how many I’ve taken, because there have been so many that I quit because of the side effects. I’d just like to see some acknowledgment that people should SEEK HELP if they’re experiencing symptoms of mental illness, and that medication is one way of treating mental illness.

  7. It is amazing to me that we are taught to believe that if we love ourselves, live better lives, just be strong, people with mental illnesses will get better. Would the same be thought about insulin for someone with diabetes? Why the double standard when ultimately medication is being used to compensate for a body that isn’t working at a 100%.

    • Exactly! I love the diabetes-insulin comparison for mental illness medications. It very aptly describes my relationship with my medications–if my levels aren’t at a certain point, it’s not healthy and even dangerous for me, as simple as that.

  8. Thank you.
    I lost my brother 4 years ago because only a pussy would take meds. Soldiers don’t take meds. .. I’ve heard it all. I have no issue taking mine – I wouldn’t be here if I didn’t, but so many members of my family fight it – I don’t get it. And now I have a son with serious OCD – he’s disfigured due to his anxiety, and my daughter is Bi-Polar, a cutter, and it’s a battle to get her to take the meds. She misses her high highs. I wish they could feel how much I miss THEM when they aren’t taking them, and how scared I am of losing another one….. Your age, your experience – people need to hear it. LOUDLY, and frequently.

    • I’m so sorry to hear that your firsthand experience with this issue has been so hard. Being mentally ill is a struggle, sometimes every minute of every day, but with treatment it DOES get better. I can attest to that. I’m sending positive thoughts to you and yours!

  9. I feel cautious when I read posts like this, because sometimes, what was true in your case is true . And sometimes, it isn’t.

    Going off of my medications was one of the best decisions I’ve made. I wasn’t misdiagnoised; what happened was that my psychiatrists *did* lie to me. They downplayed side effects and lied about the necessity of my medications; they bullied me into taking them when I didn’t want to; and they prescribed new medications to handle the old when the old put me into the emergency room, despite the fact that the old wasn’t even stopping my symptoms.

    You say that you’re sick of hearing about meds making people feel like they’re swimming through syrup — but that was what medication was like for me. I won’t go through the list of side effects, but I will say that it was not worth it for me. I am genuinely disabled, and my mental illness is not “rebellion” or cool. Being off of medication means that I have to make different choices sometimes. I have to manage my illness. But I do not have to be on medication, and I would definitely urge caution for anyone considering going on it. For some people, it saves lives. For other people, it ends them. I know someone who tried to kill herself because of a med adjustment she was pressured into. She’s okay now, thankfully, but she might not have been.

    It is true that the narrative of faulty meds is the most common, and some of that is because of abled people making assumptions and romanticizing mental illness. Some of it is also because a lot of mental illness medications are not empirically tested, are prescribed by doctors who don’t understand what they are supposed to be used for, and are forced on patients without meaningful consent

    • You raise an excellent point, which is that meds aren’t perfect, either. There’s no foolproof way to treat mental illness, and I agree that there are many troubling cases of unethical or simply uninformed psychiatrists and doctors, as well as opportunistic pharmaceutical companies. All I’m asking for is recognition from pop culture that meds can save lives, too.

      I struggled for a long time with getting the dosages right on my meds, which almost confirmed all my worst fears about taking them. There were days I would sleep for 20+ hours, days I wouldn’t sleep at all, days I wouldn’t eat anything, days I would binge-eat. I felt clumsy all the time, and worst of all, I couldn’t think straight. Luckily, I had a psychiatrist who worked with me to resolve these issues, because unfortunately, I don’t have the option of being without meds–I’ve discovered the hard way that my life is literally in danger without them, even with extensive therapy.

      It’s important to accurately depict all sides of the mental illness experience, good and bad. I certainly don’t want to silence the voices of those who have had a less than wonderful experience with medication.

  10. There is always a trial and error period with medications. Different people with the same illness can react very differently to the same medication. My husband has bipolar and it took him years to be okay with his meds, both physically and psychologically, because it took his doctors years to find the right combination. But even though he realizes now that taking the meds is the better option, he still doesn’t like the things that the meds have taken away from him. He is tired all the time. He has trouble focusing. He has lost his creativity. It’s better than vacillating between violent mania and suicidal depression, though.

    Everyone is different. Some people just can’t get through that trial and error phase with their medications. It’s extremely difficult, especially early on when you aren’t stable. I understand why so many people have such a negative reaction to taking meds. And I would never assume that taking medication is *always* the best option for *everyone.* But at the same time I agree that we need to see the other side of the coin in our literature, not just “bad bad bad, get those filthy pills away from me.” It shouldn’t be one-sided. Thank you so much for this post and for putting the spotlight on an area that could use improvement in YA lit.

    • Medication certainly isn’t always the best option for everyone–looking back at my post, I wish I’d included more about therapy, which has been equally important in regaining my mental health. My trial and error phase with my medication lasted about a year, and it was extremely difficult to have all the nasty side effects of the medication–sleepiness, weight gain, etc.–and few of the benefits. But as you say, in the end, it’s better than the constant switch between mania and depression, and accurate portrayals of that side of the experience are what I’m looking for. I’m glad to hear that your husband has found a good mix of medication and is doing well–it’s a rough road for anybody.

  11. Jasmine Baggenstos on

    I think I’ve only read or watched things portraying this idea a handful of times, but I grew up with the idea at my church. I mean everyone always said “God sometimes uses doctors to do his work” but it was always viewed more as a last resort. I think that way of thinking combined with my lack of education about mental illness when I was younger led me to believe I couldn’t possibly be depressed. I just always thought that since I had a fairly happy home life and wasn’t bullied or anything I just didn’t have it bad enough to feel that way. Thus, I didn’t get on medications until about two years ago when I likely should have been on them for about 5 years before that.
    I think there should definitely be more YA books that deal with mental illness in a positive and informative way. I feel like it’s something that still gets swept under the rug for the most part so teens don’t always get the information they need to feel that they aren’t alone.

  12. Thank you for this. I have a degree in psychology and sometimes teach it and you’ve expressed perfectly why this misconception is dangerous.

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  14. Pingback: Medication, Depression, and I Was Here — @TLT16 Teen Librarian Toolbox

  15. Oh, agreed, agreed, agreed. Antidepressants have been a lifesaver for me. Of course, on the other hand, you get people like my brother, who go through tons of versions of antidepressants and never get the right result. I mean, maybe he’s kind of doing good on the newest one. But it’s complicated and it shouldn’t just be glossed over with the “throw it away, yay I’m just better now!” thing.