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.  

The first question, which is alluded to but is not the topic of the book, is how does having a mental illness and all that entails, color the child’s life, relationships, self-attitude, and future?  I don’t believe the two questions – how does medicine change you, versus how does mental illness change you –c an ever fully be separated, and in all fairness, the author didn’t actually try to separate them, she simply emphasized the medication aspect and all the unknowns that go along with that.

My second issue with the book is a bigger gripe, one I’m not giving a pass to.  There are many references to how medications are prescribed – quickly and sometimes thoughtlessly – and the role of psychotherapy – mostly cognitive-behavioral therapy – in the treatment of mental disorders. The author talks about the “15-minute medication check” and how psychiatry doesn’t allow the time for doctors to get to know their patients in the full context of their lives, much less allow time for the patients to discuss how they feel about their medications.  Ah, psychiatry is reduced to a symptom checklist followed by medication adjustments.

And while this may be how psychiatry is practiced by some doctors or in some settings, it’s not how everyone practices, and there are certainly child psychiatrists who see patients for psychotherapy, or who see patients for 50-minute sessions to monitor medications, even if formal psychotherapy is not being done. The author does not mention, except as an afterthought at the very end of the book, the option of seeing a psychiatrist for more than a rushed visit.    

I’ll let the young people’s histories speak for themselves; they did not all turn out as I would have expected and the reader will enjoy following their stories.

The book is thoughtfully written, a wonderful presentation of the full range of the issues everyone should be thinking about when prescribing psychotropics to children and teens, and Kaitlin Bell Barnett does a commendable job of communicating her masterful understanding of a complex topic.

—Dinah Miller, M.D.

If you would like to comment on this article here, please register with CLINICAL PSYCHIATRY NEWS. If you are already registered, please log in to comment.

If you’d like to see Kaitlin Bell Barnett talk about her book, her video is posted on Shrink Rap here (taken from the Kickstarter site).

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, recently released by Johns Hopkins University Press.

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.  

The first question, which is alluded to but is not the topic of the book, is how does having a mental illness and all that entails, color the child’s life, relationships, self-attitude, and future?  I don’t believe the two questions – how does medicine change you, versus how does mental illness change you –c an ever fully be separated, and in all fairness, the author didn’t actually try to separate them, she simply emphasized the medication aspect and all the unknowns that go along with that.

My second issue with the book is a bigger gripe, one I’m not giving a pass to.  There are many references to how medications are prescribed – quickly and sometimes thoughtlessly – and the role of psychotherapy – mostly cognitive-behavioral therapy – in the treatment of mental disorders. The author talks about the “15-minute medication check” and how psychiatry doesn’t allow the time for doctors to get to know their patients in the full context of their lives, much less allow time for the patients to discuss how they feel about their medications.  Ah, psychiatry is reduced to a symptom checklist followed by medication adjustments.

And while this may be how psychiatry is practiced by some doctors or in some settings, it’s not how everyone practices, and there are certainly child psychiatrists who see patients for psychotherapy, or who see patients for 50-minute sessions to monitor medications, even if formal psychotherapy is not being done. The author does not mention, except as an afterthought at the very end of the book, the option of seeing a psychiatrist for more than a rushed visit.    

I’ll let the young people’s histories speak for themselves; they did not all turn out as I would have expected and the reader will enjoy following their stories.

The book is thoughtfully written, a wonderful presentation of the full range of the issues everyone should be thinking about when prescribing psychotropics to children and teens, and Kaitlin Bell Barnett does a commendable job of communicating her masterful understanding of a complex topic.

—Dinah Miller, M.D.

If you would like to comment on this article here, please register with CLINICAL PSYCHIATRY NEWS. If you are already registered, please log in to comment.

If you’d like to see Kaitlin Bell Barnett talk about her book, her video is posted on Shrink Rap here (taken from the Kickstarter site).

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, recently released by Johns Hopkins University Press.

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.  

The first question, which is alluded to but is not the topic of the book, is how does having a mental illness and all that entails, color the child’s life, relationships, self-attitude, and future?  I don’t believe the two questions – how does medicine change you, versus how does mental illness change you –c an ever fully be separated, and in all fairness, the author didn’t actually try to separate them, she simply emphasized the medication aspect and all the unknowns that go along with that.

My second issue with the book is a bigger gripe, one I’m not giving a pass to.  There are many references to how medications are prescribed – quickly and sometimes thoughtlessly – and the role of psychotherapy – mostly cognitive-behavioral therapy – in the treatment of mental disorders. The author talks about the “15-minute medication check” and how psychiatry doesn’t allow the time for doctors to get to know their patients in the full context of their lives, much less allow time for the patients to discuss how they feel about their medications.  Ah, psychiatry is reduced to a symptom checklist followed by medication adjustments.

And while this may be how psychiatry is practiced by some doctors or in some settings, it’s not how everyone practices, and there are certainly child psychiatrists who see patients for psychotherapy, or who see patients for 50-minute sessions to monitor medications, even if formal psychotherapy is not being done. The author does not mention, except as an afterthought at the very end of the book, the option of seeing a psychiatrist for more than a rushed visit.    

I’ll let the young people’s histories speak for themselves; they did not all turn out as I would have expected and the reader will enjoy following their stories.

The book is thoughtfully written, a wonderful presentation of the full range of the issues everyone should be thinking about when prescribing psychotropics to children and teens, and Kaitlin Bell Barnett does a commendable job of communicating her masterful understanding of a complex topic.

—Dinah Miller, M.D.

If you would like to comment on this article here, please register with CLINICAL PSYCHIATRY NEWS. If you are already registered, please log in to comment.

If you’d like to see Kaitlin Bell Barnett talk about her book, her video is posted on Shrink Rap here (taken from the Kickstarter site).

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, recently released by Johns Hopkins University Press.