Jagged little pills

Where only first names appear, names have been changed to protect the identities of the sources.

"Zoloft, Effexor, Lorazepam, Wellbutrin, Neurontin..." Tyler, a junior, rattles off the labels of the 15 day-glow orange pill bottles that line the top of his bedroom dresser. "Buspirone, Paxil, Trazodone, Celexa, Zyprexa," he continues. "Those are the main ones."

He threw out the last of his pills at the beginning of 10th grade but kept the empty bottles as a reminder of the two years he spent switching between a long line of prescriptions for depression, anxiety and obsessive-compulsive disorder (OCD).

Tyler belongs to the increasing number of American teenagers who have used prescription psychiatric drugs. According to a 2005 Gallup Youth Survey of 13- to 17-year-olds, nine percent of U.S. teens have been prescribed medication for depression, while four percent have prescriptions for anxiety and 10 percent have prescriptions for attention-deficit hyperactivity disorder (ADHD). These prescriptions can open the door to a better life but at a cost that some Blazers are not willing to pay.

100 mg of happiness

When Alex, a junior, started showing signs of depression in seventh grade, his mother, who suffers from an anxiety disorder, hesitated to seek professional help. Her late sister had been schizophrenic and suicidal, and she feared that her son had inherited the same traits that drove her sister to kill herself.

Last summer, however, Alex's mother started taking Zoloft at her doctor's suggestion. It lessened her anxiety, reduced the frequency of her panic attacks and allowed her to come face-to-face with her son's condition, so she took Alex to get a prescription at the start of the school year.

By November, Alex's perspective on life began to change. Before he started taking Zoloft, he had trouble dealing with people. He would overanalyze their words and actions, have panic attacks and often end up curled up in a ball in a corner, he says. Once he began taking medication, however, his life seemed easier to manage. "I can sort of see that you don't have to worry so much," Alex says. "If you're alive and you're fed and you've got a warm place to sleep, there's no reason to freak out."

After months of battling depression, anorexia and bulimia, Rose, a junior, also found that taking Prozac made life easier to handle: It helped her find a normal fluctuation of moods and a new outlook on life.

Although Rose cannot stand the thought of spending the rest of her life on medication, she plans to stick with her prescriptions for now. Shortly after Rose's psychiatrist put her on Prozac, she grew to resent the unsolicited prescription, so she stopped taking the pills without telling anyone. Off the medication, she felt more aggressive, anxious and depressed. It was, Rose explains, like "being in a constant state of PMS."

Reminded of her life before Prozac, Rose willingly returned to her medication, which has since helped with both her depression and eating disorders. Rose feels that her prescription provides comfort not only to herself but also to her concerned family. "I think I needed the meds. I think they helped me a lot," she explains. "I think they helped my family feel like something was being done."

These benefits, however, came with a price. For Rose and other medicated Blazers, the unwritten side effects of prescription drugs can be more serious than those listed on their warning labels.

"A pretty old-fashioned idea"

After spending two years on medication, Tyler has noticed that psychiatric drugs tend to carry certain social stigmas. "A lot of people still have the misconception that people who take medication are different or crazy," Tyler says. "If you break your leg, no one shies away from you, but if you develop some sort of mental problem, people think that it makes you different."

Sarah, a former Blair student, first felt the sting of stereotypes associated with users of prescription medications in eighth grade, when she told her friends about her depression. Rather than sympathizing, they told her that she was "faking it" in order to get attention. She severed ties with those friends, but the memory of their accusations still lingers.

According to Sheila Sontag, a professor of psychiatry at Georgetown University Hospital, the backlash felt by Sarah and Tyler stems from the ignorant and immature attitude that some people hold towards prescription drugs. "It's a pretty old-fashioned idea that just because someone takes a psychiatric medication that they are `crazy,'" she says. "Hopefully, [the stigma] will lessen over time as awareness and sophistication spread."

Sontag points out that the number of American children and teens who are treated with psychiatric drugs has increased significantly in recent years as more U.S. families gain access to quality medical care and become aware of treatable psychiatric problems like depression and ADHD. According to the annual report prepared for 2004 by Intercontinental Marking Services Health, $10.9 billion worth of antidepressants were sold that year, a 12 percent increase over 2003. In the past 13 years, there have been 250 billion prescriptions of Zoloft alone.

Rose, who takes two ADHD medications in addition to Prozac, believes that prescription drugs are doled out too carelessly. She feels that some parents, doctors and patients view psychiatric drugs like Zoloft and Ritalin as quick, easy fixes for mental problems. "People don't have the right attitude about it," says Rose. "If you expect the meds to fix it, that's not going to work."

When Natalie, a junior, saw a psychiatrist for the first time in sixth grade, it was not of her own free will. Her parents decided she needed to see a doctor, and when her psychiatrist prescribed her medication for ADHD and depression, no one told her what prescriptions she was being given.

In retrospect, Natalie blames puberty for the intense mood swings that her parents mistook for symptoms of depression. Had she been given a say in the matter, she would have turned down the pills.

May cause dizziness

The medications Natalie took in middle school produced a haunting change in her demeanor: They wiped her clean of all feelings. "They made me a rock. I had no emotions whatsoever," Natalie remembers.

Disturbed by this transformation, Natalie stopped taking her pills. Her parents, eventually realizing that her daily pill always ended up in the trash, cancelled her prescription.

Natalie voluntarily began taking psychiatric drugs again last fall when she was prescribed Lexapro for depression and anxiety. Her psychiatrist is still struggling to find the right dosage for her. "If you take too much, then it'll work on depression, but it'll increase your anxiety, and if you take too little, it does nothing for your depression," Natalie says.

Over the four years she has been taking prescription drugs, Sarah has had her own struggles with dosage. She estimates that she spent at least three months of her eighth-grade year bedridden with nausea. The queasiness first resulted from her anxiety, she explains, and later from the combination of Prozac and Wellbutrin that she was prescribed to treat her anxiety. Her psychiatrist put her on Zofran, a nausea medicine given to chemotherapy patients, and she began a long, slow recovery.

Although Tyler's prescriptions made him feel less anxious and gave him better control over his OCD, they were taxing, both physically and emotionally.

Over the two years Tyler spent on medication, he kept a log of the side effects that each of his 10 prescriptions gave him. Heartburn, dry mouth and constipation plagued him through most of the two-year period, he remembers. Some prescriptions would make him ravenously hungry, while others would strip him of his appetite. His energy level would fluctuate depending on which medication he was taking. Some pills, he explains, left him "bouncing off the walls," while others put him to sleep in minutes.

One of the prescriptions Tyler took in middle school left him lacking any attraction to the opposite sex, a disconcerting feeling for him. "It was seventh grade. I was a boy. I was going through puberty," Tyler explains. "It didn't feel quite right to be totally devoid of sexual feeling."

On average, Tyler would spend several weeks on a particular medication, waiting for his body to adjust to it. If the side effects failed to dissipate, as was usually the case, he would ask his doctor for a different prescription. As Tyler bounced from prescription to prescription and found that his experiences on each were usually the same, he began to question the effectiveness of the medications.

Moving past the prescriptions

Tyler remained unshaken by his medications' side effects until one night when, while watching a movie with his family, he lost himself in a mental haze brought on by the prescription he was taking at the time. All the details of the experience — the title and plot of the movie, the name of the pills he was taking, even the month it happened — are "fogged out" in his memory, Tyler explains. For the first time, he felt truly at the mercy of his medication.

The side effects began to raise questions in his mind about his identity. "I didn't like wondering what part of my personality comes from me and what part comes from the medication," he explains.

At the beginning of his freshman year, Tyler gave up all of his prescriptions. He was surprised to discover that his anxiety levels remained the same as they had during the two years he spent switching from prescription to prescription. Although Tyler cannot say for certain what caused his natural drop in anxiety, he is sure of one thing: "I'm lucky," he says. "I'm not completely cured now, but I can manage the anxiety that I do feel."

In the end, Tyler decided his medications' benefits were not worth the years he spent suffering through their side effects. "It's a double-edged sword," Tyler explains. "You have to make a choice between being influenced by medication and trying to live a difficult life."