Karp, D. A. (2006). Is it me or my meds?: Living with antidepressants. Cambridge: Harvard University Press.

Book Content and Style

Is It Me or My Meds?: Living with Antidepressants (2006) by Robert Karp is a dive into the often unseen sociological depths of antidepressant medications and their recipients. A social psychologist doing his own decades-long “awkward dance” with these drugs (p. 7), Karp’s personal and professional experiences inform his perspective that taking an antidepressant is hardly a matter of what works solely at the biomedical level. Rather, using these medications may be considered a journey, a relationship, and a highly personal yet very social process that is far more complex than it appears, even to the professionals who prescribe them. Karp exposes this perspective in a highly compelling, well-synthesized presentation of fifty qualitative interviews with antidepressant users ranging from teenaged to late life. Centering hundreds of direct quotes, Karp expertly conveys how these medications can impact one’s sense of self—whether it is the effect of the drugs or simply the act of taking them.

Impressively, Karp begins by presenting a relatively balanced perspective as it relates to the efficacy of antidepressants. For some patients, as readers discover, they are a lifesaver; for others, they are a nightmare. Ultimately, however, this is not Karp’s message. Regardless of how the drugs actually work for any one person, almost every perspective Karp shares is united by the fact that it underscores what could be perceived as the thesis of his work: the notion that “drug taking is a social event that extends well beyond the pill and the person taking it” (p. 54). In one instance, a young adult on antidepressants shares the anxiety of an intimate partner seeing their medicine cabinet; in another, a teenager laments the powerlessness they feel against their parent who has the last word on whether they’ll take the drug. A chapter dedicated to the concept of authenticity highlights how deeply profound and unclear the question of “Who Am I?” can become for people on antidepressants as they question whether their true selves are in fact enhanced or diminished by the medication’s influence. Karp’s final chapter, informed by his research, is a critique of the current state of affairs in psychiatric medicine and diagnoses, asserting that caution should be taken to avoid the continuance of over-diagnosing and overprescribing for normal problems.

Strengths and Weaknesses

Karp’s work certainly exemplifies the power of firsthand accounts: he showcases the interviewees’ passion, diversity, and insight in a way that quantitative data could not achieve. Readers feel the fear, anguish, or sheer resignation of some subjects towards the impact of antidepressants on their lives; on the other hand, there is the joy and relief that people experience when they discover the right drug and find peace with its place in their medicine cabinet. The balance of viewpoints that Karp presents is impressive. Further, the journey on which Karp takes readers is both personal and professional for him, and this makes his argument all the more compelling. Karp capitalizes on his personal interest in the subject to conduct thorough, often emotional interviews, and then uses his expertise to analyze patterns and present salient, informative data with important sociological context. It is clear that this book is not armchair sociology, but rather the product of competent engagement with the population about whom he writes.

Overall, Karp may lean too hard on the qualitative nature of his data for readers to accurately understand the overall picture. While he does feature a wide variety of voices and ideas, Karp does not present any quantitative data on the percentage of respondents represented by each viewpoint. This makes it unclear to the reader how prominent or rare any one perspective might have been in his interviews; Karp could over- or under-emphasize perspectives of his choosing. Further, Karp very occasionally highlights a problematic patient perspective without sufficient analysis or debrief. For example, in his discussion of dissatisfaction with the patient-doctor hierarchy, Karp quotes an interviewee who abruptly discontinues their medications, is reprimanded by their doctor, and concludes that “[doctors] think we owe them something…and I can do whatever I want” (p. 149). Here, Karp almost glorifies a medically unsafe decision without indicating it as such. While his point about patients feeling controlled is sociologically significant, Karp fails to provide necessary context for readers in this instance.

Impact on Thinking and Contributions to the Field

As a person who aspires to work with youth and families, of particular interest to me was Karp’s chapter called “Teens Talk,” in which the voices of adolescents ages 14 to 19 are featured. The testimonials were eye-opening, demonstrating that in this population, the physiological risks, impact on identity, and power dynamics which already complicate antidepressant use are intensified by developmental stage, cultural context, and family influence. Overall, Is It Me or My Meds? sheds light on the deeply complex nature of taking an antidepressant pill at any age; it is an action which, at face value, may seem so simple. The decision to accept and maintain a life on antidepressants involves so much more than a patient and a doctor, but the factors that contribute to patients’ attitudes and adherence are vast and often invisible to a prescriber. The sociological perspective on this issue has critical implications for people in any discipline who work professionally with individuals either considering or taking psychotropic medications. Karp demonstrates with qualitative evidence that one’s relationship with psychotropic medications can impact identity in a way that medications prescribed for physical illnesses typically do not. His work goes to show that effective and responsible practice with this client population necessitates empathy, creativity, and open-mindedness from professionals as we listen, learn, and collaborate to problem-solve around these critical issues.

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