Part II of a series of reports on the Michelle Carter story. Updated on August 16. Part I can be found here, and Parts III and IV here and here.
While Michelle Carter and her family worked their way through the crowd and the bristling hedge of TV cameras outside the Massachusetts courthouse on the way to Michelle’s sentencing, the atmosphere inside and outside the courtroom was tense. The same judge had previously convicted her of manslaughter-by-texting in the suicide of her boyfriend, Conrad Roy.
For more than two hours, I had been sitting in front of a camera in a studio in Ithaca, New York, being a pundit in a box. I was waiting to hear in my earpiece that the camera in front of me was now turned on and my mike would go live in a few seconds.
I would spend most of this third day of August from 12 noon to 8 pm listening to and responding to television coverage of Michelle Carter’s sentencing by the judge. The best news was that my wife Ginger was in the engineering room, helping me keep on track with what was important.
Surrounded by Outrage
The word came in my earpiece that I would be live in seconds, and I straightened my posture and focused my eyes on the camera. I prepared once again to talk about the real Michelle Carter, a warm and caring youngster largely at the mercy of forces beyond her understanding or control. Then the control room in Atlanta shut down my camera again.
The coverage shifted to an incident outside the courthouse. As Michelle passed through the crowd looking fearful and frail, someone shouted at her, “Kill yourself!” The channel replayed it to make sure we all heard the words. For the TV producers and commentators, it was great theater.
I felt immersed in an alternative reality dominated by anger, revenge, and hatred toward Michelle, playing out for millions watching Headline News (HLN), owned by CNN. This condemnation, sometimes subtle and sometimes not, was being directed at Michelle by most of the TV network’s commentators; by the bystanders selected for filming; by interviews with the deceased young man’s enraged family members; by the fuming prosecuting attorneys selected for the show; and even by some of the mental health “experts.”
The Larger Picture
After spending a day listening to HLN’s media coverage—with a few breaks to look at CNN, the Fox News Channel, and other media—I began to realize that TV coverage of Michelle’s story and legal case was one more media diversion to keep Americans from focusing on what really troubles our country and the world today. In this instance, the story to avoid at all costs was the epidemic drugging of our children and youth, and how we have handed them over to the drug companies and their medical minions. Instead, hate and blame the victim, and distract us from the stranglehold that the Pharmaceutical Empire has upon psychiatry, medicine, insurance companies, the media, the Congress, the educational system and virtually our entire culture.
ABC TV’s 20/20 devoted an hour to the Michelle Carter story on August 4th, 2017, the day after her sentencing, and did provide glimpses of the hidden realities. Based on filming me for more than 90 minutes in their New York studio, my interview probably had an influence in shaping the story in a more balanced fashion. In several short clips in the final production, they gave me the opportunity to make my most important summary observations: that Michelle tried for two years to save Conrad until she broke down under the influence of his abusive threats to kill himself and the involuntary intoxication caused by a recent change in her medication.
Michelle Experiences Traumatic Losses
Michelle’s story in infinite variations is daily lived by millions of children in America and elsewhere around the world, especially in the industrialized world.
As far as anyone can tell, she was doing well up to age fourteen as a good student, a star athlete, and a girl who was liked and often loved by the people who knew her. She had not a hint of any antisocial qualities.
Then in September of 2010, one month after turning 14 and entering the 8th grade, Michelle endured a double trauma. Her much-loved maternal grandparents, who lived nearby as active members of her family, died unexpectedly in quick succession. First, her maternal grandfather died unexpectedly of a heart attack, and then, within a few weeks, her grandmother died without warning of a stroke. These traumatic losses would be enough to temporarily overwhelm any child and Michelle went through the normal process of grieving—except that it was officially diagnosed as anxiety and depression, instead of a healthy and necessary grieving process.
One month after the death of her grandparents, Michelle’s strong, athletic young body had dropped an estimated 20-30 pounds. She now weighed 85 pounds, in the bottom 2% for her age group and height.
Michelle’s gastroenterology consults described Michelle as “emaciated” from self-restricted eating, and she was diagnosed with anorexia, anxiety and depression. Her liver functions were abnormal, and would remain so for years. Her electrocardiogram showed abnormalities that would clear up. Her cardiovascular system was so unstable that she developed orthostatic hypotension—that is, her blood pressure dropped precipitously when she stood up. She was a very emotionally distressed and physically ill child.
What Michelle and Her Family Really Needed
Michelle needed an experienced family therapist who would have quickly brought the whole Carter family together to help them deal with their grief. Michelle’s younger sister had also lost her grandparents and Michelle’s mother had of course lost both her parents. The two children especially needed help in expressing their inevitable fear and anxiety over death itself. In family counseling, all four family members could have worked together to increase their loving communication and process their shared emotions of grief.
Instead of focusing on Michelle as the patient, a family therapist would have emphasized helping Michelle’s parents, because they are the leaders of the family. In my experience, by helping the parents, the therapist’s need to see the children often declines. The parents, with their new understanding and better communication skills, become able to help the entire family heal. In Michelle’s case, where she was communicating almost exclusively with her peers through social media, a great breakthrough would have involved shifting more of her communications toward her parents and sister.
Giving Michelle antidepressants instead stifled her ability and motivation to grieve. One of the most common effects of the antidepressants is the suppression of emotion while imposing apathy and indifference upon the individual. The drugs thereby impede bonding with the family and grieving. After withdrawing from antidepressants, many patients realize that they went through momentous events, such as their children’s graduations or their parents’ deaths, “without feeling anything.” (For studies of antidepressant apathy, see part four of the scientific papers on my antidepressant resource center.)
Starting Michelle on Prozac
Instead of treating her as member of a shocked and grieving family, Michelle was treated as if she had a mental illness. On February 17th, 2011, her primary care doctor started her on Prozac to increase her weight and perhaps to treat her “depression.” Within one week, her doctor doubled her dose to 20 mg.
Twenty milligrams is a common adult dose of Prozac. For Michelle, in her frail condition, it became a mammoth dose. Her cardiovascular system was unstable. She was in the bottom 2% in weight. To add to this vulnerable state, her liver malfunction was likely to reduce her ability to metabolize or break down the Prozac, leading to an even higher level in her bloodstream than anticipated. Her impaired cardiovascular system put her at risk for a drug-induced arrhythmia and death.
Then on April 5th, 2011, without explanation, Michelle’s primary care doctor raised her dose of Prozac to 30 mg. This dose, above average for an adult, was a prescription for tragedy for Michelle.
Within a week of the raising of the dose, the doctor exclaimed in the record, “Weight gain!” Michelle was three pounds heavier and her BMI was now 3%.
At the time, Prozac was already approved for depression in children, but it would never be approved for eating disorders in children. The immediate impact of SSRIs usually causes weight loss, a fact that misguided doctors have used in pushing it on women who want to lose weight while also trying to overcome depression.
Unfortunately, the longer-term effect of antidepressants like Prozac, Celexa and Lexapro is often weight gain, and for a child who is desperately phobic about fat, that feels like a calamity. Michelle’s weight gain on SSRI antidepressants would contribute to her growing despair over the next three years. As she lost control of her weight, she became bulimic, pursuing extreme running as a way to keep herself from ballooning in weight.
What Did We Know How About the Harms of Antidepressants in 2011?
By 2011, anyone who read the scientific literature, much of it from leading American medical centers, would have known that children cannot tolerate SSRIs and should not be given them. The following scientific report, as well as many other confirmatory studies, can be obtained without cost from my website www.123antidepressants.com.
A team led by Riddle from the Yale Child Study Center, affiliated with the Yale Medical School, found that 50% of 24 children, ages 8 to 16 years, developed serious behavioral abnormalities when treated with Prozac. Eleven children (45%) developed “motor restlessness,” which is usually a sign of akathisia, a disorder known to cause a worsening of a child or adult’s condition, sometimes leading to psychosis, violence or suicide.
Six of the children and teens developed “social disinhibition,” which can also cause dangerous behaviors, such as those Michelle would later display toward the end of Conrad’s life. Three developed “a subjective sensation of excitation,” which is the beginning of mania, with all its hazards, including its often disastrous feelings of grandiosity and omnipotence, which Michelle would also express in Conrad’s last days in a way that sounded very nasty.
As if further warning of Michelle’s future, the authors conclude:
Clinicians treating children with fluoxetine [Prozac] are cautioned to be aware of behavioral side effects… These side effects may be difficult to differentiate from common psychopathological symptoms such as hyperactivity, restlessness, and impulsivity.
Drug-induced “impulsivity,” along with “social disinhibition,” and other manic-like drug-induced symptoms, would eventually take over Michelle’s life.
Reactions to Prozac and to all other newer antidepressants can destroy lives. Drawing on my clinical and forensic experience, I have described many such cases in my book Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime.
Borrowing in part from one of my scientific papers, in 2004 and 2005 the FDA modified the Full Prescribing Information for all antidepressants including Prozac. From then on, every antidepressant Full Prescribing Information would have multiple references to an activation or stimulation continuum of adverse effects similar to methamphetamine and cocaine:
All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for Major Depressive Disorder as well as for other indications, both psychiatric and nonpsychiatric. Section 5.1 (bold in original)
A significant percentage of hospital admissions are caused by antidepressant-induced psychosis and mania. As the excerpt from the FDA-approved Full Prescribing Information confirms, they are often accompanied by drastic changes toward antisocial aggressive behaviors including “irritability, hostility, aggressiveness, impulsivity” and manic-like symptoms such as grandiosity, all of which Michelle would display for a brief and tragic ten-day period before Conrad’s suicide.
Michelle’s Reaction to the First Round of Prozac
Michelle’s prescriber only recognized “headache” as an adverse reaction after raising Michelle’s dose to what was for her a mammoth dose of 30 mg. Michelle’s texting with her friends shows the first known development of problematic behavior. Although attracted to boys, Michelle developed a girl crush, and compulsively pursued her friendship until the girl’s mother intervened. The loss of that relationship would add to her earlier losses, and add to her grief throughout the next few years.
For Michelle, her relationships were always about deep emotional attachments. She wanted to help people and she sought help from them. She wanted to love people and she sought love from them. With boys or girls, youngsters or adults, the goals were always the same, love and mutual help; and people responded very warmly and appreciatively to her.
These passionate but platonic feelings were openly shared in hundreds of texts among Michelle and her friends who held each other in deep affection. Michelle’s potentially hazardous focus on helping and being helped became more desperate and obsessive under the influence of antidepressants and Conrad’s relentless abuse of her.
Because Michelle felt she was doing well for a time, her primary care doctor weaned her off Prozac, ending the taper in early October of 2011. Michelle was off Prozac when she met Conrad for the first time in February of 2012. She was now fifteen years old.
Restarting Prozac Seven Months Later
On May 3rd, 2012, her primary noted in Michelle’s chart: “Returned mom’s call—Mom concerned Michelle overeating—can stop herself from eating then exercises compulsively. Michelle now asking for help, but does not want to return to [other] office as is worried that office staff will view her as a ‘failure.’”
At the time, Michelle’s mother estimated her daughter’s weight at 100 pounds, which was about 25 pounds underweight. Her previous prescriber referred her to a new doctor in the same group at another location.
The new primary, who would remain with Michelle through Conrad’s death, quickly accepted Michelle’s request to restart Prozac. In a very rapid escalation of fourteen days, the primary raised Michelle’s dose from 10 to 30 mg, simply because Michelle had been taking 30 mg in the past.
Michelle and Conrad Have Limited Contact Leading up to his Suicide Attempt
Michelle and Conrad met through their families on a vacation to Florida in February of 2012 when she was fifteen and he was sixteen. The first communications between Michelle and Conrad made available to me are direct message exchanges on Facebook that began a few months after their initial meeting on July 17th, 2012.
They met again in August of 2012 at the Carter home. Their last two meetings were in their hometowns in Massachusetts in the summer of 2013, and they did not see each other again at any time during the year before Conrad’s death.
Their available communications from July 17th, 2012 through September 5th, 2012 seem childlike and playful, often consisting of only one to three words. At one point, Conrad writes, “love ya” and a few lines later Michelle amplifies, “it’s perfect. I love you so much.”
On October 10th, 2012, Conrad began another direct message exchange on Facebook in which he told Michelle that he had recently left a hospital following a serious suicide attempt. Michelle, who had no suspicions that he was emotionally upset, was shocked.
In 2011, Conrad seriously overdosed on Tylenol in the first of four or more attempts (my testimony & Public Records 3, 29, & 51). I testified that changes in Conrad’s antidepressant medications aggravated his suicidality and his mother agreed that his parent’s divorce “hurt him deeply” (Public Record 23). There were also allegations that Conrad was physically abused by his father and verbally abused by his grandfather and uncle (my testimony, police testimony, and Public Records 34, 49 & 50).
Conrad’s first serious suicide paralleled his completed suicide by involving a girl (Public Record 51). Conrad’s father explained to the police, “the first time Conrad attempted suicide he was talking to a girl that he had met in a group and she called the police right away, and she saved his life . . .” (Public Record 2).
For the next two years, Conrad repeatedly threatened to kill himself while texting Michelle. For ten days in July 2014, these threats combined with her antidepressant broke her down mentally, and she agreed to support his goal of dying quickly and easily to go to heaven.
Conrad’s Tragic Transformation
During this October 10th exchange on Facebook, Conrad no longer displays the innocence and relative sensitivity of his earlier drug-free communications with Michelle. Instead, he goes on for a day tormenting her with repeated threats that he plans to kill himself that night. Terrified, she begs him not to do it. He insists, “no, I’m going to,” and then explains “just letting you know the voice in my head told me to.” He calls himself a “freak” and says he will carry out his plans.
Conrad continues to torture Michelle with descriptions of his various methods of suicide, insisting, “I’m going to try my best to and not fail like last time.” He repeats his intentions that he will do it “tonight.” She tells him, “You’re scaring me” and reiterates how much she loves him and wants to help.
Michelle becomes frantic and calls a friend and a relative of Conrad in his home town, which is an hour’s drive away. Meanwhile, not yet quite 16 and on 30 mg of Prozac, Michelle remains unsure what else to do until she hears back.
Michelle, whose main goal in life is to love and to help people, is now caught up in a desperate situation. She believes that she loves Conrad and he has her convinced that only she can save him. This desperate pattern will continue for almost two years.
Their messaging is broken off for five hours until after 9 pm that night when Michelle sends a single unanswered message, “Conrad please answer me right now please.”
The next communication provided to me is dated six weeks later. At that time, on November 19th, 2012, Conrad continues with what will become periodic descents into bizarre, dark communications. He talks about, “I want your blood” and “I want it mixed with your saliva and mixed with my blood.” Michelle gets drawn into what she describes in the messages as this “disgusting” talk.
Devil Nightmares and Hallucinations
After midnight on November 24th, 2012, still on 30 mg of Prozac, Michelle sends a direct message to Conrad on Facebook that, for the first time, she is having terrible nightmares about the devil that make her avoid going to sleep.
In his communications with Michelle, Conrad shows gross indifference toward her feelings, probably caused or aggravated by the emotionally blunting drug effects. When Michelle brings up the disturbing nightmares, Conrad crudely jokes about himself raping her in her dreams.
She replies, “I try to kill myself in them [the nightmares]” and then elaborates, “actually the Devil tries to kill me haha.” She then describes how a girlfriend slept over and helped her with the nightmares.
The next night, she again brings up her nightmares. “I’m going to Hell though. The Devil told me. I swear… I’m not kidding. I’m being serious.”
Conrad asks, “He told you?” and she replies, “Yup.”
Then he turns the attention back to himself: “I saw the devil already.”
Michelle replies, “Me, too, and how did you?”
Conrad answers, “He was at the hospital one night staring at me. And he told me to kill them all.”
There is no discussion of his “kill them all” command hallucination. Instead, Michelle asks, “Are you serious?”
Conrad says, “Dead serious.”
Michelle once again becomes the sympathetic helper. “I’m so sorry baby!”
Conrad describes his sighting of the Devil: “He was red and had a black cape.”
Michelle tells him not to listen to the Devil. “I learned to fight him and yeah I know I’ve seen him too. I see him a lot actually.”
She elaborates that all this takes place in her sleep “but to me it seems like real life.”
Conrad says, “I saw real life.”
Michelle continues, “and I thought I saw him in my bed one night but I think it was an hallucination. I don’t know.”
Conrad replies, “I blinked and he disappeared” and she replies, “Yeah, that happened to me.”
Conrad then introduces the idea that their mutual experiences with the Devil indicate that “Maybe we were meant to be together.”
Michelle says, “No one believes I actually see him but I do.”
Conrad states flatly, “the devil brought us.”
Michelle replies, “and yeah maybe ha funny way of meeting,” which Conrad follows with, “cause I don’t know anyone else that [has] seen the devil.”
Michelle concludes, “we are destined to hell then?” and Conrad confirms, “Yeah.”
Michelle goes on to describe, “like babe one time I hallucinated my eyes were bleeding. It was scary. I thought it was real at the time but it wasn’t. It scared me so much.”
They shared how scary all this seems, and Michelle goes on to wonder, “like I don’t know what he wants from me or you. Like why us?”
Conrad gives the answer to her question, “cause we are his victims.”
Without gaining clarity, they go on to discuss why all this is happening to them.
The nightmares, and Conrad’s emphasis on the devil bringing the two of them together, had to leave Michelle further confused about what is real and what is not real. She would at times in the future cling to her little dog at night in the hope of scaring off the devil.
From the first Prozac Full Prescribing Information to the most recent one, “abnormal dreams” have been listed as the most frequent adverse reaction to Prozac. Neither Conrad nor Michelle seemed to have been warned about this common but distressing drug effect, despite both being on SSRI antidepressants.
Severe nightmares have also been reported in the scientific literature. Thirty-eight days after beginning a double-blind placebo-controlled clinical trial comparing Prozac to a sugar pill, a twelve year old boy “experienced a violent nightmare about killing his classmates until he himself was shot.”
He awakened from it only with difficulty, and the dream continued to feel “very real.” He reported having had several days of increasingly vivid “bad dreams” before this episode; these included images of killing himself and of his parents dying. When he was seen later that day he was agitated and anxious, refused to go to school, and reported marked suicidal ideation that made him feel unsafe at home as well. P. 180
This school-shooting nightmare that persisted after waking is remarkable for having occurred long before the outbreak of well-known school shootings initiated by Columbine High School in 1999. The boy’s double-blind clinical trial was stopped and it was confirmed that he was taking Prozac, 20 mg. The drug was withdrawn and he gradually improved. When Prozac was restarted some time later, he again became suicidal, and again the medication had to be stopped.
The Role of Prescribers
Doctors who fail to warn their patients about nightmares, compulsive suicidality, violent feelings and other potentially dangerous and distressing adverse drug reactions from antidepressants are doing their patients and society a grave disservice. Their patients’ lack of information leaves them at the mercy of horrifying experiences that border on psychosis. The unsuspecting patients will fear they are going crazy. They will think that they are “so far gone” that not even the potent antidepressants can help them. That often leads to despair and sometimes to suicide.
Michelle and Conrad in Isolation
These two wounded and distraught adolescents, fifteen and sixteen years old, would develop an on-and-off relationship—mostly without seeing each other, and dominated by Conrad—that would overwhelm the two of them. The mental disturbances induced by their antidepressants, their own emotional vulnerabilities, and their impact upon each other would cut them off from other people, devastate their lives, and cause unimaginable suffering to their families and friends. Most of the time both of them would be taking antidepressants drugs, while displaying all of the most serious adverse effects, including an overall worsening of their condition, irritability and hostility, grandiosity, and suicide.
We can show respect for Michelle and Conrad, and all victims of the Pharmaceutical Empire, by elevating their lives as examples of what we must prevent from continuing to happen. We can tell their stories and listen to their stories. We can be warned and inspired to reclaim our children from what I first called the Psychopharmaceutical Complex in my book Toxic Psychiatry.
The Pharmaceutical Empire, with its heavy marketing of psychiatric drugs for the real-life problems of children, has robbed these youngsters and their families of the will and capacity to seek out and to use more caring and human approaches for dealing with and overcoming the inevitable struggles that young people face while growing up and becoming mature persons.
Conrad’s escalating emotional abuse and terrorization of Michelle, and their mutual decline while taking antidepressants, will be the further subject of the third installment. Conrad and Michelle will seal off their relationship from everyone else in a profoundly disturbed and eventually doomed manner, but Conrad is always in charge until Michelle finally breaks down and becomes aggressive.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.