Adolescent Suicide and The Black Box Warning: STAT Gets It All Wrong

Robert Whitaker
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STAT has presented itself as a reliable publisher of health news, and it has a number of first-rate, experienced journalists who write for it. However, on August 29, it published an opinion piece on adolescent suicide and antidepressants that revealed, once again, how regularly the mainstream media publishes information about psychiatric treatments that is misleading and easily debunked.

In the piece, Stephen Soumerai, a professor of population medicine at Harvard Medical School, and Ross Koppel, from the University of Penn, argue that the FDA’s black box warning that antidepressants increase the risk of suicidal behavior in adolescents is doing harm. They contend that the warning, which was first issued in October 2004, is “continuing to dampen effective drug and non-drug treatment and monitoring for depression,” and that this has led to a steady rise in suicide among youth 10 to 19 years old ever since.

To support their argument, they first return to an old, oft-repeated claim that issuance of the black box warning led to a drop in the prescribing of antidepressants to adolescents, and this in turn led to an increase in suicides among this age group. It would have been nice if the STAT editors had checked this assertion, for it is easy to show that it is factually wrong.

Here are the data.

The prescribing of antidepressants to adolescents 10 to 17 years old hit a high-water mark in 2004, when—according to one calculation—2% of this age group were prescribed an antidepressant. The black box warning was issued in October of 2004, and this led to a decrease in the prescribing of antidepressants to adolescents from 2005 to 2007. Then, in 2008, the rate of prescribing began to slowly rise again.

Here’s a chart showing this:

 

The question then becomes this: what were the suicide rates for adolescents aged 10 to 19, per 100,000 population, from 2004 to 2007? Soumerai and Koppel are asserting that suicide rates rose during this period, but as a report from the Centers for Disease Control reveals, the opposite was true.

Here are the suicide rates for this age group for those four years:

This is not rocket science. As anyone can see, the black box warning led to a drop in prescribing of antidepressants to adolescents, which was associated with a drop—rather than an increase—in suicides among this age group.

The irony is that Soumerai and Koppel published a graph that actually shows this. In the graphic (copied below), the yearly suicide rates are marked with dots, and you can see they show a decrease in suicides from 2004 to 2007. They are presenting the data cited above. But then what they do is draw a trendline back to 2004, which completely ignores the 2004 to 2007 data, and instead makes it look like the suicide rate has been steadily increasing since 2004, when the FDA first issued its black box warning.

This is a kind of visual misdirection that magicians use: The reader’s eye sees the trendline and thus misses the drop in suicides—as marked by the four yearly dots—from 2004 to 2007. You can see this misdirection for yourself:

Having (wrongly) asserted that the black box warning led to an increase in adolescent suicides from 2004 to 2007, Soumerai and Koppel then make an argumentative leap forward in time. The warning, they say, is still dampening the use of helpful antidepressants and psychotherapy for depression, and still dampening the diagnosis of depression in adolescents. Then they blame this lack of diagnosis and lack of treatment for the steady rise in suicide among adolescents since 2007 (although they make it seem that the steady rise began in 2004).

So, clearly, in order to support this part of their argument, they must provide evidence that the black box warning has continued to discourage such treatment to adolescents, and has done so up to now. To make this case, they would need to show that the prescribing of antidepressants to adolescents continued at the same level as it was in 2007, when the prescribing of antidepressants had hit a low-water mark in response to the black box warning, and that the percentage of depressed youth who do not get treatment is the same as it was that year. That would be data that showed a sustained “dampening” effect of the black box warning.

However, they don’t present any such data, and that is because it doesn’t exist. Instead, the “correlational” data goes in the opposite direction.

The suicide rate among youth 10 to 19 years old began to climb in 2008, and it has risen steadily ever since. It rose from 3.9 per 100,000 population in 2007 to 6.1 per 100,000 in 2016. During this time, there has been an increase in the percentage of youths treated with antidepressants and psychotherapy.

In 2016, researchers reported that antidepressant use among U.S. youth 15 to 19 years rose 16% from 2007 to 2012. They found that 6.24% of adolescents 15 to 19 years old were exposed to an antidepressant at some point in 2012, up from 5.36% in 2007.

That same year, in an article published in Pediatrics, researchers reported the following:

  • From 2007 to 2014, among adolescents who suffered a major depressive episode, the percentage who got treatment rose from 37.2% to 42%.
  • From 2007 to 2014, among adolescents who suffered a major depressive episode, the percentage who were prescribed an antidepressant rose from 17.8% to 20%.

In short, during this period of increased suicide among adolescents (since 2007), the number of adolescents who were treated for major depression—with psychotherapy and with antidepressants—rose.

With this closer look at the data, we can see how grossly the STAT article misleads readers. Here is the actual correlative data since the FDA issued its black box warning:

  • The prescribing of antidepressants to adolescents from 2004 to 2007 dropped, and during this period adolescent suicide rates decreased.
  • There has been an increase in the use of psychotherapy and antidepressants to treat major depression in adolescents since 2007, and adolescent suicide rates have increased since then.

The conclusion that might be drawn from this data is this: The black box warning worked for a few years, but its dampening effects have worn off with time, and as this has occurred, suicide rates in adolescents have risen. Recently, Martin Plöderl and Michael Hengartner published a paper detailing this correlation in detail (and wrote about it for Mad in America).

But that, of course, is not a conclusion that will be promoted widely to the public, which is why STAT’s publication of this opinion piece is so disheartening. STAT has built a good readership for its health coverage and a reputation for skillful reporting. But it has now provided a platform for a piece that, although it is easily debunked, will shape public thinking about the prescribing of antidepressants to youth. The public is being encouraged to worry that the black box warning has done harm because it has prevented adolescents from getting effective drug treatment, and it is being informed that there is scientific evidence to support this worry.

In short, STAT has lent its good name to a “false” story. Its publication serves as yet another example of how society gets misled, time and time again, about what science really has to say about the merits of psychiatric drugs.

70 COMMENTS

  1. So, how do these guys get away with publishing stuff that’s obviously wrong? Why are they not held accountable for publishing an article that is not only misleading but pushes faulty information? It seems like they have no qualms about just outright lying. And why didn’t Stat catch all of this?

    I’m so glad that your background in journalism is in science because you dismantle things so well by going to the heart of the matter. You do it with the scientific facts. Thank you for caring enough to research for the truth all those years ago when you began looking at all this through the lens of true science rather than listening to the great and mighty voice of Oz.

  2. The STAT article obviously ignores the data Robert presents. But the authors seem to be making the argument that if the TREND toward increasing use of antidepressants had continued after 2004, adolescent suicide rates would not have gone up. In other words if there had been enough of an increase in antidepressant use, the adolescent suicide picture would be better and, by implication, the drop in suicides after the black box warning is insignificant. So while Robert is looking at the actual data, the STAT authors are looking at what they believe might have been if antidepressant use trends had continued. Their contention must be based on a belief that antidepressants are so beneficial that no other proof need be offered. I guess, because their thinking isn’t clear to me. The STAT article obviously errs by not looking at what has actually happened and addressing that issue.

  3. Psychiatrists have nothing to do with truth. They follow Hitler’s precepts on propaganda:

    “The function of propaganda is, for example, not to weigh and ponder the rights of different people, but exclusively to emphasize the one right which it has set out to argue for. Its task is not to make an objective study of the truth, in so far as it favors the enemy, and then set it before the masses with academic fairness; its task is to serve our own right, always and unflinchingly.

    […]

    The people in their overwhelming majority are so feminine by nature and attitude that sober reasoning determines their thoughts and actions far less than emotion and feeling. And this sentiment is not complicated, but very simple and all of a piece. It does not have multiple shadings; it has a positive and a negative; love or hate, right or wrong, truth or lie never half this way and half that way, never partially, or that kind of thing.

    […]

    But the most brilliant propagandist technique will yield no success unless one fundamental principle is borne in mind constantly and with unfiagging attention. It must confine itself to a few points and repeat them over and over. Here, as so often in this world, persistence is the first and most important requirement for success.

    […]

    When there is a change, it must not alter the content of what the propaganda is driving at, but in the end must always say the same thing. For instance, a slogan must be presented from different angles, but the end of all remarks must always and immutably be the slogan itself. Only in this way can the propaganda have a unified and complete effect.

    This broadness of outline from which we must never depart, in combination with steady, consistent emphasis, allows our final success to mature. And then, to our amazement, we shall see what tremendous results such perseverance leads to results that are almost beyond our understanding.

    All advertising, whether in the field of business or politics, achieves success through the continuity and sustained uniformity of its application.”

    http://www.hitler.org/writings/Mein_Kampf/mkv1ch06.html

        • No, that’s true. But I am talking about the psychiatric INDUSTRY, the LEADERS of psychiatry. They are, in fact, pretty crooked. As you can see in this article, “thought leaders” continue to conspire to “spin” the data to make it look like a reduction in adolescent AD prescriptions is behind the increasing suicide rate, when there is no evidence at all that this is true. I’d call that pretty crooked.

          There are always individuals even in the most evil of empires that try to do good (Shindler’s List, for example). But that doesn’t make the empire itself less evil.

          • I wonder if Hitler, like Goebels, was a big fan of Eddie Bernays? One of Sigmunds relatives. Thankfully Hitler didn’t last long, though did got a golf shot named after him, two shots in a bunker.
            Good takedown of false reporting Mr Whitaker.

          • I think the ideas of Bernays are important here. His thoughts on exploiting irrational fears (about teen suicide) and creating a herd mentality. Facts don’t matter to the herd, only the dissipation of the anxiety from the fear. His “torches of freedom” campaign highlighting this type of exploitation. Got a whole bunch of new customers for the cigarette companies. Doctors, politicians movie stars all assisting in the selling of the product. Eventually the truth wins out but by then a whole bunch of people had lung cancer, and the money had gone from tobacco companies to ….. pharmaceuticals?

          • I actually never heard of Bernays, but his ideas certainly seem to be the dominant ones of our time. We are all being governed by the “herd mentality,” and most people aren’t even aware that it’s happening.

          • I’d suggest the term “Anti Depressant” was no accident. Calling them “Chemical Imbalancers” was not going to create the image that would allow the reduction of the anxiety. I fear my child may be suicidal, hypervigilance, and I’d be a bad parent if I didn’t do what all other parents are doing to ensure my child does not commit suicide. Enter public relations of Big Pharma. Facts are no longer of any significance as the herd is doing this, so I would feel terrible if I don’t do this and something happens.
            How much does this fit in with Burnays ideas about “happiness machines”? I leave that to you.

          • Yup. Government by focus group. What’s true is less important than what people are willing to believe or are afraid of. If you are told your child will suffer if you don’t do as the authorities say, it takes a pretty strong parent to say, “Wait a minute – whose agenda is being served by your statements?” Most people aren’t up to it, especially when the media and their friends/family are siding with the psychiatrists.

        • It’s not just being corrupt. There are so many who discredit anything of value about the people that they’re supposedly giving “good treatment” to. They call them liars and manipulators and many other things. Their first response to anything that the “patients” say is to discredit it right off the bat. There was an older woman admitted to one of the units where I work. When they asked her about her educational level she told them that she had a doctorate. When they came out of the meeting they were all talking about what a liar she was. One of the social workers decided to verify what the woman said and low and behold…….she had a doctorate in political science! All of a sudden all discussion of her educational level and about how much of a liar she was and how her delusions were rampant ceased, not another word. Since I knew one of the psychiatrists on her case fairly well I asked said psychiatrist one morning if he’d like a little salt and pepper with his crow. He sat there and gave me the big stare and then halfheartedly admitted that she certainly had fooled them. She was never trying to fool them. All she did was answer their question truthfully. Now she is addressed on the unit as Dr. So and So.

          Yes, there are some good psychiatrists but I don’t know any these days. All the good ones left the “hospital” where I work. They went to jobs where they had more freedom to treat people as human beings with talents and abilities.

          • The discrediting of people with college degrees is rampant. Your mental patient status trumps your degree. There are exceptions, people who have MH-related degrees. I have been discredited on here, on MIA frequently, discredited by other patients and survivors, and dismissed by supposed “professionals.” All this renders my degree and extensive education meaningless on the social level. I can’t be trusted, I might be violent, and if I say I am good at something, that gets scoffed at as grandiosity or just dismissed. I have far more authority and get more respect at my workplace than I do here.

          • Look who’s delusional. The psych staff. Lol.

            Talked to a psychiatric social worker about graduate school–how my over-protective mom didn’t want me to go. 20 minutes later she told my folks they “needed to cut the apron strings and let Rachel get her GED.” Someone wasn’t taking notes. 😀

    • I like this quote
      “No one understood better than Stalin that the true object of propaganda is neither to convince nor even to persuade, but to produce a uniform pattern of public utterance in which the first trace of unorthodox thought immediately reveals itself as a jarring dissonance.”
      ~ Alan Bullock, in Hitler and Stalin: Parallel Lives

      While calling out false witness by affirming the true includes ‘debunking’ (a term readily thrown around by those in positions of ‘power’ but lacking substance) – the core reeducation that I see a need of is identifying the devices of deceit that can run as unconscious habit – as in a believer in a cause – or by design, as in the intent to deceive.

      The willingness to be deceived is inversely proportional to awakened self responsibility; ie the wish to escape our issues looks for ways to not have to face them and displace or hide them in someone or somewhere else.
      Thus responsibility becomes associated with blame, guilt and punishment making the block against owning what is ours. No one can change what are unwilling as yet to own and know – though of course we can hurt ourselves trying.
      So I write more to the undoing of the fears that lock us in guilt, shame, inadequacy or powerlessness – rather than reinforcing the guilt of those driven by such fear to take positions of power in a society that itself is ‘captured’ by a sense of power to reframe and redistribute guilt, invalidity and the power to ‘outsource it’ to others and to our world.
      The rising to public knowledge of the methods of manipulative deceit in place or beneath of true communication is also a recognition of just how powerful belief ARE. Because the ability to shape them is the management of mind-capture to which all else is a supporting side show.
      Reclaiming our mind – as I see it – is retraining ourselves to pause and look and check in instead of automatically reacting in thought and behaviour.
      Phishing is associated with identity theft as a result of passing off the false as true.
      But it is our acting from the acceptance of false that is our part in becoming subject to its framing – and so the willingness to pause and look and check in is the opportunity for a wider communication to occur than what would otherwise be effectively reinforced by acting as if it is true.

      The idea that people are in a sense robotically programmed is itself a self-reflection but the instigators of theories do not regard themselves as subject to their own judgements. What we see and meet in others is not just ‘OUT THERE’ so much as what we accept and believe by acting as if true and so we tend to draw responses that reinforce our beliefs of each other when seen through the filters of reactive fears running as survival.

      It may be wise to separate from what separates as part of a growing of self-integrity – away from the framing influence of a false sense of not having any. But from a fresh sense of shared worth, we re-engage from a true willingness in place of struggle within conflicted purpose. But we can only live from where we are currently at – and if we do not own our fears and find ways to move with them to move through them, then we are still in the wish these parts of us didn’t exist and liable to be ‘sabotaged’ by our own denials – reflected in our world, perhaps as prison guards, deceivers and ill intent. Not that our world hasn’t such things – but that our loss of freedom in a misidentified reaction to something we hate in ourself is perhaps the opening to a possibility of something within our capacity to learn NOT to do. One step being the beginning of any journey of steps taken in some willingness of true desire – which of course can be covered over, but never truly lost because it is the movement of our being regardless our current fixation of attention.

  4. Thanks so much for this Robert.

    It seems that suicide IS well correlated with consistent increases in antidepressant prescription in the US over many years. This is the real alarm bell that should have the FDA sitting up.

    I have been hyper ventilating over this all day, wondering in which parallel universe these academics live. It would be laughable if it wasn’t so dangerous.

    I just cannot believe after all the data and meta-analyses that there is clearly a campaign to increase clinically useless antidepressants in youth.

  5. I understand that this article was in the “First Opinion” section of STAT, but it still carries an air of authority coming from two professors who should be experts in research. This is just poorly researched and shows a bias in favor of antidepressant medications as the best solution for suicide prevention and for downplaying the side effects of these drugs. Very concerning that so called “experts” on research from prestigious schools are not doing their homework and having such a pro-medical model approach to solving mostly psychosocial problems.

    Thank you, Mr. Whitaker, for critical analysis of this STAT publication as well as other articles out there in mainstream and professional publications that are misleading and incorrect. We need to hold professional organizations, publications and “experts” accountable.

  6. Good that this paper was debunked here. Unbelievable that “research” like this is still published.
    But: Where are the critical papers about the fact that the FDA warning is not effective anymore? Antidepressants are precribed like never before.

  7. Thanks for debunking this study, Bob. You would think people would figure that one out. However, many are likely too drugged or shocked to think straight anymore. These drugs have made their way into the medicine cabinets of so many people at this point. Back in 1980 I barely knew what mental illness was and I had never heard of psych drugs, even with my college education. Is the trend beginning to turn as more and more are harmed? Or do they have more tricks up their sleeves?

    Maybe it’s about time we shouted “Bah Humbug.” If we are ever heard.

  8. How could the blackbox warning have led to a decrease of drug use AND psychotherapy? I don’t believe that at all. They just made that part up, if you ask me. You would think that it’s the fear of drugs that drives people to see a therapist instead. You know, to avoid having to take a pill.

        • Toastmasters is recent. That happened 27 years ago when I was a nervous college freshman getting over years of sexual harassment from high school.

          My phobia is gone but I’m terrified of people learning about my past. So I try to keep all relationships as surface as possible.

          I no longer act “mentally ill” but at 45 I have no past. At least none that doesn’t embarrass me.

          No family, no career history. I’ll have to stay in the shadows for the rest of my life.

          I feel like Richard Kimball in The Fugitive. I know I’m innocent but the authorities assume my guilt and everyone assumes what they say is the gospel truth.

          Keep running. And hold everyone at a distance.

          Man am I lonely!

          • Hi Rachel –

            I relate to so much of your post, especially as follows.

            The “Richard Kimball” part because I recently “ran away” to a new area where I knew no one. I’m sure people wonder what’s up with that but I have a feeling I’m not the only one around here in that situation.

            The lonely part, but I also believe it’s better to be cautious about who I allow in my life than letting in the wrong (for me) people.

            Staying in the shadows – but I do hope both of us can find our way out of them.

          • Me too. It is lonely because if I share I risk wrecking my social life with whomever I share with. I have, in my new life, with mixed results. I have had to end relationships with people who hear my story and then act afraid of me. I generally just cut it off. I have to constantly fight off the urge to tell my story because doing so is a natural inclination as an activist. I feel that telling it is powerful and a story communicates to others. However, the results can be disastrous if they assume you’re psychotic and won’t believe otherwise.

  9. The thing that’s interesting to note is that all age categories decreased for this study after the black box warning, not just under 18 and I finally get an answer how they got the age of 24 into the black box warning. As far as I’m concerned, this black box warning should be “for all ages” according to the graph.

    No one ever discusses it these days. Only one commented in the Washington Post article discussing children and the anxiety of attending school. Her daughter committed suicide after taking this crap. She brought up the black box warning.

    We need to take this off the market and stop the debate. It’s a public safety hazard for all, not just children. Unfortunately no one’s listening.

  10. It does seem that Soumerai is simply rehashing an argument made in a 2014 BMJ paper:

    https://www.bmj.com/content/348/bmj.g3596

    The 26 responses to this were pretty critical, focussing on the terribly flawed use of psychotropic poisonings as a proxy for suicide rates, when suicide data is available and of course does not support their claims.

    Also criticised was the presumption that antidepressant prescribing is a good thing.

    So roundly castigated was this study that I for one would welcome any future rehashings by its authors, should they be able to find someone to publish it. It’s desperate really.

  11. This deception results in more exposure to the risk of AKATHISIA, and those who prescribe SSRIs are not trained to promptly recognise, and correctly manage this serious and dangerous adverse reaction.

    The prescriber does not appreciate or understand that akathisia causes suicidality and completed suicide.

    The prescriber has a duty to know of, and to understand the adverse drug reactions of the “medications” that he/she prescribes.

    They do not, and our children (and many adults) pay a terrible price for this professional failure.

    Because of prescriber ignorance of akathisia it is misdiagnosed as “emergent serious mental illness” and the poisoned patient is likely to be incarcerated and forced to ingest more of these akathisia inducing drugs.

    The resulting injuries destroy lives. This is an intolerable denial and/or ignorance.

    There appears to be immunity from medico-legal accountability.

    Those killed and so terribly injured have no access to compensation.

    TRM123. Retired Consultant Physician.

    • Thank you Doctor. I wish there were more members of your profession like you.

      Every MD I visit unquestioningly supports psychiatry. Why is this?

      Are they afraid of challenging an accepted medical specialty? So ignorant they actually believe drug ads? Or a little bit of both?

      They have found a lot of things wrong with me but refuse to speculate on the cause or advise a plan of treatment. Heart arrhythmia and malabsorption are my main health issues. Both caused by psych drugs used long term.

      They will diagnose and refuse to answer any of my questions but send me home. Like they know something I don’t–or they hope I don’t.

      • It’s interesting to me that other specialties of medicine are so supportive of psychiatry these days. This wasn’t the case a number of years ago when psychiatrists were seen as wannabe doctors. Other specialties made fun of them and refused to accept them. A former supervisor of mine told a story that reflects this. Her father was a surgeon. On Saturdays he would take her with him to make hospital rounds. One day they went into the doctors’ lounge and there was a man sitting at the table reading the newspaper. Her father laughed, pointed to the man and said, “He’s a psychiatrist who thinks he’s a real doctor. All the rest of us let him pretend but we all know that he’s no doctor at all!”

        I wonder what worked the change so that no GP will say anything against them. I’ve expressed my disdain and dislike for psychiatrists to my doctor but she never will look at me or act as if she’s heard anything that I’ve said. I want to shake some sense into her.

        I also believe that they’ve all drank the Kool-Aid and actually believe what they’re told. They don’t read enough on their own to really know what’s going on.

        • They do no doubt serve a function in the political scheme of things though Stephen.

          I was once told by a prof of cardiology that he “didn’t have the stomach for it”. A guy who cuts peoples chests open and sticks his fists in? Lol

          The recent changes to our MH A seems to have been brought in to address the problems faced by police, domestic violence and drug addictions. These issues are now being dealt with by psychiatrists who have little interest in the recovery of the patients, merely wishing the issues to disappear from public view.
          This resulted in 40% of our public system psychiatrists leaving, they still want to do medicine, not take people out the back and …. ‘medicate’ them.
          So we needed to import a few Pinkertons to get the job done. I’m sure as time progresses other political issues will surface and their powers and roles will change again. Cant make it a crime to be poor, but we sure as hell can drug anyone who thinks they have a right to food and housing lol. Note the people who are usually most vocal about the ‘burden on the taxpayer’ are usually really rich people who don’t pay any. How’s that work?

          • True. The people destroying any programs that benefit the poor are people who will never have to ever worry about money in their entire lives. It’s amazing how determined they are in their destruction. And now you have to work to be able to receive what pitiful little benefits people were getting in the first place. Never mind that if you’re a mother of three that you can’t afford child care so you can meet the mandate. They’ve fixed everything so that the poor cannot get what they justly deserve. And now everything is being dismantled by the stooges of a certain person in Washington, D.C.

        • Churches used to sneer at psychiatry. Now they unquestioningly preach about “scientifically proven chemical imbalances” during assembly.

          Yay! The latest state-of-the-art proven scientific theories from the early 1990’s. And the APA didn’t buy it then. Pretty scientifically advanced of these churches huh? Hip and current like the trendy music they play.

          If you point out the damage done you’re a meany and probably have secretly joined Scientology as well.

          Many preachers honestly want to help those they think have brain diseases. BUT others just want annoying people–often hurt by other church members–to shut up and take psych drugs. Even if you do–I speak from experience–they’ll treat you worse than a convicted pedophile and do all in their power to freeze you out.

          Way to go pro-psych church! Aren’t you a bunch of humanitarians? And scientific sounding too. Like the techno-babble from Star Trek. Don’t throw out your shoulders from hours of patting your own backs.

          Rick Warren needs to ask himself, “Do the mentally ill have souls?” His treatment of those labeled SMI makes me wonder.

        • Pharma was considered REAL medicine – bolstered by its ‘sacred history’ as the bedrock of a rational cure for all illness given time. Evil had been replaced by germs and superstitious psychism disowned and distanced by the rituals and robes of intervention by technologist.
          Psychiatry was not REAL science until it sought and ‘found’ theories of a physical or biological causation for mental-emotional states, or patterns of behaviour and experience that were either problematic for the ‘patient’ or to the ‘patient’s society’.
          The urge to shut down and block out psychic-emotional difficulty or conflicts is the unwillingness or unreadiness to own them or face them, this is as evident in society as in individuals who become ‘patients’ to a system or belief that posits causation ‘out there’ and away from the self. That is, there is a very strong desire to see something else as cause so as not to see what is really here to be healed or undone and the personal and collective agreement as the the ‘REAL’ world as an assertive and defended narrative identity is that which keeps the lid on all that persons and society are as yet unwilling to accept or see, recognize or release.
          The desire to ‘get’ one’s own salvation, freedom or escape from feared unowned fear, operates a ‘selfish’ mindset that can no longer recognize wholeness – but fears it as a sense of total loss of what is now taken as self -and is driven by its self-evasion to re-enact the thing it thinks to have escaped. That is a blindness and even unkindness towards others set by the beliefs that seem to hold its sense of control within its ‘reality’ stable.

          Every belief acted from is reinforced in its experience in the mind of its believer. We are not often conscious of our beliefs because we live them as our presumed reality. I hold that healing results from letting go of beliefs that are not true of you but which run largely as habit of acquired and inherited learning or conditioning.

          It is easy to believe in evil people if we have such a belief of ourself – and are wanting to get rid of it or at least offset it by seeing in others what we do NOT accept in ourselves and in one way of another attacking it there. This seems to bring MORE guilt onto self and if that were be-lived true it would be destructive and not healing. The belief in guilt is the belief in self-judgement. But if the case were brought to a higher court, it would be thrown out.

          Hindsight can interject guilt the moment after an act that was expressing who you were being at that moment – and frame it as more than or less than, worthy or unworthy. But you are not outside your being now and can choose to be and see within who you truly are now in cooperation with a desire for peace of wholeness. Judgement cuts reality into pieces and all the kings men can never put Humpty together again – because a partial selection rejects and coercing ‘pieces’ to fit a rejecting mind can never be whole or know peace.
          Noticing judgements without adding judgement is like feeling fear without fearing fear. It is a growing of self awareness that is inversely proportional to the use of blame and penalty.
          What if ‘The Last Judgement” is a Living Communication through you to all of the meaning; “This is my beloved in whom is my Joy”?
          What is the call to joy but the re-call to be who you are? The ‘world’ seems to be the mass and entanglement of blocks or denials to the movement of our true being as a felt and flowing communication within being. And so we live as ‘when these conditions change, I will be free or able to change’ – which is believing the conditions as CAUSE to our state of being rather than a reflection of reinforcement to beliefs that can be uncovered and re-evaluated from a more relational willingness and capacity than was available in the setting of them.

          • Funny. Everyone says, “Be yourself.” Unless they think you’re mentally ill. Then your Self is a disease to be destroyed if it kills you.

            Psychiatry is popular with the mainstream because it helps them box the world into two neat categories: the good sane and the evil insane. Psychiatrists don’t like the words “good” or “evil” cause they don’t sound like real SCIENCE. But their “diagnoses” are really moral judgments. And bad ones.

            Moral judgments used to be based on good or bad behaviors. Psych labels often have little or no bearing on moral conduct at all. Once they call you “schizophrenic” or “bipolar” everyone assumes you do stuff you quit doing long ago or never did to begin with.

            According to psychiatrists “bipolars” are drunks, promiscuous, unpredictably violent, and have 0 empathy. Many folks these science guys brand “bipolar” are teetotalers, celibates, visit each other in the hospital, volunteer, and lavish love on the one creature–a cat or dog–we can love because psychiatry has segregated us.

            A friend was dying of kidney failure. Two of us at the center offered our own kidneys since they wouldn’t put a worthless SMI on the transfer list. That very week Germanwings occurred and some psych doc got on TV to reduce “stigma” by telling the public how “bipolars” just are that way. No love or empathy is how they’re born. S’cuse me?

            That idiot was full of it! Like some white guy claiming to want to eradicate racism by explaining how everyone of African descent is incurably evil because they were born inferior.

            Hmm. No empathy…

            You mean like deliberately driving a bunch of people insane without their knowledge or consent so you can write a book bragging about it?

            You mean cheating on your wife with a younger woman but keeping it hushed because you’re a big shot congressman?

            You mean routinely lying to patients and selling them mind altering drugs by calling them “life saving medications” they’ll die without?

            Mother Theresa they ain’t!

            But rest assured they are all perfectly good or sane because they say so. As medical experts on morally acceptable (sane) behaviors they have diagnosed themselves the epitome of Moral Rectitude. All that is sane and virtuous.

            Bwa ha ha! 😀

            Lest I be accused of DEMONIZING shrinks–only they’re allowed to malign entire groups of people they don’t even know–yes, not all are reincarnations of Josef Mengele.

            Some actually want to help folks. The help they offer is like blood letting for cholera patients but that’s incompetence. Not evil.

            It is noteworthy how the shrinks who rise to the top seem devoid of conscience though. The nicer ones don’t wind up leading the APA. And the APA sets the tone for psychiatric practices in America even though there can only be one Dr. Pies, Dr. Torrey, Dr. Lieberman. (Always a bright side.)

            They also go on TV to lie to the public about the sick and stupid but very dangerous SMIs. Yeah, the “crazies” are dumb as a box of rocks AND diabolically clever at murdering people. Not sure how both characteristics can apply but the experts say they can. And they are never wrong.

            Dr. Biederman is never wrong. He has diagnosed himself as practically God. Sounds like a down-to-earth, well-balanced individual. 😀

  12. Robert, beyond the adverse effects of psychiatric drugs, what do you think about sociocultural factors that increase distress and suicide in young people – such as zealous overprotection of children and adolescents? For example, look at this interesting article:

    https://quillette.com/2018/09/02/is-safetyism-destroying-a-generation/

    I ask anyone reading this the same question – what do you think about the overprotection of youth as the negative mental health factor?

    • It’s a good point, I have wondered about this a lot in relation to my own situation, particularly since extreme independence seems very therapeutic in recovery. I kind of concluded that the problem was not over protection, not directly anyway. It’s a cliche but the social and aesthetic micro inspection that kids suffer from their peers seems to me to be a dominant factor. Bluntly, today’s youth are even more vicious about trivial aspects of the way you look and behave, and there needs to be more emphasis on being decent and supportive (I had to edit my earlier more colourful version).

    • I’m actually more thinking that the lack of a clear path to economic success is the big driver for adolescent anxiety. When I went to college, I knew for certain that I’d be able to get a job that paid enough for me to raise a family. Kids going to college these days come out with often $100K or more in debt and no guarantee of a job good enough to pay off their loans, let alone raise a family. Not to mention our bizarre political situation that seems to be plunging downhill fast, global warming, and the insistent sensationalization of mass shootings and international terrorism. Overprotection may play a role as well, but I’d also point to parents having fewer children per family and therefore putting more unconscious expectations onto their kids in order to feel competent as parents, and I believe that overprotection often comes from that frame.

      BTW, do you have any data on to what degree “overprotection” has increased in parents over the last couple generations? I’d be interested to hear about it.

      • The easiest way to gain notoriety as an unpopular teen is to go on a shooting spree. Wrong on so many levels!

        Talking about them is unavoidable. But the news media insists on publicizing the name and face of the bullied turn bully everywhere. Wish they would stop.

      • Steve, Typically, shrinks accuse parents of ED kids of “overinvolvement” or “enmeshment.” However, I know my own parents were not like that at all, yet I still got an ED. I think the theory is total bullshit and a way to blame parents for what is simply a dieting problem. I do know helicopter parents, though. I believe this is a cultural value. As I see it, some cultures value helipcopterism, while others shun it. The tendency goes in waves. It’ll be huge with one generation, then half a generation later it will swing the other way. This also goes with parental emotional sharing. Didn’t all of us who grew up kids of WWII parents experience a certain reserved attitude? Of my young girlfriends, only one said she was “close” to her mother. The rest of us had normal parents, or, as we saw it, normal for the day.

        Changing parental attitudes affected me when I went to work as a nanny. The dad had a totally different attitude about parenting than I had ever seen. He insisted his way was the only right way, which I found offensive and actually an offense to my upbringing. I had to put up with it, though. I was being paid to do so.

        We have to be open-minded to different parenting styles. I don’t think there’s a one right way. We may see parents in another culture in a negative way, but I think we have to accept these differences instead of being overly critical.

        For instance, some parents of cultures that aren’t mine seem too rushed and pushy with their kids. I hate hearing a parent tell their kid to hurry up constantly. However, if I had been raised like that I bet I’d see it as normal and even acceptable.

        My parents used spanking. Most did that I knew of. Many used a belt. My dad insisted on not doing that. I wondered if he was weird or maybe one of those hippie pacifists. I don’t believe spanking harmed me in the least, not that I would advocate it nowadays. They did not shame us or verbally abuse us. That made the difference.

    • Hi Vortex,
      I know of some hydroponic farmers that either put strong fans in the growing space or move the small plants outdoors (as weather permits) because without this stress the main stalk never grows strong enough and as the plant matures it cannot hold itself aright under the weight of its own buds (let alone fruit!). Unless you tie the plant to a stake, it will break,

      I think the same thing is true of all things in nature. Children are born with natural curiosity and will explore their environment as much as possible. They are naturally scientists- testing out: what happens to this thing if I do this action? This is the beginning of confidence in one’s abilities; it is the seed of autonomy, watered by periodic failures and nourished in the light of successes.

      But in this nanny-state that modern culture has become, babies don’t even get to crawl anymore! Children are constantly supervised, all their options are provided for them– no room to explore and discover, or invent their own way. They hit school and are actively discouraged from coming up with their own ideas– the tests consist of guessing well. Their thinking is confined to the bubbles- no more are they asked to explain why/how, or to compare/contrast two things. Parents who dare to let their children have a smattering of independence, of responsibility, find that some busybody has called the cops and/or social workers and they are scrutinized for months (or even years) as neglectful!

  13. Slightly interesting recent take on this idea in the UK.

    The Guardian ran a story recently reporting that the rate of NEW ADULT users of antidepressants has fallen by something like 20-25% over the last 2 years, and suicide has fallen 8%. I don’t claim any association, but I think the reduction in new users indicates that the truth is coming out, and there has been no disastrous explosion in suicide. I wander what the RCPsych and others would say about that.
    https://www.theguardian.com/society/2018/aug/10/four-million-people-in-england-are-long-term-users-of-antidepressants

    On the other hand over the last 15 years there is been a 3 to 4 fold INCREASE in young people poisoning themeselves on antidepressants to the point that 10% of poisonings are from this source in England, more than opioids.

    I don’t normally think of antidepressants as the go-to suicide method, particularly since amitriptaline is not on the approved list. But from what I have read there are 2 increasingly popular drugs that are much more associated with suicide than the usual SSRIs: Mirtazapine and Venlafaxine. I am cross about this because we had Mirtazapine pushed at us very hard.
    https://www.theguardian.com/society/2018/sep/11/sharp-rise-in-young-people-overdosing-on-painkillers-and-antidepressants

    So in the UK/England,it seems that antidepressant prescribing is falling overall, with no visible deterioration in suicides. However, in young people, antidepressant poisoning has over time been rising markedly, and I do think they should look at the safety of the individual antidepressants they are prescribing. Apart from the obvious fact that they don’t work at all in young people, there are a couple of them that have an elevated suicide and poisoning risk.

    • At a minimum, it certainly seems to indicate a LACK of correlation between AD use and suicide. And scientifically speaking (though we know that most who make these claims aren’t really being scientific at all), it is the responsibility of the person CLAIMING the correlation to prove the correlation. Hence, if there is no proof that AD DO reduce the suicide rate, we have to assume that it does not, especially when evidence such as what you present is present to undermine the case.

      • Sorry – just to correct myself, the RATE of new antidepressant users is falling. The total number of antidepressant users is still rising due to long term usage and the fact that there are still new users, even at a rate that is slowing down. You could say that the juggernaut is slowing down but it has not stopped or reversed yet.

        60% of users of antidepressants have in fact been on them a year or more, so it will be a while before we could see falls in the absolute level of antidepressants.