No, Dr. Friedman: The Solution to Teen Suicide is Not So Simple

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In the largest newspaper in the world this week, one of the largest problems in the world was proposed as having a very simple solution.

There are few problems more heartbreaking and excruciating than the growing epidemic of youth (and adults) taking their own precious lives. So it’s understandable that we all continue putting significant attention towards solutions that can make a difference.  

In response to this urgent challenge, psychiatrist Richard A. Friedman asked in a recent New York Times op-ed: “How is it possible that so many of our young people are suffering from depression and killing themselves when we know perfectly well how to treat this illness?”

Do we? That’s certainly a widely shared perception among many in the general public today. But are the answers really so crystal clear?  

Dr. Friedman certainly thinks so, suggesting that little more needs to be discussed: “The good news is that we don’t have to wait for all the answers to know what to do. We know that various psychotherapies and medication are highly effective in treating depression.”

While it’s true there are different therapies and treatments that have been helpful for many, there are also wide-ranging debates that continue today about inadvertent consequences associated with some of the most commonly used treatments — over both the short and long term. Shouldn’t we be weighing those in the balance? And what else could be done to help more people find sustainable healing over time?  

Instead of having that important (more complex) conversation, we continue to be invited into a much simpler discussion: How do we get more people to be able to access more treatment? 

After noting that rates of youth treatment are significantly below treatment rates for adults, Friedman goes on to suggest that the pathway ahead is obvious: “We just need to do a better job of identifying, reaching out to and providing resources for at-risk youths.”

On its face, this seems a clean and compelling solution: just get these kids some more help! 

How could we not simply rally around that?  

Because that’s what we’ve been rallying around for many years now.  

The other day, I sat in a suicide prevention presentation in my home state where the speaker advocated the same solution: “the biggest need is to get more teens access to treatment.” 

I raised my hand during the Q/A and asked my sincere question: “Haven’t we been doing that for quite a while already? If so, are there other questions we should be considering?”

A 2011 report released by the National Center for Health Statistics (NCHS) showed that the rate of antidepressant use in this country among teens and adults (people ages 12 and older) had increased by almost 400% between 1988–1994 and 2005–2008 — with estimates of one in every 10 Americans now taking an antidepressant. (During this same period, rates of psychotherapy usage have not increased in corresponding fashion — with some studies finding these rates decreasing in recent years).  

If getting more teens more help was really the answer, wouldn’t we have reasonably seen a measurable decrease in suicide, depression and anxiety by now? In striking contrast, the rates of these concerning numbers have increased markedly during this same period.  

Indeed, these troubling numbers have reached such historic levels that one would think it was time to reassess and reevaluate a lot of things: from the way we conceptualize these problems, to what we’re doing about them (and what we’re not doing about them).  

Instead of this kind of a pause for reflection, all across America what we see today is a doubling down of the approach we’ve taken for the last twenty years. Is this a responsible way to respond to the suicide crisis among our youth (and our adults too)?

No, it’s not. And it’s time for a bigger conversation about not only suicide, but mental health care in America today.  

It will likely be the voices of people who are seeking and finding healing in their own lives that lead the way in this conversation. Too often, it’s the professionals who orient us back towards something more narrow. As Dr. Friedman himself wrote to his worldwide audience, “Our collective failure to act in the face of this epidemic is all the more puzzling” — even asserting, “Teenagers and young adults in the United States are being ravaged by a mental health crisis — and we are doing nothing about it.”

Not true, Dr. Friedman. We have done something about it.  And it’s just not working.

During this same period of time in which antidepressant rates have soared, depression, anxiety and both suicidal ideation and suicidal completion have continued to increase. I was so troubled by this counterintuitive pattern that I reviewed the research and found seven different lines of evidence that confirm a concerning linkage between antidepressants and suicidality — especially among youth. To provide just one illustration, a 2017 study in Sweden that examined 483 suicides from young women between 1999-2013 (representing 93% of all confirmed suicide for this subgroup) explored treatment they received 6 and 12 months before the suicide.

Not only did antidepressants not “lead to a drastic reduction in suicide rates,” the author, Dr. Larsson, noted: “On the contrary, it was found that an increasing tendency of completed suicides follow the increased prescription of antidepressants,” adding, “This analysis shows a covariance between increased prescription of antidepressants and an increasing trend in the number of suicides among young women.”

This is not an anomaly, but one of many examples in a broader pattern hardly receiving attention in America’s mental health conversation today. And perhaps that shouldn’t be surprising, since it runs in the face of the conventional wisdom taken for granted not only by psychiatrists like Dr. Friedman, but by many faith and community leaders across the United States today: that the real issue in this crisis is “undertreatment.”  A great deal of rigorous scientific, epidemiological, clinical and randomized-controlled trial data — not to mention the precious lives of our youth today — call for much greater care in making such a conclusion.

It’s not just caution we need, however — it’s hope. And it’s important to note that the same research literature is remarkably full of solid reasons to hope. Alongside the encouraging understanding that continues to emerge from neuroplasticity and epigenetic studies, there is a vast research literature documenting hundreds of lifestyle adjustments that can make a difference in reducing emotional pain over the long term.  

And not just for mild cases. A Pubmed search of “suicide” and “risk factors” reveals well over 15,000 scholarly articles documenting a dizzying array of possible contributors. Factors commonly cited as making a likely contribution to increasing suicide rates among youth include a more pervasive social media and digital presence, widespread sleep deprivation and a nutrient-deficient American diet, growing cyber-bullying and social anxiety, the unsettling influence of compulsive pornography use, and the uniquely painful trauma of sexual abuse or assault. 

After examining cases of suicide in our own state, one state suicide research summarized: “Our investigation showed that suicide is complex and youth can experience multiple risk and protective factors. No single behavior or risk factor could explain all the reasons for the increase we’ve seen.”

If that’s true, then there are a lot of things we can do in response. And that’s the good news hidden in all this: there’s so much we can act on and do something about!  

Starting with better protecting our youth from early trauma and abuse. Underscoring perhaps the most important theme across studies, a 2014 Utah summary of factors involved in youth suicide notes that “Suicide is also often preceded by a lifetime history of traumatic events.”

We can do a better job of protecting our youth — rallying together to help provide them with the kind of lives overall that don’t drive them to despair. And we’ve got a lot of options to do just that: improvements in a nutritious diet, more time outside in nature and away from screens, physical activity, better connection with those who love them the most, discussions that bring them greater meaning and purpose. And yes, in cases of previous abuse, finding ways to increase access to trauma-oriented therapy is crucial.  

When asked what the alternative to standard care was for teens for whom the medications weren’t working, another leading psychologist responded simply: “all of life!” This is precisely what the research also confirms — with a large wealth of possible adjustments showing up that can make a measurable difference for anyone, especially over time.

So no, Dr. Friedman, the answer to our suicide crisis among youth is not to rally more force of will (and legislative dollars) to encourage more teens to embrace more treatment. It’s to have a little — or a lot — more humility about what is facing us. To breathe deep, and to pursue multifaceted answers to a complex, multifaceted problem.  

It’s time to do just that, uniting around the precious youth who depend on the steps we take next.  

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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.

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24 COMMENTS

  1. Nobody seems to acknowledge that large numbers of people attempt suicide while religiously adhering to the drug regimen–exactly as prescribed by the doctor.

    While taking my cocktail exactly as prescribed by my shrink I frequently was suicidal and would be hospitalized 1-3 times every year.

    Off my drugs for 30 months and despite my poverty and sickness (iatrogenic digestive system damage) I have regained the will to live. But no one wants to hear stories like mine.

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  2. Dr Friedman obviously is desperate or lazy.

    We can even do studies to see whether the mothers or fathers were on meds while they conceived.
    I think there are a LOT of answers to the why’s of “final solution” many opt for, and psychiatry and meds is the last option to consider, as a fix.
    It is however, the simplest because in this way, we can simply say they were “treatment resistant”

    It’s all so silly, the games we play, the empty words we give as solutions to a problem. We are desensitized.
    It is a question of how to fix a world.

    Dr Friedman might want to hand out placebos, since they have a good success rate without the damages.
    Especially if a person is suicidal.

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  3. At the risk of being redundant, the causes of suicide are not mysterious or difficult to understand. However, since the solutions have nothing to do with “treatment” of individuals but transforming the basic structure of society, we can expect all “professional” approaches to continue to consist of denial coupled with coercive attempts to pound human beings into square holes.

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  4. “We know that various psychotherapies and medication are highly effective in treating depression.” These psychiatrists, who claim to know nothing about the adverse effects of the antidepressants, are a part of the problem, not the solution.

    “we continue to be invited into a much simpler discussion: How do we get more people to be able to access more treatment?” because this is what is profitable for those ignorant psychiatrists.

    “On its face, this seems a clean and compelling solution: just get these kids some more help! How could we not simply rally around that? Because that’s what we’ve been rallying around for many years now.” True, and this has been a complete failure.

    I do largely agree, it should be “the voices of people who are seeking and finding healing in their own lives that lead the way in this conversation.” But it’s not. We’re being silenced, both in real life and on most social media.

    I do also agree, “there’s so much we can act on and do something about! Starting with better protecting our youth from early trauma and abuse.” But given the reality that both the psychological and psychiatric industries, historically and today, have as a primary societal goal, and by DSM design, covering up child abuse as their primary goal, rather than actually helping child abuse survivors:

    https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1
    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://www.madinamerica.com/2016/04/heal-for-life/

    I’m quite certain that protection of child abuse survivors should be put into the hands of some other industry, or merely group of ethical people. Anyone other than the systemic, primarily child abuse and rape covering up, psychological and psychiatric industries.

    And, of course, our society should start arresting the pedophiles and child sex traffickers, who are destroying our society from within, with the help of the systemic child abuse and rape covering up psychologists and psychiatrists.

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  5. A few belts of electricity to the head seems to be working where I live. It wasn’t until the government passed the new Mental Health Act that doctors could feel safe forcing the teens into ‘treatment’ and not needing to get their parents consent. But now, as per an article by Dr Niall Mclaren on this site, we have increased the ECT rate by a whopping 194%.

    Now the word on the street (and on the TV by Drs such as Pat McGorry) is that ‘treatments’ such as Fish Oil once a day seem to be effective, so could you pass laws that will allow us to get these kids into ‘treatment’ asap. What they don’t seem to mention is that it isn’t fish oil they’re giving, but a dose of brutality dressed up as medicine. And I guess as word gets around these kiddies might think twice before posting anything on Facebook about how they’re really feeling about their lives.

    I’m sure these docs mean well, and I guess that the huge profits associated with ECT (see Dr McLarens article) are simply coincidental.

    Must admit these guys are good at exploiting the fears of parents. I think back to the ‘mental health professional’ who stated openly on TV that whilst the mental health system was good for others, don’t come near her child.

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  6. Unfortunately, the best treatments for suicidal depression are fought tooth and nail by Big Time Psychiatry because they aren’t drug based. What psychiatrist is going to risk his reputation, his office toys and his free vacation trips at pharmaceutical company expense, just to keep his patients safely alive, when they were bonkers enough to consult with him because they were severely depressed?

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  7. We have not been well served by the mental health community, especially the psychiatrists, who pretend that emotional distress is a disease, not a normal reaction to pain, abandonment, and hopelessness.
    There is a reason that suicides go down in times of war, and that is because then people get a sense that they belong, that they matter, that everyone, rich and poor, are inside the circle.
    But shrinkdom makes a fortune being the drug dealers of the nation, so that won’t stop anytime soon.
    Hugh Massengill, Eugene Oregon

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  8. Dr. Friedman isn’t going to be able to do anything about suicidally depressed teens, because he thinks depression is some kind of exotic disease to be treated with equally exotic drugs. Well, Doc, depression’s a syndrome that can arise from multiple (pedestrian) causes, not an independent illness awaiting treatment with a magic (and expensive) cure from Big Pharma.

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    • Lauren, I think we need to pump alternative information out there, ongoing, not relenting.
      To give people an alternative view of humanhood, experience. Psychiatry in it’s promotion that humanity should only have experiences of X Y Z, should be exposed for that simplistic thinking, or non- thought.
      The biases and abuse contained within such linear thought should be put out there more, igniting other people’s ability to think. If not immediately, possibly at a time when their brain is in alignment to connecting with information that is not linear.
      People are far from linear and it scares psychiatry and thus are born more “illness” in the DSM.
      It is high time to “brainwash” our children against psychiatry so perhaps they can “make up their own minds lol”.
      I sit here reading an article on MIA, and then see an ad chattering away on TV about “mental illness”.
      It would be refreshing to see alternative ads on TV. When the media FINALLY realizes that not allowing other information, is indeed censorship, then we will have moved forward.
      Journalists and media have absolutely NO rights in promoting an idea of biases unless that information is countered with an alternative view.

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  10. It’s well know that long use of benzos and antidepressants can be
    associated with suicide. From my own experience, and from years
    of reading and interaction, I know that a large fraction of ruin and
    suicides can be avoided if these dangerous drugs are not
    stopped or cut “quickly”.
    I’ve had a tough life, then in the last 6 years I’ve been tested
    beyond what I could imagine after stopping these drugs on my own
    out of fear of toxicity. I am only alive now because my wife would be
    left alone and likely hopeless in her twilight years.
    And entering a detox program is often a kiss of death; they don’t
    know that stopping under insurance guidelines often damages
    the brain and ruins the life.
    (it’s also well know that many have damaging reverse effects
    if they try to restart; and I am one of those)

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  11. Having medicalized social problems as disease
    and fraudulently diagnosed symptoms of bona fide diseases (called Medical Mimics/ Psychiatric Pretenders) as “Mental illness’s”
    “MH” is not remotely addressing or able to address the Social Determinates of Health
    or correct the underlying root causes be they social/spiritual/medical.
    There simply are no Mental Illness’s to treat.
    Unless and until the DSM is exposed as the fraud it is in a Junk Science lawsuit
    death, disability, addiction, WD and discrimination for profit will continue.
    Unfortunately, the court profits just as much as the misnomered “MH” system defrauding people of their lives, does. As such no one is accountable for harm they cause others; they simply cry “mental illness” get a label & drugs for life.
    It’s a sick world

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  12. More suicides means more treatment, pills, and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment, pills, and drugs means more suicides means more treatment pills and drugs means more suicides, means more treatment pills and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment pills and drugs means more treatment means more….
    Psychiatrist Richard Friedman practices a distinct sub-specialty of psychiatry known as “Genocidal Fascist”.
    Psychiatrist Friedman advocates for practices designed to maximize pain, suffering, distress and suicide….
    Because more suicides means more treatment, pills, and drugs, means more suicides means more treatment, pills and drugs means more suicides means more treatment, pills and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment, pills and drugs
    means more suicides means more treatment pills and drugs means more suicides means more treatment pills and drugs means more suicides means more treatment pills and drugs means MORE$$$$$$for Dr. Friedman and his ilk….

    psychiatry is a pseudoscience, a drug racket, a means of social control, and a vector for the Global De-Population Agenda of the U.N. and the Globalists/Progressives/Leftists/Liberals,Capitalists/Democrats, etc.,
    ….ain’t dat true fax Jack!…. Right, “oldhead”….????….

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  13. With all due respect Steve, that is simply not accurate. Nor is it helpful or fair to the millions of people with bona fide diseases being misdiagnosed because the physical ailment they are suffering from comes part and parcel with -symptoms- that have been commandeered by the pseudo-sciences AKA BIG”MH” as evidence that they are “mentally ill”.

    The medical profession is widely aware of “Medical Mimics” which are well documented in the literature. They are complex and universal across bodily systems. Perhaps the term “Psychiatric Pretender” (which I -think- Kelly Brogan coined and uses limited examples of) is more helpful as a tool to understand this critical, but largely ignored phenomenon.

    We know that symptoms such as depression, anxiety and psychosis are not diseases in and of them selves. Simply put, they are responses to the lack of or excess of a trigger and the bodies innate intelligent warning system that something is out of balance that needs to change. Drugging them into submission cures nothing, creates imbalance and triggers the disease response.

    “MH” built a fraudulent industry on a host of false premises, all of which revolve around the illogical fallacy that thoughts and feelings (negative mental/emotional experiences) are treatable diseases. This is called fear mongering and disease mongering.

    They severed people into compartments in order to tic off boxes to point to some imaginary illness that justified the need for their services. They severed human being, thus the very concept of a whole person and human health into imaginary compartments, they invented a hypothetical social construct called the “mind”, declared it capable of getting sick and in so doing, managed to control the lives of everyone they can convince this to be true.

    It takes on average 7 years to get an accurate “medical” diagnosis. It is far faster, easier and more profitable for millions of sloppy, lazy GP’s to simply misdiagnosis anyone with any “SYMPTOM” that fits into the false category “mental/emotional” to be slapped with a DSM label to ensure reimbursement, and as a convenient means of practising defensive medicine, where in the event that they harm the patient, they can claim s/he is “mentally ill” thus calling their credibility and wellness into question to begin with.

    The fact that the body gets sick and dies does not under any circumstances lend credence to the overall “mental health” scam.
    It IS the scam.
    it further reveals the scam and it is the basis of unravelling the scam. Assuming that’s the goal.

    I follow the awakening on Twitter and people with a host of real diseases including Thyroid, Lyme, B-12 deficiency to name but a few, know they were misdiagnosed and are speaking out about it. Kelly Brogan and Paula Caplan’s address women (bulk of the victims) whose health issues are highly falsely pathologized as Psychiatric in nature. There is a long well documented history of medical abuse and discrimination against women as “mad”.

    I do see how at first blush; one might consider that acknowledging the fact that people can have symptoms MISDIAGNOSED as “MI” means the flip side might that “MI” might actually exist, could be valid and be used by unscrupulous quacktisioner to maintain and augment their income.

    Again, with all due respect, its an illogical fallacy (I’m not sure which one) that suggests that because A exits, B must exist. One reality does not automatically verify the other. The opposite of a fact does not magically manifest into existence because a fact exists. That, again, is the slight of hand.

    The fact that the human body gets sick and dies, and bona fide testable diseases exist stands alone as an undeniable fact.

    The fact that insidious, deeply engrained, lies, disinformation and mass fraud such as “MI” exists, stands alone as a fact.

    One is the truth, the other is a lie.

    The lie cannot disappear the truth (it can only be used to further confuse and con people to buy into and spin their lives around a false belief to fulfill a social agenda.)

    The truth does not validate the lie (it can and must be used to expose the extend of the harm of the lie.)

    ©JMGayton MH/AB/CA 2020
    Sorry this is so long

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    • I don’t disagree with you on that point. There are certainly diseases and medical situations that cause what has come to be known as “mental illness.” My objection is only the idea that they are “mimicking a mental illness,” because there is no such thing as a “mental illness” to mimic, at least not as defined in the DSM. It is an absolute certainty that anything which is called a “mental illness” COULD be caused by real physiological problems (there are literally hundreds of examples), and one of the greatest harms done by psychiatry is to stop doctors and patients looking for actual causes and allowing the “mental illness diagnosis” stand in place of actual research into causes.

      SO in essence, it seems we agree with each other, terminology notwithstanding. I appreciate the feedback.

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      • Yes, totally agree Steve.
        Any number of illnesses, even death itself will present with MI.
        So in fact, now we can diagnose certain heart disease as not only “heart disease”, but also an “MI”. Called “co-morbid” disorders. Then they do “studies”, on how “MI, or depression as a “co-morbid” condition, results in earlier deaths”

        Some people are satisfied that it makes sense that stress from “real illness”=stress on body=earlier death.
        In “studies”, those studies we read, ALL heart patients, ALL Lyme is treated as equal in severity, and depression is looked at as some isolated thing that affects a percentage.
        This is so very false. And again is false information meant to further the psychiatric view.
        The real truth is, diseases vary in severity, which then looks like MI. Our science is so poor that we simply cannot measure severity, although some folks actually believe that 2 people suffering lung cancer should experience the same symptoms, never once entertaining the idea that the lungs are not just an empty bag, but rather very complicated.
        I am SO sick of reading “studies”, so tired of people believing studies about diseases they know nothing about, and all they can ever know about them is to experience their own unique presentation of disease and the falsities they read online or hear from the public.
        I know NOTHING about kidney disease, but I hold enough common sense that Mary and Nancy will experience their disease differently, NOT because one “tolerates” it better, but because the variability of disease. Pain causes “anxiety”. That is not MI.
        They often like to name the “disease” as causative of MI, so it kind of allows people to not see it as a defamation.
        It is all an attempt to reduce reality to MI. It is meant to minimize real disease. Developed to let a GP and shrink pass a patient back and forth.
        Chronic illness is frustrating for science so they try to make it look as if science is applied.

        Those absolute grubby tentacles of psychiatry.
        The biggest insult is to have psychiatry invade physical ailments.

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      • Another problem comes from not properly examining the “depressed”, which is where the examiner fails to look deeper into a patient’s depressed state and prescribes the wrong medication, a serious problem if the “depressed” patient actually has distorted perceptions. Such individuals can be turned from “depressed” to floridly psychotic by antidepressant therapy, leaving the shrink to devise bizarre explanations for this outcome (and cover up his/her negligence).

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