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Antidepressants linked to increased suicide and self-harm in teens
A new study pushes back on psychiatry industry talking points.
- Australian researchers note a link between rising antidepressant usage and rising suicide rates in youth.
- Their research pushes back on psychiatry talking points that SSRIs decrease suicide risk.
- The top method for self-harm and suicide in younger age groups is overdosing antidepressants.
In 1947, Dr. Howard Rusk published an article in the NY Times. The doctor is advocating for better public education on issues of mental health. Considered to be the founder of rehabilitation medicine, Rusk was trying to destigmatize mental disorders in the same manner as physical disorders.
Psychiatrists were facing an upward battle. "Madness" was considered an aberration, not a treatable ailment, in a health care system that was increasingly relying on pharmacology. Thanks to a new class of tranquilizers showing promising results, Rusk drew a parallel between diseases of the brain and diseases of the body.
"We must realize that mental problems are just as real as physical disease," he wrote, "and that anxiety and depression require active therapy as much as appendicitis and pneumonia."
As a rehabilitation specialist, Rusk knew the importance of physical movement for trauma recovery. He was likely aware of the connection between physical and mental health. Unfortunately, his good intentions were usurped by the psychiatry industry. Desiring status equivalent to medical doctors, psychiatrists understood that having a "painkiller" in their arsenal would cause the public to treat their profession with the same regard.
The process took another four decades to unfold. By the time Prozac was released on the American market in 1987, the chemical imbalance theory of anxiety and depression had become the going narrative in the psychiatry industry. Once a narrative grips the public's imagination, it's difficult to overturn. Psychiatrists finally achieved a similar status as medical doctors thanks to the parallel Rusk drew forty years before.
A safety narrative has long been attached to the chemical imbalance story: antidepressants are a safe intervention in the treatment of anxiety and depression. As three Australian researchers—Martin Whitely at John Curtin Institute of Public Policy in Perth and Melissa Raven and Jon Jureidini at the University of Adelaide's Critical and Ethical Mental Health Research Group—write in a new study, that story is suspect.
Published in Frontiers in Psychiatry, these researchers push back on the narrative that antidepressants decrease the risk of suicide. Since the FDA first issued a black box warning citing an increased risk of suicidal thoughts and behaviors in adults under age 18, psychiatrists and public officials have contested any link between antidepressants and self-harm.
Antidepressants Can Cause Suicide and Homicide — Peter Gotzsche, M.D.
Australia, which ranks second in the world in per-capita consumers of antidepressants among OECD countries, has never been provided the same safeguards as America—and the efficacy of America's safety measures are questionable at best. The FDA first issued that block box warning in 2004, updating it to reflect adults under age 25 three years later. In 2005, the Australian Therapeutic Goods Administration (TGA) required leaflets be included in antidepressant packages to reflect the risk of suicidal ideation.
The researchers write that the data put forward by psychiatrists and mental health organizations was misleading. Much like the industry ran with Rusk's assertion, many professionals cite a 2007 ecological study by Robert D. Gibbons that incorrectly associates SSRI usage with a decreased risk of suicide among U.S. youth. This misreading is the basis of the narrative of minimized harm.
The data tells another story. The researchers point out that between 2008-2018, prescriptions for antidepressant (predominantly SSRIs) increased by 66 percent in the 0-27 year age group, while suicide rates increased by 49 percent in a similar age group (0-24 years). Between the years of 2006-2016, there was a 98 percent increase in intentional poisonings in New South Wales and Victoria. An overlap emerges: the most common method of attempted self-harm and suicide is prescription antidepressants.
"There is clear evidence that more young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them."
The researchers note that the FDA has long been criticized for not offering more non-pharmacological treatments. The cost of psychotherapy is prohibitive for many in the U.S. health care system. The reflex action of the medical establishment is to write a script. When one pill doesn't work or loses efficacy, it's usually replaced by another pill or added to an ever-growing pharmacological cocktail. Some people take four to six (or more) drugs to manage mental distress, each one countering the side effects of the other.
Photo: Ryan McGuire / Pixabay
As in America, Australia suffers from corporate lobbying. The team writes that many opinion leaders receive funding from pharmaceutical companies; it makes sense that these figures will tout the benefits of antidepressants while downplaying potential harm. They also note that governing bodies are likely relying on outdated evidence of risk, which translates into a lack of consumer awareness.
They also write that general practitioners account for 90.4 percent of antidepressant prescriptions in Australia. Since mental health is not their area of expertise, they often repeat what psychiatrists initially prescribed.
Correlation is not causation, a limitation the researchers acknowledge. They list another cocktail, this one labelled "drivers of mental health distress." Smartphone addiction, online bullying, lack of meaningful relationships, climate change, and debt top the list. Antidepressants are not the cause of mental distress. What we need to know is whether they help alleviate it or add to the burden.
This forces us to confront a longstanding question: Why are we treating the symptoms of mental health problems with pills while never addressing their actual cause? Put another way, why does the psychiatry industry rely on pills with a long list of side effects instead of addressing the environmental and social issues that are at the foundation of mental distress? And why are we putting increasingly higher numbers of teenagers on drugs that negatively impact their brains while their prefrontal cortex is still in development? This seems to set them up for a lifetime of dependence, which is a great profit model but a terrible health care solution.
The psychiatry industry faced an existential crisis in the nineteen-seventies when the public grew weary of their growing reliance on drugs. The industry's response was to double down on pharmacology. Thanks for a massive PR campaign around Prozac, that move worked. You cannot both have increasing numbers of prescriptions and increasing mental health problems and pretend that this intervention is working.
While more work needs to be done, the researchers are confident in their assertion between increased self-harm with antidepressant usage.
"These results are consistent with the hypothesis that antidepressants increase the risk of suicidality and self-harm in young people. Furthermore, they provide compelling evidence that the antidepressants prescribed to children and adolescents are frequently the means of self-harm."
These children deserve more from us at a pivotal time in their development. The psychiatry industry needs to come through this existential crisis with better solutions.
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From "if-by-whiskey" to the McNamara fallacy, being able to spot logical missteps is an invaluable skill.
- A fallacy is the use of invalid or faulty reasoning in an argument.
- There are two broad types of logical fallacies: formal and informal.
- A formal fallacy describes a flaw in the construction of a deductive argument, while an informal fallacy describes an error in reasoning.
Appeal to privacy<p>When someone behaves in a way that negatively affects (or could affect) others, but then gets upset when others criticize their behavior, they're likely engaging in the appeal to privacy — or "mind your own business" — fallacy. Examples:<br></p><ul><li>Someone who speeds excessively on the highway, considering his driving to be his own business.</li><li>Someone who doesn't see a reason to bathe or wear deodorant, but then boards a packed 10-hour flight.</li></ul><p>Language to watch out for: "You're not the boss of me." "Worry about yourself."</p>
Sunk cost fallacy<p>When someone argues for continuing a course of action despite evidence showing it's a mistake, it's often a sunk cost fallacy. The flawed logic here is something like: "We've already invested so much in this plan, we can't give up now." Examples:<br></p><ul><li>Someone who intentionally overeats at an all-you-can-eat buffet just to get their "money's worth"</li><li>A scientist who won't admit his theory is incorrect because it would be too painful or costly</li></ul><p>Language to watch out for: "We must stay the course." "I've already invested so much...." "We've always done it this way, so we'll keep doing it this way."</p>
If-by-whiskey<p>This fallacy is named after a speech given in 1952 by <a href="https://en.wikipedia.org/wiki/Noah_S._Sweat" target="_blank">Noah S. "Soggy" Sweat, Jr.</a>, a state representative for <a href="https://en.wikipedia.org/wiki/Mississippi" target="_blank">Mississippi</a>, on the subject of whether the state should legalize alcohol. Sweat's argument on prohibition was (to paraphrase):<br></p><p><em>If, by whiskey, you mean the devil's brew that causes so many problems in society, then I'm against it. But if whiskey means the oil of conversation, the philosopher's wine, "</em><em>the stimulating drink that puts the spring in the old gentleman's step on a frosty, crispy morning;" then I am certainly for it.</em></p>
Slippery slope<p>This fallacy involves arguing against a position because you think choosing it would start a chain reaction of bad things, even though there's little evidence to support your claim. Example:<br></p><ul><li>"We can't allow abortion because then society will lose its general respect for life, and it'll become harder to punish people for committing violent acts like murder."</li><li>"We can't legalize gay marriage. If we do, what's next? Allowing people to marry cats and dogs?" (Some people actually made this <a href="https://www.daytondailynews.com/news/national/cats-marrying-dogs-and-five-other-things-same-sex-marriage-won-mean/dLV9jKqkJOWUFZrSBETWkK/" target="_blank">argument</a> before same-sex marriage was legalized in the U.S.)</li></ul><p>Of course, sometimes decisions <em>do </em>start a chain reaction, which could be bad. The slippery slope device only becomes a fallacy when there's no evidence to suggest that chain reaction would actually occur.</p><p>Language to watch out for: "If we do that, then what's next?"</p>
"There is no alternative"<p><span style="background-color: initial;">A modification of the </span><a href="https://en.wikipedia.org/wiki/False_dilemma" target="_blank" style="background-color: initial;">false dilemma</a><span style="background-color: initial;">, this fallacy (often abbreviated to TINA) argues for a specific position because there are no realistic alternatives. Former British Prime Minister Margaret Thatcher used this exact line as a slogan to defend capitalism, and it's still used today to that same end: Sure, capitalism has its problems, but we've seen the horrors that occur when we try anything else, so there is no alternative.</span><br></p><p>Language to watch out for: "If I had a magic wand…" "What <em>else</em> are we going to do?!"</p>
Ad hoc arguments<p>An ad hoc argument isn't really a logical fallacy, but it is a fallacious rhetorical strategy that's common and often hard to spot. It occurs when someone's claim is threatened with counterevidence, so they come up with a rationale to dismiss the counterevidence, hoping to protect their original claim. Ad hoc claims aren't designed to be generalizable. Instead, they're typically invented in the moment. <a href="https://rationalwiki.org/wiki/Ad_hoc" target="_blank">RationalWiki</a> provides an example:<br></p><p style="margin-left: 20px;">Alice: "It is clearly said in the Bible that the Ark was 450 feet long, 75 feet wide and 45 feet high."</p><p style="margin-left: 20px;">Bob: "A purely wooden vessel of that size could not be constructed; the largest real wooden vessels were Chinese treasure ships which required iron hoops to build their keels. Even the <em>Wyoming</em> which was built in 1909 and had iron braces had problems with her hull flexing and opening up and needed constant mechanical pumping to stop her hold flooding."</p><p style="margin-left: 20px;">Alice: "It's possible that God intervened and allowed the Ark to float, and since we don't know what gopher wood is, it is possible that it is a much stronger form of wood than any that comes from a modern tree."</p>
Snow job<p><span style="background-color: initial;">This fallacy occurs when someone doesn't really have a strong argument, so they just throw a bunch of irrelevant facts, numbers, anecdotes and other information at the audience to confuse the issue, making it harder to refute the original claim. Example:</span><br></p><ul><li>A tobacco company spokesperson who is confronted about the health risks of smoking, but then proceeds to show graph after graph depicting many of the other ways people develop cancer, and how cancer metastasizes in the body, etc.</li></ul><p>Watch out for long-winded, data-heavy arguments that seem confusing by design.</p>
McNamara fallacy<p>Named after <a href="https://en.wikipedia.org/wiki/Robert_McNamara" target="_blank">Robert McNamara</a>, the <a href="https://en.wikipedia.org/wiki/United_States_Secretary_of_Defense" target="_blank">U.S. secretary of defense</a> from 1961 to 1968, this fallacy occurs when decisions are made based solely on <em>quantitative metrics or observations,</em> ignoring other factors. It stems from the Vietnam War, in which McNamara sought to develop a formula to measure progress in the war. He decided on bodycount. But this "objective" formula didn't account for other important factors, such as the possibility that the Vietnamese people would never surrender.<br></p><p>You could also imagine this fallacy playing out in a medical situation. Imagine a terminal cancer patient has a tumor, and a certain procedure helps to reduce the size of the tumor, but also causes a lot of pain. Ignoring quality of life would be an example of the McNamara fallacy.</p><p>Language to watch out for: "You can't measure that, so it's not important."</p>
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".
Generation Ships<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a1e6445c7168d293a6da3f9600f534a2"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/H2f0Wd3zNj0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Many of the most popular apps are about self-improvement.
Emotions are the newest hot commodity, and we can't get enough.