The Medication Generation

How fear and psychiatric coercion are creating a mental health epidemic for adolescent girls.

At my center, I offer a specialized 16-week training program designed for parents of teenagers struggling with severe emotion dysregulation. These difficulties frequently manifest in persistent issues such as chronic school avoidance, suicidal ideation or attempts, non-suicidal self-injury, and impulsive behaviors. Alongside the comprehensive group training sessions held over the course of 16 weeks, I extend additional support through phone coaching/consultation calls and individual sessions as needed.

The overarching objective of the treatment is to stabilize what have evolved into episodes of crisis events, preventing recurrent hospitalizations, and establishing a consistent home environment. Here, parents serve as role models, demonstrating skills in emotion regulation, interpersonal effectiveness, and distress tolerance.

Additionally, they are empowered to set and enforce limits and boundaries for their children, fostering an environment conducive to learning and growth. More importantly, as you will read in this article, we attempt to prevent and/or recover from the ongoing harmful treatment that was previously provided.

Considering the severity of these crisis behaviors, one might assume that these parents have been struggling with chronic emotional and behavioral challenges since their children were young. Or the home environment may have been characterized by chaos or even abuse. Almost universally this has not been the case.

The majority of participants are parents of girls aged 13 to 16, whose challenges began to surface around the onset of puberty and may have been compounded by the repercussions of the pandemic. Nearly all exhibit a heightened level of emotional sensitivity, often leading to intense responses to perceived interpersonal rejection. Many rely heavily on their phones for social interaction, displaying what is commonly referred to as FOMO (fear of missing out).

Lacking the coping mechanisms to manage anxiety and navigate peer interactions, a significant portion have found themselves inundated by the stress of forming and maintaining relationships. For some, this leads to severe social and appearance anxieties, which are undoubtedly amplified by exposure to social media.

Others struggle with identity development, exhibiting rapid shifts in presentation influenced by the prevailing norms of their social circles. As anticipated, a subset may also experience gender dysphoria or identify as transgender.

While the media often attributes the current mental health crisis primarily to the pandemic, it's important to recognize that the escalation in suicide threats, self-injury, and psychiatric hospitalizations had been steadily rising prior to the pandemic. This trend predominantly affected girls, indicating that underlying factors beyond the pandemic also significantly contributed to the crisis.

Parents report various mood changes, many of which would have previously been viewed as normal during the onset of puberty. Young girls are at a heightened risk for mental health struggles during the onset of puberty as hormonal and body changes accompany a series of emotional and self esteem challenges.

Girls who heavily rely on social validation and derive their self-worth from peer feedback are at a heightened risk for a spectrum of emotional and behavioral challenges. They tend to be more susceptible to the adverse effects of social media.

How the school and home environment responds to these challenges is absolutely critical!

Are these issues comprehensively understood within the framework of developmental challenges?

Are emotional struggles acknowledged and addressed with opportunities to acquire skills for managing these emotions and effectively navigating genuine social challenges?

Is there effective management of phone usage and screen time?

Furthermore, are factors such as sleep, nutrition, and physical activity adequately prioritized?

Ultimately, how their problems are understood and communicated shape the outcome.

A Culture of Fear

What we're witnessing is the result of a culture driven by fear, perpetuated by the growing influence of psychiatry in Western societies. Schools, lacking sufficient resources, education, and expertise, have been influenced by years of fear-based conditioning. This has led to an over-reliance on psychiatric misunderstandings of emotional problems. It’s as if everything is a disorder requiring treatment. This was not the case 30 years ago (hint: mental health outcomes are much worse).

Understandably, schools are increasingly vigilant about addressing serious issues such as school violence, suicide, and drug use, all of which demand urgent attention. However, their concerns about potential crises and legal liabilities prompt reactions that inadvertently worsen the situation. In response, schools often request mental health evaluations and therapies, perpetuating the problems and creating new, more serious problems.

The road to hell is indeed often paved with good intentions. When a teenage girl in distress is introduced to school-based therapy or a mental health counselor, she begins to perceive her struggles through the lens of the mental health system.

Chances are, the therapist possesses fundamental skills in active listening and creating a supportive therapeutic environment. Consequently, the teenager quickly learns that emotional outbursts garner attention, nurturing, love, and validation. Conversely, other attempts (non-reactive) to express her difficulties may be overlooked, downplayed, or dismissed altogether.

This is the challenge of modern mental health care. The more extreme the reaction the greater the help.

What are they learning?

They are learning that emotional escalation gets their needs met and they are taken more seriously. This is not my opinion. This has been clearly articulated by many teenage girls at our center and by experts in the field.

Many therapists are deeply entrenched in the psychiatric paradigm, trained to diagnose according to the DSM and driven by fear of suicide and self-injury threats. This fear often prompts an overly cautious response, as therapists feel compelled to "cover their asses." Fear promotes more fear.

But do these therapists truly possess the expertise to treat complex issues like school refusal, suicidal threats, or self-injury?

Rarely.

They often default to a protocol driven by fear rather than effectiveness, outsourcing these situations to emergency rooms, psychiatrists, or physicians.

What are these teens learning?

School Refusal, Suicidal Threats and Self Injury

When an emotionally sensitive teenager faces body image or appearance anxiety, or perceives rejection from peers, they may resort to any means necessary to avoid confronting this perceived rejection.

This could begin with actions such as feigning illness, claiming a headache, or requesting a "mental health day." While these signs indicate stress and should be treated seriously, many parents are unsure of how to respond effectively.

When parents succumb to the request, the teenager's anxiety may temporarily decrease, inadvertently reinforcing this as an avoidant coping strategy. Consequently, when faced with difficulties at school, the teenager may seek refuge with the school nurse and employ the same strategy again.

Teens immersed in environments that emphasize "mental health" through the lens of the psychiatric medical establishment often perceive their emotional struggles as a "mental illness," "disability," or "chemical imbalance" necessitating medical intervention. They may view medication as validation of their condition, and the identification of a "disorder" temporarily alleviates the shame associated with their struggles. They hope it makes them feel less anxious. More secure. Even more confident.

“I HAVE depression”

“I HAVE anxiety”

“I HAVE ADHD”.

This narrative now frames their struggles within the context of a medical illness, which seems to explain why they are facing challenges. Instead of viewing their difficulties as a developmental phase with opportunities for growth and learning, they perceive them as manifestations of a medical condition beyond their control.

This is how the psychiatrists are explaining it to the parents. “If we treat (drug) the anxiety disorder she will feel less anxious”.

Hmmm.. Really?

Today's teenagers are additionally bombarded with psychiatric messaging on social media, where self-injury is portrayed as a valid expression of emotional pain, and suicidal threats can be seen as a way to seek validation and assistance. Consequently, when their emotional outbursts are met with forceful parental reactions, such as being pressured to attend school despite intense anxiety, the teenager may escalate their behavior further.

Instead of merely feigning illness, they might resort to more extreme measures, such as making suicidal threats or self-harming during moments of heightened emotional distress. This can leave the teen feeling deeply misunderstood, invalidated, and out of control.

Understandably, parents react with immense fear in such situations. They often yield to their teenager's desires and permit them to stay home. They may adopt a more nurturing, affectionate approach and become more attentive listeners.

What are the teens learning?

If the teenager is already involved in the mental health system, parents may reach out to their child's therapist, who typically advises a trip to the emergency room for assessment. If the teenager is not already in the mental health system, parents may feel that their only recourse is to take them to the emergency room to ensure their safety.

Fear, Psychiatric Coercion & “Mental Illness”

When they arrive at the emergency room, if the teenager has made a threat of suicide or engaged in non-suicidal self-injury, they will likely be admitted to the psychiatric unit for evaluation and monitoring. In these situations, an overwhelmed and undertrained social worker often determines the course of action based on what they perceive to be the safest option for the teenager.

Why take the risk?

The teenager is typically swiftly diagnosed with a series of psychiatric conditions by an inpatient psychiatrist, who often lacks any prior relationship, incentive, or vested interest in the outcome. Many individuals report that this diagnostic process takes as little as 15 minutes, with the doctor showing minimal interest in understanding the events leading up to the crisis moment. Instead, they often receive generic diagnoses such as "ADHD," "Depression," and "Anxiety," as if these were legitimate medical conditions requiring immediate treatment.

Indeed, the psychiatrist in the psychiatric unit often presents the image of authority, clad in a white coat and possibly even sporting a stethoscope around their neck. This appearance lends an air of legitimacy to their actions and diagnoses, reinforcing the perception that their assessments are unquestionably valid.

Within just 5 hours of admission to the hospital, the teenager is typically administered multiple psychiatric medications. Shockingly, if the teenager is over the age of 14, these medications are often administered without parental consent, raising serious ethical and legal concerns.

The majority of parents I've encountered express genuine reservations about psychiatric medications, but their concerns are often overridden by the doctor's confident assertion that these drugs are necessary for treating their child's "mental illness." Unfortunately, the doctor's authority and conviction in their prescription often dissuade parents from questioning the necessity or potential risks of the drugs.

Did they receive informed consent? Were the risks carefully weighed?

Hell no. They are the doctor, your kid is ill, you follow the plan.

In some instances where parents have refused psychiatric medications, doctors have resorted to extreme measures, such as threatening to involve child protective services. In other cases, they've employed fear tactics, asking parents, "Would you rather have a dead child?" These coercive tactics leave parents feeling trapped and pressured to comply with the doctor's recommendations, regardless of their reservations.

This marks the beginning of the journey into the mental health system, where parents are often directed to follow a protocol of medication combined with therapy. However, it's important to remember that the therapist their child is working with likely does not possess the expertise to effectively address these complex issues and reinforced the mental illness illusion.

Moreover, the medications prescribed are known to potentially exacerbate problems rather than resolve them. They are not medicine in the traditional sense; rather, they are potent mood and mind-altering drugs that carry significant risks and uncertainties.

Psychiatric drugs come with a plethora of adverse consequences, including but not limited to worsening mood, heightened risk of suicidal thoughts or behaviors, weight gain, emotional numbness, manic episodes, sleep disturbances, and even psychosis. The combination of drugs prescribed to these teenagers represents a form of experimentation on developing brains, as they have never been thoroughly studied in the specific combinations and dosages administered.

Psychiatrists are often treating adolescents with off-label medications, which means they are prescribed for uses not approved by regulatory authorities, thus operating outside the bounds of established safety and efficacy.

As anticipated, the inevitable unfolds. Since the teenager isn't learning how to effectively manage their emotions or address the genuine challenges they face in their social and academic lives, they often fall back into the same behavioral patterns.

In the most severe cases, the multiple medications prescribed exacerbate their condition. Unfortunately, psychiatrists frequently fail to recognize this deterioration as a reaction to the drugs, instead attributing it to the supposed progression of their "mental illness."

The cycle persists: emotional escalation, self-injury, and suicidal threats continue, leading the teenager back into the psychiatric hospital. The response remains eerily familiar: stop one drug, add another, increase the dosage, change the diagnosis. This relentless cycle epitomizes the hell that characterizes our current mental health treatment system.

The teenager, now labeled as "mentally ill," begins to internalize this identity, which permeates their interactions at home, school, and among peers. Every challenging emotional experience or distressing thought is now filtered through the lens of having a "mental illness." Parents are left bewildered, children's conditions worsen, and the situation spirals further out of control.

Through my interviews with parents entering our program, I've encountered alarming instances where teenagers are prescribed an astonishing number of psychiatric drugs—sometimes up to five or six medications simultaneously. Many of these teenagers have experienced significant weight gain, emotional volatility, and a profound change in their demeanor, becoming mere shadows of their former selves.

It's hard to characterize this situation as anything other than medical abuse.

The treatment has tragically morphed into the very disease it purports to cure. Despite the evident crisis in mental health treatment, the response from our government and medical establishment often involves allocating more funding toward the sam harmful treatment methods.

What’s the definition of insanity?

This perpetuation of a flawed system only exacerbates the suffering of vulnerable individuals and underscores the urgent need for a comprehensive overhaul of mental health care practices.

Picking up the Pieces

By the time parents arrive in my office, their child is deeply entrenched in the mental health system. They've embraced their diagnoses, diligently adhered to prescribed medications, and engaged in ongoing therapy sessions. They're earnestly following medical recommendations, yet despite these efforts, the outcomes are typically far from favorable. This is not an exaggeration; the situation often deteriorates.

So, what's the remedy?

Let's go back to the beginning. How did these problems start, and how were they addressed? Have you thought about the effects of the prescribed medications? Are you familiar with the black box warning associated with some of these drugs? Did you know that many of these medications were never thoroughly evaluated for use in children and are being prescribed off-label? Additionally, combining these drugs without established safety or efficacy profiles raises serious concerns. It's important to understand that behaviors like agitation, sleep disturbances, fatigue, and weight gain may actually be caused by the medications themselves.

Let’s safely titrate off these drugs and observe baseline.

It's time to reclaim some common sense. Your child isn't mentally ill, but the treatment provided may certainly make anyone feel overwhelmed. Let's focus on restoring your child's health. It's time to reintroduce structure and authority into your home. Give your teenager the chance to learn and grow. She can develop skills to manage difficult emotions and confront fears. She can enhance her interpersonal effectiveness. She is not disabled and do not reinforce that reality.

Let's begin by detoxing her from excessive phone use and getting her actively engaged in life. There is no path to feeling well sitting in bed all day with her head in the phone.

Parents often express a sense of relief and approval when I confirm what they've always believed to be true. Deep down, they doubted whether hospitalization and medication would truly help their child. However, fear of not adhering to medical advice held them back.

Nowadays, many of us harbor reservations about following standard medical recommendations. The erosion of trust in our healthcare system is a profound tragedy.

It's crucial to ask ourselves: How did we end up here?

No more bystanders.