How Much of a Factor Is ADHD in Teen Suicide?

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Yet another distinct voice from the Palo Alto community writes in, a “longtime leader of a free, open-to-the-public Adult ADHD discussion group”:

Thanks to Hanna Rosin for her sensitively written story. When I saw her byline, I knew the piece would not be sensationalized. I live here in Silicon Valley, and I’m very familiar with this phenomenon of academic pressure and teen suicide.

One factor left out of the equation: ADHD. In the parents and the children. ADHD is one of the most inherited traits, almost right up there with height. Most people do not realize the risk for suicide among people with unrecognized or poorly managed ADHD. And here in the Bay Area, we draw these “stimulation seeking” folks from all over the world. Even though many people in this “coveted” school district are educated, sophisticated, and well-heeled, their ignorance about ADHD is astounding.

As the longtime leader of a free, open-to-the-public Adult ADHD discussion group of Palo Alto, I see the fallout every day, among people who were not diagnosed until their 30s, 40s, and even 80s. It is very difficult to find expert care for ADHD here, despite Silicon Valley’s “bookends” of Stanford and UCSF. Don’t go to either of these hallowed institutions expecting to find ADHD expertise. It is shocking.

It is also a fact. Parents who would not hesitate to give a “depressed” child an antidepressant, as if it is the only informed thing to do (in addition to therapy), will cite the Yellow Journalism in The New York Times as proof that ADHD is an invention of Big Pharma. Surely ADHD could not apply to their child. They live in Palo Alto. Their child is above average and gifted, just like them.

Yet they do not realize that a child who acts “depressed” might instead have ADHD. And giving that child an SSRI or other antidepressant could actually exacerbate ADHD symptoms, including ones around impulsiveness. ADHD-related suicides are typically impulsive, based on momentary feelings.

At our local group, we once welcomed a young man who had gone to Paly and had taken antidepressants all the way through for his “depression.” He enjoyed structure and strong support at home and at school. When he went away to college, however, he flopped miserably and was back home by the end of the first semester.

He did not discover that he might have ADHD until he joined some friends in abusing Adderall. While his friends were ready to go party, he was ready to sit down and read. He had focus like he never had. It was that chance “abuse” that led him to discover that he had ADHD, not “depression” (at least not exclusively).

I know that this phenomenon is complex, and Ms. Rosin has painted a vivid picture of the complexity. I would only add another missing detail: Do NOT give your child an antidepressant without a thorough screening for ADHD. And you must get educated before you even consult a mental-health professional, because there are as many biased fiefdoms in the mental-health field as there are in any field, perhaps more.

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