A clinical psychologist in Palo Alto recommends some reading on the subject:
The still unsurpassed professionally authored book about the diagnosis and treatment of ADHD is Lawrence Diller’s Running on Ritalin: A Physician Reflects on Children, Society, and Performance in a Pill. Diller has no ax to grind and doesn’t hesitate to prescribe stimulant medication when he believes it’s appropriate. But realizing that the “ADHD phenomenon” is extraordinarily complex, he refuses to overgeneralize, insisting that each patient is unique.
A reader in Lakewood, Colorado, shares her story:
I can’t help but share my own family experience: when our youngest daughter started to have anxiety symptoms in 8th grade, the mismanagement of her mental health crisis by the principal (interestingly enough, she was the principal of another school during a year of three suicides, and she let her own anxiety over the experience lead her response to our daughter’s problem), and how our daughter was finally diagnosed with inattentive ADHD and dyslexia.
We were so lucky that our daughter’s psychologist’s own daughter had been diagnosed with ADHD as a teenager, and how she was very aware that my daughter’s struggles to get organized at school (weak executive functioning) were the root of our daughter's anxiety, and not the other way around, as the school administration insisted.
The principal labeled her as suicidal, a description that was strongly disputed by the psychologist. She told us several times to demand from the school to stop doing uninformed, and probably illegal, mental health diagnosis.
We suspected that the interest of the school for labeling our daughter as suicidal was forcing her to leave the school. Even though the principal repeatedly told us and others that she was worried our daughter was suicidal, she never contacted the district Student Services office nor followed the district protocol for at-risk students. That was the unbelievable uninformed, uncaring, and misguided way of a school to deal with a child in a mental health crisis.
The good news was that the psychologist screened our daughter and referred her to the pediatrician and Child Psychology department from a local university, where she was finally diagnosed with ADHD and dyslexia. Since then we have had to deal with the stigma of ADHD diagnosis from some teachers and people in the community, but many others have been helpful.
About a year after diagnosis, my daughter’s anxiety is gone and she is a mature, happy, and confident teenager. Meanwhile, our school district (Jefferson County Public Schools in Colorado) is dealing with its own version of Palo Alto teen suicide crisis. Besides the three suicides at Green Mountain HS in 2002-03, last year Golden High School had three suicides, and since October of this year, another two local high schools have experienced one each—the second one only this week, according to a letter sent to parents of Arvada HS students on Monday. (On their favor, I have to add that the very capable and caring professionals have increased screening and services offered to students in crisis.)
This reader flags another spate of suicides:
The Atlantic has a similar cluster right in its own backyard. Woodson High, a relatively small high school in suburban D.C., experienced six suicides in two years (and depending on who you talk to, at least two more deaths were likely suicides that the family did not want disclosed). The area demographics are similar to Palo Alto, albeit without the glamour of high tech. This is not a Silicon Valley problem by a long shot.
Dr. Diller is an interesting guy. The son of Holocaust survivors, he took the trouble to acquire professional training that was considerably broader than the training that most physicians and other health care professionals receive.
That said, he’s not a psychiatrist and has very little background in any of the other traditional professional mental health disciplines, and his book, as good as it is, doesn’t really address the extremely complicated relationship between ADHD and traditional mental health diagnoses, especially depression. However, his intelligence and curiosity and old-fashioned commitment to treating the whole person (i.e., as opposed to push-button treatment-by-diagnosis) continue to make the book, which was published in 1998, essential reading for any person, lay or professional, who wants to understand and help anyone who suffers from one or more of these conditions.
I guess your thread (that just came to my attention) has been going a long time. Perhaps my response is still of interest. I read Hanna Rosin’s article on the Silicon Valley Suicides with great interest. Until very recently, I lived just a few miles north of Palo Alto. My beloved daughter, a recent Stanford graduate, took her own life in 2002 as a result of an adverse reaction to an SSRI antidepressant.
It was totally unexpected and out of character despite a brief period of mental distress due to insomnia and career upheaval. At the time she died, she was under the care of academic psychiatrists, whom I have now come to believe were a large part of the problem in her death rather than any solution. I know that in at least one of the cases Rosin referred to in her article, the young woman who jumped off an overpass, the victim was also under the care of revered professionals.
It’s my premise that not only the culture of Silicon Valley, but also, almost more importantly, the nature of the remedies that are being proposed in the name of mental health counseling, are to blame in these deaths.
Because I recognized immediately that my daughter’s death was the result of agitated and highly disturbed behavior brought on by medication adjustments in the last days of her life, I became a student of psychopharmacological safety and effectiveness. What I learned was highly disturbing. The FDA is far from a protector; it’s largely the puppet of pharmaceutical industry interests. Psychiatry itself is in the pocket of industry and promotes a highly flawed biomedical model for mental illness that divorces itself almost completely from the trauma and dysfunction that drive most symptoms of mental distress.
I co-founded the website SSRIStories.org, now administered by Julie Wood, who wrote an excellent series of articles (available on RxISK.org) about the significance of what is revealed in that database. I also testified at FDA hearings in 2004 and 2006 and my testimony, along with those of several other victims and survivors, led to a black box warning on antidepressants, which is all too often dismissed a decade later.
While I realize it would be reductionist to say that the suicides going on in Palo Alto are solely the result of adverse reactions to medication—not simply antidepressants, but also stimulants and other treatments that may have been started in childhood—this is still an issue that should be seriously considered. It is no secret that stimulants are now being promoted as a cognitive performance enhancer and Silicon Valley is a prime market for these drugs. [Related discussion in Notes here and here.] But how many people also know that they are a segue to other psychotropic drugs, since stimulants often lead to depression and/or mania? How many children are being labeled “bipolar” or “clinically depressed” because of their response to treatments they are receiving rather than any underlying condition?
As Ms. Rosin so poignantly (though implicitly) points out, these children are not suffering from “brain disease,” but rather some glaring societal and cultural pressures that are inappropriate and damaging. And these children and their parents are not being adequately alerted to the potential for harm of psychiatric drugs. Mental health professionals, least of all, understand that these drugs come with enormous risks of, yes, suicide and self harm, but also chronic dysthymia, sexual dysfunction, sleep disorders etc. etc.
The medications are not helping to alleviate the other broader pressures that exist in the environment (how could pills really do that?!); they are exacerbating those pressures, which is why, in my opinion, the number of suicides continues to grow.
How many of the victims in Silicon Valley were already being treated for mental disorders and how many had labels that are debilitating to live with when it’s the environment that should have the label, not the students? How many were taking medication, which is disabling and harmful over the long term, reducing rather than enhancing coping skills, unless used in a very cautious and short term way?
Mental health counseling, as it is practiced today, is, in so many cases, actually aggravating the problems rather than mitigating them. This is an issue very much worth investigating further for the sake of our next generation.
Thanks to our reader for sharing her personal and impassioned story. Anyone in the psychiatric community or pharmaceutical industry want to provide a different view of medications used to treat depression and other mood disorders? Drop us an email.
Charlotte Hornets point guard Jeremy Lin opened up to his fans in a long and heartfelt Facebook post last week that addressed his experiences dealing with professional and academic pressure, as well as suicides in his high school. Lin wrote that his reflections were prompted by the cover of this month’s Atlantic magazine, “The Silicon Valley Suicides,” a report of how expectations on high school students in the tech mecca could drive them to the brink of a dangerous — and sometimes fatal — depression.
Lin as a freshman sat next to a classmate who committed suicide, as did one of his friends the following year. From his Facebook post:
The pressure to succeed in high school is all too familiar to me. I distinctly remember being a freshman in high school, overwhelmed by the belief that my GPA over the next four years would make or break my life. My daily thought process was that every homework assignment, every project, every test could be the difference. The difference between a great college and a mediocre college. The difference between success and failure. The difference between happiness and misery.
That passage reminds me of one of the emails still sitting in our inbox, from a current senior at a high school “situated in the district of St. Louis with the highest median annual income.”
Anything less than perfect is inexcusable. And of course it’s overwhelming. I starting seeing a therapist my sophomore year.
It’s a common joke among my friends about how often we cry. (Though we almost certainly never let the others see.) It feels that a single mistake can end one’s future. I took a lit class sophomore year, and the teacher taught a lesson on cause and effect. She wrote this down: “Cause: You don’t study for your math test. Effect: ? ”
We were to fill in the effect. Most of the students filled out standard answers (You fail the test, your parents get mad, you get detention) but my friends and I, the high-achieving AP students plunked into a required course, differed. Almost uniformly, we wrote, “You fail the test. You get a poor grade in the class. Your GPA lowers. You don't get into college. You work minimum wage the rest of your life.”
This twisted script of cause and effect is rote to us, innate, and unquestionable. A single mistake ruins your life. Academia is horrifically high-stakes to us, and the pressure is awful.
I’m in five AP classes. I’m also on the speech and debate team, and National Honor Society, and president of the school’s a capella club. I love to write, so this November I participated in National Novel Writing Month, and I landed a main role in the spring musical. I sleep less than six hours a night.
I’m not trying to complain, but merely attempting to give context for this: my GPA is a 3.9. I consider this a failure because it is not a 4.0. And even though it’s perfectly understandable because I do take on a lot, it’s still a failure, because, theoretically, getting a 4.0 would have been possible. A friend of mine is president of the speech and debate team, vice president of our National Honor Society, president of our black students coalition, and in 5 AP classes as well. She has a perfect 4.0. Why shouldn't I?
Despite my course load and extracurriculars, I’m actually in a very good place, mentally. I’ve only cried twice this semester, and I feel tentatively optimistic about semester finals. But acceptance decisions for Early Action and Early Decision college applications come out next week and the one after. And my friend—the president of the debate team with a 4.0—broke down in tears last week because she has a B in AP Chemistry. So the stress never really ends.
Thanks to Hanna for writing this article. I haven’t seen many like it. (I did, however, watch the documentary Race to Nowhere last week, which focused similarly.) I hope that in the future, things will change.
Following the two clusters of youth suicides in Palo Alto in recent years, the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration have sent a five-person team to conduct an epidemiological assessment, the San Jose Mercury News reports.
More from the Mercury News:
The assessment will survey the extent of the health problem and track trends, as well as identify risk and protective factors, in coming up with recommendations for prevention. [...] Students and other community members have already taken numerous steps to support teens to discourage them from harming themselves. Schools are starting later so that students can get more sleep. Gunn High School students created a student support group. New fencing rims the Caltrain tracks. The school district and city have offered sessions on parenting and mental health issues. And counseling services have been expanded.
I am a 2012 Paly graduate, currently studying at Washington University in St. Louis. I’ve read Hanna Rosin’s “The Silicon Valley Suicides” four times now, but it feels like a hundred. The story is honest and true, and Rosin provides a clear overview of what has happened in Palo Alto, but it offers little that is new, at least not for someone who lived it. Rosin’s insights into Suniya Luthar’s research and the parallels between high achieving and underachieving inner-city and affluent kids are interesting and welcome, but ultimately the article provides a bird’s eye view of a community that deserves much more than that.
Here’s more from another reader, Jeremy Neff:
I grew up in Palo Alto, down the street from where the Blanchards live. I graduated from Gunn in 2012 and now I am a senior at George Washington University. Like everyone who went to Gunn when I did, I have powerful memories and emotions pertaining to the suicides of my peers. Below is my personal experience with suicide and a few current thoughts I have on the matter.
One drizzling night in early 2011, I sat in the lonely darkness of my home and wondered why I had to keep living. I was 16. I thought about how easy it would be to not do anymore homework, to not have to worry about whether I was cool, to not have to struggle to succeed in any of my passions, to not have to deal with any conflict, loneliness, or sadness.
It was 1 a.m., past my usual bedtime, and I was exhausted but still I couldn't sleep. I wanted a long rest. I didn’t think about how much my family loved me or about how my friends would cry years later when Facebook said it was my birthday or how everyone that knew me would feel unshakably sad at even the slightest mention of suicide.
Instead, I wondered how J.P. did it. I wondered if I could do it. I wondered if I had the strange courage one needed to walk two blocks to the tracks and let Caltrain sweep them away.
J.P. lived a block down the street from me. When I was 11, he came over for my older brother’s birthday and laughed when I made jokes about how nerdy my brother was. He was absolutely my favorite of my brother’s friends.
His suicide was also part of the reason I opened my front door and walked down to the crossing that night. I don’t know what I would have done if a train had come. Would I have remembered that killing myself would ruin my parents’ lives and hurt so many people? Or would I have made an impulsive leap and given up the mysterious struggle that awaited me in the rest of my life?
I stood in the shadows by the tracks for half an hour before I realized that Caltrain doesn’t run past midnight on weekdays. I didn’t tell anyone for five years, especially not my mother.
Looking back, it is hard to fully understand what drew me so close to tragedy. Certainly I had struggled with depression in the past, and had taken medication until I was 14. But I wasn’t struggling with depression in high school. Perhaps it was the feelings of inadequacy that come from being surrounded by brilliant and impressive people that drove me to consider suicide. But I definitely thought I was at least a little brilliant and impressive to some people, so that couldn’t be it. Mostly, I think I just thought nothing was worth living for.
Years later, at the ripe old age of 21, I look around me and see how I can matter in the world. I see how I can inspire someone, tell a story the world needs to hear, heal a community, bring ease or comfort to people who deserve it, or even just show one person that they are absolutely and without question beautiful and loved. But at the time, everything was just a selfish chore to help me succeed in the future.
For me, high school felt like a time to prepare so I could matter later. But that's wrong and unhealthy. My friends died and I could have too. It is wrong to think that being 16 is any less of a reason to tell a story, to heal a wound, or to make someone feel loved. And it is unhealthy when 2000 students at Gunn are doing great things like that every day, but feel selfish and unfulfilled because at the end of the day their accomplishments are going on a college app where all the beauty of their passions is reduced to a vain attempt to “be the best” and go to a selective college.
If you asked me what should be done, we could talk for hours. But I think most of it comes down to perspective and mental health. If only students fully understood how different the rest of the country was than Palo Alto, I think they would have monumentally less fear about succeeding and monumentally more optimism about how they could use their abilities to matter in the world. And if everyone had the same attitude about mental health as they did about physical health (such as having six-month mental health check-ups and getting easily excused for mental sick days), I think students would both have better mental health in the first place and feel less of a stigma when it came to reaching out for mental health care.
But as the article seems to conclude, it is impossible to be certain what might make a difference or why someone might find so much solace in death. I still don’t know why I walked down to the tracks that night, and I don’t think I ever will.
The family structure we’ve held up as the cultural ideal for the past half century has been a catastrophe for many. It’s time to figure out better ways to live together.
The scene is one many of us have somewhere in our family history: Dozens of people celebrating Thanksgiving or some other holiday around a makeshift stretch of family tables—siblings, cousins, aunts, uncles, great-aunts. The grandparents are telling the old family stories for the 37th time. “It was the most beautiful place you’ve ever seen in your life,” says one, remembering his first day in America. “There were lights everywhere … It was a celebration of light! I thought they were for me.”
The oldsters start squabbling about whose memory is better. “It was cold that day,” one says about some faraway memory. “What are you talking about? It was May, late May,” says another. The young children sit wide-eyed, absorbing family lore and trying to piece together the plotline of the generations.
The similarities between 2020 and 1972 are too astonishing to ignore. But there’s one big difference.
Let me begin with a confession. When I started to report out and write this article, I had a simple thesis: Bernie Sanders is not George McGovern.
The catastrophic loser of the 1972 presidential election, McGovern has become a convenient bogeyman for any moderate or conservative arguing that leftism is a fatal disease in a general election. McGovern won just one state, Massachusetts, while the incumbent, Richard Nixon, commanded 96 percent of the Electoral College vote. It was then the largest Republican landslide in U.S. history.
Surely, though, I thought, the McGovern analogy was just glibness masquerading as historical analysis. America in 1972 was a different country—before personal computers, Star Wars films, 40 years of rising income and wealth inequality, and the electoral gender gap.
How much do members of “Generation Alpha,” or any generation, really have in common?
The cutoff for being born into Generation X was about 1980, the cutoff for Generation Y (a.k.a. the Millennials) was about 1996, and the cutoff for Generation Z was about 2010. What should the next batch of babies be called—what comes after Z?
Alpha, apparently. That’s the (Greek) letter that the unofficial namers of generations—marketers, researchers, cultural commentators, and the like—have affixed to Gen Z’s successors, the oldest of whom are on the cusp of turning 10. The Generation Alpha label, if it lasts, follows the roughly 15-year cycle of generational delineations. Those delineations keep coming, even as, because of a variety of demographic factors, they seem to be getting less and less meaningful as a way of segmenting the population; in recent decades, there hasn’t been a clear-cut demographic development, like the postwar baby boom, to define a generation around, so the dividing lines are pretty arbitrary. How much do members of this new generation, or any generation, really have in common?
It’s shocking how many of the tropes of middle age have been acted out by the most visible tech titans. And now the companies they built are also showing signs of entering an existential crisis: Despite the ideals that drove their younger selves to excellence, they’ve gone corporate, sold out, and moved to the top of the power hierarchy instead of tearing it down.
How new technologies and techniques pioneered by dictators will shape the 2020 election
Updated at 2:30 p.m. ET on February 10, 2020.
One day last fall, I sat down to create a new Facebook account. I picked a forgettable name, snapped a profile pic with my face obscured, and clicked “Like” on the official pages of Donald Trump and his reelection campaign. Facebook’s algorithm prodded me to follow Ann Coulter, Fox Business, and a variety of fan pages with names like “In Trump We Trust.” I complied. I also gave my cellphone number to the Trump campaign, and joined a handful of private Facebook groups for MAGA diehards, one of which required an application that seemed designed to screen out interlopers.
The president’s reelection campaign was then in the midst of a multimillion-dollar ad blitz aimed at shaping Americans’ understanding of the recently launched impeachment proceedings. Thousands of micro-targeted ads had flooded the internet, portraying Trump as a heroic reformer cracking down on foreign corruption while Democrats plotted a coup. That this narrative bore little resemblance to reality seemed only to accelerate its spread. Right-wing websites amplified every claim. Pro-Trump forums teemed with conspiracy theories. An alternate information ecosystem was taking shape around the biggest news story in the country, and I wanted to see it from the inside.
The president has interpreted the Republican-controlled Senate’s vote to acquit as a writ of absolute power.
There are twokinds of Republican senators who voted to acquit Donald Trump in his impeachment trial two weeks ago: those who acknowledged he was guilty and voted to acquit anyway, and those who pretended the president had done nothing wrong.
“It was wrong for President Trump to mention former Vice President Biden on that phone call, and it was wrong for him to ask a foreign country to investigate a political rival,” Senator Susan Collins of Maine declared, but added that removing him “could have unpredictable and potentially adverse consequences for public confidence in our electoral process.”
But Collins, like her Republican colleagues Lisa Murkowski of Alaska and Lamar Alexander of Tennessee, was an outlier in admitting the president’s conduct was wrong. Most others in the caucus, like Senator Tom Cotton of Arkansas, deliberately missed the point, insisting that Democrats wanted the president removed for “pausing aid to Ukraine for a few weeks.”
The former chief of staff explained, in the clearest terms yet, his misgivings about Trump’s behavior regarding North Korea, immigration, and Ukraine.
MORRISTOWN, N.J.—Lieutenant Colonel Alexander Vindman, the former National Security Council aide and impeachment witness President Donald Trump fired Friday, was just doing his job, former White House Chief of Staff John Kelly told students and guests at a Drew University event here Wednesday night.
Over a 75-minute speech and Q&A session, Kelly laid out, in the clearest terms yet, his misgivings about Trump’s words and actions regarding North Korea, illegal immigration, military discipline, Ukraine, and the news media.
Kelly, a retired Marine Corps general, said that Vindman is blameless and was simply following the training he’d received as a soldier; migrants are “overwhelmingly good people” and “not all rapists”; and Trump’s decision to condition military aid to Ukraine on an investigation into his political rival Joe Biden upended long-standing U.S. policy.
Where socialism imagines greater concentrations of power, her vision ultimately points in the direction of a more decentralized, more competitive economy.
Despite all the newspaper endorsements, Senator Elizabeth Warren is an underappreciated politician—and the candidate herself is among the ranks of those who have sold her short. She is a deep and original political thinker. Over her time in academia and in the Senate, she has evolved a distinctive critique of American capitalism as presently practiced, and a lyrical vision of what might replace it. Based on her presidential campaign, however, you wouldn’t really know it.
While Warren has clashed with some of the candidates to her right—she chastised former South Bend Mayor Pete Buttigieg for his foray into a wine cave and accused former New York City Mayor Michael Bloomberg of oligarchic tendencies—she has declined to truly delineate herself from Senator Bernie Sanders. The sharpest distinction Warren has drawn with her ally from Vermont is her gender. In a more accurate rendering of the pair, that is only the beginning of their differences.
If there’s anything corporate America has a knack for, it’s inventing new, positive words that polish up old, negative ones. Silicon Valley has recast the chaotic-sounding “break things” and “disruption” as good things. An anxious cash grab is now a “monetization strategy,” and if you mess up and need to start over, just call it a “pivot” and press on. It’s the Uber for BS, you might say.
Cloying marketing-speak, of course, isn’t limited to the tech world. As a health reporter, much of my work involves wending my way through turgid academic studies, which are full of awkward turns of phrase such as salience and overweight (used as a noun, as in “the prevalence of overweight”). Even more tedious is reading some of the reports put out by nonprofit organizations, which always seem to want to arm “stakeholders” with tools for their “tool boxes.” I wish journalists were immune, given that we fancy ourselves to be plainspoken, but sadly common in our world is talk of “deep dives” and “impactful long form.” (Use of the word impactful is strongly discouraged by The Atlantic’s copy desk. As is the use of many other words.)
Americans don’t need Russia’s polarizing influence operations. They are plenty good enough at dividing themselves.
Updated at 6:06 p.m. ET on Friday, February 21.
“Please move.” The white woman doesn’t raise her voice; she’s got her shirt on inside out and she’s aiming a cellphone at the taco-truck vendors parked on her street. She wants them gone, and they’re telling her to go back inside. “Okay, baby girl,” she says. “Vamonos. I’ll call ICE.” “Stupida bitcha,” comes a reply.
A video of the confrontation, filmed outside a house in Dallas last spring, soon went viral, with the title “racist woman talking about shes gonna call ICE ON US FOR SELLING FOOD IN DALLAS WHEN WE HAVE PERMIT.” Within weeks, it had more than 170,000 views.
This is the new face of Russian propaganda. In 2016, the Kremlin invested heavily in creating memes and Facebook ads designed to stoke Americans’ distrust of the electoral system and one another. Now, after nearly four years under a president whose divisive rhetoric and policies have inflamed voter anger on issues such as race, inequality, and his own conduct, the Russian government is still interfering, but it doesn’t need to do much creative work anymore. The taco-truck video wasn’t fabricated in some St. Petersburg workshop. It was a real video of a real incident, made in America—and all Russia had to do was help it spread with its Twitter trolls.