Philip Dawdy’s post Texas Teen Commits Suicide After Taking Lexapro contains a link to a streaming video of a newscast. At one point in the news story, the dead girl’s father talks about how Kayla was going from highs to lows, typical of most teenagers. Then the newscaster’s voiceover says, “But when the highs became higher and the lows lower, a doctor placed Kayla on Lexapro.”

Now, it’s very likely he could have gotten this wrong. The media gets quite a lot of things wrong. But if he’s right, and Kayla was vacillating between abnormally low lows and abnormally high highs, then it’s not just Forest that her parents should be thinking of suing. Prescribing an antidepressant alone for someone who shows signs of being manic-depressive is criminally stupid, especially if you don’t provide them with adequate information and follow-up care.

I am tired of tragedies happening to families all because of people who should know better, or who should care, and don’t.

Some brief thoughts, most about the Virginia Tech shootings. Most are interrelated, but some kind of aren’t.

• Postmortem diagnosis of someone you’ve never met is stupid and pointless. This doesn’t mean that I’m entirely uninterested in it (hey, I have a copy of Touched with Fire, too), but I doubt its usefulness.
• I’m a good Canadian girl and I like gun control. I am not very interested in discussing this point any further in general, and I’m certainly not interested in doing so right now.
• I am shocked and appalled that Virginia Tech didn’t lock down campus and cancel classes after the first shooting incident at 7 a.m. I have a hard time imagining that a university wouldn’t do that. It’s terrible. I know the police thought they had apprehended the perpetrator, but shouldn’t the university have done something more just in case there was more than one shooter or the police had the wrong guy, which just so happened to be the case? I disagree with a lot of things that one of the universities I attended has done, but I’m positive they would have cancelled classes and done a better job of warning people.
• It is fucking hard to be mentally ill in university, but I think that might have had surprisingly little to do with the Virginia Tech shootings. I’m crazy, I was really ill in university, and most of the treatment I received only made me worse. But I’ve never killed anyone. My mom thinks that better mental health treatment for university students could prevent further mass murders; I don’t necessarily agree. I do think that mental health on campus is a very serious problem, though, and solutions like threatening to kick me out of residence for cutting myself superficially don’t help anyone.
• People have talked about how the people around Cho should have reached out to him. It seems, though, that some people did reach out to Cho while he was at university. He merely ignored and brushed off any attempt at friendliness. It was pretty nice of people to try to talk to him at all, since he scared the shit out of plenty of other people. I like to think I’m a generally nice person, but if there was some guy who followed girls around and repeatedly sent them emails or whatever after they’d asked him to stop, and surreptitiously took photos of girls and blamed it on other guys, and ignored people who spoke to him, well, I don’t see that there’s any problem with me being too scared of him to try to “reach out” to him. (As a side note, one of the guys who raped me, I later found out, had a previous history of stalking other girls when he took classes at the local university. This was not at the same university I have referred to previously, we were not on campus when he raped me, and he was not even a student when he raped me… but he did later get a part time job on that campus, despite the previous complaints that he was a stalker.)
• I do think, however, that Cho really could have used some compassion when he was younger. Maybe if his peers and other people had been kinder to him in high school, or junior high school, or elementary school, it would have helped him and he wouldn’t have become the twisted person he eventually did become.
• Since I’m very fond of freedom of speech and freedom of expression, it doesn’t bother me that Cho Seung-Hui’s plays were violent, profane, and bizarre. It bothers me that they were poorly-written and pointless as well as being violent, profane, and bizarre. This is not me poking fun at bad writing; this is me writing badly myself as I fail utterly in my explanation of why I do agree that they were somewhat disturbing. Mainly I guess, they seemed like the kind of thing that someone who’s 23 should have moved way beyond.
• In theory, I have absolutely nothing against the idea of briefly hospitalizing someone involuntarily if she is judged to be in imminent danger of harming herself or others. In theory, I am all for this. In practice, sometimes it even saves lives… but other times it’s extremely damaging. I could go on and on about this, but since it wouldn’t fit into point form, I’ll have to get back to it another day.
• People are responsible for their actions unless they are so completely psychotic that they honestly can’t tell right from wrong. You know, the legal definition of insanity. This doesn’t happen all that often. I have been that way only once, and this one time where I had zero chance of controlling myself lasted only for minutes. I had been psychotic nearly constantly for several months at that point, but the actual insanity lasted only minutes.
• At that point, I snapped back to being 99% out of control. And at 99% out of control rather than 100%, you are responsible for your actions. At that point, it’s extremely difficult to talk yourself out of things you’re about to do, but it’s not impossible. At that point, psychosis is an explanation for your actions, but it’s not an excuse.
• I am generally harder on myself than I am on anyone else. Additionally, not being in anyone else’s head, I don’t know how I’d judge whether they were 99% or 100% out of control. But if I did have a way to judge that, I’d hold other people to the same standards of responsibility to which I hold myself.

It’s so depressing. From the Times Online, Bullied girl ’stepped in front of train’.

A 14-year-old girl stepped in front of a train after her stepbrother confronted a classmate accused of bullying her, an inquest heard yesterday.

Kay Miller, who suffered from anorexia and a borderline personality disorder, panicked after her brother, a Welsh Guardsman, pushed the alleged bully over a wall and warned him to leave her alone…

…In a written statement her sister, Chloe, said: “I was with Kay, my stepdad and Geraint when we saw Scott Walker.

“He was in Kay’s class at school and he was saying things to her. Geraint went over and said, ‘Leave Kay alone.’ More of Scott’s friend’s came along. Scott’s sister slapped Geraint across the face. But he didn’t react. Tim told us to go home but Kay just ran away crying. She was a bit hysterical.”

God, I hate bullying. I’m so glad I’m not in junior high anymore. I’m so glad I got through it without killing myself, even though one of the bullies suggested that I should commit suicide. Yeah, like I was going to do anything that they said to do.

The inquest heard that the teenager had suffered from “borderline personality disorder” for six years. But she was tackling her problems and had lectured to more than 300 people on her eating disorder.

Also, how much do you think it helped this girl to diagnose her with borderline personality disorder at the age of eight? Would you say not at all? I would. Would you say it probably hurt her more than it helped her? I certainly would.

I’m just mentioning that this Associated Press article exists: Benefits trump risks for children taking antidepressants: study. I don’t remember reading about it before.

The authors of a new comprehensive analysis of antidepressants for children and teenagers say the benefits of treatment trump the small risk of increasing some patients’ chances of having suicidal thoughts and behaviours.

The risk they found is lower than the one the U.S. Food and Drug Administration identified in 2004, the year the agency warned the public about the drugs’ risks for children.

After the warning, U.S. youth suicides increased and some mental health experts said reluctance to try antidepressants might be to blame.

The new analysis includes data from seven studies that were not part of the FDA analysis…

The abstract of the actual journal article is here, but I don’t think I can read the whole thing for free and don’t really feel like commenting on the study results without having read it.

Anyway, more from the AP article:

“The medications are safe and effective and should be considered as an important part of treatment,” said study co-author Dr. David Brent of the University of Pittsburgh School of Medicine. “The benefits seem favourable compared to the small risk of suicidal thoughts and behaviour.”

Effective, when only Prozac worked better than placebo in depressed children under twelve, and none of the other antidepressants in the studies did? When overall, 61 per cent of depressed kids and teens in the studies improved on antidepressants and 50 per cent on placebo? (The data are better for OCD and other anxiety disorders, which I think we already knew, but I’m less personally interested in anxiety disorders.) I know that research-wise, you can define this as “effective,” but as a patient, it’s not good enough for me. So I at least appreciate that the article mentions the need for careful monitoring of the effects that antidepressants have on children and teens taking them:

Dr. John March, chief of child and adolescent psychiatry at Duke University Medical Center, welcomed the study as “the most comprehensive analysis of the data yet put together.”

He said the suicidal behaviour risk, although lower than that found by the FDA, demands that doctors and families watch for warning signs…

If I thought antidepressants were completely evil, I wouldn’t be taking them. I’ve taken them since I was a teenager. I have found them beneficial at times. I’m finding Zoloft beneficial now. But I think that even if this study is accurate and antidepressants will cause suicidality in only one out of 101 kids who take them (and I’m not saying it is accurate; I haven’t even read the thing), that’s still a cause for concern. And so do the parents of kids who are suicidal or dead because of antidepressants.

Is it wrong for me to be amused that one of the co-authors of the study has the same name as the incompetent boss from The Office? Probably, but hey, if it’s wrong, I don’t want to be right. No offense meant to Dr. Brent, I swear.