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Fire and firewater in Native America

There is a mental health crisis in Indian country, and its casualties are
the young. From suicide clusters on the northern Plains to the school
shooting at Red Lake, Native youth have spent this year issuing a
collective cry for help more plaintive and more chilling than any since
Wounded Knee.

There is no sadder evidence of this than the 17 teenagers who killed
themselves in recent months at Cheyenne River. As Julie Garreau, executive
director of the Cheyenne River Youth Project, recently testified: "Some of
these suicides were young men who had made a suicide pact with one another.
They drew numbers, and decided to hang themselves in that order. One by one
their families found these boys, often hanging in their homes, as their
number came up."

When I first heard that story - still reeling at the news from Red Lake -
my immediate reaction was to wonder if the same might not be said for the
human species as a whole. Was our number up, too? Are the kids simply
taking themselves out first?

An overreaction, I'll admit. But this is a situation that compels a
dramatic response.

Consider the numbers: While the suicide rate has fallen for most social
groups in America, it is on the rise among teenagers and American Indians.
According to the American Academy of Child and Adolescent Psychiatry, the
rate of suicide among American adolescents has tripled since 1960. The
trends are even worse when the adolescents are Natives.

If you are an Indian, you are already 72 percent more likely to commit
suicide than the average American, according to the IHS. If you are an
Indian teen, however, you are over 300 percent more likely. And if you are
a Native teenager living on the northern Plains, you are fully 10 times as
likely to initiate your own death.

Of course, none of this is meant to detract from the successes of Native
youths who are doing well. In fact, the ironic flipside of this crisis is
the very good news that many young Indian lives are improving, as seen for
example in certain indicators of academic performance and reduced poverty
rates.

But we should not fall into the dangerous trap of thinking that only some
of us - the "abnormal" - are afflicted with individual emotional problems
right now. This is a community crisis.

Think of it as a burning house. People in some rooms might be untouched by
the fire, perhaps even unaware of the blaze; but in adjacent rooms, others
are choking on smoke. The goal isn't simply to offer oxygen to the
suffering. The goal is to put out the fire.

So how can we keep our houses from burning down?

First, we must understand what we're dealing with here: mass unhappiness.
There is no lurking scientific mystery. What doctors call depression is
simply a persistent unhappy emotional response to life: intense sadness,
often accompanied by feelings of hopelessness, despair, self-loathing or
guilt.

In the 19th century this emotional state was called "melancholy," and it
was believed to result from an excess of black bile in the body. During the
20th century it was termed "depression," then designated as a "disease,"
and finally described as a "chemical imbalance" in the brain. Soon it
became common to speak of "clinical depression."

Whatever we call it, it's still unhappiness: an emotional response to life.

Everyone wants the pain to stop, but there is little agreement about how to
do it. Increasingly in our society - the same society that invented the
concept of clinical depression - the trend is to focus on chemical
imbalances and medicines designed to correct them.

We've all heard the brand names before: Prozac, Zoloft, Luvox, Celexa,
Paxil. Doctors call this class of drugs "selective serotonin reuptake
inhibitors," or SSRIs, but they're more commonly referred to as
antidepressants. What they do is artificially cause an excess of the
neurotransmitter serotonin to accumulate in the brain's synapses, the idea
being that the brain will respond with more activity, and hence, more
happiness.

It is certainly true that unhappy emotions are the result of chemical
reactions in the brain. So are all emotions. But there are significant
problems with the idea of relying on drugs to regulate feelings.

For one, serotonin is only one of hundreds of brain chemicals, and very
little is known about them or their relationships to each other. Little
wonder that research studies and clinical trials are very sketchy on the
question if SSRIs work at all, let alone in ways we might desire. In some
studies, depressive symptoms respond just as well to placebos as SSRIs.

For another, there is evidence suggesting that SSRIs are dangerous,
especially for children and adolescents, and can actually increase thoughts
of suicide - and homicide. Psychiatrists David Wilkinson, David Healy and
Peter Breggin have all written extensively on these dangers, suggesting
that the current popularity of SSRIs has less to do with beneficial results
than drug companies' desire for profits.

SSRIs have also been found on the scene of several school shootings. Eric
Harris was on Luvox when he conducted the Columbine assault. Jeff Weise had
his Prozac dosage increased shortly before the Red Lake shootings. Some
have speculated that SSRIs may have played a role in these and other
violent outbursts committed by young people, begging the question: why
isn't this a major national issue?

It is, elsewhere. In 2003 England banned the prescription of SSRIs to
minors, then in 2004 issued a strong warning against adult prescriptions as
well. That same year, the European Union banned Paxil across Europe. Closer
to home, last October the FDA followed suit, but only with mandatory black
box warning labels on SSRI packages.

I think sovereign indigenous nations should consider SSRI bans of their
own, at least for people under the age of 18. There are no legal precedents
against such a ban in Indian country, so why not? As a potentially
dangerous panacea for troubled times, SSRIs just might be the new
firewater.

At very least, no one can say with absolute certainty what SSRIs actually
do. But we can all see what they cannot do.

Drugs cannot address the real social forces operative in peoples' lives.
They do not counter the violence of poverty, abuse or addiction. They are
unable to address the needs of an adequate diet, decent health care or a
sustainable environment. They do not speak back to racism, historical
trauma or low self-esteem. They are mute on the subjects of meaning, values
or identity. They are unable to provide love.

Aren't these the burning issues facing American Indian teenagers today?
Isn't this what started the fires at Cheyenne River, Red Lake and
elsewhere? If the problem is mass unhappiness with life, what is the
solution if not fixing life itself?

Scott Richard Lyons, Leech Lake Ojibwe, teaches writing, literature and
Native American Studies at Syracuse University.