I am Ramon Solhkhah, an expert in psychiatry and behavioral health. I’m trying to address the crisis of high rates of anxiety and suicides among young people. AMA.

Is there any difference in the amounts of suicide and depression based on medical issues? Like ADHD or say dyslexia? Compared to the normal average students?

ADHD and Dyslexia are psychiatric conditions that can increase the risk of depression and anxiety. You can imagine that difficulty students would face as it relates to school and socialization. These stressors are significant but with proper treatment of ADHD and Dyslexia, will certainly minimize the risk of depression and ultimately the risk of suicide. - Dr. Solhkhah

What are some of the biggest factors in suicide do you think, and this one is important to me personally, what do you think directionless young adults should do to get over the existentialism of not feeling that could ever succeed in more traditional careers? (Me personally, I’m 18, and the only path I see going forward is to become a writer, or join the military, which the outlook on me doing is not good)

I'm sorry to hear that you're struggling but I'm so glad you reached out and asked me the question. Please know that you're not alone - many adults have difficulty in deciding a career choice and these decisions can be daunting at times. Talking to a someone is a good first step to help sort through these issues. School guidance, mental health therapist, or vocational therapist are available in most community organizations. Also you can also speak to someone on a hotline (1-800-273-8255) or if you need immediate attention or go to you local emergency room where you can get immediate attention to your needs. - Dr. Solhkhah

How big of a role does social media, like Reddit, play in the massive uptick in depression among users?

Social Media is certainly an outlet for many people that suffer from depression utilize. Just like most things, there are "pluses and minuses" in have an social media account. Social media can provide necessary support and understanding, by connecting them to groups of people with similar issues. This can be very beneficial if done in a thoughtful manner. It can also be not be so beneficial if the interaction leads to feeling more isolated and not finding the support that is needed. If you use the AMA on Reddit today, this is a great venue to seek information and provide the necessary information needed in helping those that are feeling depressed. Thanks for a great question! - Dr. Solhkhah

What do you think about the current research on psycadelic assisted therapy specifically psilocybin? Does the idea that set and setting could be more important then the specific psycadelic being used suggest that we may be coming at drug based therapies wrong by prescribing drugs and not including behavioral changes and life situation adjustments to go along with them?

According to the National Institute of Mental Health, 17.3 M (7.1%) of adults suffer from depression in the United States. Of those, some will be resistant to classical treatment of depression. There are some studies involving drugs such as Ketamine that have proven to be effective. Psylocibin research is ongoing but still too early to determine if it would be an effective intervention for the treatment of depression. Antidepressant treatment alone is beneficial in some forms of depression, but a combination of medications and therapy are by far the best treatment modality for depression. Whether Psylocibin will contribute to being a beneficial drug is too early to tell. - Dr. Solhkhah

Good morning ... thank you for joining us for this very important topic. Please post your questions. Ramon will be online to respond to your questions beginning at noon eastern.

In your opinion, why do you think anxiety in particular is so high in young people? Is there a particular experience or central factor that plays in high anxiety?

My brother and sister (23 - 25) were diagnosed with moderate / severe anxiety and were given meds to help them cope. I have no idea why they have anxiety issues as we were all brought up in the same house and experienced almost everything together. The only difference between our upbringing was that they went to live on dorms for college while I commuted from home. I do not know why they have anxiety issues and they don't either.

I agree that young people have unique stressors that contribute to increasing levels of anxiety. In particularly, internet access. In a world of immediate gratification like having items coming to your home in 2 days or less, not having to leave your house to get food, etc young people struggle with regulating their distress and tolerance. The need for an "immediate fix", if not obtained, may lead to increase anxiety. If supports systems, such as friends and family, are not ample enough to help mitigate this, anxiety can certainly increase. - R.S.

How can third world young people address this where mental health is a topic of stigma and no one really bothers about it?

Stigma is a significant concern when trying to address mental illness. Education is key and needs to be tailored to the cultures and customs of your area. Here is a great article that can help give you some insight to your question. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355984/ - R.S.

What are your thoughts on Michelle Carter and the more recent case of Inyoung You where people are being charged for pressuring their “loved” ones into suicide? Does the psychology back the idea that a person can be forced into killing themselves because of their significant other’s wishes? How do these cases differ from typical cases of bullying into suicide and how are they the same?

These are very unfortunate cases where someone suffering from depression reached out to someone that thought they could confide in. Depressed patients are vulnerable and should be treated as such. Suggesting or telling them to do something that is harmful is an act of maleficence. In these cases, the depressed person was willing and open to hear the other person thoughts and opinions whereas in bullying is the complete opposite of that. - R.S.

How do you feel about weed for depression and anxiety?

The research shows no clinical evidence that cannabis is beneficial as a treatment for depression or anxiety at this time. - R.S.

have you looked at atmospheric deposition of elemental mercury? Some places like Utah have a yearly deposition of enough mercury to cause hand tremors in dentists, who, in their golden days, had a disproportionately high amount of suicides, possibly due to mercury exposure

I have not, but I'm interested in learning more - following. R.S.

Why is there not a more concerted effort to ban vapes/cigarettes/nicotine when it’s so obviously harmful to mental health, especially for young people?

The loss of taste/smell when smoking contributes to memory loss, malnutrition & exacerbates mental illness. Anecdotally, I’ve observed most psych in patient’s are heavy smokers.

I can't agree more! Vaping in particularly is becoming a huge concern for teens and we all need to create a sense of urgency in addressing it. All nicotine products are detrimental for both physical and mental overall health. The FDA, in particular, has fallen short in implement rules and regulations to vaping products, in particularly advertisement and warning labels. Their is a misconception that vaping products are "safer" than cigarettes which is just not true. Communities, School and healthcare providers need to educate parents and teens about the risks of vaping and other nicotine products. It starts with education at home, making sure parents talk to there kids about the risks, as well as advocating to our local and government officials to pass laws that regulating the sale and use of these products. - Dr. Solhkhah

In your opinion, what's the best clinical/therapeutic method of counselling people with anxiety/depression?

The best clinical intervention in regards to counseling is Cognitive Behavioral Therapy (CBT). It is the most studied type of psychotherapy that has proven effective in improving symptoms. That said the best overall treatment for depression is combined treatment of CBT and medications, which is superior to drugs and psychotherapy alone. - R.S.

Thank you for all your thought provoking questions. Please remember you're not alone and that there is help in addressing your needs. Please note the National Suicide Prevention Lifeline at 1-800-273-8255 or text TALK to 741741 for yourself or if you're trying to assist someone in seeking help. Thank you all for participating and the AMA is now complete. - Dr. Solhkhah