Monday, February 28, 2005. "Healthy Heads: Addressing Mental Health in your Students," Ross Szabo.

 

MS. BRIZINDINE: Good morning, everybody. We'll get started so we have plenty of time for our speaker.

 

Wasn't last night wonderful? Reveta wants everyone to know that there's going to be a Brownie reunion in the lobby at noon. Wear your uniform.

 

A couple of housekeeping announcements. One is, tonight for our journey on the boat, it's very casual, but wear layers. There will be an outside deck and an inside deck, but you're well advised to wear lots of layers. Again, casual, casual.

 

All meetings are actually in this room, in spite of what the program says, so please know that this is our central station for meetings henceforth.

 

Your poem for the day. This is by Billy Collins, our poet laureate as we speak, and it is called -- remember, I tried to find those poems that were good for us. This one is called "Forgetfulness."

 

The name of the author is the first to go

Followed obediently by the title, the plot,

The heartbreaking conclusion, the entire novel

Which suddenly becomes one you have never read,

Never even heard of,

 

As if, one by one, the memories you used to harbor

Decided to retire to the southern hemisphere of the brain,

To a little fishing village where there are no phones.

Long ago you kissed the nine Muses goodbye

And watched the quadratic equation pack its bag,

And even now as you memorize the order of the planets,

Something else is slipping away, a state flower perhaps,

The address of an uncle, the capital of Paraguay.

Whatever it is you are struggling to remember

It is not poised on the tip of your tongue,

Not even lurking in some obscure corner of your spleen.

It has floated away down a dark mythological river

Whose name begins with an L as far as you can recall,

Well on your own way to oblivion where you will join

Those who have even forgotten how to swim and how to ride a bicycle.

No wonder you rise in the middle of the night to look up the date of a famous battle in a book on war.

No wonder the moon in the window seems to have drifted out of a love poem that you used to know by heart.

 

MS. BRIZINDINE: So good morning, everybody. And it's my pleasure now to remind you where you are, and to bring Judith Glickman to the podium. This is a good time to turn off cell phones, if you haven't remembered to do so.

 

MS. GLICKMAN: Thanks, Bodie. I don't know about you, but after that poem, I just feel like crawling into a hole and feeling really comfortable.

 

It's my pleasure this morning to introduce our speaker, Ross Szabo. When I learned that Ross was going to be a speaker, I didn't know him, so I immediately Googled him and found a press release, some of which I'm going to read, but I think I'd like to start with the comments that I heard from Arlene Hogan this morning.

 

When Ross came to Archer -- and this is a young man who's the director of youth outreach for the National Mental Health Awareness Program -- at first glance he looks very normal. He seems to have everything going for him. But between work, extracurricular activities, and the pressures that come with being young, Ross has been dealing with something bigger.

 

Szabo had put a face to a problem confronting many of America's youth, an estimated one in every five teenagers and young adults in this country alone. Diagnosed bipolar, with anger-control problems and psychotic features at age 16, Szabo has waged a battle against mental illness and related problems.

 

I know that several of you have had Ross come speak at your school, and going back to Arlene's point, Archer is a school for young women, as you know, and apparently, when Ross came on the campus, it was so off-putting, this nice, good-looking young man that all the girls, as they saw Arlene welcome him to campus, were coming up and saying, "Good morning, Ms. Hogan," something that they hadn't been saying for a long time, or perhaps ever.

 

I think the point here is that the minute Ross started speaking and the girls started listening, it was a very poignant moment for them, and no longer did his good looks and youth become the compelling argument for listening.

 

This young man has spoken to over 400,000 young people throughout the country, and it is going to be particularly compelling for us to hear him this morning. I already have found his web site, so that after this morning, I'm going to be going back to my school and determining how we could use young Ross Szabo to share with us the compelling issues of mental health.

 

Please join me in welcoming Ross Szabo.

 

MR. SZABO: Good morning. It's very easy to go into situations when people don't expect much from you other than your outside appearance. It's been great, traveling around the country. Thank you very much for having me here. It's an honor for me just to be here among some of the best schools in our country, with some of the best leaders from those schools.

 

I always look forward to the opportunity to address the people who are going to be making the decisions of what young people are going to be going through and what they have at their disposal, what resources and things that you all can set up for them. So it's an honor for me to be here today.

 

My name is actually Ross "Szay-bo." You did pronounce it correctly. That is the Eastern European correct pronunciation. However, my family decided to change it when we came over, so my name is actually Ross "Szay-bo."

 

I'm the director of youth outreach for the National Mental Health Awareness Campaign. Those of you who have had me speak at your schools know I start off my presentations with voice impressions of Chris Farley and Dave Chappelle and sometimes the Rock. I don't know how those will go over here, so since I saw that "Forrest Gump" was on the other night, that seems to be something everyone knows, so I will start with that voice impression. I haven't done this one in a while.

 

"You might not believe me if I told you, but I can run like the wind blows. From then on, whatever I did, I was running." (Laughter.)

 

All right. As many of you know, Chappelle and Chris Farley are a lot more motivating and energizing, but the reason I start all my presentations with humor is because I think with mental health issues, it's always important to start on an upbeat note, because as many of you know, when you deal with mental health issues, it's not always fun. It's not always something to laugh at. These are the issues that are causing young people to take their lives. They're causing young people to cut themselves, to drink enormous amounts, binge drink, to do drugs, to just pretty much live in a state of pressure where they put on a happy face while inside they want to die.

 

These aren't the most fun issues in the world. However, these are also the most treatable issues, the most manageable issues, the issues that we've learned so much about that they don't have to impede a person's life anymore. Even schizophrenia, diagnosed at the earliest time point in someone's life, doesn't have to impede his or her life anymore. However, if I went out and only said that mental disorders are treatable, manageable, things everyone can deal with, I would get a lot of very cross-eyed looks. I'd get a lot of furrowed brows, people saying, "I don't understand. That's not what I grew up with. That's not what I'm used to. That's not what I heard."

 

There's a big disconnect between what people have heard and the truth about mental disorders. The biggest reason I go into schools is to take away that disconnect. There are statistics that show that one out of every five young people in this country suffers from some diagnosable form of mental disorder each year. Suicide is now the third leading cause of death in high school students. It's the second leading cause of death in college students. Over 66 percent of young people with a substance use disorder have a co-occurring mental health problem.

 

I can go on with these alarming statistics forever. And I don't mean to say that mental disorders are easy or fun things to go through. But when we deal with mental disorders, we have to have a starting point. The starting point, the starting statistic, for me is, over 66 percent of young people who are going through anything, whether it be divorce, whether it be death, a breakup, anything, don't talk about what they're going through. So you can hit them all with all the statistics, all the medications, all the diagnoses, all the treatments. If someone isn't talking about what they're going through, as you know, things aren't going to change.

 

So I open every presentation by asking the audience: Why is it that over 66 percent of young people aren't talking about what they're going through? This is the interactive part. Someone raises their hand, I call on them, they say something, I move on to the next person. I can repeat the question if you want.

 

The question was: Why aren't young people talking about what they're going through, a mass amount of young people?

 

DR. CLARK: We want to treat the symptoms more than we want to treat the causes. And there's the stigma, of course, that if you have problems, people will look down on you.

 

MR. SZABO: Absolutely. Anything else?

 

MS. BOWERS: We haven't made safe places or people in our schools to go to.

 

MR. SZABO: Haven't made safe places. You could find that trust is one of the large issues young people would use in talking about their problems.

 

SPEAKER FROM THE FLOOR: They often think they're unique.

 

MR. SZABO: Unique. They may be alone. Okay. Anything else?

 

SPEAKER FROM THE FLOOR: They're talking in a way you don't hear and their friends don't hear.

 

MR. SZABO: Okay. You don't care. Friends don't hear -- or care?

 

SPEAKER FROM THE FLOOR: They don't understand. The person is talking about it, but not in a way that's explicit, that's easy to understand.

 

MR. SZABO: Okay. Talking about it not in a way that's explicit, easy to understand.

 

SPEAKER FROM THE FLOOR: Children feel the pressure to be more adult-like so much earlier.

 

MR. SZABO: Adults aren't talking about their problems, then, either. That's a very good one and that's a big one that I see, as well. A lot of times I laugh when young people are blamed for all the problems in our society, because they're learning this behavior and these types of experiences somewhere. It's usually from older adults. Last one.

 

SPEAKER FROM THE FLOOR: Afraid of what people will think about them.

 

MR. SZABO: Yes, and of course, the biggest stereotype that is out there, is if you talk about emotion, if you cry, if you actually talk about how you feel, then you must be weak. What's wrong with you? Why don't you suck it up? Why don't you deal with it on your own?

 

All these are things we're going to talk about in this presentation today. When I go places to talk, everyone kinds of looks at me and thinks, All right. What is this pretty boy going to tell me that I don't already know? You know, he doesn't look that tough. He doesn't look like he's been through much.

 

And in our society we now place such a large focus on exterior appearances that interior problems are being magnified to extents that they don't really have to be. The exterior appearance is prevalent on MTV. I don't know if you click by MTV at all, but you can now watch programs like "Pimp My Ride," "I Want a Famous Face," where young people will now get plastic surgery to look like their favorite celebrities. You can hear songs that say, "My milkshake brings all the boys to the yard." Obviously, you assume what that's about. And a bunch of other different songs that put a huge focus on exterior appearances.

 

In my program I don't talk about exterior appearances. I talk about interior thoughts, feelings, and emotions. When you have problems with thoughts, feelings, and emotions, it doesn't matter what race you are, doesn't matter what gender you are, doesn't matter what your socioeconomic status is. These are problems that can affect all of us.

 

But when I speak, I make it extremely clear that I don't know what it's like to be other people. I don't know what it's like to be you. I don't know what it's like to go through what you go through. I don't know what it's like to experience half the things all of you have experienced. When I speak, it's to open people's eyes to the outlets, the options, the choices they have in front of them, to make them feel a little bit more comfortable in making those choices, in having those options available to them. So I first speak about my personal experience.

 

I visited my brother in a psychiatric ward at age 11. I was diagnosed bipolar at age 16. At age 17 my diagnosis changed to bipolar disorder with anger control problems and psychotic features. I was hospitalized during my senior year of high school for wanting to take my own life, and I was hospitalized again ten months later and I had to leave college because I relapsed with bipolar disorder.

 

Now, what I want you to understand as I speak about my personal experience today, I'm going to branch off at certain points and talk about what I see in schools today, what I see in young people. I spoke to over 100,000 young people last year all over the country, so I have a very broad understanding of what's happening in our society today with these issues. So I'm going to mix my personal story with experiences, with statistics, and with other research that can help us all.

 

After I speak to you about the problems, I'll talk to you about ways we can combat the problems. So it's not just all negative and scary and more of the glorifying of these issues that you see every day in our media and on our televisions.

 

So I'll start with my personal experience. I visited my brother, when I was 11, in a psychiatric ward, which was probably one of the most eye-opening experiences of my life. I came out of elementary school one day. I was sixth grade. And my dad came to pick me up from school, which was rare, and climbed into the family minivan. We're driving down the highway. My dad turns to me and says, "Your brother is in the hospital."

 

Now, at the time, my oldest brother was at the University of Pennsylvania, so I thought, All right. Dad is making some really bad comparison between hospital and college. I knew no reason for my brother to be in the hospital. When I turned to look at my dad, I saw tears streaming out from underneath the sunglasses. I'd never seen my dad cry a day before in my life.

 

So I asked him, "Well, did he get hit by a car? Did he break his arm? What happened?"

 

My dad was really quiet in the car. Later that night my parents sat me down and they said, "Your brother is not only in the hospital. He's in a psychiatric ward of a hospital."

 

Well, at age 11, the only time I had ever heard about psychiatric wards was in cartoons, and there's no way I thought my brother could possibly be there. But two weeks later my parents and my other brother and I drove down to the University of Pennsylvania Hospital. I remember parking the car, walking down the hallways, taking elevators. I remember going through security in the psychiatric ward at age 11, seeing people in straitjackets, seeing nurses talking to other people. I remember thinking to myself, There's no way my brother could be here.

 

When we got to his door and I saw him for the first time, I felt relieved. He didn't have an oxygen mask hooked up to his face. He didn't have an IV in his arm. He didn't have a cast on any part of his body. So I thought he must be okay.

 

I walked over to my brother and said, "Hello," and he didn't know who I was. He didn't know my parents. He didn't know my other brother. He has bipolar disorder. He was hospitalized on an extreme manic high, and he had lost touch with the way he saw his world.

 

On the way out of the hospital that day, everyone was crying except for me. My mom leaned down to me and said, "You know, Ross, it's all right for you to cry about this."

 

I asked my mom if my brother was going to die. She said no. So at age 11, I looked up at my mom and I said, "If he's not going to die, then there's no reason for me to cry about this."

 

My outlook on it was, if this isn't something that's going to kill him now, this must be something he can get through, which is a very adolescent outlook. However, that's the truth. Eighty to ninety percent of people with severe mental disorders who seek help and find what works best for them go back to functioning the way they used to.

 

So that's not unimaginable. This was proven to me. My brother did take a year off from Penn. He went back to Penn. He got his degree in physics. He went on to Florida State University, got his masters in physics. He's currently in USC's astrophysics doctoral program. So he's a bit of a freak, but he dealt with his mental health problem in a great way. He dealt with it very well. And that was my positive example.

 

Now when we speak about the brain, it's important to treat the brain as a part of the body, as an organ of the body, which it often isn't. You know, I often say during my presentations, if I was standing up here right now, with my shinbone sticking through my pants and I was bleeding everywhere, no one in this room would question me seeking help. No one in this room would look at me and say, "Well, he should suck that up, deal with it on his own, and if he can't, he must be weak." Most of you would wonder why I'm not in the hospital.

 

What I think you should keep in mind as I speak to you about the brain is that your brain is just as much a part of your body as your arm, your hand, your heart, your leg, except that when your brain has a problem, you're not going to limp, bleed, but you may cry a lot. You may not be able to sleep at night.

 

How many of us have had nights where we can't sleep? You may want to sleep too much. You may have a lot of anxiety. You may have a lot of nervousness. You may develop more severe problems, like depression, bipolar disorder, eating disorders, schizophrenia, ADD, ADHD. But because the brain is just as much a part of the body as the rest of the body, you shouldn't be afraid to talk about the thoughts and emotions that run through it.

 

Whether young people like it or not, the thoughts and emotions that run through their minds make them who they are. You can run, you can drink, you can do drugs, you can hide everything you want. Whether we like it or not, the thoughts and emotions in our minds are what make us who we are.

 

You may have heard that if anyone in your family has a history of heart problem or cancer, as you get older you have to watch out for that. For guys now it's prostate cancer. Well, guess what? If anyone in your family has a history of mental health problems, whether that be depression, schizophrenia, bipolar disorder, or more severe ones, alcohol abuse, drug abuse -- or even little quirks like my dad. My dad doesn't wash the car because he thinks it will take the paint off.

 

You can laugh at this. Don't act like your families are perfect, okay? My dad's not that weird compared to the whole spectrum of things. My dad's come to hear me speak. He knows this. He still doesn't wash the car.

 

These problems are both environmental and biological. If it's in a family, someone else has a high rate of developing it. In my family, my dad's bipolar. My mom has ADD and a mood disorder. My dad's dad was an alcoholic. My dad's brother is an alcoholic. My mom's mom has bipolar disorder. My mom's brother was an alcoholic. We have a whole lot of anxiety disorders. I was bound to get something, is what I'm trying to get to here.

 

The problem is, when people go to a doctor, the doctor will say, "You have some type of depression," prescribe a medication, and the person will leave. They won't educate themselves, learn about it. They don't adjust their life outside of that medication.

 

Well, if you took blood pressure pills for your heart, and you drank alcohol, you smoked cigarettes, you ate cheeseburgers, cheesesteaks, French fries, you didn't exercise or eat healthily, you would run the risk of dying a lot sooner.

 

If you only take medication for a severe mental disorder and you don't work on yourself outside of it, you're not going to deal with it nearly as well as you could.

 

The number one form of treatment for these problems is some level of medication with some level of therapy. Less than 80 percent of people who seek help are getting that therapy or talking about their problems outside of it, and that's the current state we're in. We're in a current state now where I see two groups of young people. A group of young people diagnosed, on meds, in treatment, and drinking and doing drugs and cutting themselves, and continuing negative coping mechanisms while they're diagnosed.

 

If you're diagnosed and on any medication and you are drinking or doing drugs or cutting yourself, you might as well not be on the meds, because they're not going to be helpful.

 

And I see a group of young people who are deathly afraid to talk about the first imaginable problem in their life. I don't see a group of young people who are out there, who are healthy, who are treating this in the model I just spoke about, where, yes, you have a diagnosis, but you're a person with a diagnosis. You're not that diagnosis.

 

Unfortunately, the words we use to describe young people at a young age are the words they use to define themselves. If the young person grows up in an abusive home where they're told they're lazy, stupid, other things like that, they use those words to define their self-image. When you deal with mental health issues, if you don't provide a positive example, and all you say is, "You have depression," what I see is young people becoming that depression, becoming that bipolar disorder, becoming that eating disorder, instead of a person with the disorder.

 

And that's why positive examples and setting this model of, "Okay, yeah, even if you have to take medication, you still have to take care of yourself outside of that and find what works best for you," is important, because that's the model that is the only healthy model we have.

 

But finding what works best for you is different on all levels. There's no quick fix. I don't have a five-step plan. I don't have a two-step plan. I don't have a book that says, "If you do this, this, this, and this, and you'll be fine." It's just not true. Everyone is different. Everyone needs to find what works best for him or her.

 

And that's really what I stress today, and that's what you'll hear in my presentation. Everyone needs to find what works best for him or her. But young people are getting most of their information on these issues from the media, and the media will constantly tell you that young people kill themselves, cut themselves, drink and do drugs.

 

I was once turned down by MTV for a documentary because I'm doing too well. Apparently, doing well isn't the model we want to provide from the media. My book was recently turned down by a couple of publishers because I showed that you could recover and go on with a mental disorder.

 

So that's the problem. That's the barrier we're facing. Do I think it's possible to change the media to only portray positive things? No. I don't know that that's possible right now. What I think is possible is setting up positive examples in the schools, so that we combat negative messages with positive examples.

 

Now, as I said before, I visited my brother in the psychiatric ward, came out, and I did some research and I learned that if someone in your family has any mental disorder, you can have it. At age 16, all of the symptoms started to hit me. How many of you have heard about bipolar disorder? It's also called manic depression. I'll explain it briefly.

 

Bipolar disorder is two main moods. A manic high is a very elated feeling. You feel like you're on top of the world, nothing can stop you, nothing can bring you down. You may talk very fast, may not be able to stop talking. You may not sleep for days, may not sleep for weeks, for months, and not be tired. People on manic highs can abuse large amounts of alcohol, drugs, become very promiscuous, spend large amounts of money they don't have. Always on edge.

 

One of the biggest symptoms of a manic high is having mind-racing thoughts. That would be like if this was a television screen and I kept my finger on the channel "up" button and I didn't take it off, channels would just keep flipping, flipping, flipping, you can see your favorite programs, but you couldn't stop on one channel. Picture that television as your mind and those channels as your thoughts.

 

When I was on a manic high, I could think between eight to twelve thoughts a minute. Your mind races so fast that you lose touch with your world. So when I played basketball on a manic high, I thought I was running faster than everybody, jumping higher than everybody, moving quicker than everybody. I didn't think I was Michael Jordan or Tracy McGrady or Kobe Bryant. I thought I was better than those guys.

 

And if all of you saw me play basketball on a day when I was on a manic high and on a day when I wasn't, all of you would notice no difference. All of you would notice no change. The change was in my mind. That's why my brother didn't know who we were when we visited him in the hospital.

 

Some people tell you manic high is the best feeling of their life. On a lot of levels that's wrong, because it's not a feeling at all. It's a lack of feeling, lack of being able to tell what's happening in your world.

 

On the opposite side is a depressive low and I'll talk about depression in a little bit, because this is one of the most widespread confusing words I see around the country. What's important to understand is if everyone in this room had bipolar disorder or depression or an eating disorder or anxiety disorder, all your symptoms would be the same, but all of your experiences would differ because all of you are different. So finding what works best for you would be different in each individual.

 

Now, when I was 16 all these things started happening to me. It started off with me not sleeping for four days at a time. I'd be awake, I'd go to school, I'd play sports, I'd hang out with my friends, I'd party. Then my moods would change violently. I'd flip out, punch things, kick things, flip out on my friends, flip out on my parents. Then my moods wound change again and I wouldn't want to get out of bed, wouldn't want to do anything. Because my mind was going through so much, I wanted to shut it down.

 

The quickest way I could shut my mind down was to drink, drink as much alcohol as possible in the shortest amount of time and shut my mind down. So I didn't drink to hang out with people. I drank to shut my mind down. At age 16 I could drink a case of beer and pass out, drink a bottle of vodka and pass out. Drink a bottle of rum and pass out.

 

When I was in high school, we had presentations like this. Somebody would come in, they'd say, "Don't drink alcohol. It's bad for you." All right. There was never a day I woke up hung over or puking and thought alcohol was good for me. I drank alcohol because it was bad for me. No one ever came into my high school and said, "Don't drink alcohol because you hate yourself. Don't drink alcohol because you don't know how to deal with what you're going through. Don't drink alcohol as a form of communication."

 

Whether we like it or not, alcohol is probably the number one form of communication among young people, and probably among most males for the rest of their lives. When I was in high school, I didn't talk to my friends; we drank together. We played PlayStation together, we played sports together.

 

Oh, wait. That's actually not true. Maybe some of you have seen this. Sometimes when people get really drunk, they get really emotional and then they talk about everything they have been through. When I was in high school, guys who never talked about anything would get drunk and cry, say, "You're my best friend. No, I mean it. I love you. I care about you. This is what happened to me. This is what I'm going through."

 

And as soon as we sobered up, it was, "Well, I'm okay. I was just drunk. I don't know who that was. That was drunk me. That wasn't anything that has to do with my life. That was just the drunk guy talking."

 

Unfortunately, this is the current state of the youth population today. When I do this segment in schools, kids are dying, rolling on the floor laughing, pointing at their friends, and highlighting, obviously, the people who do this, because it's true.

 

So when I speak, I don't tell kids not to drink. I'm not going to tell them not to do drugs, not to drink and drive, not to hurt themselves. They know this. I would rather they think about the reasons why they want to do that. "Why do you want to drink? Why do you want to cut yourself? Why do you want to do drugs? Why do you want to drink and drive? Why do you want to put yourself in that danger?"

 

And hopefully if they work on those reasons, they'll stop doing that behavior. I didn't. When I was 16, I was class president. I drank and drove. I drank on the weekends. I drank with the rest of the student council. I did everything. We were some of the most highly involved students. National Honor Society, all these other things, and we drank. And the biggest reason for it was, we didn't like ourselves. We didn't know how to deal with what we were going through. We didn't know how to change that.

 

Luckily, my brother told a friend of the family. The friend of the family came and took me for a walk. He said he thought I needed to seek help. He didn't use those exact words. He cursed and yelled a lot. I got the drift.

 

I went to see a psychiatrist at age 16. I was diagnosed bipolar. I wish the story stopped here. I wish I could say at age 16 I was diagnosed, now I'm here today to talk to you about it, but it's not that easy. It's not that simple.

 

The diagnosis is just the tip of the iceberg. Had I gone to a doctor at age 16 with no ligaments in my knee and my kneecap broken, the doctor wouldn't say, "You have no knee left. Go back out and do what you want to do." I would have to go through surgery and rehab before I could fully use my knee again. But even after being able to fully use my knee, I would always run the risk of having my knee give out on me.

 

Your brain is very similar to that. The diagnosis is just the tip of the iceberg. You need to go back out and find what works best for you. When I travel, the diagnosis is so scary. I have been at a couple of your schools this year, and I have talked to students who have just been diagnosed, and they don't know what to think. They don't know that it can get better. They don't know that it can change. When you're young, you view emotion as final. That's part of the problem. These problems that are large become even larger because when you're 14, 15, 16, 17, 18, emotion is final. You don't know that it can change. You don't know that it can mature. You don't know that it can grow.

 

So any negative emotion is usually what a lot of young people end up defining themselves off of. They define themselves off of one negative event, one negative emotion, one negative word. And again, without that positive example model, they won't understand that it can change and it can grow.

 

So I had this diagnosis and I thought that, Okay, I'm just bipolar. Everything will get better. At age 17 my diagnosis changed to bipolar with anger control problems and psychotic features, and I'm going to get to the anger and psychosis in a little bit.

 

First I want to talk to you about depression. After I speak, I have been approached by probably, last year, individually over 12,000 young people who wanted to talk about what they have been through, or what they're afraid of, or what they're going through. And one of the biggest things I see is a mass confusion on these words, a lack of education on these words.

 

Sometimes people come up to me and say, "I had a bad day. I'm depressed." Could be. Chances are, you're upset. Chances are, you're sad. Chances are, you have a mental health problem.

 

So let me explain the difference. Mental health problems are things that have an identifiable cause. You go through death, you go through divorce, you go through a breakup, you go through rejection, neglect. I talk to a lot young females who are sexually abused, a lot of young males who are physically abused. You can obviously become upset, but you know why you're upset.

 

Now, sometimes those things are so severe that you still need to talk about them. Let me give you an example. When I was 13 years old, my friend was killed. He was killed in front of my best friend. Two 13-year-olds were playing on a highway. My one friend fell down, got hit by a truck. He was killed in front of my best friend.

 

My best friend grew up in a home where you don't cry about it, you don't talk about it, you don't ever say anything about this. You suck it up, deal with it on your own. And that's what he did, except that from that point on, anytime something major happened in his life, he would shut down. He'd bottle it all up inside. Anytime something minor would happen, he would snap.

 

So as we were growing older, this was a kid whose grandfather dies, an uncle dies, he bottles it all up inside. Something minor happens and he snaps. Call him a wimp, call him a punk, call him anything like that, and he would flip out. This was a guy who was arrested for underage DWI, arrested for dealing drugs, arrested for assault, assaulting police officers, all different kinds of things.

 

UCLA did a study that showed the brain reacts the same way when someone loses an arm as it does when someone faces social rejection. The problem is, we know what it looks like when someone loses an arm. Social rejection could be anything. It could be death, could be divorce, could be a breakup, could be a problem at school, could be neglect, could be abuse.

 

What we know is this: The way a person first learns to deal with that major form of rejection is the coping mechanism that they're most comfortable with the rest of their lives. So if a young person first turns to bottling it up inside, flipping out later, or alcohol, or drugs, or one of the largest phenomenons now, cutting, that's what they will be most comfortable turning to the rest of their lives. The earlier they learn a healthier way to deal with this, a healthier coping mechanism, the better off they're going to be.

 

When I turned 22, I went over to my friend's house, and I told him I was going to start going around the country talking about this and my friend started crying. And I had never seen him cry before a day in my life. I said, "Why are you crying?"

 

He said, "I hope someone listens to you. I hope they don't end up like me." And when I speak, it's not a scared-straight program. Not everyone ends up like my friend. I use that to illustrate the fact that it's okay to talk about what you're going through. It's okay to learn a healthier coping mechanism so that the rest of your life isn't filled with dysfunction.

 

Now, obviously, a lot of young people learn negative coping mechanisms in their home. In my father's home you drank. That's all you did. My dad didn't have a birthday party, didn't have a friend come over, didn't have a parent tell him he loved him, hugged him, or anything like that. That's not too uncommon. So it's another added challenge to deal with coping mechanisms at a young age, when they're learning other negative coping mechanisms from the home.

 

But none of what I just spoke about is depression. None of it. Because when you have depression, clinical depression, you don't have an identifiable cause. When you have depression, everything in your world sucks. And what happens when everything is bad? You're going to take it out on other people, on yourself. When you have depression, you stop doing the things you enjoy. You're crying for no reason, you stop taking care of yourself. You may stop dating, you may stop eating, you may want to eat too much. You lay in bed all day and may not be able to get out of bed; you have no energy to do anything.

 

The problem with depression is that all those symptoms I just named are physical. So what do we say to people with depression? "Why don't you just get happy?"

 

What do we say to someone with an eating disorder? "Why don't you just eat?"

 

What do we say to someone with an anger problem? "Why don't you just calm down?"

 

What you need to understand is, there's no physical solution to a mental disorder. You have to address the thoughts and emotions of that person. And if you don't, things can only get worse. The opposite of depression is not happiness. The opposite of depression is vitality. It's wanting to live. And you had better find a way to get to the thoughts and emotions quickly, because the number one most dangerous symptom of depression is having suicidal thoughts.

 

During my senior year of high school, I was hospitalized for wanting to take my own life, but that didn't all just happen in one day. In September of my senior year, I started feeling lonely. I felt like there was no one to talk to, no one to understand me. But even if there was someone to talk to, I should suck this up, I should deal with this on my own.

 

I always thought one day I'd wake up and this loneliness would go away. It didn't. November my senior year I started thoughts of suicide, death. That built to a point where I was thinking about suicide and death 24 hours a day, seven days a week, but again, I didn't talk about it. I always thought that I should deal with it on my own. For two months of my senior year, anytime I was by myself, I was crying. Anytime I was in front of people, I was strutting around, laughing, talking about what everyone else was talking about. I sacrificed my thoughts and emotions because I always thought one day I would wake up and I would want to live again.

 

Unfortunately, that day never came. On January 5 of my senior year I was hospitalized for wanting to take my own life. But nothing happened that day. I went to school just like I always did. I had a basketball game that night. I played in the game, I scored in the game, we won the game. I went to a restaurant with my friends to celebrate the victory, just like we always did.

 

And on the way home from that restaurant, I decided I no longer wanted to live. My three best friends, who had known me seven years, saw me leave that restaurant, and they would never see me again.

 

So when I speak, even if people aren't thinking about the most severe types of taking your own life, they may be thinking about something less severe. I would never want them to think about it either, but I would never want any of them to be in a position where they see someone leave somewhere and they never see them again.

 

I came home from that restaurant with only one thought on my mind. I walked upstairs to my room. And before anything too major happened, my dad walked by.

 

I should step back here. I didn't have an openly communicating family at the time. My oldest brother had left the family when I was 16. My middle brother used to beat me. And I just didn't talk to my parents about these issues, didn't talk about emotion.

 

So when my dad walked by my room that night, he wasn't supposed to be awake. He wasn't even supposed to be home. He stopped at my door and he asked me what I was doing. I didn't know what to say. I froze up. I started shaking. He said, "Why don't you come downstairs and talk to me?"

 

I followed my dad downstairs to the kitchen. I said, "Dad, if you don't take me to the hospital right now, I'm going to kill myself."

 

And I was lucky, because my parents believed me. They put me in the car, drove me down to the hospital. That night in the waiting room of the hospital, I was extremely violent. They gave me a tranquilizer. I woke up 24 hours later with no drawstrings on my sweat suit, no shoelaces in my shoes, no sheets on my bed. The social worker watched me 24 hours a day.

 

A couple days after that, in group therapy, it was time for everyone to stand up and talk about why they were there. The stories before mine were filled with sexual abuse, physical abuse, suicide in the family. It was my turn to talk about why I was there. I really didn't know what to say. They said, "Why don't you tell us about yourself?"

 

"All right. My name is Ross. I'm president of my class. I played varsity basketball for two years. I'm a member of SAD, a member of Peer Helper, I volunteered five years for the Special Olympics, I attended the National Young Leaders Conference the summer before my senior year," and I stopped, and I felt really stupid. Because the life I was describing was the life that everyone else saw, but not the life I lived.

 

I didn't stand up and say, "Hi, my name is Ross and I hate myself. And I hate myself so much that I don't care about my future. I'm willing to drink and drive, I'm willing to drink, I'm willing to do drugs. I don't care what happens to me. Everyone important in my life has already left. No one should really care about me."

 

I didn't say that. But as I travel the country, 100 percent of young people have an exterior life that everyone else sees and an interior life that they actually live. When those exterior lives and those interior lives are in conflict with each other, you don't need a mental disorder. That conflict is going to come out. And when that conflict comes out, it's not going to be good. It's usually going to be negative.

 

So it's very important to address that exterior life and interior life conflict, so that young people can address it in a healthier way.

 

I went on to get out of the hospital. When I went back to high school, everything was different. All of a sudden, I went from the cool guy, the guy everyone knew, everyone partied with, everyone liked, to a looney, a quack, a psycho, a crazy kid. I was a kid who lost friends, I was a kid who was made fun of, I was a kid who was no longer allowed in a lot of people's houses.

 

Two months after I got out of the hospital, a psychologist came in to speak to my classroom. As he talked about the patients he was treating, every single student in the classroom started laughing. My friends who had seen me hospitalized two months before this were laughing.

 

I wasn't laughing. I was angry. I grabbed my teacher, I took him out in the hall, and I said, "This isn't funny. This isn't something that people should be laughing about."

 

He asked me what I wanted to do about it, and I said, "Let me speak. Let me tell people what it's like to visit your brother in a psychiatric ward, to be hospitalized for wanting to take your own life."

 

He said I could speak. Two weeks later I stood up and I spoke the very first time. And it was easily the worst experience of my entire life. I was sweating all over the place, I was shaking violently, I didn't know what people were going to think. But when I finished my presentation, everyone came up to me. My mom, my aunt, my uncle, my cousin, all these other things. It's gotten to the point now where, when I travel, I don't even tell people I work for a mental health organization, because I have been on too many five-hour plane rides hearing, "What can I do for my husband? What can I do for my kids? My grandmother had schizophrenia. I never knew her, but she did."

 

Now I tell people I work for a nonprofit organization and they usually leave me alone because they think I'm going to solicit money. "That's a really nice thing you do," and then they read or sleep or something.

 

But what I'm trying to show is that I learned at a young age that everyone knows somebody going through some level of a mental health issue, but we still don't talk about it.

 

I went on to graduate from high school. I'm not going to go into my college years, just because I don't want to stress that as much as I do the high school part of this. When I went away to college, making the transition was horrible. College for me was going to be a place that I started over, a place no one knew me, where I could change. It wasn't. I had a horrible relapse. What every statistic shows is during times of change or transition, or when these problems come out, without the awareness in high school, making a leap to college was almost impossible.

 

I relapsed severely, had to take a medical leave of absence. I was hospitalized again, took a year off from school, went to a local college near my house in Pennsylvania for three semesters. I took another year off from school. I eventually returned to American University four years after I started. I went on to graduate with honors with a degree in psychology, so I got to go back. I got to do what I wanted to do, but I did it on my time.

 

So many times, young people are under a great amount of pressure, great amount of stress right now. Pressure from school, pressure from home, pressure from sports, maybe pressure from a job, from their friends. All these pressures build up on that to the point where they no longer do things for who they are. They do things because they think they have to.

 

Most young people now have fallen into a pattern of life of not actually living it. It's a pattern of, "Okay, I have to get the best classes. I have to get the best internship. I have to play the best sport. I have to do the best extracurricular activities. I have to build up a resume, get to the best college, get the best job, best" -- everything like that. They often don't take time for themselves.

 

I talk to so many young people who tell me in two years they're going to do this, in four years they're going to do this. Who are they today? Who are they right now? Because if they don't know who they are today, if they don't know who they are right now, getting to those two years, getting those four years, is going to be extremely difficult. Sadly, most young people who are in these positions, who are in these pattern-of-life positions, don't have an appreciation for themselves, either.

 

The statistic I use alarms a lot of people. I get a lot of gasps, things like that. 70 to 80 percent of young people I have seen in this country -- which is not a small cross-section -- well, I guess it is in the overall scheme. I won't give myself that much credit. 70 to 80 percent of young people either do not care about their future, do not care about themselves, or they hate themselves, hating themselves being the most severe of that model. That might sound high, but it's what I have seen and what I have heard from a lot of schools and a lot of people I have spoken to, and a lot of other speakers who have been all over the country.

 

If you do not care about your future, yourself, or you hate yourself, change is going to be extremely difficult, extremely hard, because you don't care enough about yourself to even want to change, or want to grow.

 

Obviously a part of this whole mental health spectrum is, how do we help change that? How do we help look at that model and work on it? Because obviously, we're still placing a large number of people in colleges. We're still placing a large number of people out of colleges. And if there's this underlying mood, this underlying interior thought and emotion about themselves, it's not going to be as fulfilling for them.

 

I'm not saying it's bad that they're going to college or school. I'm just saying that's one thing we need to address and keep in mind.

 

So now I have done a pretty good job of highlighting all the problems that we're going through. I want to tell you a little bit about how we can address this. I think the most important thing to address is, again, this positive message. No one chooses to go through these problems. When I was six years old and people asked me what I wanted to be, I didn't say, "I'd like to be bipolar. Maybe anger problems. Maybe psychosis."

 

Nobody says that. When I was six, I said I wanted to be president of the United States, which I believe, after watching what these guys went through, was a clear sign of a mental disorder. I think someone should have approached my parents and said, "Hey, the kid is not right. He might need some help."

 

But seriously, no one chooses to go through these horrible things, death, divorce, disorders, whatever it be, physical handicaps. But young people have to make a choice to change the way they deal with it. They have to make a choice to be responsible and to be honest, responsible being the model I talked about before. If you do have a disorder and you are on meds, you can't drink. You can't do drugs. You can't cut yourself. You have to take care of yourself. If someone with diabetes doesn't take their insulin, didn't watch their blood sugar level, doesn't watch what they eat, and they end up dying, it's not solely the diabetes' fault.

 

You have a responsibility, if you have a disorder, to take care of yourself. We need to present this model of saying that you don't choose to go through these things, but you have to make a choice to be responsible and honest, and you have to talk about what you're going through.

 

I think a lot of mental health groups have done what they think is best, and they talk about diagnosis, they talk about treatment, they talk about programs, they create all these great things, but they miss the fact that we didn't start at step A. People aren't comfortable with these issues. They aren't comfortable talking about it. And the biggest reason for that is this stereotype: "If you talk about emotion, you must be weak. Why are you crying? What's wrong with you?"

 

That stereotype is dead wrong. It takes a lot more strength to talk about what you're going through, to walk away from a negative situation, to change a negative problem, than it does to turn to alcohol, drugs, violence, cutting, whatever it is. Anybody can do that. Anybody can isolate themselves. Anybody can shut down. It takes a lot more strength to talk about what you're going through than it does to turn to a negative coping mechanism.

 

Now, I am not talking about the people who talk about the same problem for four years and never change it. That's not what we're talking about. You talk about a problem to identify what the problem is and change it, whether it be as severe as depression or maybe as minor as getting a bad grade or some type of rejection. Talking about it is the key.

 

The other stereotype to address is that people with mental disorders can't function in society, because that's wrong, too. As I said before, 80 to 90 percent of people with a severe disorder who seek help will eventually go back and function the way they used to. You're still dealing with a society in which over 70 percent of people are not talking about this issue at all.

 

Abraham Lincoln had bipolar disorder. Some of our greatest artists, poets, and writers had all different types of mental disorders. Athletes from the NBA, the NFL, the Olympics had these disorders. In any genre of music, people have these disorders. Jack Osbourne, the son of Ozzy Osbourne, just got out of rehab two years ago, not because he's famous, but because he couldn't deal with his mom getting cancer. He turned to alcohol and he turned to Oxycontin. If you didn't know this, the Osbournes have a history of drug and alcohol abuse in their family. I read that Ozzy did some drugs in the '70s and '80s and '90s. Maybe today. I don't know. (Laughter.)

 

The most important thing is to address those two stereotypes. We don't necessarily need everyone to understand mental disorders as much as we need people to understand that they can talk about emotion, talk about anything they're going through, because when you're young, you have the feeling that, "Yeah, it's cool to be myself as long as there's somebody else like me."

 

Young people are validated when they're understood. All people are validated when they're understood. Unfortunately, a lot of this validation is coming in negative feelings. It is much easier to find someone who doesn't care about himself than it is to find someone who does, find someone who wants to be positive, healthy, and changing.

 

It's been that way for a while, and when a young person has a thought or emotion that he doesn't think anyone else has, he's going to hide it. And you can only hide it for so long before it's going to come out.

 

We have differences in our society that we don't normally talk about, and it's especially prevalent in our youth cultures. But those differences are what make us who we are. We have differences in the way we react, differences in the way we think, differences in the way we feel, and currently it's only acceptable to have a certain way to think or feel, and that certain way is to hide it, to suck it up, deal with it on your own. Not talking about your problems is not a way to deal with it. Talking about your problems is the only way actually to identify it and change it. And I'm not asking for a utopian society where all young people go out and everyone talks to each other and gets along and loves each other. I don't expect people to leave my presentation, as they're walking out, saying, "I feel lonely," and have the next person say, "I feel lonely, too." That's not what I expect. But people must feel comfortable enough to talk about the major issues in their lives. Let them know that they can at least talk to the people they love or the people who love them.

 

We also need to find a way to address the issue that a lot of times young people may want to talk about a friend. They don't know what to do for a friend or a family member. The only advice I give is, you need to find a way to turn confrontation into conversation. I came up with that on my own. Confrontation into conversation. And what I mean is, when you bring up an emotional issue to someone, when you say something to someone, usually it turns into instant confrontation. "I'm fine. You don't know me. I'm okay."

 

There is no one way for everyone to feel comfortable in talking about these issues, and I'd be ignorant to stand up here and say I have a model that works for everyone. But there is a way for people to sit down with a counselor or professional, talk to them, and find a way to turn confrontation into conversation, so that person talks about their issues, not the defense mechanisms and insecurities that come out and protect and hide their issues.

 

The last thing I want you to understand is: These are all very easily combatable problems. They're not fun to go through. You're not going to see a shift in culture immediately. You're not going to see people open their minds and their eyes and their emotions right away. But the smallest steps you're able to make, the smallest programs you're able to start, whether that be taking your peer groups, SAD, Peer Help, or whatever it is, and having them start promoting mental health outreach in the way you would drinking and driving and the way you would any other issue, whether that be setting up counselors and mental health days at your school, or a mental health day where people can relax, or people can talk about anything. Or you make it fun. You have a massage therapist or other people come in and help the kids relax.

 

Or maybe it's having a mental health week, where you acknowledge the fact that these problems are happening. Or perhaps you start an intensive school program, which we are currently developing and trying to test in Los Angeles schools. Whatever you're able to do to change this, to open young people's eyes and outlets to the fact that they can talk about whatever they're going through is going to be a huge start.

 

There are flyers about my presentation in the back, but also I want you to know you can contact me with any questions about what you can do for your schools and the best ways to address this. Usually it is peer-to-peer outreach. A counselor can stand up in your school and say the exact same thing I say every day and not have half the effect, and that's nothing against counselors. It is the way our society works. An outsider frequently has more credence than insiders.

 

There are other presentations and other things you can do, but the bottom line is: We didn't choose to live in a world like this. These stereotypes have been passed down for hundreds of years. We didn't choose to live in a world where people talk about each other but don't talk to each other, a world where it's almost more acceptable to have a friend who is wasted 99 percent of the time than it is to have a friend who cries once, a world where you're made to feel afraid of the thoughts and emotions that make you who you are, to the point where you don't talk about them for the sake of other people.

 

We didn't choose to live in a world like that, but we can choose to end it. Each and every one of us can make efforts to end these stereotypes today. There are two ways we can do: Continue to watch people die, suffer, turn to alcohol, drugs, and violence, or we can make a change, we can make a difference.

 

But it's time for all of to us stop losing to the old ways of dealing with these problems. Stop losing the lives of our friends, our family members, or people we care most about to these stereotypes, to stop losing, period, and to start winning the campaign of many for a sound mind.

 

I have worked with some of the top psychiatrists and psychologists in the country, if not the world, on this issue. Our board is made up of very, very prominent people. So not only do I have the personal experience, from speaking to so many young people, but I also have the scientific, psychological research and studies that can help answer any other questions.

 

SPEAKER FROM THE FLOOR: Can you describe a successful peer outreach program?

 

MR. SZABO: Sure. A successful peer outreach program would be basically on the model of SADD. Do you have SADD? Basically, you'd have to get a group of young people who feel this issue is important and they want to do outreach on it. That's the most important thing. You don't make young people just do it. Find a group of young people who want to do it, and then have them meet and talk about events they think would work best in your school. If that's a mental health week or mental health day, there should be a presentation.

 

There should be a full-school assembly, which I think is one of the most important things, because everyone needs to get the same message. If you have mixed messages or different messages, then there's very little anyone can talk about.

 

If you're going to have a full-school assembly, we have a true-and-false quiz that can follow the assembly. It's electable. Some people may want to do it; some people may not. But after the assembly, all the teachers would give the same true-and-false quiz so that the same main points of the assembly would be reinforced.

 

Then there is peer-to-peer outreach, offering resources and information available in the area. So you have now told them they can talk about it and seek help. They had better have a place to do it. They can't just be told, "Talk about it, seek help," and have nowhere to go. So you make up flyers, different things like that, to let young people know where they can go.

 

In terms of peer outreach, you may want to have students in your school speak about their experiences. If they're going to do that, I would definitely be willing to talk to you about the best ways to do that, just because you don't want it to turn into a negative thing. For example, in some schools, it's currently cool to cut yourself. It's cool to have depression. It's cool to be on antidepressants. You don't want that to come out of it. You want it to be more positive.

 

The peer group should give information all year long, not just that day. Because of tight time schedules, you may only be able to have a mental health day or mental health week. Well, mental health awareness shouldn't just end. It should be in place all year round with information and different resources for help.

 

Lastly, to promote a community understanding, you may want to have a walk or a run or some type of event to raise awareness for mental health. These are new. You have had walks for cancer, all different other things. But that would involve the community.

 

You also want to have information for parents and the community so that they're not out of the loop, either, because you don't want to be a school and say, "Well, everyone should talk about their problems and seek help," and then have a parent come into your office, angry, saying, "No. My kid shouldn't talk about their problem. They shouldn't seek help. You're lying to them, and this is wrong."

 

The only way to combat that problem is education. You're not going to be able to combat it with every parent. You're not going to be able to change the culture in every parent's mind. But with education, hopefully you can get some parents to understand that it's better to have your student talk about this than kill himself or cut himself or drink or do drugs. Those are all key components of it.

 

I think that a full-school assembly is vital. I have gone to areas where there have been six suicides in a year, and the school has had a full-school assembly with all the parents, teachers, community members, school board invited. Obviously that's your most severe extreme, six suicides in one year. But what I found is, when you have a full-school assembly, you're telling everyone in the room to talk to anyone who's in that room. When you only address mental health in a health class, a lot of times the message is, "Well, if it's in health class, then it's much like sex. I don't really talk about that with everyone. I'm not going to talk about this issue with everyone." So it's very important, I think, to have the assemblies. And I'm not just saying that to promote my speaking presentation. I'm saying it because I think it is vital.

 

SPEAKER FROM THE FLOOR: Years ago I used to work in a girls' school and we would invite recovering anorectics, for example, or folks with eating disorders, and I was always struck with the reaction that many girls had, that, "She looks great."

 

MR. SZABO: Right.

 

SPEAKER FROM THE FLOOR: And I'm sitting with the same reaction. You seem like you're doing just great. How do you respond to that issue of, "Well, you're fine now, so hopefully I'll be fine, too"?

 

MR. SZABO: That's a very good question. The DARE program statistically on almost all levels failed because they had speakers go in and say, "When I was in high school I was a drug dealer. I had a nice car, I had all the girls in the world, I had a lot of money, and I did drugs."

 

And kids didn't hear that they did drugs. It was like, "Oh, I'd like to have a car and be dating people and have money."

 

I'm always surprised, when I speak, at how much the difficulty does get through. The way I speak, a lot of times I present myself now where people think, Oh, well, he looks great and feels great now, but they don't lose focus of how bad it was. I think, because I do such great job of explaining how bad it was, the message does get through that it took a long time for me to get to where I am. I'm 26. The last major episode I had was when I was 19. So while people do say I am doing well now, I have never really had a major issue with anyone saying that they feel they should change today, or they feel it will just go away. Usually I'm pretty clear in getting it through that it does take time, and everyone is different.

 

Even in the school I was in last week, a lot of people stayed around to talk to me afterward, and it was, "This isn't changing for me. I'm 15. I don't think I have anything to live for."

 

And it's explaining to them, "You have 70 or 80 years of your life left, and it can change, and it can get better."

 

So it's more that message of time and explaining. I didn't do my full presentation here today, just because it's a different crowd, and there are different points to hit on. But I haven't really run into that problem too much of me being great and them losing sight of what I went through.

 

Part of my training from some of the top psychiatrists and psychologists in the country was to combat that aspect and show that it takes a long time to change before it just gets to the point where it is now.

 

With eating disorders, it's going to be different, because with eating disorders, it's a whole different animal. Eating disorders are the deadliest mental illness in our country, and they kill a significant number of young people, females, each year. Now they're growing into the male population at an increasing rate. So there would be a difference in a presentation between eating disorders and depression, bipolar disorders, anger, and things like that, just because most young people with an eating disorder would be looking more for someone who is looking healthy and great now, as opposed to depression or bipolar disorder, which are just different animals, as far as mental disorders go.

 

SPEAKER FROM THE FLOOR: Ross, I'm very pleased that you're here today sharing with us your experiences, and so forth. But my concern is one that probably isn't usually addressed right away in crowds like this, which I want to bring up, and that's the finances of it. As you said, if the leg is hanging off, no one thinks about finances or insurance. They just go to work and put it back together again.

 

But I hear from my counselors that parents' first question, when they don't believe their child is in the throes of death, or anything, is often about finances. "What is this going to cost us?"

 

Tell me what the insurance companies are doing that you know of. I know you're only 26, and most of us are twice your age and have had to deal with insurance for longer than you have. What's been your experience? How can you help us talk to our parents or counselors and say, "Money can't be an issue here"?

 

MR. SZABO: I wish I had a good answer for you here. Unfortunately, almost every insurance company in the country will only pay for medication and not therapy, meaning therapy comes out of pocket. There was a bill in the Senate for parity, basically treating mental health disorders the same way you treat physical disorders. It didn't get out of committee, because it was going to cost corporations 1 percent of their overall bottom line.

 

Now, depression costs this country $213 billion a year in missed workdays and other losses of productivity. You would think that that $213 billion would weigh more than the 1 percent. It didn't.

 

There are ways around it. It's different in every area. Your counselors are telling you that it's going to cost a lot of money for medication and for therapy. Frequently insurance companies won't even cover the medication, which can be expensive, and then there's therapy on top of it. Sometimes they authorize five visits. After a student is hospitalized for wanting to take his or her own life, insurance will cover five visits after that. Those five visits could be in a week, as far as that goes.

 

The best thing to do, if you do want to do something on this issue, would be to sit down with your counselors or a mental health professional in your area and figure out what's going to work best for that area, as far as cost. But I would also like to point out one of the biggest reasons people don't address this issue. MIT is now being sued because a student took her own life and the school didn't let the parents know. This is one of the biggest reasons they don't, because they say, "Well, it's kind of opening Pandora's box. We say you can seek help. Now everybody wants to seek help. It costs more money."

 

My concern in that approach -- and I'm not saying you're doing this at all -- is that with more awareness and with more people seeking help comes a parity, comes the insurance, comes everything else. If we stay in this stagnant point where we're just saying, "Well, we're opening Pandora's box. Can we afford to do that?" we'll never be able to afford to do it. Eventually these problems must be recognized, and our Congressmen and our country are going to have to react by giving us the insurance and the parity and everything else to make it easier.

 

In every college I have spoken at around the country, there is a two-to-three-week waiting period just to get in to see a counselor, and the school has no funds for mental health. So eventually there's got to be a breaking point. Does that mean it's an easy transition or it's something that we can easily address now? Absolutely not. But I don't know how long we go with two-to-three-to-four-week waiting periods where students call a counseling center and say they want to take their own life, and, "Well, we can't see you for another week." I don't know how long we go at this level.

 

So the best thing, again, is to meet with individuals in your community and figure out the best way to combat it, if you choose to do this. But also let's not lose sight of the fact that it's either going to continue on this level, where we don't have funds, we don't have resources; or we all push and show that we need the funds and resources, and we get it.

 

I'm not saying that every program, obviously, gets that immediately, you know, but the Garrett Lee Smith Memorial Act, which Congress passed, approved $87 million for mental health and suicide prevention. The Act also wants to screen every middle school and high school and college student to see if they're at risk for suicide, which I think is a horrible idea. But there are things like that being done. Now, it took two senators' sons killing themselves to accomplish that, which is sad. But eyes are being opened, and I think that we need to continue to open them.

 

I'm sorry I don't have a set answer for that, but there are ways around it. Sometimes it's difficult.

 

SPEAKER FROM THE FLOOR: I know when we were growing up, we didn't often see things such as, moving to the physical side, asthma, peanut allergies, and they seem to be epidemic now. We similarly didn't see suicide, eating disorders, and cutting, in particular.

 

So as much as you're working with kids at the kid level and at the national level to work on these things, whenever I see something like peanut allergies, I think something else is going on that's causing peanut allergies to come on the map. Something else is going on to cause the cutting.

 

What's the thought about the bigger causes? And we all can guess some of them. Is work being done in those areas, as well?

 

MR. SZABO: One of the biggest causes for these issues is obviously the pressure, the vast amounts of pressure on young people now that weren't before. Now you have 14-year-olds, and even younger, choosing the colleges they want to go to. So pressure is one of the biggest causes of all these things. What you're seeing is different coping mechanisms for the pressure.

 

Along with that, there's a lack of education on these issues. Now, whenever a young person has a problem, it's almost like, "Well, it has to be so major, it has to be depression. It has to be bipolar disorder. I have to cut myself. I have to binge drink," whereas a lot of these problems aren't severe disorders, and without that education of what is depression, what these problems are, you'll continue to see that need for almost glorification and that need for almost the attention of the severity of the issues.

 

You also have influences that are new, the media reporting things immediately, you know. Crime has gone down significantly over the past ten years. Reports on crime have gone up 650 percent over the past ten years. So there's a lot of fear. There are a lot of people thinking that there's more death, more destruction, more problems in our society when, in all reality, you look at the air quality in Los Angeles just from 1982 to now, the air is cleaner. Does it mean there's not a problem? No. Not at all. But we are advancing as a civilization, and we are doing better. We just have this constant state of fear and negativity from resources that you can't always combat. I would say those are the main factors: The stress, the glorification, and the fear. Those are definitely things you can address.

 

There are a lot of different theories on suicide, a lot of different theories on why it spiked so quickly in the early '90s and has leveled off since then. Some of it has to do with youth culture and music. There are many different influences. But I think the main one is stress right now, and that's the main thing people are seeing.

 

I have been to many college conferences that focus on sleep. I spoke at Duke recently, and their counseling center said their students just don't sleep at all. That creates so many other problems. So obviously, they're not sleeping because of the stress and the pressure involved. So stress and pressure definitely are main points.

 

MR. GALBRAITH: Ross, as you described your symptoms, I envisioned a male, and some of them really tracked with what I would expect for a young man. Could you talk about what we should expect to see with young women? And is cutting more prevalent in females?

 

MR. SZABO: There are the same symptoms. The symptoms associated with these disorders are the same across the board, especially the loneliness, and everything I named for a manic high and everything I named for depression. Young females statistically are ten times more likely to experience depression. We don't know if that's because they actually experience depression more, or because they report it more.

 

Young females are more prone to cutting, as well, and for those of you who aren't familiar with exactly what cutting is, remember when I talked about the emotional pain you feel in your mind? UCLA's study said that the brain reacts the same way for someone who faces rejection as someone who loses an arm. That pain is there. And when someone cuts himself, while the cutting does hurt, after they cut, the pain that they feel in their arm registers a different area of the brain, which essentially relieves the pain that was registered in the brain. So once an individual discovers that cutting can relieve emotional pain, it becomes addictive, and the individual will start cutting different parts of the body to relieve that emotional pain. Eventually, the individual becomes addicted to that type of coping mechanism.

 

First you have to get the person to stop cutting, and then find out why they were cutting. It's a very, very difficult scenario. But cutting is more prevalent among females. The reported percentage among young females is higher than young males. The book "Odd Girl Out" describes the mental damage done to young females through cliques. There have been many studies demonstrating the horrible ways personalities and behavior are demeaned, creating a social outcast.

 

It has also been found that young females are much less prone to become friends again, more prone to hold grudges for the rest of the school year, and young girls feel horrible enough about themselves that they even change schools and take other actions like that.

 

But as far as symptoms and disorders go, the symptoms are the same. The disorders are the same. I have been surprised at how violent young females can be. I hear their stories and hear that what they're doing. They are getting more violent. They're getting a lot more outspoken and a lot more dangerous with each other.

 

Young females are more likely to attempt suicide, whereas young males are more likely to complete the suicide.

 

Outside of that, everything is pretty much the same. A couple of the all-girls' schools I have spoken to have said that the message actually comes better from a young male, because if a young female were to stand up in front of the group, she would be judged, ripped apart, and not taken as seriously, almost immediately. And I don't know that for sure. But that's what I have heard from some of the heads of the schools.

 

I think it's also rare for them to see a male talk about emotion at all, which is something that can also leave an impact. But we are looking to expand our speakers' bureau.

 

SPEAKER FROM THE FLOOR: One last question, Ross. When someone in a family is diagnosed with a mental illness, it affects the entire family structure. I can speak from personal experience on that. I think the program of awareness is fantastic, but there still is a stigma that is attached to it, and it's not something that you freely talk about outside of your closest circle of friends. And that's one thing for the family unit.

 

I think it's another thing where it affects schools, for siblings. When you have someone recovering, or in rehabilitation, or whatever, when it's another sibling of similar age, it's very hard, as friends come over and you have to explain. Can you speak a little bit to that and what we can do in schools, perhaps?

 

MR. SZABO: Yes, I agree. The message shouldn't be that everyone talks about it with everyone. That message isn't going to work. So again, when you're dealing with siblings, education is the primary thing. You can do that through a school program where you educate everyone on all these issues, all the awareness, what to look for, what to be aware of. But if you know of a particular student whose sibling has been diagnosed and is going through something, then you definitely would have to take them aside with either a counselor or someone else, and go through again that confrontation-into-conversation thing where you get the young person to talk about how they feel.

 

When I was diagnosed, my middle brother completely abandoned me. He didn't understand it. It was much easier to beat me than it was to talk to me about it, and be concerned about it, and learn about it.

 

The goal of the counseling center -- or whoever it is in that situation -- should be to educate the young person on what's going on, and also try to open up communication between the sibling who's affected and the sibling who's not affected, because what can end up happening is, if they don't talk, the sibling who is affected feels worse about himself because the other sibling won't even talk to him anymore, because they're already going through this horrible thing. The sibling who isn't affected may feel worse about the sibling who is affected just because, "Well, they're weird. They have this problem." They're getting more attention now from the parents, or not.

 

People can educate both siblings on what they need to do, but they should also try to open up communication between them, to make sure it's okay. It doesn't mean that it's the role of the school to make sure that the family unit is okay, because I don't know that that's right. I think what they should at least do, though, is make the effort to open the communication and start the education among the siblings and at least be an avenue of resource for them.

 

You're not going to have every sibling get along, and a lot of times these issues are a major source of contention. My brother just didn't believe I had a problem. He came to visit me after I wanted to take my own life, and that's when I think he started to get it. But he still just really didn't want to believe I had a problem, which was obviously even harder for me, because now someone in my family didn't believe me. It hurt, and it increased my level of self-hatred and not caring about myself, as well.

 

You have brought up a really good point. It should start with education and hopefully opening up some level of communication among the siblings. If you can bring in the parents, and the parents are willing to try to continue it, great. If the parents aren't, it doesn't mean you don't try to address the siblings.

 

I also don't know what the legality of the school would be in that role. I don't know if you can do that. I don't know in every school if that's even possible. But that's the model you should try for, because when people aren't educated on these issues, they can do a lot more damage to the sibling and to everyone.

 

Thank you very much. (Applause.)

 

MS. GLICKMAN: Thank you so much, Ross. You have an uncanny talent of connecting, and you connected with us really well. I can see you connecting with young people and with our parents, three entirely different audiences who must hear your message.

 

Ross asked me to remind you that there are handouts at the back.

 

Bodie asked me to remind you that we're to be back here at 10:30 for the next session.

 

Reveta wants those Brownie uniforms on at noon.