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In our communities, we care deeply about emotional well-being, yet sometimes we rush to interpret a young person’s unhappiness as a psychiatric crisis rather than a call for understanding.
Not every struggle is a mood disorder, and not every sensitive or overwhelmed teen needs medication.
Many simply need to be heard, supported, and allowed space to grow at their own pace.
When a child or adult feels out of place socially, spiritually, or emotionally, the pain can look dramatic.
Often it is a response to pressure, loneliness, or not fitting into expected roles. Before reaching for labels or prescriptions, we can pause, listen, and ask what the heart is trying to say. When we respond with empathy, patience, and curiosity, we not only help prevent mislabeling, we create a community where emotional honesty is welcomed and healing can happen with dignity and compassion.Thank you for highlighting such an important distinction. You’re absolutely right that we need to balance our care and concern with discernment about what a young person actually needs.
I’ve found it helpful to think in terms of “triage” – understanding which struggles call for community support versus professional intervention. Many teens are navigating normal developmental challenges, family transitions, social pressures, or spiritual questions that, while painful, are part of healthy growth. These situations benefit most from what you describe: patient listening, validation, and giving them room to find their footing.
At the same time, we also need to recognize when struggles cross into territory requiring professional assessment – persistent changes in functioning, safety concerns, or symptoms that significantly interfere with daily life. The key is responding proportionally: not every tear needs a therapist, but some patterns of distress do signal the need for professional support.
What I appreciate about your approach is the emphasis on curiosity and listening first. When we start by trying to understand the young person’s experience rather than rushing to categorize it, we’re more likely to respond appropriately – whether that means offering mentorship and community support, or recognizing when additional help is needed.
Creating communities where emotional honesty is welcomed, as you said, actually makes both responses possible. Young people can share their struggles without fear of being pathologized, while also knowing that if they need more intensive support, it’s available and carries no stigma.
The question isn’t whether to provide support or seek professional help – it’s about matching the level of response to what the situation actually calls for, always starting from a place of compassion and understanding.
Anyone who has questions about medications should ask those questions
to a Doctor of Medicine [MD] or/and a licensed Pharmacist.Very much agree with Kingdavid on the importance of communities where emotional honest is welcomed, particularly for young people.
Understanding the bio-psycho-social model of psychological symptomology has deeply helped me in this regard.
Basically ailments from addiction to schizophrenia, come from a mix of biological factors, upbringing and care (or lack there of), experience of trauma, and other societal factors like what we as a community make space for also other factors like how race, age, gender etc impact this… its all layered together and all happening at once.
To assign medication alone to treat this, can be in some cases not enough, and in many cases, actually lead to us missing the actual issue.
The symptoms often act like keys, guides for us to understand the actual challenges this human is experiencing.I realize meds deeply help people, not here to shame that, but medication is WAY overprescribed. And psychiatrists way undertrained on actually seeing the WHOLE person. Good psychiatrists exist but few and far between.
We see similar problems in the psychology field, rooted in the ancient disease model, that sees people as more illness then neshama.
We need to see the full person. In their context. It is not nature, not nurture, but both and all at the same time.
Quick example. Addiction can come from covering up emotional pain. Treatment cannot just focus on taking away the substance. If anything, the key to healing, lies within the urges to use. It is what they LOVE about the substance, that can help us learn about what they are so deeply seeking, and so deeply missing in their lives, or areas of hurt that deeply need healing.
There is a great model for this in addiction called Harm Reduction Psychotherapy by Dr. Andrew Tatarsky. Powerful stuff. Highly recommend checking out.
The level of boredom in the dirahs in Brisk and Mir must be off the charts.
Evaluating depressed mood is a skill. Mental health professionals of several disciplines are trained in this. The non-medical ones need to know whether there is a biological component that would respond to medication. They then need to make appropriate referrals. There is never a one-size-fits-all. Each individual must be evaluated. The right medication for one might not be for another, even when the symptoms seem identical. Psychiatrists are the best equipped by training to make a most accurate diagnosis and plan for intervention. They once did psychotherapy, but the trend has been for psychiatrists to stick to medications while leaving the therapies to the other disciplines, psychology, social work, and others. A good psychiatrist will evaluate well enough to know the role that therapy needs to take, whether medication is being used or not. It is quite disturbing to read remarks that everyone needs meds, no one needs meds, and other generalizations. Every intervention has those who will carry it our best, and those who need it most.
R Twersky always suggests to ask such shailos of rabbis who are bokehs in psychology or are willing to work closely with professionals. Look at his books for more details.
I don’t know about schools in your area, but I saw cases where school request parents to put kids on medication as a condition of enrollment, while it is quite possible that the kids need better teachers. [As one rav, who byh had a double-digit of kids graduating from such schools, observed – everyone behaved in a class by the most respected rav and but almost everyone misbehaved in many other classes]. So, maybe start with paying attention if behaviors vary with the teacher.
I wanted to humbly add my voice to those others thanking Mrs. ShalomSimcha for opening up this important thread.
Perhaps (among many other things) it might be helpful to add the following:
The problem of over-diagnosis of mental illness and over-medication of the “worried well” has been recognized by experts at the very pinnacle of the field, including Dr. Allen Frances, who served as chair of the APA’s task force overseeing the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which is widely used in the diagnosis of Mental illness. A simple google search of his name will turn this up: “He’s a strong critic of expanding diagnostic criteria, arguing it turns normal human responses (like sadness or shyness) into disorders, often driven by financial incentives and pharmaceutical marketing”.
He argues that over-diagnosis of MI has led to “false epidemics” of ADHD, autism and Childhood Bipolar Disorder, among other conditions.
Besides many scholarly articles on the subject, almost 12 years ago, he wrote a book for layman on the subject, aptly titled “Saving Normal: An Insider’s Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life”. Just check out Amazon.
One would think that when the fellow in charge of writing “The” manual about diagnosing MI complains about his work, clinicians would take notice. Alas, very few of the clinicians I spoke to ever even heard about him. Mostly, the false belief that seems to prevail is that only fringe elements of society would find fault in the prevailing attitudes to mental illness.
Another name worth mentioning is that of Dr. Tom Insel, who was Director of the National Institutes of Mental Health ( known as the largest research organization in the world specializing in mental illness), for 13 years.
Almost 12 years ago, before Yom Kippur Dr. Insel wrote the following:
“As it turns out, Mental Illness Awareness Week this year began with Yom Kippur, the Jewish Day of Atonement. Which begs the question: what do we (in the mental health community) need to atone for? There are so many answers. For some, it may be the culture of blame and shame perpetuated for years by clinicians who explained all mental illness as being caused by trauma and evil parents.
For others, it may be the singular reliance on medication and modifying behavior rather than holistic care and the provision of skills.
Others will name the paternalistic structure of mental health care, which can undermine rather than empower individuals and their families. …
My own favorite atonement issue for Mental Illness Awareness Week this year is the lack of humility in our field. Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods. Yet, we know so little about mechanisms at each level. Too often … much of mental health care is based on faith and intuition, not science and evidence”.As noted earlier, both the book written by Dr. Frances and the blog post written by Dr. Insel are almost 12 years old. Unfortunately, very little progress seems to have been made over the past 12 years in rectifying the situation.
May I humbly submit the following question: Perhaps ShalomSimcha, kingdavid, flamingOTD, and the other excellent commentors on this thread would like to get together (probably through an online forum) to further this discussion? Perhaps the mods of YeshivaWorld would want to facilitate such a discussion?
In referring to the “sensitive or overwhelmed teen“, ShalomSimcha’s comment decries the fact that though our community cares deeply about emotional well-being, “… yet sometimes we rush to interpret a young person’s unhappiness as a psychiatric crisis rather than a call for understanding.”
Perhaps this could be restated, since sensitive people often notice things that are both true and important, which the rest of us fail to notice on our own.
Thus, perhaps this revision would be in order: “… yet sometimes we rush to interpret a young person’s unhappiness as a psychiatric crisis rather than an opportunity for us to learn from them about something true and important, which we failed to notice ourselves.”
There are various sources in Chazal that point to the belief that although personality traits are stable, the ADAPTATIONS of these traits can be changed. In other words, we have the ability to use our innate G-d given traits for either good or evil, but not satisfactorily repress these traits.
Wouldn’t the struggling teen – or adult – be much happier knowing that he isn’t doomed to carry around a “faulty” psych for the rest of his life, but instead believe that Hashem gifted him with the ability to eventually accomplish highly praiseworthy things more competently than many other people could easily do, since he would simply be fulfilling his innate nature?
The DSM IV relegated this concept to a minor role, and DSM 5 totally ignores it. DSM IV lists various ways how different people cope with stressors. Among the Defense Mechanisms resulting in optimal adaptation in the handling of stressors they include one called “Sublimation”. They explain sublimation as follows: “Sublimation allows instincts to be channeled, rather than blocked or diverted. Feelings are acknowledged, modified, and directed toward a significant object or goal” … (DSM 5 got rid of this section).
As believers in Hashem’s kindness, wouldn’t it make sense for us to seek out the “silver lining” hidden within emotional struggles?
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