The feud between pop tart Miley Cyrus and singer-songwriter Sinéad O'Connor has only intensified after Cyrus's October 7, 2013, appearance on the Today show. After admitting to Matt Lauer that her crass public behavior has been calculated to boost album sales ("I'm an artist, so I'm hoping that I get a little attention, or my record sales might be a little sketch," "It's a month later, and we're still talking about it, so it definitely went as planned"), Cyrus went on to attack O'Connor, calling the open letter from the Irish songstress "kind of crazy." That's when O'Connor wrote another open letter to Cyrus.
"My problem with you stems from your response to my first letter," O'Connor writes. "Until you exposed me (and Amanda Bynes) to abuse on the grounds of my having sought help [...] when experiencing suicidal compulsion as a side effect of a medication called Tegretol, I had no problem with you whatsoever." O'Connor is referring to Cyrus's response to her first open letter, which was to tweet a screenshot of old tweets from O'Connor from a period of time when she was suffering particularly acute mental and emotional problems.
The effects of Tegretol (a brand name for carbamazepine, an anticonvulsant also prescribed for bipolar disorder) on suicidality has been debated by researchers for years. A 2005 article in the Archives of Suicide Research sheds light on the difficulty in identifying the role this drug may play in mental health: "Compared to lithium, the relative risk of suicidal ideation was numerically slightly higher for valproate, carbamazepine, and a small group treated with either levetiracetam, oxcarbazepine, or topamirate, but lower in patients treated with lamotrigine, without reaching statistical significance. Confounding variables in more intensive care of these patients participating in a naturalistic study may blur small differences and contribute to a generally favorable outcome." It is very difficult, in a research setting, to separate the effects of pre-existing mental illness, pharmaceutical therapies, and non-pharmaceutical therapies.
O'Connor is seeking an apology from Cyrus, as well as a removal of the screenshot from Cyrus's Twitter page. She warns Cyrus that she is sending her young fans a dangerous message, namely that they should not seek help when experiencing mental health problems. She points to the very real problem of suicide, which was the second leading cause of death among children ages 12 to 17 in 2010. "When people ask for help," O'Connor says, "the media and celebrities like yourself mock them."
Regardless of how the disagreement between O'Connor and Cyrus is (or isn't) resolved, individuals experiencing suicidal ideation should know that there are many resources available to them, including the Youth America Hotline, the Trevor Project (aimed particularly at lesbian, gay, bisexual, transgender, and questioning youth), ULifeline (for college students), Lehigh County Emergency Mental Health Services, and Northampton County Crisis Intervention Services.