Annie-Xmas - I agree about the overuse of anti-depressants, and medications for mental health in general. I’m wondering what you think should happen if someone calls the police because a loved one is threatening suicide? What should be the next step to ensure that the person is given appropriate help and doesn’t harm herself or others?
That’s the first thing I thought of. Any MAOI, any SSRI, anything that has among its effects the alleviation of clinical depression is an anti-depressant, regardless of what any given patient is taking it for.
It’s like saying BIGNUM% of women are on anti-PCOS medication, why are doctors diagnosing so much PCOS?
This isn’t wholly wrong, just mostly.
One the one hand, I mean, I’ve semi-facetiously suggested renaming depression to “neurochemical anomaly 3A,” because when someone says “I have depression” people like you hear “I’m a mopey whiner who refuses to face my problems” and maybe if I just put in the effort to learn to look at things correctly I wouldn’t need these so-called glasses.
But a person who has a mental illness learns all sorts of tricks and adaptations and workarounds – not always consciously. And some of those tricks will prove maladaptive once the neurochemical issue is being dealt with, and then they have to be unlearned. So again, not wholly wrong.
There will always, always, be condescending people. Especially with chronic depression so often misunderstood as a kind of moral failure. Best not to engage them at all - it only gives them the excuse to whack you with the mallet of moralization all over again.
The card you might play in your own mind, however, is, “I’m acknowledging my condition. That’s step one to facing it. What this person means by ‘face it’ is ‘ignore it - sit on it - get it out of my face’. They don’t understand or care, and I don’t owe them any room in my head.”
I have been on two antidepressants for many years, and I am not depressed.
Both are used off-label.
- Old-style tricyclic, to treat chronic muscle pain. It does a much better job than narcotics, and is not addictive.
- SSRI, to treat migraines.
More granularity is needed to describe how, and whether, antidepressant use is justified.
So what was the upshot of all that? Did the piece of shit who framed you ever get what was coming to him/her/it? Did you ever convince the knuckle-dragging judge that no crime was committed, and the person had filed a false police report?
First of all, there is no way to keep someone who is really suicidal from committing the act. When I was locked up, I got a conversation going with the other patients about how they could commit suicide in the hospital.
I would recommend talking to a person to verify what’s going on before shoving drugs down their throat like candy.
Why is it that no one has brought up the dangerous side effects of these drugs, including the fact that they make people suicidal?
No one? What, like the FDA which regularly slaps new black box labeling on them?
Not to mention that many times, last I saw the research, a big part of the reason for the suicide increase is because the hugely depressive person is better than near-catatonic now, and has enough energy and motivation to kill him/herself, but isn’t quite well enough yet to believe that’s not the answer.
I meant no one in this thread, and Cecil himseld didn’t mention the “side effects.” Nor did the person who gave them to me.
Isn’t it odd that when nature provides the means to keep a suicidal person from committing the act, people think that giving them drugs that might maybe make them able to actually do it is the answer.
No one is giving them drugs so they can commit suicide. The intent with antidepressants is to affect the brain chemistry balance to actually remove the depression. However, it isn’t an exact science. Like everything with biological systems, there’s a lot of individual variation that affects how things actually work.
Yes, it is a risk to give antidepressants to a suicidal person. The thing is, they are not supposed to be delivered in isolation. There’s supposed to be a lot of things going on, including counseling. The point of a severely depressed person is that some improvement may counteract the lethargy but not remove the suicidal thoughts. That’s definitely not ideal.
But leaving suicidal people alone isn’t the answer, either.
Another off-label use: sleep aid. Mirtazapine is an anti-anxiety medication that, to quote the psychiatrist who first prescribed it to me, “fell out of favor” because it made its users so darn sleepy.
The sleep from mirtazapine is one heck of a lot better than from zolpidem (Ambien), and it doesn’t cause the kooky (albeit enjoyable) hallucinatory/perceptional dream-like side-effects.
The association of early SSRI use and suicide, especially among young people, is well known, and actually, pretty well understood. It is almost a classic instance of correlation not implying causation.
You are depressed, and extremely suicidal. However, because of the depression, you are not really able to put two thoughts together in a row coherently, or even muster enough determination to follow one course of action for more than a couple of minutes, let alone simply get out of bed, so your suicidal tendencies are difficult to act on (not impossible, many many many severely depressed people are able to get it together enough to kill themselves).
You go on SSRIs, and a week or two later, you ***start ***feeling just a little teeny bit more able to hold a thought for a few minutes, and can even get yourself out of bed. To your excitement, you can actually hold a train of thought together for a few minutes. Yay, you can now get out of bed and kill yourself. And if you are not cared for, there is an increased chance that you just might.
If, however, you hang in there for a couple of more weeks, you actually start to feel rational and good enough about life that suicide no longer seems like such a great idea. It can take months or even years before most depressives take it right off the table, hell, many of us with perfectly normal serotonin levels never quite take it off the menu, but its imperative recedes to normal levels.
SSRIs take time, is all, they aren’t instant cures out of a bottle. And they do not cause suicide, though it would be fair to say that they give you enough of an initial boost to enable suicide.
So no, the side effects of SSRIs do not really include suicide, that particular impulse was there all along. Side effects do, however, exist: most people on them can pretty much kiss their sex life goodbye. Most people, male and female alike, find orgasm while on SSRIs problematic. Not necessarily impossible, but problematic. There are no free lunches.
I know an anecdote is not data, but to share my story, I was put on an anti-depressant a few weeks ago. Within a week, my suicidal thoughts had stopped, and within another week, it was like my whole inner monologue had changed. I went from spending, oh, 50-75% of my time thinking about what I had done wrong and ways I had screwed up to thinking about… stuff. Work, dinner, my garden… normal things.
My life isn’t perfect, and I have some issues to work through with a counceler ( I damn near destroyed my marriage while I was depressed, still not sure what’s going to be the final result of that). But, the medication lets me think well enough to actually work on those issues. I’ve also had almost nothing in the way of side effects (If anything, my sex drive, which is one a lot of people complain about, is off the charts).
The weird thing is that my brain doesn’t seem to know what to think about when it’s not self-criticizing, so I end up with this endless stream of pop songs. It’s hard to fall asleep because my mind is racing so fast. In the first two weeks, it was up to four songs at a time; now it’s down to one or two.
I spent two or three years on anti-depressants - SNRI. I finally decided that they weren’t much use so tapered off under medical supervision.
The weeks following the last minor dose were hell! I had to go into hospital twice for acute emotional attacks - despite me being pretty normal during the entire treatment.
I’m fully weaned now and generally I can say I am as depressed as during treatment but at least I’m drug free.