Posted by pseudoname on May 9, 2006, at 17:54:59
In reply to Statistical question on SSRIs - Psychobabble says » linkadge, posted by Squiggles on May 9, 2006, at 17:14:07
I'm glad Squiggles made that point about the AD giving oomph to pick up a gun or whatever.
The relationship between suicide and depression isn't linear. I've noticed that, over the last 4 months as I've been getting less depressed (mostly due to my med), I've also experienced increased anxiety and suicidality.
For myself, various projects and problems in my life (financial, legal, etc) have piled up over the years of depression. Although they were serious, I could ignore them while severely depressed because I didn't care and I was too depressed to fix them anyway. But as the drug removed depressive barriers, these problems suddenly became threatening and overwhelming in a wholly new, urgent way. I had my first panic attacks because I was getting less depressed.
Also, as I started getting better, I more often felt suicidal because I could now think things like, “Even though I'm not depressed, I can't handle all this. Clearly, my situation is hopeless. I have no choice but suicide.”
Plus, as people start getting better, family dynamics can change for the worse. As the patient gets more assertive with a partner or less dependent on a caregiver, the partner or caregiver may react badly and launch a new attack or withdraw support or start getting depressed.
With complex feedback systems like these, ironically the more *effective* an antidepressant initially is, the more likely it might be to result in suicidal action. I think that would be a higher risk in a situation where the patient is just getting the drug and isn't getting any other therapy or support.
Whereas if relief from depression comes from therapy, the client would have the ongoing support to turn to as the situation changes.
poster:pseudoname
thread:640557
URL: http://www.dr-bob.org/babble/20060504/msgs/641893.html