Archives for 

antidepressant medications

Suicide in Depression

Why does treatment for depression increase the risk of suicide?

Whether you are bipolar or suffer from major depressive disorder – when you start taking medication for depression, your risk of suicide actually goes up for a short period of time.

The risk of suicide in depression

Every time an advertisement for a medication for depressive disorder or bipolar depression comes on the television, one thing that seems to stick out is the warning that states “May increase the risk of suicide“.  This is often an arguing point for people who are opposed to psychiatric medications.  If it is supposed to improve your mood, why does the risk of suicide go up?  Shouldn’t the opposite be true?

How do antidepressants work?

Antidepressant medications work by increasing the activity of neurotransmitters in the mood centers of the brain.  Nerve cell signals are transmitted by the release of chemicals known as neurotransmitters.  These include naturally occurring chemicals such as serotonin, norepinephrine and dopamine.  The neurotransmitter is released from one cell which signals the next cell to react.  The same cell then “gathers up” the neurotransmitter to be used again later.

Most antidepressants specifically work by blocking the “reuptake” of neurotransmitters so that they are in the synapses or spaces between the nerve cells for a longer period of time.  This increases the likelihood that the neurotransmitter will send a “happy” signal to the next cell – sooner.

Why do antidepressants increase the risk of suicide?

Suicide and DepressionThe problem with depression and how long it takes to recover is twofold, because depression involves both mood and energy levels.  In a person with depression, the mood state is lowered because there are often not enough neurotransmitters available.  This leads to the mental effects of depression causing sadness and an inability to enjoy normal activities.  There is also a corresponding drop in energy levels making the victim lethargic and sleepy.

When antidepressants are prescribed, most healthcare practitioners make it pretty clear that the mood state will not really begin to get noticeably better for at least 2 to 3 weeks. What is not always made clear is that energy levels actually begin to improve before the mood level is increased.

Once this person with low mood level and low energy level begins to take antidepressant medication, their energy levels go up fairly quickly.  The mood level, however, stays depressed – sad and unable to see the light at the end of the tunnel.

If patients had been thinking of suicide as part of their depression, they may not have had the energy to make actual plans or to carry them out.  Once their energy levels are boosted – they may find themselves still having the same thoughts, but this time – able to act.

Are the newer medications worse?

This increased risk of suicide is not new, despite what the media has portrayed.  It is not specific to a certain medication or even a certain kind of medication.  It is a fact, a well-known risk that has existed since the beginnings of treatment of depression.

Suicide and MedicationOur medications, today, are really much less dangerous than medications of old.  Thirty years ago, your choices for the treatment of depression included only tricyclics such as Elavil and Tofranil or MAO inhibitors such as Parnate.  Both of these medication types carried a lot of very debilitating side effects (dry mouth, constipation, excessive sweating, dizziness, and food intolerances) as well as the increased risk of suicide.  While they were effective, they were also quite dangerous in the event of an overdose – possibly resulting in death.

We now have more advanced medications – the SSRIs or Serotonin specific reuptake inhibitors, Norepinephrine reuptake inhibitors (NRIs) and newer MAO inhibitors that have much fewer side effects and are less likely to result in a serious overdose – but they have not been able to eliminate the actual risk of suicide.  This is inherent in the treatment of depression because the energy improves before the mood.

With older medications, the psychiatrist would often only prescribe a few days’ worth of medication at a time because the old medications could be dangerous if too many were taken and lead to overdose by someone trying to commit suicide.  This often meant that the patient was seen once a week or more often during the first month.

Now that overdose is not such a risk, physicians often prescribe an entire months’ worth of meds at once, and no one keeps track of the patient during this dangerous period  – giving them plenty of time to plan and act.  Generally the newer medications cannot be used as a suicide tool but it does not stop patients from finding other tools.

What can help decrease the risk?

The solution is to know your patient – know your friends, know your family.  If you have a friend or relative who has been depressed and is placed on medication, be aware.Check on them frequently. Drag them around to social activities, out to eat, to outdoor events. Note any changes or patterns that indicate they may be considering suicide.  Help them through the funk.  You may get on their nerves, but you may also save their life.

A little effort and toleration of irritating friends is way better than going to a funeral and wishing you had done something.

 

Newer medications used for prevention of suicide in depression are much less dangerous than medications of old.

Clinical Depression vs. Situational Depression

Clinical depression is a serious health problem that warrants immediate professional intervention.

Depression is one of the world’s most frequently encountered maladies, and recent United Nations World Health Organization research indicates that the problem will continue to increase and will soon be the second most dangerous global medical problem, following only heart disease.

Not allbipolar banner depression is the same, however. A passing sense of sadness is normal for all of us. Depression exists when normal emotions are experienced without sufficient motivation, or if that sadness remain after it should have passed. Clinical depression is the most severe form of the problem. Others suffer from situational depression or chronic low-grade depression (dysthymia). All incidences of depression deserve careful attention, but those experiencing clinical depression should seek treatment immediately from a qualified physician.

Situational depression is fetched from some specific event in life, and normally it will dissipate within a few weeks. Although it may share many of the same features of clinical depression such as agitation, nervousness, changes in appetite or sleeping habits, it is not as severe or long-lasting.

One may be experiencing clinical depression when their “down mood” lasts for over two weeks. Those suffering from the illness are virtually unable to enjoy any part of their life. Suicidal ideation and a sense of complete hopelessness are common.

Clinical instances of depression do not necessarily require any specific trigger. However, events in a person’s life can precipitate the onset of the condition. This indicates that episodes of depression which can seemingly be easily linked to a specific happening, should not be automatically presumed to be situational in nature.

Whereas, situational depression may disappear as the sufferer finds ways to cope with the problem`s triggers. Clinically depressed individuals require professional assistance to deal with the condition. Frequently, antidepressant medications and/or therapeutic solutions are prescribed for the treatment of clinical depression. Those who fail to seek out help for their depression may experience an escalation in the severity of symptoms. This will certainly undermine one`s quality of life, and that can even be fatal.

All forms of depression adversely impact the quality of life for sufferers and should be taken seriously. However, clinical episodes of depression are of such tremendous potential severity that one must take action to stave off a worsening of the situation.

If you or someone you know is experiencing common symptoms associated with depression and has been in that rut for more than a few weeks, medical intervention should be immediately sought. The age-old stigma regarding mental illness in our society should not be an excuse to avoid seeking treatment. Not only are those biases beginning to disappear as the extent of the depression epidemic becomes more widely known, the stakes are simply too high to justify such behavior.

The condition can be successfully treated. Thousands of people recover from illness and go on to live happy, well-adjusted lives, after dealing with clinical depression.

This might be a helpful resource for someone: When Going Through Hell… Don’t Stop! A Survivor’s Guide to Overcoming Anxiety and Clinical Depression

clinical depression

Description:

In this groundbreaking book, self-help author Douglas Bloch shares his struggle with and ultimate recovery from a life-threatening depressive illness. Although the managed care mental health system failed to provide him with adequate treatment, Mr. Bloch devised a daily survival plan for living in hell which he adopted until the power of spirit, acting through a group of committed, loving people, brought about his recovery.

In addition to his compelling story, Mr. Bloch outlines a fourteen point brain maintenance program holistic approach to the treatment of anxiety and depression that includes: diet; nutrition; exercise; stress-reduction; medication; vitamin, mineral and herbal supplements; and the importance of creating strong bonds of social support (social isolation is both a cause and consequence of depression).

The book also includes a comprehensive 130 page self-help section on treating depression, including a 10 page listing of Internet sites for on-line healing assistance.

Moreover, the narrative is complemented by paintings from history’s great artists that visually depict the various states of mind that the author experienced. In receiving words and images that stimulate both sides of the brain, the reader is given a complete picture of the journey from depression to recovery.