eli5-How does medication cause suicidal thoughts?
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I’m not sure how accurate this is, but the way my psychiatrist explained it is that antidepressants are supposed to help regulate neurotransmitters and energy. The warning is that you’re more likely to have the energy to actually follow through with such thoughts. For a dumb example that probably only makes sense to me, you’re more likely to cook if you have ingredients.
My understanding – the medicine doesn’t make you have the thoughts, but could exacerbate your current emotions. Different medicines alter the chemicals in your brain, and have varying effects on different people, as well as people’s different situations. Easy way to say it, some medicines don’t work and you “could” slip deeper in depression. Consult with your psychiatrist about the effectiveness of your medication. That’s why they ask you a million questions on emotions, mood, feelings, etc. They’re trying to determine is a medication is effective or not.
The common theory is that since planning and following through with suicide requires at least a little energy and motivation, some people are depressed enough where even that is too much for them.
When someone starts on anti-depressants a common occurrence is that things get better in two steps, with usually the first being energy & motivation, while the more positive outlook on life comes later.
This is bad because the person is still super depressed, but now they suddenly have enough energy and motivation to think more about how they’re going to kill themselves, as well as actually following through with those plans.
The traditional explanation for increased suicidal ideation with antidepressants is that energy/motivation can lift prior to mood, and a bedbound person with a vague desire to die can temporarily become more prone to serious thinking/action before improving further. It’s never been clearly understood, though.
At least one serious researcher I know would argue that it probably involves specific receptors/switches at the cell/ molecule level. Suicidality is often portrayed as the inevitable end point if enough bad things happen, but research suggests it’s really a fairly specific state that certain ingredients like alcohol can aggravate or cause.
We don’t know exactly what causes depression or suicidal thoughts, and it’s probably not a single issue or at all uniform across all people.
So, a drug that simulates a hormone could help one person feel better because their body doesn’t make enough of it, but another person might be perfectly fine with that one chemical but make too much of another chemical, the underlying problem isn’t addressed, and you’ve thrown another part of the brain out of whack.
Then there is the issue that people’s brains work differently. What might feel better for one person could feel worse for another. Maybe the depression numbed a certain pain, with the numbness lifted things get worse.
It could also just be that some drugs stimulate the part of your brain that generates suicidal thoughts.
Just to add a distinction – while antidepressants can apparently cause suicidal thoughts, it is also true that some people stop taking them abruptly. (It is necessary to taper off carefully under a doctor’s supervision.) This can also cause such thoughts, as well as actual suicide.
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