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Speaker 1: Welcome to brain Stuff, a production of iHeartRadio. Hey Brainstuff,

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Speaker 1: Lauren Vogel bomb here. Today's episode discusses mental health, including

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Speaker 1: suicidal thoughts and tendencies. If you're not up for that today,

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Speaker 1: go ahead and skip this one, okay, and hey, take

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Speaker 1: care of yourself. Many prescription drugs taken as antidepressants, and

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Speaker 1: especially SSRIs or selective serotonin reuptake inhibitors, carry the warning

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Speaker 1: label may cause suicidal thoughts. It seems counterintuitive that medications

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Speaker 1: used to treat depression, which can lead to suicide, could

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Speaker 1: possibly have this side effect and still be considered a

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Speaker 1: viable treatment. To understand the reasons that these medications are

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Speaker 1: nonetheless prescribed, and the reasons why they need these labels

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Speaker 1: in the first place, let's talk about how antidepressants work.

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Speaker 1: For the article this episode is based on How Stuff Works.

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Speaker 1: Spoke via email with licensed clinical psychologist doctor David Goodot

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Speaker 1: with psycholob Psychology Center. He explained the name antidepressants is

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Speaker 1: kind of a marketing term that makes the problem of

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Speaker 1: suicidality less understandable. Antidepressant medications do not actually reduce depression.

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Speaker 1: They simply increase levels of certain neurotransmitters of forty years ago,

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Speaker 1: a researchers imagined that depression was caused by a shortage

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Speaker 1: of those neurotransmitters. However, research has not supported that hypothesis

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Speaker 1: at all. The brain is much more complicated than that. Indeed,

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Speaker 1: our brain seem to be constantly flipping the script. Reactions

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Speaker 1: to psychological medications and treatments can vary widely from person

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Speaker 1: to person, and the outcomes aren't always what you'd expect.

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Speaker 1: How Stuff Works also spoke with Lewis Lave's Web, a

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Speaker 1: psychotherapist in Austin, Texas whose name I hope I'm not butchering.

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Speaker 1: I did try to look it up. He said, as

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Speaker 1: depression lifts, it can make a person feel more motivated.

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Speaker 1: The vast majority of the time, this is a good thing.

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Speaker 1: It means they're motivated to engage in activities that make

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Speaker 1: their life happy and meaningful. Unfortunately, this isn't always the case,

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Speaker 1: and due to mechanisms we have yet to comprehend, a

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Speaker 1: small minority of patients find the motivation not to play,

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Speaker 1: but to make a suicide plan. How Stuff Works also

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Speaker 1: spoke with a patient who's experienced this phenomenon. A blogger

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Speaker 1: Esther Louise has used antidepressants to successfully manage her lifelong

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Speaker 1: battle with depression and anxiety, but the benefits haven't come

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Speaker 1: without some pitfalls. She said, I've been through the process

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Speaker 1: of starting the SSRIs on three occasions now, and each

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Speaker 1: time I've found it to be very difficult. When starting

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Speaker 1: the medication, I tend to experience an increase in the

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Speaker 1: severity of my symptoms for a short time before they

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Speaker 1: slowly start to get better. This means that for about

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Speaker 1: a week after starting the antidepressants, I will feel very

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Speaker 1: depressed and experience suicidal thoughts, even if I had not

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Speaker 1: been suffering with them before starting the medication. She says

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Speaker 1: she still finds this experience to be very alarming, even

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Speaker 1: though she's aware of what's going on. She explained, during

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Speaker 1: this time, I feel very out of character, more impulsive,

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Speaker 1: and not as stable. It can be incredibly scary to

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Speaker 1: feel like you're out of control in this way. However,

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Speaker 1: I have to remind myself that it is only temporary

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Speaker 1: and these feelings will go away soon. In my case,

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Speaker 1: they always have. This reaction probably occurs because it takes

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Speaker 1: time for antidepressants to really make a difference in your

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Speaker 1: brain function. A goodo explained, Oh, when you take prozac,

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Speaker 1: your serotonin levels will increase within about a half hour,

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Speaker 1: but therapeutic benefits are not expected for at least two weeks.

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Speaker 1: Oh why because something else has to happen in the

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Speaker 1: brain and body in response to the elevated neurotransmitter levels.

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Speaker 1: And frankly, no one in the world knows exactly what

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Speaker 1: that something is. Our bodies and brains are complicated. Despite

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Speaker 1: the risk, antidepressant use seems to be a case of

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Speaker 1: the good outweighing the bad. Typically, antidepressants do have a

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Speaker 1: protective effect against suicide. A death by suicide has been

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Speaker 1: shown to be more common in patients not taking an

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Speaker 1: antidepressant versus patients who are. It also appears that the

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Speaker 1: risk of suicidal thoughts is far greater in children and

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Speaker 1: adolescents taking these medications than in those over the age

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Speaker 1: of twenty five. A one review published in two thousand

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Speaker 1: and three of twenty three clinical trials using SSRIs in

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Speaker 1: children adolescents with depression found that there was a four

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Speaker 1: percent risk for suicidal thoughts when using SSRIs versus a

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Speaker 1: two percent risk when on a placebo. Although no one

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Speaker 1: died by suicide during these trials, The Food and Drug

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Speaker 1: Administration determined that it was appropriate to add a warning

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Speaker 1: that antidepressants may increase suicidal thoughts to the drug's labels.

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Speaker 1: A Lavee's Web said in number, it's only a small percentage,

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Speaker 1: but to parents of any child lost suicide due to antidepressants,

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Speaker 1: the problem is enormous and inconceivable. Since awareness of this

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Speaker 1: issue has risen, prescribing doctors have added risk of suicidal

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Speaker 1: thoughts to their patient education checklist. How stuff Works also

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Speaker 1: spoke with a therapist and author by the name of

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Speaker 1: Lauren Cook. She said providing the patient with information about

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Speaker 1: this process is crucial so that they too can look

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Speaker 1: for signs. By normalizing conversation around suicide, a patient is

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Speaker 1: that much more inclined to share if they are thinking

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Speaker 1: about hurting themselves. Today's episode is based on the article

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Speaker 1: why do antidepressants have warnings about suicidal thoughts? On HowStuffWorks

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Speaker 1: dot Com? Written by Leo Hoyt. Brain Stuff is a

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Speaker 1: production of by Heart Radio in partnership with HowStuffWorks dot

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Speaker 1: Com and is produced by Tyler Klang and Ramsey Young.

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Speaker 1: For more podcasts from my Heart Radio visit the iHeartRadio app,

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Speaker 1: Apple podcasts, or wherever you listen to your favorite shows.