Antidepressants May Lower Suicide Risk
Better Treatment of Depression Aids in Suicide Prevention
Treating Depression is Only One Part of Suicide Prevention
"Depression is the number one risk factor for suicide. Of those that commit suicide, 40% to 70% have a diagnosis of depression," says Douglas Jacobs, MD, professor psychiatry at Harvard Medical School and founder of National Depression Screening Day. "However, the majority of people with depression do not commit suicide."
Jacobs says increased antidepressant use has also been associated with a drop in the suicide rate in the U.S. over the last decade, but it's difficult to prove definitively that greater antidepressant use is fueling the decline because suicide is such a complicated issue.
"The public should understand that antidepressants are correlated with a reduction of the suicide rate, but any one case of depression has to be treated very individually," Jacobs tells WebMD. "Unfortunately suicides do occur even in those taking medicine."
Herbert Hendin, medical director of the American Foundation for Suicide Prevention and professor of psychiatry at New York Medical College, says improved use of medicines that treat depression are just one aspect of suicide prevention.
He says that while SSRIs have made depression treatment easier for both doctor and patient, effective suicide prevention requires more than just prescribing antidepressants.
"You can identify depressed persons who are suicidal from ones who are not," says Hendin. "There are differences emotionally. [Suicidal people] tend to be angrier, more anxious, and they are very often in a state of desperation, and if they don't get immediate relief they feel life is intolerable."
Hendin says many people with depression are not receiving adequate doses of antidepressants or all the other necessary medications, such as anti-anxiety drugs, to treat their depression appropriately and effectively lower their suicide risk. But he says there are also people for whom an antidepressant may be the first step in suicide prevention.
"Sometimes there will be people trapped in a situation that is making them miserable, and you can't cure it simply with antidepressants," Hendin tells WebMD. "Sometimes [with antidepressants] you give them enough energy, but then you have to help them get out of that miserable situation."