the most extreme example is depressed people having an increased risk of suicide if an antidepressant lifts their akrasia before it improves their mood.
I’ve also read that people with bipolar disorder are more likely to commit suicide as their depression lifts.
But antidepressant effects can be very complicated. I know someone who says one med made her really really want to sleep with her feet where her head normally went. I once reacted to an antidepressant by spending three days cycling through the thoughts, “I should cut off a finger” (I explained to myself why that was a bad idea) “I should cut off a toe” (ditto) “I should cut all the flesh from my ribs” (explain myself out of it again), then back to the start.
The akrasia-lifting explanation certainly seems plausible to me (although “mood” may not be the other relevant variable—it may be worldview and plans; I’ve never attempted suicide, but certainly when I’ve self-harmed or sabotaged my own life it’s often been on “autopilot”, carrying out something I’ve been thinking about a lot, not directly related to mood—mood and beliefs are related, but I’ve noticed a lag between one changing and the other changing to catch up to it; someone might no longer be severely depressed but still believe that killing themself is a good course of action). Still, I would also believe an explanation that certain meds cause suicidal impulses in some people, just as they can cause other weird impulses.
My mom is a psychiatrist, and she’s given an explanation basically equivalent to that one—that people with very severe depression don’t have the “energy” to do anything at all, including taking action to kill themselves, and that when they start taking medication, they get their energy back and are able to act on their plans.
the most extreme example is depressed people having an increased risk of suicide if an antidepressant lifts their akrasia before it improves their mood.
I’ve also read that people with bipolar disorder are more likely to commit suicide as their depression lifts.
But antidepressant effects can be very complicated. I know someone who says one med made her really really want to sleep with her feet where her head normally went. I once reacted to an antidepressant by spending three days cycling through the thoughts, “I should cut off a finger” (I explained to myself why that was a bad idea) “I should cut off a toe” (ditto) “I should cut all the flesh from my ribs” (explain myself out of it again), then back to the start.
The akrasia-lifting explanation certainly seems plausible to me (although “mood” may not be the other relevant variable—it may be worldview and plans; I’ve never attempted suicide, but certainly when I’ve self-harmed or sabotaged my own life it’s often been on “autopilot”, carrying out something I’ve been thinking about a lot, not directly related to mood—mood and beliefs are related, but I’ve noticed a lag between one changing and the other changing to catch up to it; someone might no longer be severely depressed but still believe that killing themself is a good course of action). Still, I would also believe an explanation that certain meds cause suicidal impulses in some people, just as they can cause other weird impulses.
My antidepressant gave me a sweet tooth.
Interesting. Are you sure that is going on when antidepressants have paradoxical effects?
Not absolutely certain. It’s an impression I’ve picked up from mass media accounts, and it seems reasonable to me.
It would be good to have both more science and more personal accounts.
Thanks for asking.
My mom is a psychiatrist, and she’s given an explanation basically equivalent to that one—that people with very severe depression don’t have the “energy” to do anything at all, including taking action to kill themselves, and that when they start taking medication, they get their energy back and are able to act on their plans.