When it comes to treating depression or anxiety, different methods of treatment can be provided at different levels of care. However, one of the most common forms of treatment is, unfortunately, prescription medication. Used as an assumed “cure-all” for these illnesses, doctors, and psychiatrists can tend to look for treatment methods that surround the use of these prescription drugs without enough consideration of the side effects.
In some instances, these medications can cause those taking them to feel worse off than before, exaggerating symptoms and creating new, more harmful side effects that can be exponentially more damaging. One of the side effects that commonly appears is an increase in suicidal thoughts and suicidal ideation. Because of how prescription medications alter your brain chemistry in an attempt to mitigate mood, they can cause impulsivity, violence, mania, and depression. These changes can lead to suicidal ideation or even suicide attempts.
That’s why people experiencing mental health issues like depression, anxiety, PTSD, and substance use disorder and seeking active, helpful treatment should know prescription medication is not the only answer. Seeking alternatives to these harmful compounds is critical to effectively treating the disorder while helping suppress thoughts of suicide.
What Are Psychiatric Medications Used For?
When it comes to mental health treatment, the various disorders can be treated with a multitude of therapies. For example, traditional talk therapy, counseling, or EMDR are often used as a form of care for those working through post-traumatic stress disorder (PTSD) or repressed childhood trauma, while those experiencing clinical depression or generalized anxiety disorder may benefit from alternative therapies like equine therapy or art therapy. No matter the condition, however, approaching a psychiatrist for a diagnosis will likely end in a prescription. All too often, these prescriptions are used to take the place of a care plan designed to treat your specific issues.
Psychiatric medications were developed to treat a host of mental health problems. These issues include depression disorders like major depressive disorder (MDD), seasonal affective disorder (SAD), postpartum depression (PPD), and bipolar depression. Psychiatric medications have also been used to treat anxiety-related disorders like post-traumatic stress disorder (PTSD), general anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder, and more.
Depending on what illness is being treated, psychiatrists will often prescribe different kinds of medications believed to help control that diagnosis. However, these prescriptions are usually based on the preference of the psychiatrist, who may arrive at a diagnosis and rely on what they view as the simplest form of treatment with no regard for any other methods of rehabilitation.
Antidepressants
For those suffering from severe depression, or those that have a combination of anxiety and depression, antidepressant medications, like fluoxetine, citalopram, sertraline, paroxetine, and escitalopram, are often prescribed as a way to address both. These medications are classified as selective serotonin reuptake inhibitors (SSRIs), which build up and slowly release in your system over the time that you take them in an attempt to regulate serotonin levels in the brain. These daily maintenance medications create a reservoir of the active ingredients in your system that must be maintained daily.
A significant problem with antidepressants is having to constantly stay on a regimen to see any results. If you skip a day or stop taking your prescriptions, all your previous headway in creating the intended serotonin reservoir is lost. Meanwhile, due the way SSRIs artificially boost serotonin retention, your brain can no longer manage these levels on its own. Adverse side effects are common and can make managing your condition exponentially harder than before. In most scenarios, the prescriptions provided can cause your symptoms to worsen instead of improving. Worse, withdrawals or discontinuation syndrome can set in quickly after you stop taking them, keeping you locked in a cycle of prescription medications.
Anti-Anxiety Medication
Common anti-anxiety medications, namely clonazepam, alprazolam, and lorazepam, are all forms of benzodiazepines used to limit anxiety-induced behaviors like panic attacks. These drugs, in contrast to antidepressants, are used as a form of quick relief for these sudden rushes of anxiety. They attempt to bring down the person taking the meds to a neutral, non-reactive state; however, these medications can increase a feeling of emptiness in the user, which can contribute to feelings of depression and suicidal ideation.
In long-time users, the dosage needed to reach this relief can increase as you build up a tolerance level to the substance, which can only increase negative side effects. Overall, both antidepressants and anti-anxiety medication are not guaranteed to be effective in all users, and because of common adverse side effects, they can end up being less helpful than other forms of treatment.1
How Do Suicidal Thoughts Take Shape?
Suicidal thoughts, or suicidal ideation, can occur in many forms and for various reasons. Depending on the circumstances, studies surrounding the development of suicidal thoughts have opened up a wider array of scientific data on what causes these thoughts to occur. Suicidal ideation is the overarching category of behaviors that can be attributed to those that make an individual feel like suicide is a necessary option for them.
Suicidal thoughts, which go hand in hand with suicidal ideation, are the manifestations of these ideas in those suffering from suicidal ideation and can lead to drastic consequences if acted upon. Suicidal thoughts are a subcategory of the overarching suicidal ideation, which encompasses other behaviors relating to suicide, such as self-harm.
Depression can cover a wide array of mood disorders, and each has a wide array of symptoms and side effects. On average, 60% of those with suicidal thoughts or who are at risk for suicidal ideation suffer from a depression-related mood disorder.2
For a long time, an imbalance in brain chemistry was purported to cause depression, and antidepressants were prescribed to treat this imbalance. However, that theory has never been proven, and medications can make functioning with mental illness extremely difficult for some to manage.
Instead, the most common contributors to depression and suicidal ideation continue to be:
Anxiety and other mental health disorders
Physical illness
Trauma
Substance use, including psychiatric medication
Anxiety-Related Disorders
For those suffering from anxiety-based disorders, the stress brought on by daily activities, along with the anxiety-related disorder, can cause an increase in suicidal thoughts. These thoughts can manifest from a need for control over one’s own life or as a way to decrease stress and panic from everyday routines. In fact, of all individuals reporting a suicide attempt, over 70% suffered from an anxiety disorder.3
For some panic disorders, such as post-traumatic stress disorder (PTSD), suicidal ideation is intensified by a link to both impulsive behaviors and anger stemming from their trauma and traumatic flashbacks. In these instances, the stressfulness of life tends to be too much for someone with one of these disorders, and suicide seems to be the only option for ending their stress. Again, medications meant to restore chemical balance may lead to an increase in suicidal thoughts.
Trauma
Researchers have long noted that traumatic events seem to be interlinked with mental health issues. Those who have experienced trauma, whether from an unstable childhood or a traumatic event as an adult, are more likely to encounter mental illness later in life. Complex trauma from physical abuse, sexual abuse, loss of a parent, natural disasters, war, automobile accidents, and more, can give rise to other mental health issues, especially PTSD.
Constantly reliving past trauma in the form of PTSD leads many survivors of trauma to look for a “way out” of this cycle. For some, that takes the form of substance use and misuse. For others, suicide is viewed as a means of escape. Over 10% of young adults with PTSD report having attempted suicide, compared to 5% of non-trauma exposed individuals. The number of individuals who have experienced suicidal ideation without an attempt is likely higher.4
Physical Illness
For some, the diagnosis of a long-term or terminal physical illness can be the source of suicidal thoughts. Although somewhat grim, coping with a crushing diagnosis like this is very hard, and for some, the possibility of life with these new restrictions does not seem feasible. Thought of as a release from their physical ailments, suicidal thoughts can stem from feeling like death is the only way to be free from their illness.
Especially concerning terminal diagnoses, the root causes of suicidal thoughts among those with physical illnesses are coming from a place of relieving suffering. Statistically speaking, those that suffer from a disability, especially multiple disabilities, are more likely to experience depression, suicidal thoughts, and suicide planning. Worse, some of the medications used to treat chronic illness and disabling conditions can serve to further influence suicidal thoughts.5
Recreational Drugs and Prescription Medication
The use of chemical substances has long been linked to an increase in depression and suicidal ideation. An estimated 40% of all people entering treatment for substance addiction have had a previous suicide attempt, and even more struggle with suicidal thoughts. Unfortunately, the Black Box labels present on prescription psychiatric medication indicate that prescription drugs are another frequent contributor to depression and suicide.6
As mentioned above, psychiatric medications appear to be the root cause of some suicidal thoughts. As a listed side effect, those prescribed antidepressants or anti-anxiety medications can have adverse reactions to these medications, which can overall increase their likelihood of developing worsening mental health symptoms.
Similarly, after stopping the use of antidepressants or anti-anxiety medication, withdrawal symptoms can develop, leading those previously on these medications more likely to develop strong, serious side effects, like suicidal ideation. Overall, adverse reactions to SSRIs and other psychoactive medications have been shown to cause an increase in suicidal thoughts and suicidal ideation at least 5% more often than a placebo.
Although this data has since been dismissed by pharmaceutical companies, researchers now believe the numbers could be even higher than reported, as many suicide attempts were either dismissed, falsely attributed to the placebo, or negated due to timeline inconsistencies.7
Mental wellness and mental health are critical considerations, especially when it comes to harm and harming oneself. Suicidal thoughts are sometimes thought of as a part of being depressed, but the origin of these thoughts can stem from ineffective treatment plans, like prescription medication. Being able to find the right treatment plan for your particular needs and feelings is essential to the healing process. Relying on medication that is not guaranteed to help alleviate your symptoms and can risk making side effects worse can be detrimental to your mental and physical health.8
15 Years Experience by Professionals Who Understand Your Journey.
As mentioned previously, the use of antidepressants and anti-anxiety medication as a “one treatment fits all” way of dealing with mental illness can be extremely harmful to those seeking treatment and can make you more depressed. Antidepressants and anti-anxiety medications each have a different chemical makeup that interacts with your central nervous system, with a wide range of effects.
For example, if you begin taking Zoloft (sertraline), your body relies on a buildup of the compounds in the medication as a way to combat your mental illness. Over extended use, the buildup of these chemicals can start to alter your brain chemistry artificially, bringing on negative side effects like suicidal thoughts.9
This then begs the question: can antidepressants cause suicide? Depending on how your body reacts to these medications, the answer is ultimately yes. Unfortunately, relying on medication to cure such complicated issues as suicidal thoughts or suicidal ideation is not the best treatment plan and can ultimately make the problem worse.
Taking any new antidepressant or anti-anxiety medication can be a complete shock to your system. The repercussions can range from making you physically ill to worsening and intensifying your mental health issues. This reliance on pharmaceutical drugs for the treatment of anxiety and depression has increased over the last ten years, but treatment with pharmaceuticals should not be the only option for treating depression and anxiety.10
Alternatives to Prescriptions For Those With Suicidal Thoughts
As with any illness treatment, the options for mental health treatment — including for those with suicidal thoughts — can take a variety of forms. With a variety of options, however, comes a wide variety of side effects. As previously mentioned, the variability of effectiveness and safety of choosing pharmaceutical-based treatment is different for every patient, so relying on these methods as a form of treatment can cause more harm than good. Beyond the scope of medication, here are some proven helpful forms of treatment besides prescription drugs.
Cognitive Behavioral Therapy
Residential treatment offers many tools to help deter suicidal thoughts and provides an outlet for negative thoughts and feelings. However, CBT is not limited to in-patient rehabilitation. In cognitive-behavioral therapy, one of the most helpful ways to deter negative or suicidal thoughts is through conscious, present distraction. In residential treatment programs, options for combating these thoughts are provided through different amenities and scheduled activities to help encourage independence and mindfulness during the healing process.
Counseling
Suicidal thoughts, regardless of the origin, are all matters regarding your mental health. Counseling services help determine the route of your thoughts by allowing you to speak about your feelings. Whether your suicidal thoughts are brought on by an illness or medication, speaking to the right counselor can help you overcome these thoughts, find the right form of treatment that works for you, and create a plan to help you stay on the right track.
Mindfulness Activities
Like consciously seeking a distraction, using mindfulness activities to help combat suicidal thoughts can utilize your feelings in a way that provides you an outlet for dissecting and finding the root of these issues. For example, some people turn to journaling or writing out their thoughts in a way that allows them to read more deeply into their feelings, which can be helpful for those seeking a more inward form of care. Other activities, like meditation, help provide a way for you to put your mind towards combating any negative thoughts.
Creative Outlets for Negative Thoughts
For some individuals, turning towards a more creative outlet for emotional expression is the best option for dealing with suicidal thoughts. Art therapy, or using the creation of art as a form of working through different issues and problems, is a very common method for working through tough emotional strain. Using a canvas as the receiver of your feelings, channeling any unhealthy thoughts into art helps decrease the impact of these thoughts.
Recreation or Sports-Based Recovery
One of the best ways to limit negative thoughts or feelings is by creating natural endorphins. Exercise is one of the best natural methods for increasing your endorphins. Yoga, Qi Gong, or even horseback riding are all fun, energy-filled ways to combat your suicidal thoughts while providing you the satisfaction of physical stimulation through exercise. Blending mindfulness and exercise, using both as a tool for recovery, can help you regain your mental health.
Recovery and recovery plans differ from person to person, but utilizing a more natural, adaptable approach outside of pharmaceuticals is always a better option. Besides the unconfirmed side effects, as well as the possible reactions that stem from prescription use, other forms of treatment are more effective than antidepressants or anti-anxiety medication. When it comes to utilizing more mindfulness activities in your recovery journey, these options can help you maximize your mental strength by re-training your brain to think differently about various topics, helping you move past suicidal ideation on a healthier level.11
3. Nepon, J., Belik, S. L., Bolton, J., & Sareen, J. (2010). The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Depression and anxiety, 27(9), 791–798. href=”https://doi.org/10.1002/da.20674
5. Marlow, N. M., Xie, Z., Tanner, R., Jo, A., & Kirby, A. V. (2021). Association Between Disability and Suicide-Related Outcomes Among US Adults. American journal of preventive medicine, 61(6), 852-862. https://doi.org/10.1016/j.amepre.2021.05.035
6. Wilcox, H. C., Storr, C. L., & Breslau, N. (2009). Posttraumatic stress disorder and suicide attempts in a community sample of urban american young adults. Archives of general psychiatry, 66(3), 305–311. https://doi.org/10.1001/archgenpsychiatry.2008.557
7. Spielmans, G. I., Spence-Sing, T., & Parry, P. (2020). Duty to warn: antidepressant black box suicidality warning is empirically justified. Frontiers in psychiatry, 18. Retrieved July 7, 2022, from https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00018/full
11. Luoma, J., and Villatte, J (2012). “Mindfulness in the treatment of suicidal individuals.” Cognitive and behavioral practice 19.2: 265-276. https://doi.org/10.1016/j.cbpra.2010.12.003
Originally Published Sept. 27, 2022 by Diane Ridaeus
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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