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Comment by SkyPuncher | Hacker News Reader

> Zoloft made me extremely suicidal

Were you on an upswing in your mood?

There's a tough period with anti-depressants where people are on an upswing to a more positive position. They haven't yet broke free of overwhelming suicidal thoughts and low mood, but now have energy and motivation to actually do things. Unfortunately, that means suicidal thoughts that seemed too difficult now appear possible.

It's a really interesting and tough situation. Being suicidal can actually indicate things are working properly, but will still need 4 to 6 weeks to get you to a more positive place.

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I was actually quite low. I didn't want to put it as harshly as I explain it to people close to me, but it took me from a position of "I want to die, and probably will kill myself semi-soon." to "My shotgun is loaded, 41 steps away from me. In a flash the world could be gone, and my thoughts would vanish and I would be at peace."

The prior thought process was accompanied with self-destructive methods. Abandoning friends, work, hobbies, etc. My real emotional escape has always been video games. They keep my thoughts from wandering, and I pour everything in to them. I believe my use of them in that way accompanies my skill at them. (Top 10 PUBG 2 seasons ago, A+ ESEA, Global Elite in CS, top 50 crusader D3 S13, etc.) My accomplishments in video games really help my suicidal tendencies, but they also hamper them. My depression seems to sway between a desire for success, freedom, skill, and a general over-arching hate of the meaningless-ness of existence. On a downswing it can depress me, on an upswing it can inspire me. I don't know enough about the topic from a professional perspective to determine how common that is for people.

This is exactly where the "suicide warning" on anti-depressants come from.

The "I want to die" thought and the "my shotgun is loaded" thought are at their core, the same "I don't want to live". However, the later has motive and intent behind it.

The whole goal of anti-depressants is basically to give you motive and intent. In many cases, that can be really good but it also means you have motive for the suicidal thoughts that still linger around.

Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people.

(This isn't an argument against taking medication).

> Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people.

I'm not arguing that. I'm arguing why it occurs as it's a really interesting reason.

When you're super down in the dumps, you simply don't have energy for anything. Even thinking about suicide is a chore so you simply don't do it.

When you start on an anti-depressant, it doesn't literally cause to become more depressed or suicidal.It causes suicidal thoughts by giving you the energy to actually have difficult thoughts and actions - including suicidal thoughts.

> I'm not arguing that. I'm arguing why it occurs as it's a really interesting reason.

And I'm saying that's an incomplete picture. It only accounts for some but not all suicidal action in people taking anti-depressant medication.

You make it sound like your mechanism is widely accepted. It isn't. For one thing it doesn't account for age differences in suicidality in people taking medication.

Here's an easy to read summary of recent research from a trusted source: https://www.nationalelfservice.net/mental-health/suicide/ssr...

Interesting perspective. I guess I could agree with the change from being /passively/ suicidal to actively suicidal.

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