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> He started on Lexapro, and ended up committing suicide a week later. I had to sit there and read testimonials of people that lost friends and family attributed to taking lexapro.

I don't want to belittle you're experience, because losing a friend to suicide is always brutal, but I do feel that its important to look at reports of anti-depressants causing suicide with a critical eye.

Almost all ant-depressants carry a warning that they can cause suicide, but there are a couple of factors in that:

1. Almost by definition, people who are prescribed anti-depressants are more likely to commit suicide in the first place.

2. I can't find the source on this one, but I've certainly been told by psychiatrists that the first few weeks after going on anti-depressants carries a higher risk of suicide than before going on them. The theory is that during those first few weeks you've been given enough of a kick by the drugs to provide a bit of motivation, but you've not yet had the chance to address the actual cause of the problem. That combination can result in having just enough motivation to carry out your desire to kill yourself.

Unfortunately you'll often see doctors prescribing medication without then following it up with the necessary therapy to help their patient move on from whatever got them into the situation got them to this point to begin with.

Nah, I don't think your comment belittles my experience at all. You bring up all the points that people were talking about around the time of the tragedy (last October). The point of my comment was to show there are windows open when doors seems closed, if you know what I mean, rather than sensationalizing what happened to some random guy x I that I know. Good points!

>That combination can result in having just enough motivation to carry out your desire to kill yourself.

Have we ever had a testimonial from a failed suicide in these circumstances? In my case, as my depression and anxiety issues started going away, I suddenly realized how much of a complete weirdo others must see me as and felt shame comparing myself to others in my peer group who, without depression holding them back, have become much more successful. It was a brutal eye-opener for me. I guess when I was depressed I really didn't consider these things or they simply didn't bother me.

It really brought up a feeling of hopelessness, like I wasted my youth and thus will never catch up, or will always been seen as defective in some way. I guess it doesn't bother me much anymore, but given sudden clarity like that can be intimidating. I imagine if someone is already suicidal, it can be a tipping point.

> I suddenly realized how much of a complete weirdo others must see me as and felt shame comparing myself to others in my peer group who, without depression holding them back, have become much more successful. ... It really brought up a feeling of hopelessness, like I wasted my youth and thus will never catch up, or will always been seen as defective in some way.

Preach it brother! I feel the same damned way.

> I guess when I was depressed I really didn't consider these things or they simply didn't bother me.

I revel in my weirdness when my mood is different from others-- they're just polyannas. Makes it harder to make that appt. to get the meds adjusted.

There is little doubt that antidepressants can cause new suicidal thoughts in children. In general use antidepressants can cause manic behavior and other psychological issues.

This is a very tricky subject where language fails us a bit - what exactly is a 'suicidal thought,' or 'suicidal ideation' as clinicians put it?

You can be depressed and think that you want to die, or that everyone else would be better off if you were dead, or that being dead would be preferable to stewing misery...but feel too apathetic to do anything about it. With or without drugs, you can be in a more active mode where you feel like doing something about your problems, but still feel miserable or be acutely conscious of the pit of misery that you just left, eg if you're bipolar and having a manic episode. So the drug or mood swing might correlate with the impetus to commit suicide, eg getting up and going somewhere to do so or making use of tools to that end. But is the 'suicidal thought' the desire to stop living, or the practical action upon that desire? As someone with some first-hand experience in this area, focusing on the latter seems like blaming the period for the ending of a sentence, while avoiding engagement with the semantic content thereof.

I'm not saying that drugs or other factors can't induce the idea by any means, but most discussions of this issue seem to involve a heft does of post hoc ergo propter hoc, ie the correlation = causation fallacy.

Suicidal ideation covers active thoughts ("this is the method I will use; this is my plan; here is a note") and passive thoughts ("I wish I wasn't here anymore"; "they'd be better off without me" etc).

Depression covers a broad range of behaviours and severities.

But to say "anti depressants can cause odd thinking in some people during the first few weeks of use, and people starting anti depressants should be closely monitored" is not controversial. You mention bipolar - it is important to be very careful with SSRIs and people with (possibly undiagnosed) bipolar.

http://www.mhra.gov.uk/ConferencesLearningCentre/LearningCen...

As a counterpoint, there are a lot of problems with marijuana use for depression treatment.

    1) It's inebriating, so you shouldn't drive or operate heavy machinery after using marijuana. It's definitely possible to control your dosages a bit using a vaporizer or pipe, but it takes a fair bit of experimentation to determine your tolerance level.

    2) It's short-acting. Whereas the contemporary antidepressants affect baseline mood over a period of time, the mood-enhancing effects of marijuana will largely wear off after 3-6 hours.

    3) It's illegal to grow in the US without a license and has varying legality regarding consumption, buying, and selling throughout the world. This might not matter for some people, but it should be a strong consideration for people with families or people who work in environments with routine drug testing. As a child of a parent who used to grow marijuana illegally, it stressed me out as a kid learning to be anti-drug in school yet dealing with the drug-using and growing parents every day.

Also (to those reading this) be careful to look up the fact(?) that for some psychological profiles, marijuana can actually aggravate existing tendencies for mental disorder. I have no idea of the rates, so maybe it's very rare, but I've heard of it happening.

One basic example: I've heard some with anxiety say it calms them down. I've heard others say it makes them freak out.

For some folks it can cause a psychotic episode; this happened, for instance, to an acquaintance who was also bipolar.

Carl Hart's book "High Price" had some interesting anecdotes about how drugs interact with underlying brain chemistry, environment, and cultural expectations to give different experiences.

> For some folks it can cause a psychotic episode; this happened, for instance, to an acquaintance who was also bipolar.

I believe I've also met a bipolar person who had a psychotic episode from pot, though the dude apparently was doing an insane amount; claimed to be having THC flashbacks, which I'd never heard of.

With bipolar stay well away from mind altering substances unless its under professional supervision. The combination of an already delicate brain chemistry, recreational drugs, and quite probably a cocktail of mood stabilisers and anti depressants isn't a pretty sight.

I'm one of those people for whom weed brought about psychosis (requiring a three week hospital stay -- I was certified). I smoked for ~13 years before this happened; I definitely had other negative side effects but nothing nearly that drastic. I don't smoke anymore.

I do do a lot of other stuff (meditation, CBT, ...) and life is pretty good these days.

Thank you for openly sharing here. The biggest concern I have about self-medication is a doctor isn't involved to know when helpful uses turn problematic (consider more challenging drugs shown to help brain health). In the case of marijuana the ridiculous regulations mean that the pharmaceutical companies have had a monopoly on validation studies for over 50 years. That looks to be changing and hopefully soon.

Eerily similar to a family member's journey, though without the gardening bit (just yet!), so I am glad you shared this. Self medication isn't always bad, but there's certainly a lot less data to work with in trying to find out the proper dosage and the legal gray areas for certain states or countries.

Are you not worried about the relation between marijuana and depression? Although studies on the topic are inconclusive, it's a real concern.