What people don't understand about depression is how much it hurts. It's like your brain is convinced that it's dying and produces an acid that eats away at you from the inside, until all that's less is a scary hollowness. Your mind fills with dark thoughts; you become convinced that your friends secretly hate you, you're worthless, and then there's no hope. I never got so low as to consider ending it all, but I understand how that can happen to some people. Depression simply hurts too much.
The issues of antidepressant-associated suicide has become front-page news, the result of an analysis suggesting a link between medication use and suicidal ideation among children, adolescents, a link between medication use and suicidal ideation among children, adolescents, and adults up to age 24 in short term (4 to 16 weeks), placebo-controlled trials of nine newer antidepressant drugs. The data from trials involving more than 4.4(K) patients suggested that the average risk of suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants was 4 percent, twice the placebo risk of 2 percent. No suicides occured in these trials. The analysis also showed no increase in suicide risk among the 25 to 65 age group. Antidepressants reduced suicidality among those over age 65. Following public hearings on the subject, in October 2004, the FDA requested the addition of “black box” warnings—the most serious warning placed on the labeling of a prescription medication—to all antidepressant drugs, old and new.
As modern neurobiologists point out, the repetition of the traumatic experience in the flashbacks can be itself re-traumatizing; if not life-threatening, it is at least threatening to the chemical structure of the brain and can ultimately lead to deterioration. And this would also seem to explain the high suicide rate of survivor, for example, survivors of Vietnam.
Being suicidal is really tiring. A lot of suicides are so lacking in affect and so lethargic that they aren’t able to kill themselves until their mood improves—spring, for that reason, has the highest rate of what people in the business call “completed” suicides.
With DID patients, if they feel hostility or aggression they take it out on themselves with self-harm... They’re self-destructive and repeatedly suicidal, more so than any other psychological disorder. So that's what's typical – not this wild aggression, or stalking women [or robbery].- Dr Bethany Brand, on Billy Milligan and Multiple Personality Disorder (DID)