Psychological Self-Help

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but rather by a crushing loss or failure, intense self-criticism,
pessimistic thinking, unreasonable guilt, etc.? Can you count on a tiny
pill to straighten out all these questionable ideas? Maybe or maybe not
(certainly no one today can tell you with confidence which causes of
depression are modified by drugs and which are not). 
Public Citizen, a consumer protection group, petitioned FDA early
in 2003 to ban Serzone because it is thought to cause liver toxicity.
Also, several parents who have lost children have complained to the
FDA about antidepressants (SSRIs). Some of these drugs have been
removed from European and Canadian markets. Within the last year
more governmental agencies (including the FDA) have warned
physicians to be on guard because some SSRIs may increase crying,
suicidal thoughts, and suicide attempts in young people under 18
years of age. Public Citizen is now (March, 2004) suing FDA because it
investigate this situation; their report is due by summer, 2004. The
ACNP believes, for now, that SSRIs do, on average, more good than
harm in children and adolescents. The data about the effects of anti-
depressive drugs in youth remains unclear: one autopsy study (Gray,
Moskos & Keller, 2003) of 49 adolescents who died of suicide found
that only 24% had been prescribed antidepressants and all of these 12
subjects had no SSRIs in their system, i.e., they hadn’t taken their
medicine (wonder why?). The ACNP group at first concluded that since
no young person in this study who died had actually been taking
antidepressants, it meant that medication might have helped prevent
suicide had it been taken. Yet, this study raises more questions than it
answers. There is certainly no strong evidence for using these meds
with young people. In fact, several studies of adults have also found
antidepressant meds to be no more or just barely better than a good
placebo. The ACNP group has already concluded that an older anti-
depressant (tricyclics) is inappropriate for adolescents. Conclusion:
While millions of adults believe antidepressants have improved if not
saved their lives, there are reasons to be cautious about expecting too
much from the drugs, especially when giving adult meds to young
children and adolescents. 
Intensive individual psychotherapy
Most suicidal people suffer from depression in some form but all
depressed people are not suicidal. Depression and low self-esteem
have been studied for many years. There are several types of
depression, some severe and some a lingering cloud of mild gloom.
Except for the most devastating severe depression, it can usually be
successfully treated with medication and psychotherapy. Therefore,
everyone who has the slightest inclination towards suicide should
immediately be encouraged by relatives and friends to get into therapy
with an experienced, fully trained and licensed psychotherapist and to
be evaluated by a psychiatrist for antidepressant drugs. I would
recommend that you request your health insurance (probably via a
referral from your primary care physician) to provide you with a
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