Episode 9: Can Antidepressants Reduce Self-Harm?
Self-harm is a common behavior. About 1 in 8 children and up to 1 in 5 adolescents will deliberately injure themselves without suicidal intent. But even without suicidal intention, self-harm is an alarming and potentially dangerous behavior. Self-harm is a sign that something is wrong… but what’s the best way to help?
Dr. Erik Messamore
Self-harm is a common behavior. About 1 in 8 children and up to 1 in 5 adolescents will deliberately injure themselves without suicidal intent. But even without suicidal intention, self-harm is an alarming and potentially dangerous behavior. Self-harm is a sign that something is wrong… but what’s the best way to help?
It’s not uncommon for someone with self-harming behavior to be prescribed an antidepressant. Most of us would think that someone who is repeatedly harming themselves is very sad or depressed. So, it’s not surprising that doctors might prescribe an antidepressant. But it raises several questions like:
- What causes self-harming behavior?
- Can antidepressants reduce self-harming behavior?
- What are the risks?
- Are there any non-medication alternatives to treat self-harming behavior?
Melissa and Dr. Erik address these questions and more in this episode of Ask A Psychiatrist.
Episode highlights
2:10 – What do antidepressant medications do?
3:34 – The types of conditions that “antidepressants” can be useful to treat.
4:36 – Conditions that might be worsened by antidepressant medications.
5:35 – Some less-publicized side effects of antidepressant medications.
7:00 – Why it’s useful to know about the possible side effects of any medication.
8:32 – How feelings of numbness happen, and how numbness can drive self-harming behavior.
10:13 – Differences in medication response speak to differences in the cause of the symptoms that the medication was prescribed to treat.
11:36 – What we diagnose as “depression” has many different underlying causes.
12:59 – Are there differences in how children or adolescents respond to antidepressant medications?
14:13 – Antidepressant use in children or adolescents is associated with slightly but significantly increased risk for suicide.
16:04 – Could antidepressant medications increase self-harming behavior risk?
17:46 – What are the causes of self-harming behavior?
19:30 – Self-harming to regulate emotions.
23:09 – Self-harming to change the flow of a discussion or the power in a relationship.
24:49 – The limitations of antidepressant medication as a treatment for self-harming behavior.
26:10 – Are there ways to treat self-harming behavior that don’t involve medication?
Notable quotes
“I sometimes say that drugs don’t know what they’re supposed to do… It turns out that drugs like the antidepressant medications do many things beyond just maybe treating depression.”
“It’s really helpful to know what the potential downsides are so that you don’t mistake a side effect for the symptom of some illness and then get more medicine instead of less medicine.”
“If the room is dark, it could be because somebody turned off the light switch… it could be because there’s no electricity running into the building… it could be because there are dark curtains over the lights and the windows. There are many pathways to darkness in a room. And there are probably equally many pathways to depression in a human being.”
“What we call depression is almost certainly a whole bunch of different underlying processes that have similar top-level symptoms. That the diversity is the most likely explanation for why some people get great results from a particular medicine while others get no results and others get worse.”
About the Podcast:
Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.
Useful Links