Suicide, depression and euthanasia: the debate psychiatry avoids
Depression, suicide and euthanasia: a blunt look at psychiatry's failures, the effects of sertraline and the debate over consciousness in organ donation.
English · Original discussion in Spanish · Published
Suicide, depression and euthanasia: the debate psychiatry refuses to have
Suicidal thoughts intensify in spring, but attempts peak in summer and autumn. The pattern is not new, yet this thread examines it bluntly: the first attempt is usually an impulsive act, trinc by shame; the second is more determined, but often fails due to the survival instinct. One participant describes two attempts, the first at age 9, and details how sertraline made him gain 17 kilos in a year, with constant dizziness and a feeling of a "fried brain". Alcohol, used to find the necessary courage, stopped being an option because of hepatic steatosis. The experience with medication is the core of the criticism:
Sertraline's failure and brain chemistry
"Sertraline just made me fat and fried my brain", sums up one of the testimonies. Weight gain, dizziness when lying down or walking, and no mood improvement are classic side effects of SSRIs. Against this, others point to alternatives such as bupropion or nortriptyline, which act on dopamine and noradrenaline. Real psychiatry is not prescribing the first pill off the shelf: it is tailoring the chemistry to each person, something that does not always happen in practice. Lithium, for example, is mentioned as the gold standard for suicidal ideation in bipolar disorders, but its narrow therapeutic window makes it hard to manage.
Euthanasia and organ donation: the taboo of consciousness
The debate drifts towards euthanasia. Spain's 2021 law allows it, but the organ donation process generates controversy: according to some, the patient is not fully unconscious when the organs are removed. An article from the German magazine Focus is mentioned, estimating 30,000 cases per year of insufficient anaesthesia in Germany, with patients who feel everything but cannot move. "Your heart doesn't stop beating until they cut it with the scalpel, your lungs until they cut them with the scalpel", describes one participant. This contrasts with the idealised image of a gentle death.
The two souls of the suicidal person: escape or illness
Two opposing positions: those who see suicide as a rational choice in the face of unbearable suffering ("leaving the cinema when the film is a piece of shit"), and those who consider it a symptom of a treatable chemical imbalance. The first current is more philosophical, even cynical; the second, pragmatic and medical. Both coexist without resolution, like life itself.
The thread leaves the big question hanging: to what extent does the lack of proper treatment push people towards irreversible decisions? As long as psychiatry remains a trial-and-error exercise, many will keep feeling that the only way out is the one with no way back.
Related debates in the forum
Suicidal thoughts intensify in spring, but attempts peak in summer and autumn. The pattern is not new, yet this thread examines it bluntly: the first attempt is usually an impulsive act, trinc by shame; the second is more determined, but often fails due to the survival instinct. One participant describes two attempts, the first at age 9, and details how sertraline made him gain 17 kilos in a year, with constant dizziness and a feeling of a "fried brain". Alcohol, used to find the necessary courage, stopped being an option because of hepatic steatosis. The experience with medication is the core of the criticism:
Sertraline's failure and brain chemistry
"Sertraline just made me fat and fried my brain", sums up one of the testimonies. Weight gain, dizziness when lying down or walking, and no mood improvement are classic side effects of SSRIs. Against this, others point to alternatives such as bupropion or nortriptyline, which act on dopamine and noradrenaline. Real psychiatry is not prescribing the first pill off the shelf: it is tailoring the chemistry to each person, something that does not always happen in practice. Lithium, for example, is mentioned as the gold standard for suicidal ideation in bipolar disorders, but its narrow therapeutic window makes it hard to manage.
Euthanasia and organ donation: the taboo of consciousness
The debate drifts towards euthanasia. Spain's 2021 law allows it, but the organ donation process generates controversy: according to some, the patient is not fully unconscious when the organs are removed. An article from the German magazine Focus is mentioned, estimating 30,000 cases per year of insufficient anaesthesia in Germany, with patients who feel everything but cannot move. "Your heart doesn't stop beating until they cut it with the scalpel, your lungs until they cut them with the scalpel", describes one participant. This contrasts with the idealised image of a gentle death.
The two souls of the suicidal person: escape or illness
Two opposing positions: those who see suicide as a rational choice in the face of unbearable suffering ("leaving the cinema when the film is a piece of shit"), and those who consider it a symptom of a treatable chemical imbalance. The first current is more philosophical, even cynical; the second, pragmatic and medical. Both coexist without resolution, like life itself.
The thread leaves the big question hanging: to what extent does the lack of proper treatment push people towards irreversible decisions? As long as psychiatry remains a trial-and-error exercise, many will keep feeling that the only way out is the one with no way back.
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Summary of a discussion on Burbuja.info - Foro de economía, actualidad y política., translated from Spanish and reviewed before publication. Read the full discussion (37 replies).
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