Treatment-Emergent Suicidality in Younger Patients

Psychological health of human beings is a rather controversial matter for discussion. Special complexity is added to this matter when it is considered in younger children and adolescents. In this context, the issue of suicidality is the most dangerous one, especially taking into consideration the fact that one of its causes might be the misdiagnosed bipolar disorder. “For many years, suicidality has been the most commonly encountered clinical emergency for mental health professionals” (Jobes, 2007, p. 283), and nowadays it is important to find out whether the suicidality arises from the misdiagnosed bipolar disorder for a unipolar depression or there are some other causes.

To begin with, the recent studies by Barrio (2007), Calabrese et al. (2001), etc. show that a certain connection is observed between the antidepressant treatment of the younger children and adolescents and the increasing rates of suicidality emerging in these patients. Scholars like Barrio (2007) connect this increase with the influence antidepressants have on the brain-derived neurotrophic factor (Barrio, 2007, p. 51). The major argument here is that antidepressants block the work of the brain-derived neurotrophic factor and cause irreversible changes in the human minds. However, the bipolar/unipolar disorder theory operates with other reasons to the increased rates of the treatment-emergent suicidality in younger patients.

To consider this theory, it is necessary to define its main terms. Bipolar disorder is reflected in the patient’s having the interchange of manic and depressive fits, which are also substituted by the “normal” state (Calabrese et al., 2001, p. 36). The scholars also distinguish ordinary and rapid-cycle bipolar disorder: “About one in six patients who seek treatment for bipolar disorder have a rapid-cycling pattern” (Antai-Otong, 2006, p. 55). Moreover, the bipolar disorder has been viewed as the result of “antidepressant use during a depressive episode and thus believed to increase vulnerability to phase shifting” (Antai-Otong, 2006, p. 55). Thus, obvious connection between the disorder and antidepressants has long been ignored, while the suicidality and decrease of antidepressant response has been associated with the unipolar depression.

Antai-Otong (2004), for example, recalls the statistics according to which “historically, bipolar disorder (BP II) has been underused and misdiagnosed as unipolar major depressive disorder” (p. 125). Moreover, she argues that the distinguishing features of BP II compared to the unipolar depression are “lower age at onset, more atypical features, more recurrences, and higher heritability” (Antai-Otong, 2004, p. 125). Drawing from this, the wrong diagnosis of the bipolar disorder as a unipolar depression may actually lead to the wrong treatment, which, in its turn, results in the dangerous treatment outcomes and the increased rates of the treatment-emergent suicidality in younger patients.

To conclude, the mental health of the younger generations is the basis on which the society will develop. The treatment-emergent suicidality that is observed more and more often in younger patients is a dangerous sign, especially if it is caused by the wrong diagnostics of the bipolar disorder as a unipolar depression. The misdiagnosed disorder is then treated wrongly and results in the increased rates of the treatment-emergent suicidality in younger patients endangering the whole structure of the human society. Thus, scholars and medical workers need to join their efforts in fighting this problem to assure the future of the mankind.


Antai-Otong, D. (2004). Bipolar II or Unipolar Depression: Pharmacologic Considerations. Perspectives in Psychiatric Care, 40(3), 125+.

Antai-Otong, D. (2006). Treatment Considerations for Patients Experiencing Rapid-Cycling Bipolar Disorder. Perspectives in Psychiatric Care, 42(1), 55+.

Barrio, C. A. (2007). Assessing suicide risk. Journal of Mental Health Counseling, 29(1), 50-66.

Calabrese, J.R., Shelton, M.D., Bowden, C.L., Rapport, D.J., Suppres, T., Shirley, E.R., Kimmel, S.E., & Caban, S.J. (2001). Bipolar rapid cycling: Depression as its hallmark. Journal of Clinical Psychiatry, 62(Suppl. 14), 34-41.

Jobes, D. A., Moore, M. M., & O’Connor, S. S. (2007). Working with Suicidal Clients Using the Collaborative Assessment and Management of Suicidality. Journal of Mental Health Counseling, 29(4), 283+.