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Robert Sapolsky described it this way [1]:

> You get someone who is severely depressed, like to the point of hospitalization, and when they are absolutely crippled with psychomotor retardation, that's not when you worry about suicide.

> This is someone who's having enough trouble getting out of bed and getting dressed each day. They're not going to figure out how to shred the hospital mattress and make a noose out of it.

> Where you've got your problems is when somebody begins to get better from a severe depression. When they're starting to come out, that's where the psychomotor retardation relieves enough that suddenly they've got the energy to do something catastrophic. That's when people are on suicide watches (when you have clinicians who are oriented well).

[1]: https://youtu.be/NOAgplgTxfc?t=514



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