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  • Robb G. Best

Suicide: a Stark Truth

Suicide: the word itself is sobering.

In the U.S., there are 38,000 suicides a year. This makes it one of the top ten causes of death in the country; twice as common as homicide, which in recent years has declined.

Roughly 38,000 people also die annually on U.S. highways, but that number is also on its way down; we've experienced a 50% drop in highway fatalities since the seventies.

Unfortunately, the suicide rate has not followed suit. In fact, overall it is ticking upwards.

So why do people kill themselves?

Experts on suicide are among the first to admit that their own understanding is limited. It's not something people feel particularly comfortable talking about, which makes research tough.

Big Pharma has offered no solution; there are no anti-suicide drugs for sale. In fact, it's almost the opposite: a number of drugs list suicide as a possible side effect.

From looking at the statistics, we do know some factors increase chances of suicidal behavior. These include mental illness (especially mood disorders such as clinical depression or bipolar disorder), substance abuse, poverty, discrimination (for instance, rates are much higher in transgender people), a history of trauma (including veterans and survivors of childhood sexual abuse), unemployment, homelessness, cancer, chronic pain, or a traumatic brain injury.

Of course, many encounter these conditions without attempting suicide. Some research suggests that what sends people over the tipping point might be genetic. Autopsies show that people who commit suicide have reduced levels of BDNF in their brains. BDNF is a protein involved in forming new neural connections, nerve regeneration, building neurotransmitters, and maintaining brain plasticity. The less of it a brain has, the harder it is to adapt to one's surroundings. Stress can lower BDNF levels (and exercise can raise them) but there is a hereditary aspect as well.

In general, women are more likely to attempt suicide, but men are more likely to succeed, in part because they tend to choose more violent methods. In the Western world, roughly 75% of all suicide fatalities are men. However, this isn't true across the board: in China, more women commit suicide than men. This seems to imply that the gender difference is a result of culture, and not some inborn Y chromosome issue.

One interesting find: it seems that people who attribute their troubles to some external source—the government, for instance—are less inclined to kill themselves. The risk of suicide goes way up when an individual begins to blame themselves for their circumstances.

Emotional despair in some cases might be seen as part of an elaborate self-preservation system, where the brain tries to send an alarm to move back to a more neutral feeling. In this way, depression could be a survival strategy gone awry.

In Parerga and Paralipomena, Arthur Schopenhauer writes, "Suicide may also be regarded as an experiment—a question which man puts to Nature, trying to force her to answer. The question is this: What change will death produce in a man's existence and in his insight into the nature of things? It is a clumsy experiment to make, for it involves the destruction o the very consciousness which puts the question and awaits the answer."

Schopenhauer sees suicide as a gamble, albeit poorly made. But his suggestion, that there is at least some reasoned thought behind the act belies the possibility that it represents a complete fraying of the brain's rational safety net.

Mental illness remains very much a taboo subject. When it comes to ailments of the body, we know better than to blame the patient, but we don't grant the same leniency to a malfunctioning brain. And yet neuroscience makes it clear that the brain vs. body distinction has been overturned.

Since physical pain and emotional pain share the same circuitry in our heads, there's a danger of a vicious cycle, one which overwhelms any logical response. It's similar to how the immune system can fall apart in the face of some cancers. In that regard, perhaps saying a person chose to take their own life makes no more sense than saying they chose to succumb to leukemia.

For all of the progress that has been made to keep humans alive—diseases cured, water purified, seatbelts installed—suicide remains a runaway train, carrying the likes of David Foster Wallace, Robin Williams, Sylvia Plath, and countless others.

#brainchemistry #depression #mentalhealth