What Pushes a Person to Suicide?

June 7, 2017

One May day five years ago, an ambulance arrived for me. My eyes were twitching, hands shaking, thoughts racing and confused. At that point, I hadn’t slept for three days. I’d taken drugs, fell asleep at the wheel, bumped into a car at a red light. I was closer to suicidal than ever, but I wasn’t sad. Instead, I was agitated, frantic, paranoid. What put me at risk was not sorrow, per se, but loss of control: the careless apathy that might swerve a bike into traffic. My therapist convinced me I needed help. A phone call later, the ambulance took me to the mental hospital, where I stayed for a week and left with lithium.

Animals change with the spring. Bears come out of hibernation, dogs go into heat. Geese migrate. Humans? We go crazy. Spring is the season with the most yearly suicides, manic breakdowns, and involuntary mental hospitalizations. A psychiatrist I know calls mid-April “the witching hour.” That’s when his manic patients quit sleeping and start chattering away.

The evidence that suicides peak in spring, replicated many times, is especially striking in one study from Scandinavia. It looked at everyknown Danish suicide from 1970 to 2001, using Denmark’s state-maintained death registry. The data showed a dramatic surge between March and June, particularly for people with a history of mental illness. There were also smaller upticks in mid-summer and fall. The fall peak exists primarily for women, and for “non-violent” suicide—by poisoning, for example, as opposed to gunshot, hanging, or jumping from a bridge—and may relate to the time when children go back to school.

The pronounced spring peak in suicide risk, according to one theory, may result from sunshine’s effect on the brain. In mood disorders, especially bipolar illness, the circadian clock ticks out of synch with daylight. Melatonin, a hormone released by the brain’s pineal gland at night, encourages sleep but is suppressed by the sun.

Melatonin levels begin increasing around 9pm and fade by the time we get to work in the morning. But these rhythms may cycle too quickly during mania or slowly during depression, leaving people alert at night when they should be sleepy. When melatonin goes up, so does serotonin, a neurotransmitter associated with mood and aggression. In April, the return of sunny days may act as a “precipitant,” as psychiatrists say, on a suicidal brain predisposed to impulsiveness. As to exactly how, the jury is still out.

The people “best” at suicide are known for upbeat moods and energetic drive.

The trend of spring suicide is notable because, among other things, it seems to reveal something about the nature of all suicides: Namely, that suicide has less to do with depressed mood than it does with agitated energy.

Depression is the most common mental illness, affecting some 30 percent of people at some point in life. Yet less than 5 percent of depressed people try to end their lives. What’s different about the ones who do? Apparently an aggressive loss of control.

In a 2005 review, titled “Dissecting the suicide phenotype: The role of impulsive-aggressive behaviours,” Gustavo Turecki, an expert on suicide at McGill University, argues that impulsivity is a crucial aspect of suicide. We are less likely to kill ourselves for a particular reason, than when we lose reason altogether.

“Impulsive-aggressive traits are part of a developmental cascade that increases suicide risk,” across disorders from depression to bipolar, schizophrenia to alcoholism, Turecki writes. “We all have levels of impulsivity. We may buy things without thinking, things we don’t need. But those people who tend to do this more frequently, and have a history of being a bit more aggressive, are more likely to die by suicide,” he says.

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