June 21, 2017 By danablog505 in Books, Dana Alliance for Brain Initiatives, Neuroeducation Tags: A Day in the Life of the Brain, anxious, Behave The Biology of Humans at Our Best and Worst, Cerebrum, DABI, Dana Alliance, Elena Cattaneo, Gordon Shepherd, Joseph LeDoux, Kay Redfield Jamison, Mark Schatzker, Neuroenology: How the Brain Creates the Taste of Wine, New York Times, NPR, Patricia Bosworth, Robert Lowell Setting the River on Fire, Robert Sapolsky, Summer Reading, Susan Greenfield
At the end of her recent essay in the New York Times, “To Know Suicide: Depression can be treated, but it takes competence,” Dana Alliance member Kay Redfield Jamison mentions, almost in passing, her own suicide attempt. She wrote vividly about her experiences and those of others in her book, Night Falls Fast. Ellen Frank and David Kupfer reviewed the book for us in 2000; the review includes part of the book’s epilogue:
I was naive to underestimate how disturbing it would be to write this book. I knew, of course, that it would mean interviewing people about the most painful and private moments of their lives, and I also knew that I would inevitably be drawn into my own private dealings with suicide over the years. Neither prospect was an attractive one, but I wanted to do something about the untolled epidemic of suicide and the only thing I knew to do was to write a book about it. I am by temperament an optimist, and I thought from the beginning that there was much to be written about suicide that was strangely heartening.
As a clinician, I believed there were treatments that could save lives; as one surrounded by scientists whose explorations of the brain are elegant and profound, I believed our basic understanding of its biology was radically changing how we think about both mental illness and suicide; and as a teacher of young doctors and graduate students, I felt the future held out great promise for the intelligent and compassionate care of the suicidal mentally ill.
All of these things I still believe. Indeed, I believe them more strongly than I did when I first began doing the background research for this book two years ago. The science is of the first water; it is fast-paced, and it is laying down, pixel by pixel, gene by gene, the dendritic mosaic of the brain. Psychologists are deciphering the motivations for suicide and piecing together the final straws—the circumstances of life—that so dangerously ignite the brain’s vulnerabilities. And throughout the world, from Scandinavia to Australia, public health officials are mapping a clearly reasoned strategy to cut the death rate of suicide.
Still, the effort seems unhurried. Every seventeen minutes in America, someone commits suicide: Where is the public concern and outrage? I have become more impatient as a result of writing this book and am more acutely aware of the problems that stand in the way of denting the death count. I cannot rid my mind of the desolation, confusion, and guilt I have seen in the parents, children, friends, and colleagues of those who kill themselves. Nor can I shut out the images of the autopsy photographs of twelve-year-old children or the prom photographs of adolescents who within a year’s time will put a pistol in their mouths or jump from the top floor of a university dormitory. Looking at suicide—the sheer numbers, the pain leading up to it, and the suffering left behind—is harrowing. For every moment of exuberance in the science, or in the success of governments, there is a matching and terrible reality of the deaths themselves: the young deaths, the violent deaths, the unnecessary deaths.
Since before the heyday of Ancient Greece, people made observational links between madness and creativity. In the last few decades, studies have given such speculations scientific credence.
Kay Redfield Jamison, co-director of Johns Hopkins Medicine’s Mood Disorders Clinic and a member of the Dana Alliance for Brain Initiatives, discussed these studies and other issues surrounding mental illness at a World Science Festival event last night, along with James Fallon, a professor at the University of California, Irvine School of Medicine, and Elyn Saks, a professor at the University of Southern California Gould School of Law. Nightline anchor Cynthia McFadden moderated.
Scientists looking into the genetic component of mental illness have used family studies, including those of living and dead artists and writers, which indicate that madness or mental illness “way predates the individual artist or writer,” said Dr. Jamison.
In this month’s Cerebrum article, “Suicide and the United States Army,” Dr. Elspeth Cameron Ritchie, a retired Army colonel, explains how the U.S. Military now collects data on suicides. She recommends ways to put that data to use through new strategies—like means restriction and service animals—that could bring down the high suicide rate in the military.
In July of 2011, Kay Redfield Jamison wrote the Cerebrum article “Suicide in the Young: An Essay.” She said:
“We know, ﬁrst, that suicide is a terrible killer of the young. In the United States, suicide is the third major cause of death in 15-to-19-year-olds and the second leading cause of death in college-age students. In 1996, more teenagers and young adults died from suicide than from cancer, heart disease, AIDS, stroke, and lung disease combined. Suicide kills the young dreadfully and disproportionately. And, across the world, in those between the ages of 15 and 44, suicide is the second leading killer of women and the fourth of men.”
These numbers have not changed much. According to the CDC, suicide is still the third leading cause of death for 15-24 year olds, and for every completed suicide in this age range, there are 100-200 unsuccessful suicide attempts.
Dr. Ritchie says in her new article that military suicide differs from civilian suicide in part due to the role of mental illness. Most soldiers who commit suicide have not been diagnosed with a mental illness, although substance abuse issues can be a factor. She writes that an accumulation of stressors, like pain, disability, and estrangement from friends and family are more common risk factors among active duty personnel.
In contrast, in the civilian population, writes Dr. Jamison:
“We have compelling evidence from a large number of studies that the single most important factor in suicide is psychopathology: More than 90 percent of all people who kill themselves suffered from a major psychiatric or addictive illness (depression, manic-depression, schizophrenia, or alcohol and drug abuse), a severe anxiety disorder, or borderline or antisocial personality disorder. Those who are victims of both depression and alcohol or drug abuse are especially at risk. Most people who were depressed will not kill themselves. But of those who do, the majority were profoundly depressed.”
This, too, remains true today.
So what can be done to prevent suicide in the civilian population? The National Institute for Mental Health recommends treating underlying disorders, like depression and substance abuse, while addressing suicide risks. Studies have shown that cognitive behavior therapy can effectively reduce the number of suicide attempts. A combination of medication and therapy may be even more effective. In addition, primary care physicians should be better trained to recognize warning signs of suicide.
If someone you know talks to you about suicide, take him or her seriously. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).