The changes in brain chemistry are proof that suicidality should be treated like any other urgent health issue. In this HuffPost article, Mindpath Health’s Julian Lagoy, MD, discusses what happens when we feel suicidal and how to help others if you are concerned.
If you’ve ever felt alone in experiencing suicidal ideation, please know you’re not. According to the Centers for Disease Control and Prevention, 12.2 million adults have seriously considered suicide, and the numbers rose in 2021 from 2020. It’s immeasurably hard to think about.
After the news comes out about celebrities dying by suicide, you may have seen friends post the suicide hotline on Facebook. In the wake of Stephen “tWitch” Boss’ suicide in December 2022, hypnotherapist Keylee Miracle wrote a Twitter thread about an aspect of suicidal ideation our society doesn’t talk about as much: the hormonal and neuroscientific perspective. “It’s like a hostile brain take over,” she wrote, urging people to take proactive measures.
“There is no one common pathway to a suicide attempt,” said Dr. Laura Erickson-Schroth, chief medical officer at The Jed Foundation. “We often look to construct narratives about why someone attempts suicide — such as a job loss or relationship ending — but the truth is that most people who attempt suicide do not have one ‘reason’ but instead have multiple life events leading to the attempt.” She added the person may even experience ambivalence, having thoughts about wanting to die and wanting to live.
Hormone sensitivity in the brain
Thoughts of suicide have been associated with major hormonal fluctuations and changes in the brain.
James Atkison, LCP, added that when individuals discuss their mood-related concerns with providers related to their period, some providers dismiss them because of the stigma, which can become dangerous.
This phenomenon can actually be seen in patients who have died by suicide. “Biological studies in postmortem patients who committed suicide are very limited but have given some insights into the neurobiology of what causes suicidal ideation,” said Dr. Julian Lagoy, a psychiatrist in San Jose, California. “Research points to serotonergic abnormalities, which contributes to impulsive and aggressive behavior that leads to a suicidal attempt.”
Mental and physical fatigue
While research is limited, ties between brain chemistry and symptoms/causes of suicidal ideation are everywhere, anecdotally.
“What we do know is that when people are in a suicidal crisis, they often have a reduced ability to think creatively or engage in problem-solving, and may also have some distorted thinking, such as believing that no one cares or that they are a burden to others,” said Doreen Marshall, vice president of mission engagement at the American Foundation for Suicide Prevention.
Short-term thinking and lower impulse control
Suicidal ideation and tunnel vision are closely linked, too. Marshall said individuals considering suicide often can’t see any other answer to resolving their pain. Lagoy added that neurochemical changes can lessen impulse control, which is what leads to tunnel vision.
How this knowledge helps us
While it’s important for us as a society to validate mental health as much as physical health, seeing how mental health is also physical can help people understand it and take it more seriously.
This info also brings awareness to how complex and difficult suicidality is. “We can use this knowledge to help us not blame or judge anyone who has suicidal ideation, and therefore be able to empathize with and help them more effectively,” Lagoy said.
How you can help yourself
Erickson-Schroth mentioned certain types of therapy that can prevent suicidal thoughts from turning into attempts. Dialectical behavior therapy and cognitive behavioral therapy for suicide prevention are a couple she said are underutilized.
The importance of being proactive with your mental health can’t be understated either, according to Marshall. She listed some helpful tips, such as getting treatment, sleeping enough, spending time outdoors, exercising, surrounding yourself with supportive people, practicing coping skills and more.
Medication is another important part — especially serotonergic medication, such as Prozac, Zoloft, Lexapro and Paxil, according to Lagoy. And again, don’t wait until you’re feeling suicidal.
How you can prevent suicide in other people
While suicide prevention is paramount (and not discussed enough), it’s also not something that’s entirely in your hands alone.
When you feel concerned about a loved one, reach out and offer support. Erickson-Schroth said this is the most important step. “It’s OK to say ‘suicide,’” she said. “It’s a myth that bringing up suicide will give someone ideas. Research shows just the opposite, that talking about suicide provides a sense of relief and increases the chances that someone will reach out for help.”
If the loved one doesn’t seem to want your help, The Jed Foundation advised continuing to reach out, spending time doing fun things with the person, and bringing in a professional. If the person is a kid, especially, she encouraged teaching them emotion regulation skills, such as taking deep breaths, practicing self-compassion, and cultivating positive experiences, early on.
All of us play important roles in preventing suicide.