We’re living through a suicide epidemic — one that is striking especially hard in teens and young adults.
According to the U.S. Centers for Disease Control, suicide is the second-leading cause of death in people between the ages of 10 and 30 years old.
Interestingly, the leading cause of death is traumatic injury — and experts have found that there are numerous associations between traumatic injury and an increased risk for suicide attempts. However, one of the enduring myths about suicide is that all who attempt to take their own lives are also afflicted with a major psychiatric disorder.
While suicidal ideation is linked with certain major psychiatric disorders, the fact is that most people who attempt, or die by, suicide do not have a psychiatric diagnosis — which is why a team of suicide researchers from Baylor College of Medicine, Texas A&M University, Michael E. DeBakey Veterans Affairs Medical Center, and the Texas-based Harris Health System have worked collaboratively with two goals in mind: 1) To see if there was a way to preemptively identify people who are, or may become, suicidal but do not have a single mental health diagnosis; 2) Medically treat — via lithium — those who survive an initial suicide attempt because lithium may help improve the impulse control of those with suicidal ideation.
Recently, the team published a paper about their efforts in the journal Experimental and Clinical Psychopharmacology.
Understanding who is at greater suicide risk
“Sixty percent of suicides are first attempts, so we have to predict how to prevent that first attempt,” said Baylor psychiatry professor Dr. Alan Swann, a senior author of the paper. “And to understand suicide and its prevention better, we need to get a good, logical view of how lithium works and how that is related to predictors of severe suicidal behaviors.”
Swann noted that impulsive decision-making is a predictor of suicide risk among folks who attempt to take their own lives.
That said, the process of developing the capacity to attempt suicide is complicated and not linear, said psychiatry professor Dr. Nicholas Murphy, who is affiliated with both Texas A&M and Baylor, and was a co-author of the research article.
“The capacity to commit suicide indicates that a person’s executive and emotional functioning, and the ability to sensibly make decisions about how to handle stressful situations, has been compromised,” said Murphy. “What we understand from previous research is that there are complex biomechanical factors that prevent neurotransmitters from properly encoding this information.”
The team landed on prescribing lithium, Murphy explained, because “lithium works to restore some of these cellular processes, which may make it a viable tool to improve decision-making in patients at risk for a suicide attempt.”
Giving lithium to suicide survivors
Lithium works on different cell groupings within a person’s brain and has been shown to help with restoration and regeneration of brain function. The research team gave study participants, all of whom were suicide survivors, lithium over a four-week period and measured their brain wave activity. The researchers paid close attention to the participants’ gamma waves, which are involved with executive functioning.
They were encouraged by what they found.
“We saw that lithium appeared to normalize those waves in terms of how they related to impulse and decision control,” noted Baylor professor and physician Dr. Ynhi Thomas, who also helped co-author the study. “The period when a suicide survivor is at highest risk for committing another suicide attempt is during the time after they get stabilized. So our hope is that steadying the brain activity associated with impulsive behavior will reduce their risk, or even prevent, them from making another attempt to take their own life.”
Suicide survivor’s background also matters
In studying their patients’ backgrounds, researchers also found that patients who had attempted to take their own lives more than once had usually exhibited aggressive and impulsive behavior, as well as a lack of planning, throughout their lifetimes.
Another thing they almost all had in common: an inordinate amount of childhood trauma.
Researchers concluded that the study’s participants had greater levels of baseline impulsive behavior than most people do.
The researchers noted that “decision-making strategy improved with lithium” and that “lithium-related changes to behavior were consistent enhancements to the strength of gamma waves relative to placebo and baseline.”
As Swann explained, a person’s “behavior is regulated by balance of activation and inhibition. The brain takes about 300 milliseconds before it reaches conscious awareness. Lithium enables these patients to better process information before making decisions.”
Thomas echoed those sentiments, noting that “lithium gives your brain that ability to hold back and think about your actions more.”
While lithium is FDA-approved for treating bipolar disorder, the way it has positively affected the suicide survivors who participated in this study have researchers encouraged that it can become another tool in treating those who are perhaps biologically more predisposed to experiencing suicidal ideation.
Help is available for people experiencing suicidal thoughts. Call 211 or 988 to reach the Suicide & Crisis Lifeline, available 24 hours a day, seven days a week.
Steve Dorfman is a journalist for The Palm Beach Post, part of the USA Today Network of Florida. He writes about all aspects of health, fitness and wellness. If you have news tips, please send them to sdorfman@pbpost.com. Help support our local journalism, subscribe today.
This article originally appeared on Palm Beach Post: Suicide survivors are being successfully treated with lithium
Reporting by Steve Dorfman, Palm Beach Post / Palm Beach Post
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