Wednesday, June 19, 2013

Suicide Motivation and Neural Circuits: Connecting the Studies

by Matt Kuntz
Executive Director
NAMI Montana


Note: I've underlined certain sections of this article to clearly link similar analyses in various research. All of this underlining is my own and a should not be ascribed to the quoted individual.


A University of British Columbia research team just completed a systematic analysis to help understand the motivations to commit suicide. The study, led by UBC PhD candidate Alexis May, was published by Suicide and Life-Threatening Behavior – the official journal of the American Association of Suicidology. (Read the study's official press release here.) The study was based on 120 participants who recently attempted suicide. The results suggest many motivations believed to play important roles in suicide are relatively uncommon. For example, the researchers found that suicide attempts were rarely the result of impulsivity, a cry for help, or an effort to solve a financial or practical problem. Of all motivations for suicide, the two found to be universal in all participants were hopelessness and overwhelming emotional pain.


This study's participants were Canadian outpatients and undergraduate students, but it is important to note that the motivations behind the participants' suicide attempts mirror the findings in a similar study of United States’ soldiers. In that analysis, researchers from the the University of Utah questioned soldiers who had attempted suicide. Out of the 33 reasons the soldiers could use to describe their motivation to committed suicide; all of the soldiers included one in particular — a desire to end intense emotional distress. (Read more about that study here.)

According Dr. Craig Bryan, the coauthor of that study, the soldiers tried "to kill themselves is because they have this intense psychological suffering and pain."

Beyond college students and soldiers, the New York Task Force on Life and the Law (New York Task Force) issued a report in May of 1994 stated that "the common stimulus to suicide is intolerable psychological pain." That report cited Dr. Edwin Shneidman's book, Some Essentials for Suicide and Some Implications for Response, which was published in 1986.

The accumulation of multiple decades of research into populations as varied as college students, soldiers, and people with terminal illnesses seem to generally agree that suicidal thinking and actions are a response to intense psychological pain. As someone with a brain wired to occasionally do battle with that demon, I agree with that analysis.

The unavoidable follow-on question is "What causes psychological pain so intense that suicide appears to be the only option." The New York Task Force provides that, "Contrary to popular opinion, suicide is not usually a reaction to an acute problem or crisis in one's life or even to a terminal illness. Single events do not cause someone to commit suicide."

The Task Force further specified that "Studies that examine the psychological background of individuals who kill themselves show that 95 percent have a diagnosable mental disorder at the time of death" Since serious mental disorders can generally be defined as disruptions in neural circuits, the logical conclusion is that there is something within the neural circuitry of a suicidal person's brain that causes them to experience extremely high levels of emotional pain - beyond the scope of any environmental stressors occurring in their life.

Neuroscientists are working to develop a better understanding of the process behind these deadly neural circuitry disruptions. After examining eighteen different studies, researchers from the University of California San Francisco proposed a tentative neural network for psychological pain that involves the following sections of the brain: the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. (See the abstract of their article in Brain Imaging and Behavior from March 2013 here). The proposed network has significant overlap with the neural network utilized when we experience traditional physical pain.

Take a minute to process that information. The neural circuits that transmit the feeling of physical pain such as a person's hand being on fire are similar to the circuits that transmit feeling of emotional pain. It's not surprising that a disruption in that powerful of a system in the brain would lead to the number one cause of disability in the world, depression, and potentially suicide.

It is hard to pinpoint what causes these neural disruptions and those causes may be different for different people. Genetic susceptibility, emotional trauma, brain injuries, and substance abuse are all potential contributing factors; especially when combined together.

There is no miracle cure for these devastating neural conditions, but recovery is possible through effective treatment and lifestyle changes. Life doesn't have to be a fight for survival.


***   ***
If you're experiencing suicidal thoughts and deep psychological pain, please call 1-800-273-8255. If you're worried about a loved one, call that number to learn about what you can do to get them help.



2 comments:

  1. Suicide is the way a body rids itself of the excruciating pain which is perceived as forever or non-ending. The idea of neural networks collaborating to rid the body of pain is inconsequential. The concept of the organism ridding the body of excruciating pain forever is the germ of an idea originating from the past feeling of overall wellbeing (or the Disneyesque belief that such a compilation of feelings can be contained). This feeling of pain is present in large segments of the brain and shows up as significant overlapping networks of pain inducing neurons caught in an intensifying loop of recurrent collateral inhibition. These segments are thought to be, from prior research, concomitant with the areas of depression. The tipping point is reached when events coalesce to produce intensity so dire that only cessation can alleviate the pain. Pain will not go away by itself. The organism has been duped by its environment of a totally different purpose.

    ReplyDelete
  2. Thanks for your discussion of motivation for suicide, across several populations and decades. I think your identification of the build up of pain over time underlines that early intervention could change the outcome. I look forward to this blog becoming a clearing house site for mental health information in Mt. I realize that's a lot of work, but seems to me the blog could be real helpful in helping those who live and work here overcome the problem our big distances and our limited resources overcome.
    Thanks again for all your efforts.

    ReplyDelete