Emphasize “some day” and “might.”
While suicide screenings today rely primarily on a behavioral checklist, scientists are uncovering intriguing new information about what is happening in brain of someone at high risk of ending his or her own life.
Dr. Maria A. Oquendo, professor and vice-chairwoman of the psychiatry department at Columbia University, will discuss those findings and other aspects of suicide when she comes to New Mexico on Oct. 10-11.
As part of the University of New Mexico’s IDEAS in Psychiatry program, Oquendo will talk about “Suicide: Risk Factors and Strategies for Prevention.” She will speak 6 p.m. Thursday at UNM’s Domenici Center for Health Sciences Education in Albuquerque and 6 p.m. Friday at the CCA Cinematheque in Santa Fe.
Part of what she will tell listeners, Oquendo said in a telephone interview, is that while many people think of suicide as a response to a catastrophic event, it more often stems from an underlying psychiatric condition.
“When we study brains, there are interesting differences between those who are depressed but not suicidal,” and those who are, she said.
One of those differences is linked to the fight-or-flight response, which is ignited by stress, but rarely turns off in some people, she said.
The function of serotonin, a calming hormone, in that system appears to be “quite abnormal” in suicidal people, Oquendo said.
That also appears to be connected to an impulsive-aggressive nature shown by some suicidal people, she said.
But not everyone is in that group, she added. Another suicidal type might be a very controlled, perfectionistic person – the ones about whom loved ones might exclaim never indicated anything was wrong, she said.
“They don’t like to show they feel out of control,” Oquendo said.
What shows up in brain scans is often the result of an interplay of genetics and environment, she said. Both nature and nurture affect how a person develops, even to the point of changes in bodily chemistry that determine which genes may be silent and which become active.
Adversity early in childhood, such as physical, emotional or sexual abuse, as well as concerns about adequate food and safety, are related to suicide later in life, Oquendo said. And the earlier the adversity hits a child in life, the more intense later suicidal planning appears to be, she said.
Despite these advances, there’s still no test to show if a person is likely to attempt suicide.
“That’s one of the things we’re desperately looking for,” Oquendo said. “We need to identify predictors … we don’t have a blood test or a brain scan.”
Instead, physicians and others might need to review a number of factors, she said. “Maybe measures of aggression, insomnia, serotonin receptors in the brain …” That serotonin test costs $1,500, she added.
People with blood markers indicating inflammation and low levels of omega-3 fatty acids also show a higher risk for suicide, she said.
Until then, parents, for example, still face the classic questions in evaluating suicide risk, such as whether a child lacks friends, has changed appetite or sleep patterns or appearance, has seen a slip in performance at school, or has started making despondent comments.