Thursday, June 27, 2013

More Suicide Articles

I like it when I know celebrities, it makes me feel important.  So imagine how excited I was when I went to my Epic personalization session yesterday and I was seated with that famous New York Times quoted psychiatrist, Dr. Adam Kaplin.  Dr. Kaplin's work was discussed in a Well article earlier this week on the rise of suicide in the springtime, Clues in the Cycle of Suicide.

Dr. Kaplin studies depression in patients with multiple sclerosis, an autoimmune inflammatory disease. In M.S., he says, depression and inflammation feed each other: Even after accounting for the psychological effects of any serious illness, M.S. heightens depression risk, and depression amplifies the inflammation central to the disease’s central pathologies.

Driving this relationship, Dr. Kaplin suspects, are immune-system chemical messengers called cytokines. Some cytokines increase inflammation, while others curb it.

Inflammatory cytokines play crucial roles in fighting infection, but they can also cause problems. When people with hepatitis C are given the cytokine interferon to help fight the infection, for instance, up to 40 percent become depressed and one in 50 attempt suicide. Other studies suggest that inflammatory cytokine activity reduces levels of the neurotransmitter serotonin and halts the growth of new brain cells — two hallmarks of depression.

 I couldn't tell if Dr. Kaplin was having more or less success navigating Epic than I was.

And for those who can't wait until Sunday, the New York Times Magazine will be featuring an article on a man who studies suicide.  The Suicide Detective is a story about Harvard psychologist Matthew Nock, who is working on a word association test to improve detection of suicidality.  Kim Tingley writes:

Nock began to talk about pain. He imagined the building was on fire and that leaping from the window was the only way out. He evoked piercing ear infections that no drug could touch. He said he knows what it is like to be in intense pain and have an urgent need for it to stop, though he has never been suicidal. But he knows from his research that in most cases, feeling suicidal — for whatever reason — is a state that comes and goes. This is what drives him to turn levers, to keep asking people who attempt suicide, “Why?” As individual as their responses are, they tend to share at least one detail. “Virtually all of them,” he said, “say, ‘I’m glad I didn’t die.’ ” 


Anonymous said...

There is so much we still do not understand. I truly believe that suicidal feelings come from an "infection" of some molecule, messenger, or virus. How else to explain the number of suicides in the military? Our thymus gland shrinks to nothing by age 12 or so, lending great credibility to the notion we were never intended to roam far from home. When we send someone halfway round the world with varying degrees of resilience and expose him or her to non-native organisms, doesn't it make sense that suicide and suicidal ideation is something that happens from an external source?

Gold On Runescape said...

If we send an individual halfway worldwide together with different degrees of resilience and also reveal your ex to be able to non-native organisms, doesn't it make sense in which destruction and taking once life ideation is one thing that takes place coming from another supply? World of Warcraft Gold Kaufenbuy rs gold

Manuel Mota Castillo said...

This posting is another reason to admire the work of Dr. Miller (first one is that both we are Red Sox fans). I was first introduced to the Mind-Body connection by my admired friend Dr. Rakesh Jain but 2 years ago a very personal reason came into play when my teenage daughter was diagnosed with Lupus. I truly believe that there is a lot more to learn about the role of antibodies and the whole immune system regarding mental illness.
Having said that, I want to throw 2 elements that I also found relevant in the multifactorial causes of suicide: aggression and impulsivity. In October of 2008 Psychiatric Times published “Bipolar Disorder and the Case Against Antidepressants,” a Letter to the Editor I which I described my findings as the sole consulting psychiatrist for general hospital in Florida. It was a Chart Review of over 600 cases that I asked to evaluated with a focus on the presence of a bipolar disorder Dx previous to a suicide attempt that several endings: released from the EM, survived after days in ICU or succumbed despite intensive medical efforts. The link that I found between those already identified as having bipolar disorder (46 patients) was rather striking: all of them were taking one or two antidepressants.
Furthermore, when I was working in a psychiatric hospital I had several cases of individuals that were going through divorce proceedings and I asked permission from them to call their spouses to explain to them that the “unpredictable, irrational aggression, impulsive expending, explosive tantrums, etc.” will get better after stopping the antidepressants. I can say that in 2 cases the marriage was saved and the bipolar spouses are still my patients living a stable life.
Finally, on the military suicide, several years ago I wrote to Dr. General Chiarelli (Vice-Chief of the Army) and the Secretaries of Defense and the VA making my case against the pervasive use of SSRIs on everybody diagnosed with PTSD. I pointed out that those with co-morbid bipolarity will get worse and the possibility of suicide increase but nothing has changed in the treatment protocols of the Armed Forces and the VA. I should say that General Chiarelli and the Defense Secretary responded to my letters and commended my concerns.
This is my pet issue but I rather learn more about the immunology aspect of mental health. So, please, continue reacting to Dr. Miller posting instead of this comment.