Realizations Inc

Q. My brother just committed suicide and we can’t figure it out. Do you know of any studies about the brain and suicide?

A. I can only imagine what you and your family are experiencing. Here is an excerpt from a study report. It strengthens my own belief that for people who take their own life, changes have occurred in the brain that allowed the suicidal behaviors to be exhibited. In other words, the action of suicide occurred when the person’s brain was in an altered state.

Some interesting information was contained in an article published in the Scientific American (Why? The Neuroscience of Suicide. Pages 45-51. Carol Ezzell. Scientific American, February 2003. Scientific American Inc, NY. ISSN #0036-8733. Website: www.sciam.com)

Studies found that in people who die by suicide, anatomical and chemical changes occur in two brain regions: the orbital prefrontal cortex, which lies just above the eyes, and the dorsal raphe nucleus of the brain stem. The alterations are evidence of a reduced ability to make and use serotonin, a key neurotransmitter known to be lacking in the brains of impulsive people and in those suffering from depression. Neurons in the dorsal raphe nucleus (brain stem) produce serotonin (a neurotransmitter). These neurons have long projections that carry the neurotransmitter to the orbital prefrontal cortex. In suicide victims, the dorsal raphe nucleus sends less than normal amounts of serotonin to the orbital prefrontal cortex.

At a conference of the American College of Neuropsychopharmacology in 2001, Victoria Arango (New York State Psychiatric Institute, affiliated with Columbia-Presbyterian Medical Center) reported that the brains of people who were depressed and died by suicide contained fewer neurons in the orbital prefrontal cortex, a patch of brain just above each eye. In addition, that area had one-third the number of presynaptic serotonin transporters that control brains had, but roughly 30% more postsynaptic serotonin receptors. Together the results suggest that the brains of suicides are trying to make the most of every molecule of serotonin they have, by increasing the molecular equipment for sensing the neurotransmitter, while decreasing the number of transporters that absorb it back again. We believe there is a deficiency in the serotonergic system in people who commit suicide, Arango concludes. They can be so sick Prozac can’t help them. Inhibiting the reuptake of serotonin isn’t always enough to prevent suicide.

These studies suggest that people who kill themselves are in an altered state biochemically. That can be of some comfort to survivors who can’t understand why (although the why may never be understood fully by others since each brain is as unique as one’s thumb print). You may want to refer to my article about the Grief Recovery Pyramid, designed to help survivors move through the grief process (as compared to the Kubler-Ross model that was designed to help individuals who were personally facing death).