Reckless Behavior

Reckless Behavior

Suicide is a topic that everyone cringes at because of the intense negative emtion that comes with it. It is a complex situation that claims around 38,000 American lives every year. In 2013 41,149 suicides were recorded making it the 10th leading cause of death. Interestingly enough suicide ranked higher than homicide, which was 16th on the list. Even more disturbing, it is the second leading cause of death in the younger demographic ranging from about 15-24 years old.

   

Even with suicide deaths ranked so high, so little is known about its roots and physiology. That is what researchers are trying to do, determine what happens in the brain when a person attempts suicide. I think many people make this assumption (I know I certainly did) that people who attempt suicide are severely depressed. However, fewer than 10% of people with depression attempt suicide and this statistic has caused psychiatrists to question whether suicide stems from symptoms of mental disorders or if its driven by brain biology.

This project is still in its infancy only launching last month. This is a large study with multiple experimental groups. They recruited 50 people who attempted suicide two weeks prior to enrolling in the study. Carlos Zarate, the head psychiatrist of the study, will compare the brain structure of these subjects with the brain structure of 40 people that attempted suicide a year ago and then 40 people with depression who never attempted suicide. There is also a group of 40 healthy people that will function as the control. The goal is to tease out the mechanisms that are associated with the impulse to kill oneself. There is one drug that researchers think give some insight into the brain circuits specific to suicidal thinking. This drug is called ketamine or the "party drug" and the function of this drug is to quickly arrest suicidal thoughts, but not the other symptoms of depression entirely. The effects are known to last for a week and researchers will give this drug to another group of people that recently attempted suicide.

The literature that led to birth of this study revolved around the genetic aspect of suicide. Fabrice Jollant, another psychiatrist, suggests that this genetic influence is related to impulsive and flawed judgment. He found that close relatives of people who had committed suicide showed more impulsive tendencies than a control group when playing a gambling game designed to test decision making. One goal of this research is to find biomarkers that clinicians could use as predictors for people that are at risk of suicide. Psychiatrists have already identified a set of six genes whose expression in the blood stream is different in those people that have killed themselves.

A couple weeks ago Dr. Koenings came in and gave a talk about the ventromedial prefrontal cortex (vmPFC). This region is a part of the prefrontal cortex and is paramount to the pathophysiology of mood and anxiety disorders. The vmPFC functions in regulating the amygdala. The amygdala is the emotional center of the brain. It has been well researched that vmPFC lesions are associated with changes in the personality and behavior. The reason I thought of this talk when reading this article is something that I touched on earlier. Psychiatrists reported that they found an association of suicide with impulsive or flawed behavior. Dr. Koenings talked about how vmPFC lesions resulted in impulsivity and reckless decision-making. Even more, the people with vmPFC lesions were shown to have a reduced likelihood of developing depression and PTSD. Putting this in context with the article reinforces the idea that people that are more likely to commit suicide are not necessarily severely depressed. More research could be done to see if people with vmPFC lesions are associated with similar behaviors of people with suicidal tendencies.

Sources: 

Motzkin, Julian, Carissa Philippi, and Michael Koenings. "Ventromedial Prefrontal Cortex Is Critical for the Regulation of Amygdala Activity in Humans." (2015). Web. 10 Dec. 2015.

"Brain Study Seeks Roots of Suicide." Scientific American. Web. 10 Dec. 2015.h

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