By Shaalee Sone, Outreach Intern, Ontario Brain Institute
Individuals who have attempted suicide often say that if one person had taken a minute to ask them how they were feeling it could have prevented them from engaging in suicidal behaviour. While it’s healthy to regularly discuss feelings with loved ones, and we want to support those in need, how can we tell when someone is contemplating suicide and if we should talk about it with them? Beyond individual help, it can also be challenging to find systemic help. A recent ICES report found that mental health and addictions care for youth is poor in five provinces, including Ontario.
Researchers in CAN-BIND, one of the Ontario Brain Institute’s Integrated Discovery Programs, are trying to better understand depression and suicide by looking at the biological changes. This could help clinicians predict who is at risk and what treatments may be most effective. One project is looking for biological markers that identify when someone is at risk of attempting suicide. These signs could be seen by assessing brain activity, behaviour or genetics.
“Predicting suicide is very difficult to do,” says Dr. Gustavo Turecki, a CAN-BIND researcher, Director of the McGill Group for Suicide Studies and Head of the Depressive Disorders Program at the Douglas Institute. “It is not an exact science, and we understand very little about how to precisely predict suicide risk. That’s why we need to continue doing studies, such as the studies that OBI funds through CAN-BIND, to better predict individuals at risk.”
One thing we know is that depression is often coupled with suicide ideation, and understanding how this pairing develops can help us intervene earlier on.
Normally, we find solutions for our day-to-day problems. “When we are depressed, these problems look very, very different from normal. They look much bigger and we could be paralyzed by the problems and unable to solve them,” says Dr. Turecki.
Chemical changes in the brain can cause of this change in perception. “Problems become insurmountable, and then suddenly the person is trapped in an inferno with no way out. Their suffering is so unbearable that the only way out is to die.”
Suicide ideation frequently occurs in people who are depressed, but there is variability in the presentation of these thoughts. If the thoughts of suicide are fleeting and intrusive, and the person does not feel connected to the thoughts, then they are at a lower risk of acting on them. At the extreme, the thoughts could be intense with a clear plan about dying. Someone who agrees with these structured thoughts and wants to think about their plan is at a greater risk of acting on them.
The intensity and connection to suicidal thoughts is one risk factor that clinicians use to assess the risk that someone will attempt suicide. Clinicians consider a number of risk factors in the context of the patient, but there is no mathematical formula that can accurately predict who is at risk.
The biological markers that CAN-BIND’s researchers identify will improve the predictive capacity of clinicians. Additionally, these studies also emphasize the physical nature of depression, which helps reduce the stigma and could encourage people to reach out for help.
“Although depression is primarily a brain problem, it is not exclusively a brain problem. It’s systemic. When we are depressed we have symptoms throughout the body. We feel pain, we feel tired, patients who are depressed have lots of pain throughout the body,” says Dr. Turecki.
We can each do our part to try to lessen this pain by reaching out to a friend or loved one and asking how they are feeling and if they want to talk. You can even ask if they are contemplating suicide – it may be a relief to speak about it and the start of a life-changing conversation.
If you want to talk someone about your depression or suicidal thoughts, there is always someone to listen 24 hours a day, 7 days a week.
It can be challenging to start the conversation, but the benefits of listening outweigh the effort. This World Suicide Prevention Day, take that minute to reach out to someone feeling isolated or vulnerable and change a life. Small actions can have a big impact.