What Neurobiology Can Tell Us About Suicide
by Catherine Offord (The-Scientist)
Top Image: © Lynn Scurfield. Infographic by Lisa Clark.
The biochemical mechanisms in the brain underlying suicidal behavior are beginning to come to light, and researchers hope they could one day lead to better treatment and prevention strategies.
The first time Kees van Heeringen met Valerie, the 16-year-old girl had just jumped from a bridge. It was the 1980s and van Heeringen was working as a trainee psychiatrist at the physical rehabilitation unit at Ghent University Hospital in Belgium. As he got to know Valerie, who’d lost both legs in the jump and spent several months at the hospital, he pieced together the events leading up to the moment the teenager tried to end her life, including stressful interactions with people around her and a steady accumulation of depression symptoms.
Van Heeringen, who would later describe the experience in his 2018 book The Neuroscience of Suicidal Behavior, says Valerie’s story left a permanent impression on him. “I found it very difficult to understand,” he tells The Scientist. He asked himself why anyone would do “such a horrible thing,” he recalls. “It was the first stimulus for me to start studying suicidal behavior.”
In 1996, van Heeringen founded the Ghent University Unit for Suicide Research. He’s been its director ever since, helping to drive scientific research into the many questions he and others have about suicide. Many of the answers remain as elusive as they seemed that day in the rehabilitation unit. Suicide rates are currently climbing in the US and many other countries, and suicide is now the second leading cause of death among young people globally, after traffic accidents. The World Health Organization recently estimated that, worldwide, one person ends their own life every 40 seconds.
Suicide is as complicated as it is tragic. Suicidal behaviors come in many varieties, ranging from suicidal thinking, or ideation, to suicide attempt and completion, all of which may be associated with various levels of violence or intent. The behaviors themselves differ in incidence among genders, ethnicities, and other demographic categories, and almost always occur against a background of depression or some other mood disorder—although only a fraction of people with mood disorders become suicidal.
No field of scientific inquiry can single-handedly untangle a phenomenon as complex as suicide. But van Heeringen and many other scientists are hoping to shed light on the problem by digging into the neurobiological processes underlying thoughts about ending one’s own life and attempts to do so. This work is building support for the idea that suicide is tied to specific biochemical changes that can be measured and targeted independently of, and possibly in parallel with, the mental health disorders they often accompany. Findings from this work, researchers hope, could help reveal new treatments, and perhaps even opportunities to identify the people most at risk in time to intervene.
“The knowledge we have today is way larger than what we had twenty years ago,” says Gustavo Turecki, a psychiatrist at McGill University and the director of the McGill Group for Suicide Studies at the Douglas Research Centre in Montreal. “[We’ve] made tremendous advances … in terms of understanding the complexity of the problem, understanding the neurobiology, understanding the causes.”
The role of the brain’s stress pathways in suicide
Valerie’s account shared elements with the stories of many other people who have attempted to end their lives. She showed signs of depression and social stress, and, as van Heeringen later discovered, she had a family history of suicide—a known risk factor for suicidal behaviors, independent of any psychiatric disorders.
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