In the days after two Parkland massacre survivors took their own lives, the father of a Sandy Hook victim gave a talk about brain health. He ended his own life a week later. Can brain imaging help identify people at risk for suicide?
Just a week before his own suicide, Jeremy Richman flew down Florida to deliver a talk he called “The Neuroscience of Being Human.” In it, the 49-year-old neuropharmacologist examined how brain research might help identify people in crisis, so that we might better intervene and help those at risk of violence to themselves or others.
“Tragically, his death speaks to how insidious and formidable brain health can be and how critical it is for all of us to seek help, our loved ones, and anyone who we suspect may be in need,” the Avielle Foundation posted on their website late Monday on behalf of Richman’s devastated family. “We are crushed to pieces, but this important work will continue, because, as Jeremy would say, we have to.
Even more surprising, as the team began comparing the brains to each other and those of individuals who died of natural causes, there was, they found, an identifiable constellation of neurological characteristics seen to a much higher degree in those who had committed suicide, regardless of whether they were depressed or not.
Yet the primary difference between those more likely to commit suicide wasn’t in the amygdala: the differences were in the areas of the brain known as the anterior cingulate cortex and the dorsal lateral prefontal cortex, which control how individuals subjectively assess the stress of their condition.
“All of these contribute to suicidal behavior, you feel the depression more acutely, you are more prone to act on your feelings, you can see fewer options or solutions and finally you see the individuals around you as more critical and less helpful,” Mann says. “The unfortunate thing of course is that the person themselves doesn’t realize they are any different than anybody else. They are not aware of the risk.
Aggression, too, seems to be involved. Gould notes that as far back as Sigmund Freud, theorists suggested that suicide is aggression turned inward. He has been studying the circuits involved in impulsivity and aggressiveness in animals and notes that a growing body of research has shown that the effectiveness of Lithium salts in reducing suicide amongst depressed patients likely stems from its ability to affect these circuits.
“When you have a psychiatric condition it changes the way you think about certain things,” says Marcel Just, a cognitive psychologist and Director at the Center for Cognitive Brain Imaging at Carnegie Mellon University. “A paranoid person, for instance, will have different brain activation patterns if you say the word 'police.' The same is true with certain words for those with suicidal ideations.
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