World Suicide Prevention Day
Today, September 10th is World Suicide Prevention Day.
We all need to urgently raise awareness against the tragic reality of suicide. It remains a leading cause of death in the United States, claiming over 48,000 lives each year. The overall suicide rate in the U.S. increased by 36% from 2000 to 2021, reaching 14.4 deaths per 100,000 people in 2022. It’s not just young men - there’s a mental health crisis, and we probably won’t understand how deeply it will affect this generation until it’s too late. Suicide is currently one of the three leading causes of death among Western people aged 15-24, per the CDC and MMWR reports.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2021, approximately 12.3 million adults seriously considered suicide.
Suicide is not simply a bout of severe depression. Instead, it’s a severe depression in people with a particular moment of extreme vulnerability combined with a readily available means to end their lives. The cause of most suicides is hopelessness, becoming a burden, in a vulnerable situation, with access to a lethal means.
While the factors contributing to these numbers are varied and complex, one area often overlooked is the potential of ketamine. It has emerged as a significant tool in the prevention of suicide, particularly for individuals experiencing acute suicidal ideation or those with treatment-resistant depression. This promising development offers hope in the fight against suicide.
Effect on Suicidal Ideation: Multiple studies and clinical observations have shown that ketamine significantly decreases suicidal ideations, often independently of its antidepressant effects. Ketamine is increasingly used in emergency rooms for patients with severe suicidal ideation due to its fast-acting nature. A single infusion can provide immediate relief, buying time for other interventions to take effect.
Rapid Onset of Action: Unlike traditional antidepressants, which take weeks to become effective, ketamine can reduce suicidal thoughts within hours. This rapid action is crucial in emergency settings where immediate intervention can be life-saving.
Mechanism of Action: Ketamine works differently from conventional antidepressants. Ketamine targets brain plasticity, modifies neurotransmitters such as glutamate, and increases important brain proteins such as mTOR and Brain-Derived-Neuro-Trophic Factor (BDNF). It primarily acts on the NMDA receptor, leading to an increase in glutamate and activating AMPA receptors. This cascade results in enhanced synaptic connections and neuroplasticity, effectively “rewiring” the brain to reduce depressive symptoms and suicidal ideation. This neuroplasticity might help individuals see solutions to their problems rather than feeling trapped, which is often a precursor to suicidal behavior.
Treatment-Resistant Depression: For individuals who have not responded to other treatments, ketamine offers hope. Repeated doses or maintenance therapy can sustain the reduction in suicidal thoughts and depression over time.
Limitations and Considerations: While ketamine shows promise, it’s not a cure-all. Its effects can be transient, requiring repeated administration for sustained benefits. The use of ketamine must be paired with proper therapy. Also, as I’ve written extensively about the Matthew Perry tragedy, it must be given in a proper environment with qualified healthcare practitioners. It's important to note that ketamine, like any medication, can have side effects. These can include dissociation, hallucinations, and changes in blood pressure. However, when used under the supervision of a healthcare professional, these side effects can be managed effectively.
Metabolic and Mental Health: There are strong connections between metabolic dysfunction and mental health disorders, including depression, anxiety, substance use disorders, and suicidality. Metabolic conditions such as mitochondrial dysfunction, insulin resistance, and obesity have been linked to neuroinflammation, altered neurotransmitter function, and impaired brain energy metabolism—all of which can contribute to mental illness.
Recognizing the Warning Signs of Suicide
It’s crucial to remember that more than fifty percent of suicide victims show no signs of suicidality. To prevent suicide, it’s essential to recognize the warning signs—whether friends, family members, or coworkers. Being informed about these signs can empower you to act and potentially save a life. Some of these signs include:
Expressing Hopelessness: Statements like “There’s no way out,” “I feel trapped,” or “I can’t go on” can indicate a person is feeling hopeless and may be considering suicide.
Withdrawal: Red flags include withdrawal from social activities, isolation from friends and family, or a lack of interest in previously enjoyed activities.
Behavior Changes: This can include reckless behavior, increased substance use, or significant changes in sleep patterns (either too much or too little).
Talking About Death: Openly talking about death, dying, or self-harm are direct warning signs.
Goodbye Calls, Letters, or Giving Away Belongings: This might be a sign that the person is preparing for the end of their life.
Sudden Mood Swings: Drastic shifts from extreme sadness to calmness or appearing unusually content after a period of depression can indicate someone may have decided to attempt suicide.
How to Talk to Someone at Risk
If you notice any of these warning signs, it’s vital to take action.
Listen Without Judgment: Offer a listening ear without interrupting or judging. Often, just being heard makes a difference.
Express Concern and Care: Let the person know you care about them. Phrases like “Are you doing OK?” or “I’m really worried about you” can promote deeper conversation.
Avoid Minimizing Their Feelings: Don’t dismiss their feelings. Phrases like “You have so much to live for” or “It’s not that bad” are intended to help, but they often make the person feel ashamed and defensive.
Encourage Professional Help: Suggest they talk to a mental health professional and offer to help them find resources.
Stay Connected: Keep in touch with the person, check in regularly, and continue offering your support. Knowing someone cares can be a powerful deterrent against suicide.
A Call to Action: Working Together to Save Lives
As we observe World Suicide Prevention Day, it’s important to remember that we all have a role to play in saving lives. By recognizing the intersection of mental and metabolic health, we can adopt a more comprehensive approach to suicide prevention. Encouraging healthy lifestyle changes, fostering supportive communities, and advocating for better mental and metabolic health care access can make a profound difference. If you are interested in the potential of using ketamine and how it can prevent suicide, please read my book The Revolutionary Ketamine.
For more information and resources on suicide prevention, visit SAMHSA’s Suicide Prevention Month page.
