News

Penn. Psychiatrist Calls for Change in Societal Attitude Toward Mental Health

Joshua Vaughn

09/03/2014

Aug. 31--Nearly 40,000 American lives are ended each year due to suicide -- more than motor vehicle deaths and more than double the number of homicide victims per year, according to the Centers for Disease Control and Prevention.

A stigma, however, still remains around suicide and mental health issues, causing some to call for change in the way that society views the issue.

"Saying that someone who suffers from major depressive disorder or anxiety is less incapacitated than somebody who has had a bad medical condition is very unfair," said Dr. Ahmad Hameed, a psychiatrist and director of the adult residency program at the Penn State Milton S. Hershey Medical Center's College of Medicine. "Just because I don't have my arm in a sling or my leg in a cast ... doesn't mean I'm hurting any less."

According to Hameed, 90 to 95 percent of people who complete suicide have some underlying mental health illness or disorder, like major depressive disorder. The other 5 to 10 percent, Hameed said, are driven by things like legal troubles, divorce, family problems or acute issues.

Hameed said suicide and suicidality -- thinking about, planning or attempting suicide -- does not have just one cause. There are a host of psychological, societal and even psychological causes that can lead to this premature death.

"There are multiple factors for someone completing suicide or attempting suicide," Hameed said. "It is not as simple as one (cause) or the other."

Research

Researchers at Johns Hopkins University School of Medicine may have recently discovered a genetic link to suicidal behavior.

"What we are talking about is molecular marks on genes that act like light switches for turning on and off genes," said assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, Zachary Kaminsky.

Kaminsky and his team recently published a study that indicates they may have found one of those light switches pertaining to suicide.

For the study, the team examined brains of people who had died by suicide and by other causes to compare the differences.

"We were asking the question, 'Are any of these light switches turned up or down when it shouldn't be,'" Kaminsky said. "We did find this one that was really compelling ... because it looked like this molecular mark was turning the levels of this gene way down."

The gene Kaminsky identified controls the production of the protein SKA2, which he said was part of a group of proteins that modulate how people handle stress.

Kaminsky explained that stress is an essential part of life, and when dealt with properly can be beneficial. However, when stress cannot be properly regulated, it can lead to serious consequences.

"We know that individuals who are at risk for suicide or who have attempted suicide, based on various studies, have a disregulated stress response," Kaminsky said. "We need stress for our daily lives, but when that stress is done, when it's time to relax, the stress response is supposed to shut down."

He said having a decrease in the identified protein was like trying to stop a car with worn-out brake pads. The lack of the protein makes it difficult for the body to shut down the stress response, like worn-out brake pads make it difficult to stop a moving car.

The genetic marker was then able to be identified in the blood, Kaminsy said, leading to the group producing a possible prediction model for suicidal behavior. Kaminsky, however, said that they are several years away from that point, and that the test is not meant to determine absolutely who will or will not attempt or complete suicide. He said he envisioned the blood test as a way of placing more information in the hands of mental health professionals to better tailor treatment and to make people cognizant of their risks.

A firm biological understanding of suicide may go a long way to dealing with the stigma associated with it.

"Just because it did not happen to you or I, does not mean it does not happen to the next person or the next person," Hameed said.

Hameed said many people who attempt suicide vocalize their thoughts prior to attempting to take their life, and friends and family should take any threats very seriously. He also said friends and family should look for major mood changes, like becoming reclusive, not eating or extreme changes in sleep patterns as indications that help may be needed.

"You need to empathize and sympathize with these feeling," Hameed said. "You need to seek the appropriate help. There is a fine line between overreacting and providing help."

Hameed said anyone who feels their family member or friend is contemplating suicide should limit access to means of committing suicide -- removing firearms, pills or other objects that could be used for suicide from the home -- and seek help from a mental health professional.