The Neurobiology of Suicide

Suicide is the fifth leading cause of death before the age of 65 in the U.S., and risk factors for suicide have been categorized into environmental, biological, and psychiatric factors. The highest mortality rate in suicide is due to depression. Over 90% of those have attempted or committed suicide have a psychiatric illness, and 60% of all suicides are correlated with mood disorders. Some traits that increase suicidal behaviors include impulsivity, pessimism, hopelessness, aggression, and impaired cognitive functions. Additionally, in younger suicide victims, impulsivity and aggression levels are higher. Abuse, isolation, employment and financial difficulties, and experiences with loss and death are situations that can also increase suicidal thoughts and behaviors. To date, the best method to assess someone’s risk for suicide is screening for past attempts. Current measurements used are only scales that ask individuals about their intentions and risk factors, but they provide insufficient data for future suicide attempts.

There are multiple brain regions, pathways, and circuits that play a role in suicidal thoughts and behaviors which are related to emotion and impulse regulation. Some brain regions include the ventral prefrontal cortex (VPFC) which is correlated to suicidal ideation, the dorsal prefrontal cortex (DPFC) which is correlated to suicidal actions, and the dorsal anterior cingulate cortex (dACC) and insula which are correlated with the transition of suicidal thoughts to behaviors and actions.

Impairments to the ventral prefrontal cortex (VPFC) play a role in negative thoughts and an internal state that stimulates suicidal ideation. Impairments to the dorsal prefrontal cortex (DPFC) play a role in suicide attempt behaviors. These brain regions have connections to one another, so when an injury or impairment occurs, it affects the transition of suicidal thoughts to suicidal behaviors. Many mental health conditions, such as bipolar disorder, depressive disorders, and schizophrenia have an increased risk of suicide mortality because they affect the VPFC, DPFC, dACC, and insula brain regions.

Suicidal thoughts and behaviors are also associated with neuroinflammation which affects a specific pathway that causes serotonin depletion and glutamate neurotransmission. The changes in this pathway have been linked with impaired neuroplasticity and cognitive deficits. Deficits in serotonin are linked with depression, aggression, impulsivity, suicidal attempts, and suicidal ideations. Low levels of serotonin in the cerebral spinal fluid (CSF) have also been linked with the lethality of suicide attempts and predicted future suicide attempts. Studies on suicide victims have also shown decreased density of the serotonin transporter in the prefrontal cortex, hypothalamus, and anterior cingulate.

More research is being conducted to understand the circuitry of the brain during the transition of suicidal thoughts to behaviors to be able to create targeted interventions and preventative measures. Current research is focusing on biological markers to understand risks of suicide, depression episodes, as well as psychosis.

At BiofeedbackWORKS, we offer a variety of modalities and protocols for depression and anxiety, which are common diagnoses associated with suicidal ideations and behaviors. Such modalities can help mitigate and address symptoms of depression and anxiety. Our facility also offers counseling sessions to supplement neurofeedback or biofeedback sessions, enabling further discussion of concerns or changes experienced.


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