Preventing Suicide

Preventing Depression and Suicide A University of the Philippines student, Kristel Tejada, in the past couple of week tragically succumbed to an illness that is preventable, suicide. This was followed by an avalanche of finger pointing and politically aimed calls for UP officials who did their duty to give up their office. Opinion articles and op-Ed columns have flooded the newspaper and TV news. Dozens of experts were called to give their opinions. Many, especially politicians, are calling for increased educational funding for the poor. College organizations and fraternities are now starting to fund scholarships for students who might be following the same path as Kristel. In most of the talks and media buzz, I have not seen or heard talks about the possibility that suicide is preventable just like many chronic illnesses. It started in their early childhood or teen years as an inflammatory response of the body from adverse environment like poverty, dysfunctional family, physical and emotional abuse, alcoholic parents, drug addiction, and chronic depression. This is the same body inflammation that is commonly seen in high blood pressure, coronary artery disease, and diabetes. In a recent study by Dr. William Copeland and his colleagues at Duke University Medical Center, they found that depression is also linked to an inflammatory marker in the blood called C-Reactive Protein (CRP). In a large sample of adolescent and young adult volunteers, they tracked the CRP levels from childhood and depressive symptoms or episodes. They found that the number of cumulative depressive events were associated with increased level of CRP. People with heart attacks also have high inflammatory marker CRP. People who choose to push the button “Game Over” like Kristel had been through chronic depression which started several years before. Many of them had their mental condition brewing even during the fetal life. When a mother is depressed during pregnancy or had chronic job stress they have a high risk of delivering a baby who later on in life will have ADHD, language and cognitive delays, and prone to depression. Some researchers are even proposing that Autism might be a result of severe stress during pregnancy. When a pregnant mother is chronically stressed, her cortisol or stress hormone goes up in the blood which then goes to the placenta and ends up in the fetal brain. High cortisol during the first trimester can damage brain cells particularly those in the hippocampus, the memory center. A child might have a happy family to start with, but as they grow up when the family develops financial problems, the parents separate, an alcoholic father, or a drug-addict sibling, a young child exposed to these adversities can easily fall into chronic depression with increasing CRP in the blood just like in diabetes. From the seminal study of Dr. Vincent Felitti and his group of Kaiser Permanante in San Diego, since the 1980s, of more than 75,000 interviews, they found that children exposed to ACE (Adverse Childhood Experiences) like drug and alcohol addiction, depression, and abusive parents, these children are prone to school failures, mental problems, hypertension, and suicide. Knowing these risk factors that can lead to an inflammatory response of the body, just like heart disease and diabetes, we should look at depression and suicide as a preventable illness. When I was in my second year of medical school, because of our poverty, my mother was always borrowing money from our relatives to support my tuition fee at UP College of Medicine, I entertain the thought of hurting myself. Fortunately, I was a frequent visitor of National Book Store and I found Norman Vincent Peale’s “Power of Positive Thinking” which save me from ever thinking of the “Game Over” button. I learned how to cope with the stress of medical studies and residency training by reading Dr. Peale and Dale Carnegie. And during my stressful more than three decades pediatric practice in Maine, USA I continued reading and studying how the brain works. Money or scholarship is not the best solution to suicide reduction and prevention just what many politicians are espousing in the past weeks. Or asking for the resignation of UP officials who are properly doing their jobs. I think the better solution is educating all freshman students in all colleges the new science of Cognitive and Positive Psychology. The most important thing in my life are the things that I did not learn from UP. I learned it myself by self study. Now, I am wondering why are we not teaching proven methods of how to control our time, manage our finances, principles of mastery, and most importantly how to conquer stress. Many studies have shown that vigorous and regular exercise produce more BDNF, Brain Derived Neurotropic Factors, that can stimulate new brain cell growth. With high BDNF the risk of depression and suicide is reduced. Meditation has been practices in India and many other countries for several centuries. Now it has been proven to help reduce depression, hypertension, chronic pain, and heart diseases. Many successful CEO in Fortune 500 companies are now including meditation in their corporate environment. Health Insurance giant AETNA’s CEO Mr. Mark Bertolini has brought YOGA and mindfulness to their work place. Proper diet can also reduce inflammatory responses of the body. By eating more fruits and vegetable and less of meat and processed food, we can alleviate inflammation. Like most chronic mental and physical problems in life, education and application of proven preventive methods are better than money or expensive drug or medical treatments. We should educate all freshman that they can cope and prevent depression and suicide. Leonardo L. Leonidas, MD Assistant Clinical Professor in Pediatrics (retired 2008) Distinguished Career Teaching Award, 2009 Tufts University School of Medicine, Boston, USA Outstanding Alumnus UPMASA, 2010 Overseas Teacher of the year, UPMASA, 2006 Gradaute, 1968, UP College of Medicine