Preventing depression and suicide
A student of the University of the Philippines, Kristel Tejada, tragically succumbed to an illness that is preventable. Her suicide was followed by an avalanche of finger-pointing and calls for certain UP officials to give up their office.
Opinion columns and commentaries have flooded the media, and experts have been called upon to say their piece. Some prominent people are calling for increased educational funding for the poor. College organizations have opened scholarships for students who may be following the same path as Kristel.
In all the media buzz, I have not read or heard mention of the possibility that, like many chronic illnesses, suicide is preventable. It starts in early childhood or teen years as an inflammatory response of the body to adverse environment, like poverty, a 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, Dr. William Copeland and his colleagues at Duke University Medical Center 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 CRP levels. People who have had heart attacks also have high inflammatory marker CRP.
People who, like Kristel, chose to push the button “game over” went through chronic depression that started years back. Many of them had this mental condition brewing even during the fetal life. When a mother is depressed during pregnancy, or has chronic job stress, she has a high risk of delivering a baby who will later have ADHD or language and cognitive delays, and will be prone to depression. Some researchers are even proposing that autism may 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 young child may have a happy family to start with, but if as he/she grows up the family develops financial problems and the parents separate, or if there is an alcoholic father or a drug-addict sibling, he/she can easily fall into chronic depression with increasing CRP in the blood, just like in diabetes.
In a seminal study using more than 75,000 interviews, Dr. Vincent Felitti and his group at Kaiser Permanante in San Diego, California, found that children exposed to adverse childhood experiences like drug and alcohol addiction, depression, and abusive parents are prone to school failures, mental problems, hypertension, obesity, and suicide.
Thus, knowing the risk factors that can lead to an inflammatory response of the body, we should view depression and suicide as preventable illnesses.
When I was in my second year at the UP College of Medicine, my family’s poverty forced my mother to constantly borrow money from relatives to support my studies, and I entertained 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 saved me from ever thinking of pushing the “game over” button. I learned how to cope with the stress of medical studies and residency training by reading Peale and Dale Carnegie. And during my stressful decades-long pediatric practice in Maine in the United States, I continued reading and studying how the brain works.
Money or scholarship funds, or calling for the resignation of UP officials who are properly doing their job, is not the best way to prevent suicide. I think the better way is to educate freshman students in the new science of cognitive and positive psychology.
The most important things in my life are the things that I did not learn from UP. I learned these myself through self-study. I am wondering why we are not teaching students proven methods of principles of mastery—how to control our time, manage our finances, and most importantly, conquer stress.
Many studies have shown that vigorous and regular exercise produces more BDNF, or 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 practiced in India and many other countries for centuries. Now it has been proven to help reduce depression, hypertension, chronic pain, and heart disease. Many successful CEOs in Fortune 500 companies are now including meditation in their corporate environment. Health insurance giant Aetna’s CEO, Mark Bertolini, has brought yoga and mindfulness to the work place.
A proper diet can also reduce inflammatory responses of the body. By eating more fruits and vegetables and less meat and processed food, we can alleviate inflammation.
As in the chronic mental and physical problems in life, education and application of proven preventive methods are better than money or expensive drugs and medical treatments. Using new brain research, we should educate students that they can cope with and prevent depression and suicide, and that they, too, can be successful and happy in their careers.
Dr. Leonardo L. Leonidas retired in 2008 as assistant clinical professor in pediatrics from Boston’s Tufts University School of Medicine, where he was recognized with a Distinguished Career Teaching Award in 2009. He is a 1986 graduate of the UP College of Medicine.
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If you or someone you know needs help, call the National Center for Mental Health hotline at 0917-899-USAP (8727); (02) 7-989-USAP; or 1553 (landline to landline, toll-free).
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