Another pandemic we don’t understand

There are a lot of things we know about pandemics. We know that the COVID-19 pandemic is the result of widespread viral infection caused by the novel SARSCoV-2 coronavirus. Last week, this column lamented the lifestyle-caused diseases of obesity and Type 2 diabetes and lamented the lack of concerted societal action on the pandemic proportions of these stealthy but determined killers. But there is yet another pandemic, the still-too-frequently hushed-up problem of poor mental health, sometimes resulting in its most devasting form, suicide.

The fact is, for more than 100 years, there has been little progress in understanding the factors that result in a state of dismal mental health – the state that must be the precursor to suicide. Medicine has made tremendous progress in diagnosing, treating and saving lives from multiple diseases. Advancing knowledge allowed for the development of vaccines, medical imaging, antibiotics, and antiviral drugs that drastically changed the course of human health. Organ transplants, stem-cell research, and immunotherapy have given new hope and extended lives to millions in recent years.

But our understanding of the brain and mind is slower in coming.

The World Health Organization estimates that 800,000 die of suicide each year. That’s one person every 40 seconds. For each person who dies by suicide, there may be about 20 others who attempt it. But like the obesity and diabetes pandemics, we haven’t shut down the economy. We haven’t held daily press conferences. We barely acknowledge it at all.

Yet, these statistics indicate that suicide is a bigger killer than COVID-19. And a recent article in JAMA Psychiatry cautions that the prevalence of suicide may worsen because of COVID-19.

A major concern is the extended requirement for social distancing. Researchers have documented the association between social isolation and suicidal thoughts and behaviours. But the list of other related factors is long and familiar to those living in the time of COVID-19 – economic stress, childcare pressures, limited access to community and religious support, barriers to mental health treatment, and the compounding effect of other existing health problems.

Sadly, firearm sales have spike in both the U.S. and Canada since the start of the COVID-19 crisis. Guns are the most common method of suicide. Researchers have demonstrated an association between suicide rates and access to a gun.

For some individuals, particularly seniors, and paradoxically, for some health care workers, suicidal feeling may emerge from a concern for family members or a desire to avoid adding burden.

But there is some good news to report.

Neuroscientists and other experts in mental health are starting to open new avenues for understanding the biological factors that determine brain and mind health. One such area is the connection between brain and gut. Millions of nerves and neurons send signals from the gut to the brain as part of our “microbiome”. Treating the ailments in our heads may be a matter of better minding our bodies.

But you don’t have to be a brain surgeon to make one of the most effective interventions in preventing suicide. All you have to do is reach out. Take the time to think about someone you know who may be feeling isolated. Make a phone call. Drop them a line. Send a gift. They call it the “pullingtogether effect”, when people come together in a shared experience, offering mutual support and encouragement.

If you yourself are having suicidal feelings, you must reach out too. In the U.S., call the National Suicide Prevention Lifeline (1-800-273-TALK). In Canada, call Crisis Services Canada (1-833-456-4566) or text 45645.

Sign-up at www.docgiff. com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.