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Suicide is a permanent solution to a temporary feeling, but what are the causes of those feelings of hopelessness? In the second episode of “Suicide Awareness Week,” Dr. Daniel Amen and Tana Amen discuss the psychological causes that can lead to suicide or suicidal thoughts, as well as what can be done to treat these causes.
Dr. Daniel Amen: Welcome to the Brain Warrior's Way podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. Here, we teach you how to win the fight for your brain, to defeat anxiety, depression, memory loss, ADHD, and addictions.
Dr. Daniel Amen: The Brain Warrior's Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using Brain SPECT imaging to better target treatment in natural ways to heal the brain. For more information, visit AmenClinics.com.
Tana Amen: The Brain Warrior's Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit BrainMDHealth.com. Welcome to the Brain Warrior's Way podcast.
Welcome back. We are talking about Suicide Awareness Week. This is our second episode and I think this is a really serious topic. I know this has been something, I know a lot of teenagers struggle with this. This happened this year with Chloe. At school they had a very dramatic event happen with one of the kids at school committing suicide, leaving a bunch of letters. And so this affects all of us, and I think this is really important to talk about. Why does this happen? I think in this episode we're talking about the psychology behind it.
Dr. Daniel Amen: Right. One other thing on the biology is I've actually published two studies on suicide.
Tana Amen: Mm-hmm (affirmative).
Dr. Daniel Amen: So out of the 145,000 scans we've done here at Amen Clinics, we track a lot of our patients and we know of about 40 people later who ultimately killed themselves. And so we actually went back and looked at their scans, and what we found, people who had the lowest function in the front part of the brain, what does that do? Focus, forethought, judgment, impulse control, organization, planning, empathy, learning from the mistakes you made. They were significantly more likely to kill themselves than if they had healthy function in their prefrontal cortex.
Tana Amen: So that, in my mind, means if you get this information and you know that that is your brain, it's probably really important to do whatever it takes therapeutically to get that function up in that part of the brain.
Dr. Daniel Amen: You bet.
Tana Amen: Right.
Dr. Daniel Amen: So really important. But suicide is more than just your biology. There is a psychology to it and those of you that follow us know that we talk about ANTs. Automatic negative thoughts. The thoughts that come into your mind automatically and ruin your day, and what we see is that people who have suicidal ideas and suicide attempts have way more negative thoughts running around in their head. In fact, we often say they have an ANT infestation.
Tana Amen: Mm-hmm (affirmative). It's true. So I want to talk about one thing and that is what happens. You're talking about psychology. So what happens with the psychology when you see these epidemics? Like you'll see a suicide epidemic occur. I know one teacher who ended up leaving the town and quitting his job after he saw a rash of suicides. There were two or three in his school, but through his small town there ended up being 12 within a short period of time. After the first one, it was like a domino effect. Or the show 13 Reasons Why and then you have a couple of suicides, but this happens, in real life. Where one happens, then all of the sudden you hear about two or three more happening.
Dr. Daniel Amen: We're gonna talk about that in the next episode when we talk about the social aspects of suicide.
Tana Amen: So that would be more under social, not psychology?
Dr. Daniel Amen: That's a contagion that when you see someone else do a behavior, you're more likely to replicate the behavior, which is why you have to turn the news off in front of small children. Because if they see something like a school shooting and they've been angry and depressed, they're more likely to do something like that if they had seen-
Tana Amen: That's why it bothers me that they give it so much air time.
Dr. Daniel Amen: -it over and over again.
Tana Amen: I don't like it.
Dr. Daniel Amen: But suicide is often driven by distorted thinking. Let me tell you a story. When I first opened up the Amen Clinics in 1989, one of my favorite patients, I actually saw her a couple of times a week. Her name was Betty and she was chronically suicidal. And she used to freak me out, because I care about my patients! I worry. I don't want anybody killing themselves. That upsets me because my job is to prevent that, to help them. And every time she would start with the most vile, violent wicked way of killing herself, and she'd describe it to me in great detail. And every session with her, my heart rate was elevated because I was upset about it.
And then when I started scanning brains, she had low activity in the front part of her brain, and I hadn't figured it out until I scanned her. She has adult ADD. And she was using the negative thoughts, and my reaction, as a stimulant. So she was thinking about the most violent ways she was gonna kill herself, and one day I looked at her and I said, "You're no more gonna kill yourself than I am." And she goes, "What?" And I said, "You have five children. You love them. I know you love them. You know, if you kill yourself-" See, I'm not above guilt, right? I grew up Roman catholic. I had to pass Guilt 101, Guilt 201, Advanced Guilt, so I'm not above it. And I go, "You know, if you kill yourself you've just increased the chance of your children killing themselves 500%."
Tana Amen: Wow.
Dr. Daniel Amen: "So I think you talk about suicide as a way to stimulate your brain." And it's the first time I put together that people have untreated ADD are conflict-seeking, negative-seeking, excitement-seeking, but in her case she had learned that if she focuses on these suicidal fantasies ... And so literally she stopped it, and she didn't kill herself.
Tana Amen: But my question on that, which completely makes sense. You fix their frontal lobes-
Dr. Daniel Amen: Now, don't tell people that they're not suicidal. I'm an expert and I knew her really well, so I could do it. This is not a strategy-
Tana Amen: Be careful. Right.
Dr. Daniel Amen: This is not a treatment strategy.
Tana Amen: That's my question, though. For even if you are an expert. So fixing her frontal lobe, which makes perfect sense why then, of course, she's gonna have better forethought, better judgment, better impulse control. Okay. But does that actually help with what we were talking about, the psychology of her then not being actually suicidal? Like actually not feeling these negative urges?
Dr. Daniel Amen: Well, for the psychology part, what we want you to do is when you feel mad or sad, or nervous, or out of control, write down what you're thinking. So important. And learning how to correct the automatic negative thoughts that go through your mind. And they've actually found this treatment technique. It's based on CBT, or cognitive behavior therapy, is very powerful as a primary treatment for depression. Now you have to get the brain balanced, right?
Dr. Daniel Amen: So you have to strengthen her frontal lobes and there's all sorts of ways to do it from medication to supplements, treatments called transcranial magnetic stimulation, ketamine, which is one of the most effective treatments for suicidal patients. I've been very impressed by how quickly it can turn someone around whose brain has really gone to the dark place. But, at the same time, you're working on the biology, you have to work on the psychology, or disciplining your mind to feel better.
Tana Amen: Right, okay. So here's my question, as somebody who has been really depressed. Not suicidal, but really depressed. It's one thing if someone is actually voicing it and you know they're depressed. You know what's going on. It's not hard to spot someone who is depressed, but if for a lot of people who are depressed, I know like in my case, I didn't want to talk. I didn't want people to know. You try to hide. So you're not talking about it. You don't want to share it, because you don't even know what's wrong with you. You think it's your fault. You think you're lazy. All these weird thoughts go through your head, so you're really not talking about it to people. You're kind of hiding. It's almost like a shame thing.
Dr. Daniel Amen: And a lot of people do. I don't think many people knew that Anthony Bourdain was so depressed that he would kill himself.
Dr. Daniel Amen: Now, it's very important to understand that people kill themselves often when they're drinking, because say they've had the negative thought-
Tana Amen: Oh, drops judgment. Drops judgment.
Dr. Daniel Amen: And like I said, suicidal thoughts are actually pretty common, right?
Tana Amen: Or drugs. Drugs would make sense, too, then.
Dr. Daniel Amen: But if you have the thought, "I want to die." And then you drink a six-pack of Bud Light, it drops your frontal lobe so you act, not thinking about, "If I do this, it's gonna devastate my parents."
Tana Amen: So we're back to biology/psychology.
Dr. Daniel Amen: Biology, psychology ... All these four circles-
Tana Amen: Are connected.
Dr. Daniel Amen: -work together, all the time.
Tana Amen: Right, or in my case, even having low thyroid just made it impossible for me to focus.
Dr. Daniel Amen: Right. And so when your thyroid's low, the ANTs are high, right?
Dr. Daniel Amen: So just having a health biology helps to keep the ANTs under control. I was talking to one of my patient's this week about relapse, that if she doesn't eat for six hours, or eight hours, she has low blood sugar, more likely to relapse. More likely to kill yourself if you're not eating properly. I know, isn't that crazy?
Tana Amen: I know [crosstalk 00:10:48] I'm not ... I'm just not nice if I don't eat.
Dr. Daniel Amen: That's so true. Oh my god, that's so true. Thank you for saying that.
Tana Amen: I'm so grumpy when I don't eat.
Dr. Daniel Amen: So part of the psychological interventions I do with my patients, we kill the ANTs, the automatic negative thoughts, and then I purposefully get them outside of their head. Because what depression does is it causes you to go into a cocoon-
Tana Amen: That's what I'm talking about!
Dr. Daniel Amen: -and you're only thinking about yourself.
Tana Amen: That's what I'm talking about. You sort of hide. You internalize. You go away.
Dr. Daniel Amen: Right, and so I ... We just talk about if you do this, then let's talk about who is going to be affected by it. And a lot of times ... So we'll talk about their kids. We'll talk about their parents, we'll talk about the other people in their life, and the reality of who is going to suffer and let's just be clear, that suicide is often a very angry act. Where you're going to punish someone else. Not always, obviously.
Tana Amen: So that actually brings up a good point. I had a ... Those of you who have listened to our podcast, my upbringing, my childhood was anything but rosy, okay? But one thing that my mom did really well ... My mom was ... And for those of you who are well-bonded with your kids, or you're well-bonded with people in your family, my mom was really clear about how much she loved me. She was really bonded to me. She was ... I had no doubt in my mind. My mom would take a bullet. She would die or kill for me.
So that connection, that bond, is what ultimately was probably the thing that ever kept me from actually thinking the thought that I would kill myself. So that's just to put it out there. Those of you who have good bonds-
Dr. Daniel Amen: Well, that social connection, which we're gonna talk about is so important.
Tana Amen: And she was so good-
Dr. Daniel Amen: -And it's so protective.
Tana Amen: -and my mom was good about laying the guilt trip on, too. She was like, "If I didn't have you, I don't know what I would do. If something happened to you, I would have no purpose for living."
Dr. Daniel Amen: So from a psychological standpoint, get in touch with your connections-
Dr. Daniel Amen: -With your relationships. So I just try to give the reality of the situation to my patients that ... And I often ... I've said this I don't know, thousands of times throughout my career that suicide a permanent solution to a temporary feeling. Because almost everyone that's suicidal at one point or another, they're not chronically suicidal, that it comes and it goes.
Tana Amen: And as somebody who has been in that seriously dark place ... I mean, like a really dark place, you don't think you can get out of it. You don't think it's going to end.
Dr. Daniel Amen: It's the hopelessness, and that's actually the word that there are actually hopelessness scales that when people score high on hopelessness, they're vulnerable.
Tana Amen: It was hard for me to get out of bed, because I could not see a solution. I could not see a light at the end of the tunnel. I remember how awful it was. Just this weight on you. But I look back now. I will say, I look back now at that time and still to this day it scares me enough that I would like ... Anything. I will do anything to never go back there. That's why I take such good care of myself.
Dr. Daniel Amen: Well, and plus you know how much it would hurt me, and you also know how much it would hurt and devastate Chloe.
Tana Amen: No, no, no. I never think about suicide. I'm just talking about even being depressed.
Dr. Daniel Amen: Right. But you-
Tana Amen: I just can't.
Dr. Daniel Amen: But it's because-
Tana Amen: I take really good care of myself.
Dr. Daniel Amen: -And we'll get to this.
Tana Amen: But my point that I was making is that it can end and it can turn around be the best thing you've ever experienced in your life, but if you commit suicide, you'll never know.
Dr. Daniel Amen: Right. And we're not talking about someone who is terminally ill-
Tana Amen: No, no, no, no. That's different.
Dr. Daniel Amen: -who decides to end their life. But that's common. It's very common.
Tana Amen: That's a whole different thing though.
Dr. Daniel Amen: All right. When we come back, we're gonna talk about the social aspects of suicide, and I'm gonna give you one of the first papers I ever wrote. It's called the Target Theory of Suicide and How to Evaluate people. Stay with us.
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