Biological Insights into Suicidal Depression

Growing research suggests that biological factors— many of which can be identified through lab tests—can significantly contribute to severe depression and suicidal ideation. Dr. James Greenblatt explains key lab tests that may help identify biomarkers associated with suicidal depression, helping medical professionals and families better understand and address the root causes of this condition.

Note: this article was written as a summary of the conversation between Dr. Kate Kresge and Dr. James Greenblatt on Biomarkers of Suicide Prevention, a Root Cause Medicine podcast episode that aired 10/01/2024. 

If you or someone you know is struggling with suicidal thoughts or a mental health crisis, please remember that help is available—dial 988 to reach the Suicide and Crisis Lifeline for immediate support. 

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Low Cholesterol and Suicidal Depression: A Potential Risk Factor

The brain is composed of about 60% fat, and cholesterol plays an important role in maintaining healthy cell membranes and producing hormones like estrogen and testosterone. While high cholesterol is commonly associated with cardiovascular risks, some studies suggest that low cholesterol levels may be linked to increased depression and suicidal thoughts.

When cholesterol levels drop below 120 mg/dL, there may be an elevated risk of severe depression and suicidality.

Dr. Greenblatt notes that addressing low cholesterol levels might involve medication adjustments, digestive enzyme support, or, in some cases, cholesterol supplementation. A simple lipid panel can help assess whether low cholesterol could be contributing to a client's mental health concerns. [3]

The Role of Omega-3 Fatty Acids in Supporting Mental Health

Omega-3 fatty acids, particularly DHA (docosahexaenoic acid), are important for brain function and may help support mood regulation. Research suggests that low omega-3 levels could be linked to higher rates of depression and suicidal thoughts. These essential fats are thought to help reduce brain inflammation and support the health of cell membranes involved in mood balance.

For those with low omega-3 levels, it is often recommended to aim for 3-4 grams per day through diet and supplements. An omega-3 or fatty acids blood test can help assess whether additional omega-3 intake may be beneficial. [6]

Vitamin D and Its Role in Mental Health

Vitamin D is important for overall health, and low levels may be associated with a higher risk of depression and suicidal thoughts. It plays a role in regulating serotonin, a neurotransmitter involved in mood regulation. Some studies suggest that individuals with low vitamin D levels may experience higher rates of depression and cognitive decline.

Testing for vitamin D is straightforward, and supplementing to address deficiency may help improve levels within 30 to 60 days. [1]

Lithium: A Natural Element That May Support Mood and Mental Health

Lithium, commonly used in the treatment of bipolar disorder, is also found naturally in trace amounts in water. Some studies suggest that even small amounts of lithium in drinking water could be linked to lower suicide rates. In functional medicine, low-dose lithium supplementation, such as lithium orotate, is sometimes used to help support mood balance and mental well-being, with fewer side effects than pharmaceutical lithium.

Hair mineral analysis can help assess lithium levels, providing practitioners with insights into whether supplementation may be beneficial. [4]

Inflammation and Suicidal Depression: Exploring Potential Contributing Factors

Chronic inflammation may play a role in various mental health conditions, including depression and suicidal thoughts. [5]

Inflammatory markers such as C-reactive protein (CRP), ESR, and ferritin can provide insights into underlying inflammation, which could result from factors like stress, autoimmune disorders, or gut health issues.

Research also suggests that trauma, head injuries, sleep deprivation, and infections such as COVID-19, PANDAS, EBV, and tick-borne illnesses may contribute to neuroinflammation. [5,7,8]

Testing for inflammation markers can help identify potential contributing factors, which may lead to supportive interventions such as anti-inflammatory supplements or addressing chronic infections.

Sleep Deprivation and Its Impact on Suicidal Thoughts

Sleep deprivation may increase the risk of suicidal thoughts. Chronic lack of sleep can trigger inflammation and elevate stress hormones, which may impair brain function and affect mood regulation. Even in acute cases, sleep is essential for recovery. Supplements that support sleep, such as magnesium or melatonin, may be helpful, and in some cases, short-term use of prescription sleep aids might be needed to re-establish healthy sleep patterns. [8]

Encouraging clients to prioritize sleep may help manage inflammation and support overall mental health, making sleep interventions an important part of a comprehensive wellness plan.

Using Lab Testing to Support a Whole-Person Approach

Taking a whole-person, root cause approach to suicidal depression involves looking beyond traditional psychological treatments and considering lab testing to uncover potential underlying physiological factors.

By assessing cholesterol, omega-3 levels, vitamin D, lithium, and inflammation markers, practitioners can gain insights that may help guide more personalized care and support overall mental well-being.

Lab Tests Available on Rupa

Labs for assessing cholesterol levels:

• Lipid Panel by Access Med Labs
• Cholesterol and Lipids Panel by Ayumetrix
• Lipid Panel Basic by Boston Heart Diagnostics

Labs for assessing omega-3 levels:

• Omega-3 and -6 Fatty Acids by Access Med Labs
• Omega-3 Index Complete by Mosaic Diagnostics (formerly Great Plains)
• Omega-3 Index Complete by Ayumetrix

Labs for assessing vitamin D levels:

• Vitamin D (25OH D2 & D3) by Doctor's Data
• Vitamin D by Ayumetrix
• Vitamin D, 25-Hydroxy by DHA Laboratory
• Vitamin D, 25-OH, Total by Access Med Labs

Labs for assessing lithium levels:

• Hair Elements by Doctor's Data
• Metals - Toxic + Nutrient Elements - Hair by Mosaic Diagnostics (formerly Great Plains)
• Cellular Nutrition Assay by Cell Science Systems

Labs to assess inflammation:

CRP/Hs-CRP:

• C-Reactive Protein, Inflammation (CRP) by Access Med Labs
• C-Reactive Protein, High Sensitivity (CRP, HS) by Access Med Labs
• High Sensitivity C-Reactive Protein (hs-CRP) by Boston Heart Diagnostics
• High Sensitivity C-Reactive Protein (hsCRP) by ZRT Laboratory

ESR:

• ESR by Empire City Laboratories Inc.
• Sedimentation Rate (ESR) by Access Med Labs

Ferritin:

• Ferritin by Access Med Labs
• Ferritin by Boston Heart Diagnostics
• Ferritin (FER) by ZRT Laboratory

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Prioritizing Comprehensive Care for Mental Health

Suicidal depression is a complex condition that requires a compassionate, holistic approach. While traditional mental health treatments are crucial, understanding potential biological factors through lab testing may provide additional insights into underlying contributors. 

By assessing markers like cholesterol, omega-3 levels, vitamin D, lithium, and inflammation, practitioners can help guide more personalized care that supports both mental and physical well-being. It’s important to remember that mental health is deeply personal, and different approaches work for different individuals. If you or someone you know is experiencing suicidal thoughts, seeking professional help is essential. With the right support, managing mental health challenges is possible.

Disclaimer: The information in this article is meant to provide insights into potential biological factors that may contribute to mental health challenges, including suicidal thoughts. However, it is not a substitute for professional medical advice, diagnosis, or treatment. 

Suicidal depression is a complex and deeply personal condition, and it’s important to seek guidance from a qualified healthcare provider if you or someone you love is struggling. Please remember, you are not alone, and support is available. If you are experiencing thoughts of self-harm or suicide, we encourage you to reach out to a healthcare professional or call a suicide prevention hotline immediately.

*Dial 988 for the Suicide and Crisis Lifeline