Sunday, February 8, 2015

High Altitude and Suicide: Why So Many Kill Themselves in Mountain States

Many Americans fancy living in the mountain West,  especially those who enjoy the outdoors and activities such as hiking, skiing or just taking in the scenery. What most of these folks ignore is how the West has regularly topped the list of highest suicide rate - even earning the monicker of "the Suicide Belt". In addition, a list put out by the CDC barely ten days ago showed the West with the highest alcohol poisoning rate in the country.

What is it about the West that drives these statistics? Is it the wide-open spaces (relatively speaking)? As one writer put it:  "We not only live farther apart from one another, but our independent Western spirit prevents us from seeking help and support."  This is very true, and indeed, few males here in Colorado would ever admit to seeking or getting therapy or other psychiatric help. (Which may explain why the local military bases have some of the highest rates of domestic abuse and  other violence).

But that may not be the only reason. Guns are everywhere, and they are also a mark of western independent spirit. Go back to the pioneer days and understand how a gun - or guns - meant survival in the West. You needed a good rifle to be able to feed your family, e.g. with deer, and even today venison remains one of the favorite plates at many Denver restaurants.

But now, evidently, a new research paper may provide ballast for another explanation to account for sky high suicide rates. The paper, 'Positive Association between Altitude and Suicide in 2,584 U.S. Counties," published in 2011 in High Altitude Medicine and Biology, looked at every county in the U.S., and found a strong positive correlation between the average altitude of the county and the suicide rate. Counties that lied below 2,000 feet above sea level had an overall suicide rate that was about half that of counties lying between 4,000 and 5,000 feet in altitude. Counties above 9,000 feet had the highest suicide rate. And so on. This in spite of the fact that high altitude counties generally have a lower mortality rate from all other causes.

The authors note:

Prior reports of increased suicides in the U.S. Mountain Region have prompted speculation that the excess is owing to greater access to firearms, increased isolation, or reduced income. Even after controlling for these variables in our analysis, the positive correlation between altitude and suicide still exists, which suggests that the increased suicide rate in the regions with greatest altitude, such as the Mountain Region, may be owing to, at least in part, its altitude per se.

Colorado, by the way, brags of having the highest mean altitude of any state in the Union. Where we are in Colorado Springs, we are at about 6,200 ft. altitude - some 1,000 ft. higher than those in the "mile high" city of Denver. If you are flying in from the east, you feel it almost immediately and also are aware of having to force yourself to exert your lungs to inhale, and also the dizziness. You also notice it's more troublesome to get to sleep and stay asleep at night.

But why would this be so?  How could altitude lead someone to end his or her own life? Possibly through hypoxia, or lack of adequate oxygen to the brain, the phenomenon that causes us to get dizzy, or drunk faster, at high altitude.  As the paper's authors observe:

"Altitude is a well-known cause of hypoxia, and the greater the elevation, the greater the hypoxia. Chronic hypoxia also is thought to increase mood disturbances, especially in patients with emotional instability."

This phenomenon is evident in a lot of the folks who move here, with the intent to settle, then learn they erred and can't handle the lower oxygen conditions. Alas, many learn too late how adversely it's affected their mood. The rest of us who've moved here from the east (Maryland in our case) adjust and also realize we have to be proactive to cope - which means often consciously deep inhaling as opposed to half-inhaling, and also drinking water before we feel thirst. (Insufficient water intake is another reason for many problems)

Still, though altitude is a prime suspect in our depression and suicide rates, much more work in this areas needs to be done.  The authors admit that hypoxia's effect on mood is complex, and more study is needed. One of the researchers, at least, has continued that study, and thinks he's closer to solving the mystery. But there ought to be more than one in this case, and also investigating whether ingestion or smoking of pot - now prevalent in Colo. - exacerbates problems.

Stay tuned!

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