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By the time you finish reading this article, a person somewhere in America will have committed suicide.

If you read this article again a year from now, nearly 50,000 people will have died by their own hand.

And there are more tragic statistics to consider—and to compel new, more effective action to save lives that will otherwise be lost…

Between 2000 and 2021, the rate of suicide in the U.S. increased by 36%. Emergency room visits for suicide among pediatric patients and young adults increased by 5-fold from 2011 to 2020. All told, suicide is now the 2nd leading cause of death in people aged 10-14 and 20-34; the 9th leading cause of death among those aged 10-64; and the 11th leading cause of death overall.

Clearly, we are in a crisis, as acknowledged by many organizations, from the National Bureau of Economic Research (The Re-Emerging Suicide Crisis, 2023) to the U.S. Department of Health and Human Services (HHS), which just released its 2024 National Strategy for Suicide Prevention, calling suicide “an urgent and growing public health crisis.”

But there are actually two crises occurring:
1) the rising suicide rate; and
2) the stark ineffectiveness of conventional methods to turn the tide.

Just look at the HHS report. It offers more of the same. The same hotlines…the same type of screening…the same infusion of money into programs that were already in place as the suicide rate was rising over the last two decades.

Clearly, we need new solutions to address the suicide crisis. We need new solutions to address, and help, each individual with “suicidality”—people with suicidal thoughts, plans, or attempts. That’s 13.2 million adults, according to the Centers for Disease Control and Prevention. Those solutions are available. And they are available NOW.

Functional Psychiatry:

The Biology of Suicide Prevention

Mainstream psychiatry uses psychotherapy and medications to reduce suicide risk, with little success. In contrast, functional psychiatry identifies and acts upon specific biomarkers that predict suicide risk. In fact, these biomarkers can distinguish between those at-risk patients who are more likely than others to cross whatever invisible threshold separates ideation from attempt. With functional psychiatry, you can test for these biomarkers—and know which of your clients are at greater risk for suicide. And you can then treat the imbalances that contribute to the risk.

This is a new and largely overlooked model for suicide prevention—a model I’ve used with my own patients for years, effectively reducing and preventing suicide. Bottom line: today’s clinicians now have objective, scientifically validated instruments they can easily wield to combat the suicide epidemic. Let’s take a look at just two of these many possible interventions.

Low Cholesterol: Fat Is Essential

Scientific data shows a robust connection between low cholesterol and suicide—a relationship that has been largely ignored.

For example, a study of more than 500,000 people showed that, compared to those with the highest level of total cholesterol, those with the lowest level had a:

  • 112% higher risk of suicidal ideation
  • 123% higher risk of suicide attempt
  • 85% higher risk of suicide completion

Other research shows that low cholesterol is specifically linked to increased suicide lethality. In one study, postmortem analysis of the brains of 41 suicide completions revealed that those who died by violent suicide (such as by firearm, hanging, drowning, or wrist cutting) had significantly lower levels of cholesterol within their gray matter than those who died from non-violent suicide (such as by drug overdose, carbon monoxide poisoning).

And in a 10-year study of 150,000 people, every 10 mg/dL drop in the average total cholesterol increased the risk of suicide death by 18%. This pattern held for cholesterol readings each year—meaning low cholesterol levels in years immediately preceding suicide were significantly linked to an increased risk of suicide death.

In my more than three decades of clinical experience, patients with the lowest total cholesterol display the most severe symptoms of aggression, impulsivity—and suicidality. And these cholesterol values are frequently unrelated to dietary intake. What this suggests is that there are genetic and/or metabolic components to cholesterol digestion and absorption that affect cholesterol status—and these factors contribute to the abnormal values I see in so many of my psychiatric patients.

Yet, while the scientific literature (and my clinical experience) clearly shows that low cholesterol raises suicide risk, there is not a single published study that explores raising cholesterol for suicide prevention or treatment.

Why does low cholesterol have this negative effect? Because the dry weight of the human brain is nearly 60% fat! Because the membranes of every cell of our bodies—including our neurons—are up to 80% fat. Because steroid hormones like cortisol and aldosterone, androgens like testosterone, and estrogens like estradiol, cannot be synthesized without fat. Fat deficiency is the strongest of any biological risk for suicide. But it’s far from the only biological risk.

Nutritional Lithium: A Low Dose Can Work

Lithium—an essential mineral, and one of the oldest substances in the known universe—has been present in soil and groundwater since the dawn of life on this planet.

Research consistently demonstrates that where lithium concentrations in the soil are high, rates of mental illness, violent crime, substance abuse—and suicide—are low. However, where lithium concentrations are low, the rates of the same phenomenon are higher.

In fact, more than a dozen epidemiological studies have investigated the relationship between groundwater lithium concentrations and local suicide rates—and found the correlation is inverse. The higher the lithium content, the lower the suicide rate.

In my clinical experience, low-dose nutritional lithium (a mere 1-20 mg daily of lithium orotate) promotes healing in the brain, particularly in people with suicidality (and a family history of substance abuse and suicidality).

As I said, there are many other comparable biologic risk factors, like omega-3 fatty acids and vitamin D.

Embracing A New Model

Today’s medical model of suicide prevention is fundamentally limited. If it weren’t, there wouldn’t be a suicide crisis, with rates rising more than 30% in the last two decades. Rather, there would be a steady decrease in suicides. Obviously, what we are doing is not enough. An overhaul of the current paradigm of suicide prevention is urgently necessary.

Of course, suicide is a complex, multi-factor phenomenon that requires a comprehensive, effective model of screening and prevention. But that model of suicide prevention must be inclusive of a well-researched biological approach, which acknowledges scientifically established correlations between biologic imbalances and suicidality—and can identify individuals with the highest level of risk. We must test for the biomarkers of suicidality—and treat those biomarkers if they are imbalanced.

There are two ways you can combine yourself with this new paradigm:

Want to learn more functional medicine approaches to help your patients? Enroll now in our certified Fellowship for professionals. Book a private call with Dr. Greenblatt to explore the program and available scholarships!

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