High Altitude Risk Factor for Mood Disorders, Suicide

The Western states, with Utah leading the way, have some of the highest suicide rates in the country. Many factors have been used to try to explain the phenomenon, but one seems to provide the answer: altitude.

An interesting and troubling paradox exists in the Western U.S. These beautiful, rugged and mountainous states are often cited as wonderful places to live. Residents love the fresh air, scenery and natural beauty, as well as the ample opportunities to be outdoors and active. But according to government data, Utah has disproportionate rates of mood disorders and suicide attempts. It is also the state with the highest use of antidepressants. Other Western states, including Montana, Idaho, Colorado, Wyoming, Nevada and Oregon, are not far behind and also have high suicide rates compared to other states. Rates of suicide in these states are greater than 14 per 100,000.

Being at the top of the list, the incidence of mood disorders and suicide has been a big subject of debate in Utah. Contributing factors that have been cited include Mormon influence, rate of gun ownership, poverty and a low population density. While these could contribute to the greater rate of suicides, a new idea is emerging. Many experts believe, and have done the studies to back it up, that high altitude is a risk factor for mood disorders and therefore for being suicidal.

Mood and High Altitude

The Western states with higher than average suicide rates include high-altitude areas in the Rocky and Sierra Nevada mountains. When factors that could explain the high suicide rate are compared, altitude comes out on top. One study looked at all the possible factors, including gun ownership, density of population, health insurance, availability of mental health care, poverty and altitude and analyzed how they were linked to suicide. Altitude showed the strongest connection. This is just one of several studies that have made the connection, and now researchers are trying to find out why.

The answer is likely related to brain chemistry, as it is chemical imbalances that cause mood disorders like depression. Air at higher altitudes contains less oxygen than that at lower altitudes. Hypobaric hypoxia, also known as altitude sickness, is caused by the lack of oxygen at high altitude. Symptoms include nausea, headaches and a lower tolerance for alcohol. This condition has been studied thoroughly as far as physical symptoms go, but few have looked at the mental health impacts of low-oxygen air.

Researchers are just starting to examine the effects of oxygen-weak air on brain chemistry at high altitudes. Some think that low-oxygen air causes changes to levels of brain chemicals. Serotonin levels go down. This is a chemical that helps to regulate mood, and antidepressants work by keeping serotonin levels high. Low-oxygen air may also cause dopamine levels to go up. Dopamine makes us feel pleasure, which may explain why some people feel euphoric at high altitudes. Why some see a serotonin drop and get depressed while others get a dopamine high and feel happy is still a mystery. One idea is that altitude exacerbates existing mood disorders, leading those who are vulnerable to them to become suicidal.

The mystery and paradox of suicide in the beautiful Western states of the U.S. may be close to being solved. Experts are on the trail of the increased incidence of mood disorders and suicide, but more work is needed to prove the existing ideas. When more research has been done, professionals should be better able to screen, diagnose and treat those people vulnerable to the negative effects of high altitude.

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