The American West is known for its dramatic landscapes and captivating natural beauty, and travelers from all over the world come to explore its deep canyons, high deserts, and craggy peaks. But amidst all the wide open space from Yellowstone National Park to Flagstaff Arizona and points between, there lies a sad truth.
Commonly referred to as the Suicide Belt, the eight intermountain states of the American West have a long documented legacy of increased rates of depression and suicidality. For many years, Colorado, Wyoming, Utah, Montana, Arizona, Idaho, Nevada, and New Mexico have reported suicide rates well above the national average.
Risk factors
As researchers continue to seek greater understanding as to this phenomenon, several key factors have been identified as contributing to the problem. The following list outlines several reasons why residents of the intermountain states may be at a higher list for suicide and/or depression:
- Rural terrain: The iconic American West is known for drawing those that seek solitude from the business of urban living. And living in an area where your nearest neighbor might be several miles away certainly affords a fair amount of peace and quiet. However, at the same time, all that space between neighbors can be extremely isolating, making it difficult to access resources in times of need. Urban living has been shown to be a protective factor in preventing suicide because the sheer presence of others, even strangers, can lessen feelings of loneliness.
- Poverty: In many communities in the intermountain states, poverty levels continue to exceed the national average. Poverty takes its toll on individuals and families, creating stress levels that make it difficult to function in healthy ways. Additionally, impoverished individuals may not have the means to access healthcare or mental health support when faced with depression or suicidal thoughts.
- Gun ownership: Rates of gun ownership are high in the American West, and having guns in the home puts an individual at increased risk for self-harm. A recent study from Boston University found a distinct correlation between those states that had higher rates of gun ownership and those states which reported the highest suicide rates per capita.
Oxygen and depression
Aside from the above sociocultural factors that have contributed to higher rates of suicidality and depression in the intermountain states, researchers have identified another factor that may impact how depression is treated in the future, especially in women. A study conducted by researchers at the University of Utah and Tufts University has documented that the thinner air at higher altitudes may be contributing to higher levels of depression seen in the mountain states.
In lab tests, female rats who were exposed to simulated higher levels of altitude exhibited an increase in depressive behaviors and symptoms. This is thought to be related to the way that oxygen interacts with the brain, with the rats experiencing a condition called hypoxia in which the brain does not get sufficient levels of oxygen. When oxygen is limited, the brain’s production of serotonin, the brain chemical responsible for eliciting feelings of happiness and well-being, is interrupted. As serotonin levels dip, an individual becomes more susceptible to depression.
Interestingly, male rats showed no dip in serotonin levels when experiencing the same lower levels of oxygen. This is thought to be due to the fact that male mammals naturally produce more levels of serotonin than female mammals do, making them more insulated to brain chemistry changes that could be brought on by fluctuations in altitude and oxygen exposure.
Implications for treatment
In 2007, the state of Utah had both the highest rates of antidepressant use as well as the highest suicide rate per capita. This fact clearly indicates that selective serotonin reuptake inhibitors (SSRIs) like Prozac are proving to be insufficient in combating the effects of depression that can sometimes lead to suicide. And while the study described above has several limitations, it does bring to mind some important questions about the way depression is treated in high altitude states, especially in women.
Researchers are exploring the effectiveness of antidepressants such as (SSRIs) in the Rocky Mountain States because they posit that the positive impact of these drugs may be limited if prescribed to individuals experiencing the effects of hypoxia. If indeed the lower levels of serotonin found in the brains of residents of high altitude areas renders drugs like SSRIs ineffective, it will be vital to rethink the ways that pharmaceutical intervention is used in the intermountain states.
In light of these findings, researchers are suggesting that it may be necessary to find ways to boost the levels of serotonin, especially in women’s brains, in order for them to experience relief from symptoms of depression with the use of SSRIs.
At Sierra Tucson, we provide residential treatment for adult men and women who are suffering from depression and other co-occurring disorders. With an emphasis on family, and a whole-person approach to treatment, we are your respite for healing in Tucson, Arizona. If you or a loved one is interested in learning more about beginning the path to recovery at Sierra, Tucson, we encourage you to contact us today.
