(calm music)
- Lonely, really lonely.
And when you're depressed, man,
the only thing you can think about is yourself.
I did have a lot of people there for me,
but I was just pushing them away, you know,
not even giving them a chance.
- [Narrator] Every year, around 12 million American adults
think about suicide.
Greg Whitesell, star of the Arlee Warriors
high school basketball team
on the Flathead Indian Reservation, was one of them.
(crowd cheering)
Greg told two friends about his thoughts.
They acted quickly and likely saved Greg's life.
But for too many families and communities across the US,
suicide continues to take a tragic tool year after year.
- Every 11 minutes, there's a death from suicide.
We don't talk about suicide.
We don't talk about mental health enough.
- The CDC is approaching suicide as a public health crisis
because the rate in the United States has been on the rise
since about 1999.
- [Narrator] In 2021,
around 48,000 Americans died by suicide.
That's more than the number who died in car crashes,
and it's more than the number of homicides.
Suicide deaths impact every state, community,
and demographic group.
So what do we know about suicide?
And how can we do a better job of helping people?
Science offers some answers.
- It is really important to understand
that suicide has multiple risk factors
that converge, that come together,
things that relate to impulsivity,
aggression, experiences from the past,
adversity, trauma, abuse.
And it's not really ever going to be one issue
that causes suicide.
- There are a number of risk factors
that are both internal and external,
family history of suicide,
a prior suicide attempt, substance abuse.
And then there's these other pieces,
like unemployment, economic problems, financial problems,
relationship problems, legal problems.
All of these are risk factors
that put you at greater risk of suicide.
Again, it's important to remember
that most people can survive and live through those.
Some can't.
(light music)
- [Narrator] John Mann studies the brains
of those who suffered from depression,
as well as those who died by suicide.
His research shows that differences in brain structure
and function can contribute to suicide risk.
To find out how that happens,
he and his team examined serotonin,
a neurotransmitter that helps regulate
three important factors of suicide,
mood, decision-making, and sleep.
Specialized nerve cells, or neurons,
release serotonin into the brain.
Too few of these neurons, scientists once thought,
made depression and even suicide more likely.
They were in for a surprise.
- For years, we thought that depression
is due to a deficit of serotonin,
and when we actually went and tried to count
the number of neurons and look at the amount of serotonin
that was in those neurons,
we found, to our surprise, it's the opposite.
They have more serotonin neurons than the average person.
- [Narrator] But why didn't the extra serotonin neurons
relieve depression or reduce the risk of suicide?
In the brains he examined,
Mann found that the serotonin neurons
didn't function correctly in parts of the brain associated
with depression and suicide.
When the dysfunction occurred in both places,
the result could be tragic.
(light music continues)
- [John] What emerged in our early studies
was that one could actually see
a set of abnormalities that are related
to dying by suicide
and a set of abnormalities that related
to having a mood disorder.
And the two coincided in the depressed people
who died by suicide.
- [Narrator] Mann hopes to apply what he's learned
to catch abnormalities
before they can threaten someone's life.
But the behavior and beliefs of people
who die by suicide are also important to study.
- You and Morgan are in a postdoc office.
- [Narrator] Thomas Joiner's groundbreaking
interpersonal theory of suicide
identifies three common conditions
that can lead to a desire for suicide.
- [Thomas] Perceived burdensomeness is the idea
that everyone would be better off if you were gone.
That's the perception.
It's important to underline that word perceived.
Because they're mistaken about that.
- [Narrator] The second part of Joiner's theory
is called thwarted belongingness.
That's the idea that you are alienated from others
and hopeless that you'll ever reconnect.
Though he was surrounded by a loving family and friends,
Greg Whitesell was wracked by feelings
of loneliness and isolation.
- [Thomas] Thwarted belongingness is really just a long way
of saying loneliness.
They feel disconnected and alienated,
even if the exterior world around them is peopled.
- [Narrator] Joiner argues there's a third ingredient,
the capacity to go through with suicide.
- Suicide's hard.
It's very fearsome, physically difficult.
It's really, really against our natures
to stare death in the face,
and yet, that's what suicide entails.
- I was doing the best that I could,
but in that moment,
your mind is not working right, so.
- [Narrator] As we learn more about suicide,
healthcare professionals are better equipped
to identify patients at risk.
So are members of the public
who can play an important role in their communities.
Experts say, asking direct questions about suicide
is the first step.
- The critical thing is to ask them directly,
ask them very clearly,
"Are you thinking about suicide?
Do you just wanna die?
Do you not wanna live anymore?"
And I know that's really hard,
and I know people don't do this often
and they don't like to do it, they're uncomfortable with it.
Even doctors don't like to do it.
- [Narrator] Yet in some healthcare systems
across the country,
doctors and nurses from many fields of medicine
are learning to screen for suicide risk
by asking the question directly and routinely.
- [Doctor] In the past month,
have you had any thoughts of killing yourself?
- [Patient] Yeah, it's really upsetting me
and I'm starting to feel a little
like I wanna harm myself more.
- [Doctor] Okay.
- [Narrator] Some healthcare systems
are developing protocols to help people
when screening shows they are at risk.
Although screening alone can't prevent suicide,
it's an important component
of a broader suicide prevention plan.
(door slamming)
- Nice job, right, here we go.
- [Anna] When we talk about suicide out loud,
we give people permission to talk about it.
I have complete belief that suicide is preventable.
- Do you miss high school, bro?
- Because it's really about us
being able to give hope to other people.
And with the right education,
with the right awareness,
with the availability of resources,
giving people access, removing the stigma,
and doing it with kindness and hope,
we could prevent suicide.
(calm music continues)
- [Narrator] If you are considering suicide
or if you or someone you know is in emotional crisis,
please call or text 988 for confidential,
free crisis support.
(calm music continues)
(logo chiming)