Denver -- The "Mile High City"

Steve Winwood & Chaka Khan
"Higher Love"

Orchid's collection of information on the suicide / Altitude Dispute

High Altitude & Sky high Suicide Rates

​Conjecture

​Val's Take

Altitude

           Something appears to be going on with Depression/Suicide and Altitude in Mountain States and in fact in high altitude places around the world.

            But the argument from some researchers isn't really that this is affecting the population uniformly, rather it seems to MAGNIFY biological aspects of some people with some kind of predisposition to mood disorders.

            That "predisposition" may include neuro-developmental inflammation.

              This also gets to this idea of the most recent discoveries of researchers that "social behavior" is a DELICATE BALANCE between our INNATE & ADAPTIVE IMMUNE SYSTEMS.

​What I Think:  The BIG KAHUNA of factors is Neuro-Developmental Inflammation.

Altitude is just one of many, many factors that can pile on the neuro-inflammatory load.

When we're talking about DELICATE BALANCES of INNATE & ADAPTIVE IMMUNITY --- I think Altitude is a big player in why Colorado and other high altitude regions have higher suicide rates.

But it may be the STRAW THAT BROKE THE CAMEL'S BACK rather than the major source of NEURO-INFLAMMATION.

Suicide and High Altitude: An Integrative Review (2018)

​Conclusion:
"These research studies published since 2009 support an association between high altitude and suicide rates at the state or county level, but do not provide sufficient data to estimate the effect of high altitude on an individuals' suicide risk.

"Although the impact of hypoxia on mood and depression has been hypothesized to be a contributing cause, many other individual factors likely play more important roles."

The Altitude Dispute​

Well, there is a dispute brewing within the medical research community regarding the importance of altitude & low oxygen in depression & suicide:

• ​CU medical grants that there are greater suicides but does not attribute them to "low oxygen"

https://www.cuanschutztoday.org/researchers-find-little-association-between-suicide-and-hypoxia/​

• On the other hand, Harvard Review of Psychiatry, does see a connection between depression, high altitude & low oxygen.

​https://www.ncbi.nlm.nih.gov/pubmed/29517615

This is complicated stuff, and it's very individual -- CU's pronouncement seems pretty premature.

Time will tell. 

---

​Summit County Doctor Says Sleep Apnea A REAL RISK FACTOR for Mental Health Problems for People Living @ Altitude

Summit Daily News
Excerpt:  Feb. 15, 2018

​Dr. Rosen believes that there may also be some physical reasons for poor mental health in the mountains.

One concern he highlights is "nocturnal oxygen desaturation," or low oxygen levels during sleep because of conditions such as central sleep apnea.

That lack of oxygen and poor sleep may lead to psychological issues down the line.

"Sleep apnea is a hidden danger, and a real risk factor for people living at altitude," Dr. Rosen said. "It causes fatigue, low energy levels and can also lead to depression, anxiety and other emotional problems. But we don't know enough about it, and we really need to."

Dr. Rosen added that those mental health issues, whether environmental or biological in nature, might lead to dangerous behaviors such as binge drinking.

https://www.summitdaily.com/news/the-longevity-project-part-3-despite-nation-leading-longevity-colorado-mountain-communities-face-significant-health-challenges/

Mental Health & Sleep Apnea: ​

When the Coping Mechanism You Need is
OXYGEN --
​There Really Is No Substitute

Click Here

See Val's blog

Altitude, Mental Health, & the "Highlanders" of Tanzania & Colorado

          Well, Colorado in 2014 had another record high year in suicides.
           From our perspective, we need to integrate into our mental health/physical health integrated health program initial screenings on concerns related to Altitude and Sleep Apnea.
           Altitude has been recognized as a factor in mental health problems (certainly not the only factor) and we aren't the only place in the world that is having to deal with this.
            Like us, Tanzanians are aware of the research and have recognized altitude as a factor in mental health concerns, especially for "Highlanders."
             Of course, living in the Mile High City or thereabouts, even us city dwellers are "Highlanders."
             For Colorandans, we need to take a pro-active approach on this front and many others.

excerpts from
medicinenet.com

"Once you get to somewhere between 2,000 and 3,000 feet, you start seeing the suicide rates increase," explained study author Dr. Barry E. Brenner, a professor of emergency medicine and internal medicine, as well as program director, in the department of emergency medicine at University Hospital Case Medical Center in Cleveland. "The correlation is very, very, very high, and it happens in every single region of the U.S."

"And yet as you go up in altitude the overall death rate, or all-cause mortality, actually decreases," Brenner noted. "So, the fact that suicide rates are increasing at the same time is a really significant and really striking finding."

Even after adjusting for traditional risk factors such as age, race, household income, population density, and gender, the authors found that suicide rates (whether involving a firearm or not) were significantly higher than average in those counties with higher altitudes.

Even after adjusting for greater isolation, lower income and greater access to firearms, the findings remained statistically significant, the authors said.

In contrast, those same locales defined by relatively high topography were not home to the highest rates of death due to any and all causes. In fact, higher altitude counties actually registered lower than average death rates due to all causes.

This latter finding actually highlighted the strength of the apparent connection between suicide risk and high altitudes, the research team said.

Meanwhile, the research team suggested that their findings might help draw attention to residents of higher elevations who could benefit from relocation to lower altitudes and/or suicide monitoring and prevention services.

Last fall, Dr. Perry F. Renshaw, a professor of psychiatry at the Utah School of Medicine and an investigator with the Utah Science Technology and Research (USTAR) initiative, led a similar study that reported a correlation between high altitudes and higher suicide rates.

His work -- published in the American Journal of Psychiatry -- also crunched 20 years' worth of data provided by the CDC. That effort revealed that nine states in the so-called "Intermountain West" region of the country (Montana, Idaho, Wyoming, Utah, Colorado, Nevada, New Mexico, Arizona and Oregon) all ranked among the top 10 states in the nation in terms of suicide rates.

Noting that these states have some of the highest altitudes in the country, Renshaw's analysis concluded that high altitude seems to be an independent risk factor for suicide, particularly among people already prone to depression and mood disorders.

"But for those people with pre-disposing factors to suicide, like depression and emotional distress, there really appears to be something quite pernicious about living at a higher altitude," he concluded. 

http://www.medicinenet.com/script/main/art.asp?articlekey=124856

See also:
Thin Air Might Increase Depression in Mountain States
https://www.livescience.com/50813-low-oxygen-increase-depression.html​

http://www.nbc11news.com/home/headlines/Mesa-County-suicide-rates-on-the-rise-321842682.html

Positive Association between Altitude and Suicide in 2584 U.S. Counties
High Altitude Medicine & Biology (April 2011)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114154/

Mt. Kilamanjaro, Tanzania

the Theory

It all boils down to chemistry. The research, led by a scientist from the University of Utah, suggests that oxygen levels at altitude have an impact on our individual brain chemistry. 

The lack of oxygen, according to the study, leads to a drop in serotonin, a neurotransmitter that helps stabilize emotions. 

Researchers found that thin air also leads to a rise in dopamine, which is often associated with the "pleasure center" of the brain. 

As the theory goes, people predisposed to mental illness are more likely to develop a mood disorder, because they are more sensitive to decreasing serotonin levels at high altitudes. 

On the flip side, those without a predisposition are less likely to be depressed and feel happier as the brain produces more dopamine.

http://www.koaa.com/story/28896382/study-altitude-linked-to-suicide-and-depression#.VTvUUHP0EBc.facebook

Val's Take
          Are Altitude and Sleep Apnea the only factors in mental health concerns, of course not.  If we started taking those into account in a systematic way, could we save the State beaucoup Dollars and its citizens untold Suffering, I believe so.
           What are we waiting for?