New Research Shows a Link Between Chronic Illness and Attempted Suicide in Young People
Both Crohn’s disease and ulcerative colitis can trigger life-threatening complications that may require surgical intervention. According to Statistics Canada, suicide is a major cause of impulsive and preventable death. It is one of the leading causes of death among individuals of all ages and it represents a large portion of death among young individuals between the ages of 15-30. In 2009, it was ranked the 9th leading cause of death in Canada. Research shows that mental illness is a major contributing risk factor for suicide, with over 90% of individuals committing suicide due to having a mental or addictive disorder. Other contributing risk factors include divorce, financial burden, a major loss, lack of social support, and deteriorating health.
New research
According to a new study, “Suicidal Behaviour among Adolescents and Young Adults with Self-Reported Chronic Illness”, young individuals between the ages of 15 and 30 who live with a chronic illness, such as inflammatory bowel disease (IBD), are three times more prone to attempt to take their own lives. For one year, patients’ suicidal thoughts and behavior (STB) were measured using the World Health Organization Composite International Diagnostic Interview, all the while making relevant changes in accordance with health and sociodemographic traits. In order to examine potential moderating effects, substance uses was also taken into consideration.
Published in the Canadian Journal of Psychiatry, the study aimed to identify suicidal thoughts and attempts in a trial population of young individuals with chronic illness. It also aimed to reveal the connection between STB and chronic illness as well as the role of substance use in altering mood. Researchers from the University of Waterloo gathered evidence to suggest that chronic conditions such as Crohn’s disease or diabetes may also amplify a young individual’s thoughts on suicide by 28% and plans to die from suicide by 134%. In fact, it was uncovered that having a chronic condition raised attempt of suicide by 363%.
“Evidence suggests risk for suicide attempts is highest soon after young people are diagnosed with a chronic illness. There is a critical window of opportunity for prevention and continued monitoring,” said Mark Ferro, professor at Waterloo’s Faculty of Applied Health Sciences. He continued, “having a chronic illness may increase the risk for the development of psychiatric disorder, which in turn, increases risk for suicidal thoughts, plans, and attempts. Having both a chronic illness and psychiatric disorder has a compounding effect, further increasing the odds of suicidal thoughts.”
Comorbidity with mood disorders
Results from the study indicated that suicidal thoughts and behaviors (STB) among young individuals with chronic illness is occurring, particularly among those with comorbid mood disorders. The study supports the idea that healthcare professionals need to further examine the connection between psychiatric disorders and chronic illness in order to create appropriate preventive measures. Moreover, they need to routinely ask and pay attention to suicide thoughts and behaviors among young individuals during initial and follow-up visits. “For many young people with chronic conditions, their physical illnesses take precedence in doctor’s visits, leaving little, if any, time for mental health concerns. While the idea that there is no health without mental health is becoming more pervasive, we still have a long way to go” said Ferro.
Mental health is as important as physical
Mary Horsley, columnist for IBD News Today, is an example of a Crohn’s disease warrior who speaks out about both the physical and mental aspects of IBD and how unreliable the condition can be. In her series “Crohn’s Disease Health”, she talks about how her condition affects her mental health. “From not being able to do things or participate with friends to being invited to events and spending that time worrying, IBD can affect mental health as much as physical health. After a new IBD diagnosis, or even years into a treatment, struggling with your own physical health and living with an unpredictable chronic illness can affect mental health. Stress, anxiety, depression, PTSD, hypervigilance, cognition response decline: Each can come because of IBD and each patient’s personal struggle with it,” said Mary.
Mary shares how every medication, every flare-up, and every invasive procedure can make any individual with a chronic illness feel anxious and worried. Eventually, it is these mental symptoms that may cause an individual to take his or her own life. “With IBD, a state of hypervigilance can become the norm, as you not only notice things more readily about your symptoms and body, but also you’ll likely to be unable to take your attention from it. And while hypervigilance can be seen as normal in certain situations, it’s not healthy for the body or mind to spend too long in a hypervigilant state of worry, putting many patients at risk for PTSD. IBD and the effects on patient mental health can disrupt sleep, or cause a lack of it. IBD can lead to and cause avoidance behaviors, health unreliability and it can make you antsy as well as anxious. Being on high alert and worrying all the time can be more than exhausting” said Mary.
The importance of self-care
In her column “It Could Be Worse”, Mary shares her personal experience with living with a chronic illness, such as Crohn’s disease. She too, feels anxious and frightened that her physical state is affecting her mental state; however, for her, ‘it could be worse’. “We are not unreliable, but our IBD is. Canceling plans does not make us unreliable, but rather our energy level is. Staying home does not make us unreliable, but rather our health is. Taking care of ourselves should come first,” said Mary.
“I and other Crohn’s and colitis warriors are on constant alert with fear and anxiety for our bowels and our bodies. I still get scared for accidents and anxious for finding the right medications. I will be forever worrying about another abscess or painful surgery, worried for inflammation or worried about waking up again during a scope. My emotional well-being has easily been through just as much as my physical health with my own Crohn’s diagnosis.I cannot offer medical advice, I can only share what I know from my personal experiences. Remember, my Crohn’s disease is individual for me, and what works for me may not necessarily work for you,” said Mary.
If you are living with a chronic condition such as Crohn's or ulcerative colitis, remember one thing: You come first. From diagnosis through treatment, your mental health is just as important as physical, and they go hand-in-hand in making you feel better or worse.
References
https://ibdnewstoday.com/ibd-overview/
http://www.statcan.gc.ca/pub/82-624-x/2012001/article/11696-eng.htm
http://journals.sagepub.com/doi/10.1177/0706743717727242
https://ibdnewstoday.com/2017/07/21/crohns-disease-health-physical-effects-impact-life/
