מאמר מדעי שחר 14 דקות

Okay, so let's talk about suicide. Okay. It's, well, it's obviously a really sensitive subject, but super important to understand, especially in the context of mood disorders. Right. Right. And you sent over some research on this. Yeah. And I got to say, I found it really interesting, so I'm ready to kind of dive in here with you if you are. Yeah. No, absolutely. And, you know, it's a complex area, and I think one of the things that's really important is to kind of move beyond that, I guess, that common link, but maybe simplistic link between depression and suicide. Yeah. You know, it's interesting you say that, because I think, like, we're so used to thinking of, like, depression as this main driver. Yeah. But this research really kind of points to all these other things, all these internal factors that might be setting off this whole chain of events. Yeah. Exactly. And that's where I think self-criticism comes in, not just as a symptom, which we hear about a lot, you know, in mood disorders, but potentially, as you say, this kind of key driver. Okay. So just to be clear, we're talking about a very specific type of self-criticism, right? Right. It's not just, like, oh, I want to do a good job. This is, like, that really hardcore inner voice that's setting these, like, crazy high standards, and then when we don't meet them, which, like, duh, we're human, it just tears us down. Yeah. Totally. It's really that harsh self-judgment that sets it apart from, say, you know, perfectionism. Oh. Like, you might have a friend who's a perfectionist, right? He's always striving, got to be the best, which, you know, isn't always a bad thing in itself. Sure, sure. But imagine that same friend constantly berating themselves for every little mistake. Oh, yeah. No, that's different. And that's what we're talking about here, that really negative self-criticism. And the research actually shows it's a much stronger predictor of, like, actual negative outcomes, more so than just perfectionism on its own. Okay. Yeah. That makes sense. I mean, we all know how much that inner critic can just, like, eat away at you, right? And I think what really stood out to me in this research was how self-criticism, it's not just how we feel about ourselves, it's how we then interact with the entire world around us. Yeah. No, absolutely. And I think that's a really critical insight, because it helps us see why this self-criticism thing is so powerful. It really colors how we see everything, stressful events, you know, even good things, even support from other people. Right. And you even sent me that study. It was about the congruency hypothesis. And I have to admit, like, some of the findings there were kind of surprising, at least to me. Can you kind of walk us through that a little bit? Yeah, yeah. So basically, the congruency hypothesis kind of predicted that people who are more prone to self-criticism would be hit harder by, you know, experiences of failure. Yeah. And that this would lead to kind of, like, more severe depression. Okay. So that makes sense, right? Right. Like, if you're already being hard on yourself, and then something bad happens, it's like, well, of course you'd spiral even more. Exactly. Seems intuitive. Right. Right. But, and here's the thing, that's not what they found. Oh. Yeah. It turned out that self-criticism, it wasn't just a response to failing, right? It was actually triggered by all sorts of stressful stuff, big stuff, small stuff, like, didn't really matter. And what's even more interesting is there's some evidence that self-criticism might actually contribute to more stressful experiences. So it's like this vicious cycle. Wow. So not only are you harder on yourself, but you're more likely to end up in situations where you feel like you need to be hard on yourself. Exactly. Oh, that's rough. It is. It is. And then on top of that, and this is kind of amazing, I think the research suggests that self-criticism can also make it harder to benefit from the good things in life. Really? Yeah. So think about it. Imagine having a good friend, super supportive, you know, they're there for you. Right. Offering a shoulder to cry on. Exactly. You know, when you're a critic, that voice in your head, it's like, no, you don't deserve that. It's just a pretending. Yeah. Yeah. Or I don't know, you achieve something you've been working towards. Like a goal. Yeah. A goal. But instead of celebrating, you just focus on all the ways you could have done it better. Yeah. I know that feeling. And that's kind of the insidious thing. It's like this barrier to connection to actual happiness. It is. And is that where I think I remember this being a big thing in the research, this whole idea of ruminative brooding, like how does that play into this? Yeah. Ruminative brooding. Right. It's that tendency to just get stuck, stuck in these negative thought loops. You're replaying stuff, past hurts, failures over and over. And I mean, we all do it to an extent. It's normal. Oh, for sure. Yeah. But for people who are really struggling with this self-criticism thing, it can become well, it can take over everything. It's like a broken record player. Yeah. And what the research shows is that this type of thinking, this rumination, it can really poison relationships. Oh, interesting. Like you start feeling like a burden, like you said. And it makes it harder to form new relationships, new connections, the kind we all need. And that brings us to the interpersonal theory of suicide. I think you mentioned that earlier, but can you, can you unpack that a little? Like how does self-criticism fit into all of that? So we've got self-criticism feeding this cycle of negativity and then that impacts our relationships. And then all of that increases these feelings of being a burden, of not belonging. And I'm seeing how this all kind of ties into the interpersonal theory of suicide, but can you remind me, like how does that theory work again? Sure. So interpersonal theory of suicide, basically it proposes that when someone feels like a burden, like they're just weighing everyone down and at the same time feels really disconnected, really alone, their risk for suicide goes way up. So it's like this double whammy. Yeah, exactly. It's this terrible combination of feeling trapped and totally isolated at the same time. And what's so interesting to me is that we can trace that sense of being a burden, of not belonging, like at least part of it goes back to that self-criticism thing. It's like this hidden vulnerability that has all these ripple effects. I think that's a great way to put it. And then on top of all that, we have this fascinating link to inflammation, which you highlighted in your research. Okay. Yeah. This is where I was like, wait, what? I'll be honest. When I first saw inflammation, I thought like, did I open the wrong study? Am I reading about arthritis now? What does inflammation have to do with all of this? I get it. I totally get it. Most people, they think of inflammation like a sprained ankle, you know? Right. Or an infection. Exactly. But we're talking about systemic inflammation and that's kind of a different beast. Okay. So like inflammation throughout your whole body? Yeah, basically. It's your body's response to stress, but it's not just physical stress. It's emotional stress too. Okay. So walk me through it. How does that work? How does stress cause inflammation? So picture this. Your body's like a giant communication network, right? Okay. And when you experience stress, any kind of stress, your body, it releases these proteins. They're called cytokines. And you can think of them like little messengers, like Paul Revere or something. The alarm bells are ringing. Exactly. They're telling your immune system, hey, gear up. We got a threat to deal with. That makes sense. And in the short term, this is all good. This is how your body's supposed to work. Right. It helps you heal. It helps you heal from injuries, fight off infections, all that good stuff. But here's the catch. When you're dealing with chronic stress, those alarm bells, they just keep ringing and ringing. And it's like your body's stuck in overdrive. Exactly. Stuck in fight or flight mode. Oh, wow. And all that chronic inflammation, it can actually start messing with your brain. Really? Yeah. Especially those areas that deal with mood, motivation, decision-making, all the important stuff. So my mental state can trigger this biological response, which then makes my mental state even worse. Exactly. It's like this vicious cycle. And are there studies that show that this is really happening? That inflammation is linked to suicide risk? Oh, yeah. Absolutely. There are actually studies where they've induced inflammation in people and it led to more depressive symptoms, even suicidal thoughts. Hold on. Wait a minute. You're telling me they can make someone depressed by giving them inflammation? Well, it's not quite as simple as that. They trigger it in a very controlled way, usually with an injection, something the immune system will react to. Okay. So it's ethical. Yes. Of course. Of course. And it's temporary. It's not like they're giving people chronic inflammation. Oh, okay. But it's enough to see how these systems interact. And what they're finding is, yeah, even a little bit of inflammation can have a noticeable effect on mood. That is wild. And I guess it really underscores how connected our mental and physical health are. Absolutely. And there's more. There's something called a dose-response effect. A dose-response. Yeah. So basically, the more inflammation they induce, the worse the depressive symptoms got. So it's not just a correlation. It really seems like there's something causal there. Exactly. And it's not just these experimental studies, either. There are post-mortem studies. They look at the brains of people who have died by suicide and they consistently find higher levels of inflammation in those individuals, especially those with depression. Wow. So this is actually happening in the brain itself. This is heavy stuff. Okay, so before we get to the what now of all of this, there's one more thing from the research I wanted to make sure we cover. The Katz-Pritzker study, I think it was called, seems like it kind of ties all these threads together. It does. Yeah. The Katz-Pritzker Suicidal Depression Project. It's a huge study, really ambitious, and they're doing it longitudinally, so they're following the same people over a long period. And what they're tracking is amazing. They're looking at depression, self-criticism, inflammation, all these different factors and how they interact. It's like a scientific soap opera, right? We get to see how these characters, the self-criticism, the inflammation, our relationships, how they all play off each other. Huh. I like that. And just like a good soap opera, it's got layers and layers. So break it down for us. Who are they actually following and what are they measuring? So they've got three groups of people. People with depression who've had suicidal thoughts or behaviors, people with depression who haven't, and then a control group, people with no history of mental illness. Okay. So they can compare them and see how they're different. Exactly. And they're collecting data in waves, five different points in time, spaced out over a couple of years. So they're not just getting a snapshot, they're seeing how things change over time. Exactly. And in the first three waves, they're really digging deep into the psychology, the social stuff. So like personality traits, stressful life events, what their relationships are like, whether they feel supported or like a burden. You got it. They're painting this really detailed picture of each person's life. Wow. And then in the last two waves, things get really, really interesting. Because that's when they bring in the inflammation measures. Exactly. So they're not just asking people how they're feeling, they're actually measuring what's going on in their bodies. You got it. They're looking at levels of this protein called C-reactive protein or CRP. That's what you hear about with heart disease, right? That's the one. So they're involved in all sorts of health issues, including mental health. And they're also measuring levels of specific cytokines, those chemical messengers we were talking about earlier. So they can actually see how much inflammation is present in each person. Exactly. It's amazing, really. And they're also looking at cortisol levels. Oh, right. Cortisol, the stress hormone. That's the one. It's your body's main stress hormone. And if it's chronically elevated, that's linked to a whole bunch of problems, mood disorders included. So by measuring cortisol and these inflammation markers, they can get a much better sense of how everything's interacting. Exactly. It's like putting together a giant puzzle. And each piece reveals a little bit more about suicide risk in mood disorders. Exactly. But, and I do have to say this, the Katz-Pritzker study is still ongoing, so we don't have all the answers yet. Man, you're killing me. It's like a cliffhanger. I know. I know. But even without the final results, we've learned so much already. That's true. That's true. As we're kind of wrapping up this part of the deep dive, what really stands out to you from what we've talked about? Well, I think, you know, for me, it's how this research really flips the script on how we think about suicide. You know, it's easy to say, oh, well, people who are depressed, they're more likely to attempt suicide. And yes, statistically, that's true. But this whole conversation, this whole deep dive, it's really shown me that it's so much more complex than that. Yeah, absolutely. It's not enough to just look at those surface level connections. We really have to dig deeper. Look at those hidden things, the stuff we don't always see that might be driving those thoughts and behaviors. Exactly. And I think if I had to sum it up, the biggest takeaway for me is that our thoughts, our feelings, they're not just happening in a vacuum. They're a real impact on our biology, our relationships, and yeah, ultimately, our risk for suicide. And that's a powerful message because it means that if we address those internal struggles like that self-criticism, the rumination, it can make a real difference. Oh, for sure. And that's actually kind of hopeful, right? Because if we can learn to manage those thought patterns, find healthier ways to cope, maybe we can change things. Exactly. And that's where all those different therapies come in. The stuff we talked about earlier, you know, challenging those negative thoughts, learning to be kinder to ourselves, building stronger relationships. There are things we can do. It's like we can rewrite our own stories, both in our own heads and in our relationships. I love that. You know, it's not just for people who are like actively struggling with suicidal thoughts. This is important for everyone. I mean, who doesn't want to feel better, be more resilient? Totally. It's like preventative mental health care, not just waiting for a crisis. Because let's be real, we all have those moments, right, where that inner critic pipes up or we get stuck in those negative thought loops or we just feel completely alone. We've all been there. So the more we can normalize those experiences, give people the tools to deal with them. The better. Absolutely. So I guess as we kind of wrap up this incredible deep dive, the thing I keep coming back to is if we can have this much of an impact on our own well-being just by understanding these connections between our thoughts, our relationships, our biology, what else are we missing? What other possibilities for healing are out there? That is such a good question. And I think it speaks to the importance of staying curious, of always questioning, always digging deeper. Totally. Well, thank you so much for taking this deep dive with me. It's been, I don't know, kind of mind-blowing, honestly. For everyone listening, we hope this has given you a lot to think about and maybe even inspired you to learn more about all of this. Until next time, keep asking those tough questions and keep diving deep.