A Happy State with a High Suicide Rate

How is it possible that the same state could rank as one of the happiest in the nation and have one of the highest rates of suicide? Defying logic, Utah consistently scores highly on “happiest state” surveys while simultaneously ranking as one of the 10 states with the highest suicide rates in the United States. (1, 2)

Utah is an outdoor playground for adventurous spirits. The Beehive State’s mountainous landscape provides a plethora of activities, such as hiking, skiing, camping, rafting, fishing, and climbing. Both residents and visitors love all of the opportunities to spend time outdoors and discover new scenery. (3)

But like other states in the Rocky Mountains region, such as Colorado and Nevada, Utah has a disproportionately high suicide rate. In fact, suicide rates are so high in the Rockies that the region is known as the “suicide belt”. (3)

Suicide Prevention

“We see (attempted suicides) from every community, every socioeconomic background, from homes with a lot of support,” emergency room doctor Michael Jones told KSL, a Utah news source. (2)

Doctors and state officials are especially concerned about another troubling statistic – Utah is ranked fifth for youth suicides. For youth between the ages of 10 and 17, suicide is the second leading cause of death in the state. (2)

“All of us should be very concerned,” Utah Governor Gary Herbert told KSL. ‘It’s way too high. I don’t know if we exactly understand why it is high, but we need to do what we can to lower it and stop it altogether.” (2)

And Utahns have been working hard to lower their state’s suicide rate. They’ve brought nonprofit prevention programs, like Hope 4 Utah, into schools. And House Bill 23 made it legal for Utah’s teachers and counselors to ask the youth they work with about depression and suicide. (4)

High Highs and Low Lows

When asked what’s causing the state’s high number of suicides, residents will point to a host of potential sources, such as population density, gun access, poverty, and the influence of the Mormon Church. But neuroscientist and psychiatrist Perry Renshaw and his colleagues believe something else is responsible: altitude. (5)

Before moving to Utah in 2008, Renshaw lived in Boston. He worked at Harvard University studying the brain chemistry of people with depression. Once moving to Utah, he became curious about why the rate of suicide was so much higher in this desirable living environment. He questioned whether it might have something to do with elevation. (5)

These early questions led to the publication of a study on the association between suicide and altitude, gun ownership, and rural areas in The American Journal of Psychiatry. Renshaw and his fellow researchers examined the correlation between suicide rate and population density, average elevation, and gun ownership. The team found the strongest connection between suicide rate and altitude. (5, 6)

Another study that was published in 2010 in High Altitude Medicine & Biology echoed Renshaw’s results. This study examined 2,584 U.S. counties, finding a positive correlation between altitude and suicide over the past 20 years. They noticed that counties with an elevation between 4,000 and 5,000 feet had a suicide rate twice that of counties with an elevation below 2,000 feet. Counties above 9,000 feet in elevation had the highest suicide rate. (5, 7)

Brain Chemistry at High Altitude

But how does living at a higher altitude lead to higher suicide rates? The theory is that altitude-related hypoxia has a negative effect on people with mood disorders. Hypoxia is a shortage in the amount of oxygen reaching your tissues. Renshaw thinks that this can affect brain chemistry and cause a drop in the production of serotonin. Serotonin is a neurotransmitter that plays an important role in mood. It could also impact the effectiveness of depression medication like SSRIs (Selective Serotonin Reuptake Inhibitors). (5, 6)

Renshaw’s research has garnered strong responses from the public, with some saying that altitude is too simple an explanation for the problem of the high suicide rate in Utah. They worry that focusing on altitude as the source of the issue ignores other sociocultural considerations and could keep people from getting appropriate help. (5)

But others have reached out to the scientists, thanking them for their work. They feel that there’s finally an explanation for what they’ve been experiencing. (5)

Renshaw and other researchers continue to work to explain the crisis in Utah and other high-altitude states. They are also studying potential solutions to balance people’s brain chemistry and help them improve symptoms of depression. Hopefully, with the combined work of researchers and all of the other stakeholders in Utah’s wellbeing, the state will soon be known only for how happy all of its residents are. (5)

If you or a loved one are in need of help, call the National Suicide Prevention Lifeline at 1-800-273-8255.