September is Suicide Prevention Month, and for good reason. Suicide is a leading cause of death in the United States. In 2022, more than 49,000 people died by suicide, according to the Centers for Disease Control and Prevention. That’s one death every 11 minutes.
A short, intense moment of suicidal active crisis can take a person’s life forever and devastate their family, friends and community. At the Lieber Institute, we’re using our unique resources to learn more about why people take their own lives—and how we can prevent it.
The Lieber Institute is home to a collection of more than 4,300 donated brains, the largest repository of brains used for psychiatric research in the world. Some of those brains come from donors who died by suicide—and they are a precious, one-of-a-kind resource, according to Giovanna Punzi, MD, PhD, a research scientist who leads the Institute’s suicide research program.
“Suicide is a rarely accessible phenotype, of course, so most research investigates patients who, thankfully, survived a previous suicidal attempt,” says Dr. Punzi. “What struck me when I joined the LIBD was that the brains in the repository instead would offer an actual ‘biological snapshot’ of what was going on during suicide completion.”
Dr. Punzi’s work has focused in part on one important and sometimes forgotten aspect of suicide—the method the person chooses to end their life. Her research examines why some individuals choose means that are violent, abrupt and painful, while others elect to slip painlessly into unconsciousness. Dr. Punzi wonders why—and whether their choice is related to how they were feeling, as reflected in the biology impressed in their brain at the time of death.
Dr. Punzi feels that suicide by violent methods may offer a more magnified snapshot into the underlying biology of the brain than suicide by nonviolent methods. Her quest for a deeper, research-backed understanding of this picture seeks to open novel avenues for prevention and treatment.
In her work, she uses the Institute’s brain repository to examine several aspects of suicide. She considers environmental and psychological triggers using psychological autopsies—in-depth interviews with loved ones of people who died by suicide that can provide insight into the triggers that may have affected the person.
She also looks at biological factors with genetic research that can identify predispositions to behaviors such as suicide. She looks for genetic markers that might make a person more prone to choosing violent over nonviolent methods and brain activity patterns that might signal a higher risk of suicide.
Dr. Punzi hopes these two approaches will lead to targeted interventions tailored to the needs of each person. A priority is preventing violent suicide attempts, which typically employ the most lethal methods with the lowest survival rates.
She hopes her work will one day provide a lifeline to patients and their families. She values the brains in the repository and the precious biological snapshots they provide, but even more, she recognizes that each brain belonged to a unique person with their own experiences, struggles and triumphs, personality and life experiences.
“This allows me to take into account in my research the feelings of each unique individual I am studying, and I hope it may help end suicide,” says Dr. Punzi.
If you or someone you know is struggling with thoughts of suicide, please call or text 988 to reach the Suicide & Crisis Lifeline.