Day 258

The brain is the least understood organ in our body – billions of nerve cells reaching out to millions of others forming a web of staggering complexity. Many thousand distinct cell types and trillions of synapses somehow make sense of the world around us, form memories, give rise to hopes and desires, arrange sleep, hunger and thoughts, imagine scenarios and create musical scores or plans to self destruct.

Neurotransmitters govern the interactions between the various cells and regions of the brain. They also connect the brain to the body. No one knows how many of these chemical bridges exist and how tangled the relationships among them are.

Serotonin (5-HT) was first located in the human Central Nervous System in the 1950s. It was later found to be associated with functions such as sleep, temperature regulation, feeding, pain, sex, memory, learning, movements and biological rhythms. It was also intricately involved with mood disorders such as anxiety and depression, particularly of the suicidal type.

5-Hydroxyindoleacetic acid (5-HIAA) is a breakdown product of Serotonin. Its levels in the fluid surrounding the brain and spinal cord are presumed to reflect the level of serotonin activity in the brain. Consistently low levels of 5-HIAA are seen in patients who have attempted to end their own lives. Low levels are also consistent with risk taking, excessive aggression, violence and impulsivity.

Suicidal acts are often impulsive. Research shows that even if the plans are well formulated in advance, the final decision to act is often determined by impulse. Studies have shown that those who killed themselves were three times more likely to have had a history of violent behavior. The 1999 incident of the Columbine High School massacre is an extreme example.

Its puzzling how the same tiny molecule can be responsible for maintaining order and for creating chaos. This is one of many, known and unknown benefactors and troublemakers.

I don’t know why I go looking for every little fact associated with suicide and bipolar disorder. It makes me feel closer to him. I fool myself into thinking that if I know more about it, may be it will hurt less but it doesn’t work.

The pain is in the heart that knows nothing but love.

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