A study found evidence that there may be a biomarker for suicidal thoughts in people with PTSD.
Post-traumatic stress disorder (PTSD) affects an estimated 7 to 8 percent of people in the United States, including many military veterans and sexual assault survivors.
Compared to the average population, people with PTSD are significantly more likely to attempt suicide.
Other mental health conditions have also been linked to increased risk of suicide, including major depressive disorder (MDD).
But according to a new study conducted at Yale University, the underlying mechanisms of suicidal thoughts might differ in people with PTSD compared to those with MDD.
The authors of the new study found that suicidal thoughts are linked to higher levels of metabotropic glutamate receptor 5 (mGluR5) in people with PTSD, but not those with MDD.
This suggests that different neurological processes are involved in the development of suicidal thoughts in people with PTSD compared to those with MDD.
In turn, people with different mental health conditions might benefit from different treatment approaches for suicidal thoughts and behaviors.
“It’s important for clinicians to understand that you can’t just treat PTSD like depression,” Irina Esterlis, PhD, lead author of the new study and an associate professor in the department of psychiatry at Yale School of Medicine, told Healthline.
“There could be some common mechanisms underlying these disorders but also some different ones, so we need to figure out what works best for these individuals,” she said.
The neurotransmitter receptor called mGluR5 is involved in many brain functions, including learning, memory, and cognitive control.
Past research suggests it plays a part in the development of mood and anxiety symptoms in people with PTSD.
To build on that research, Esterlis and colleagues used PET scans to measure the availability of mGluR5 in people with PTSD.
They also measured the availability of mGluR5 in people who had MDD but not PTSD.
Their research team found high levels of mGluR5 in people with PTSD who had suicidal thoughts at the time of their PET scan. In comparison, they found lower levels of mGluR5 in people with PTSD who didn’t have suicidal thoughts at the time of their scan.
They also found lower levels of mGluR5 in people who had MDD but not PTSD, including those with and without suicidal thoughts. In other words, mGluR5 was only associated with suicidal thoughts in people with PTSD.
This finding may have important implications for managing suicide risk in people with PTSD, Dr. Victor M. Fornari, a psychiatrist at Zucker Hillside Hospital in Glen Oaks, New York, told Healthline.
“This study has identified a potential biomarker [mGluR5] that may offer a possible treatment target for PTSD,” Fornari said.
“The significance of this finding may offer an intervention and potentially suicide risk management for individuals with PTSD,” he added.
More research is needed to confirm the results of this study and develop potential treatment approaches that target mGluR5 in people with PTSD.
Esterlis hopes that ongoing research on mGluR5 will help guide the development of targeted medications for PTSD.
To date, the Food and Drug Administration has approved the use of two antidepressant medications for PTSD: paroxetine and sertraline.
Those medications were originally developed to treat depression.
They can help ease symptoms of PTSD in many people, but they’re not equally effective for everyone.
“What we’re seeing is that we can’t just give people with PTSD medications that were developed for other disorders,” Esterlis said.
“That may not work for everyone, and we need to do a little more precision medicine and design medications for PTSD specifically,” she said.
People with PTSD don’t have to wait for breakthroughs in precision medicine to reach out for help, Sheila Rauch, PhD, a member of the Anxiety and Depression Association of America and clinical director of the Emory Healthcare Veterans Program at Emory University School of Medicine in Georgia, told Healthline.
In addition to paroxetine, sertraline, and some other medications, certain types of psychological therapy can also help relieve symptoms of PTSD.
For example, when Rauch and colleagues studied prolonged exposure therapy in veterans with PTSD, they found it helped reduce symptoms and lower the risk of suicidal thoughts.
“Work to increase access to these treatments and improve effectiveness is ongoing, because many people aren’t able to get the treatments that work, don’t complete an effective care, or don’t fully respond to adequate care,” she said.
If someone suspects they may have PTSD, Rauch encourages them to reach out for help from a primary care provider or mental health specialist.
“If someone is currently thinking of acting on suicidal thoughts, he or she should call 911 or go to the nearest emergency room,” she said.
People can also call the National Suicide Prevention Hotline at 800-273-8255 for free, confidential help 24/7.
Other community members also have a role to play in supporting people at risk for suicide, Rauch says.
“As a community we need to provide a lifeline by noticing the signs of suicide and reaching out to those at risk to let them know they’re cared for and we can help them get the treatment they need,” she said.