Attending religious service once a week found to lower risk of suicide and other "deaths of despair"

Photo by Ronny Hartmann / AFP
  • A study of nearly 100,000 health care workers found that those who attend weekly religious services are less likely to die from a "death of despair."
  • The Harvard researchers note that women are considerably less likely to die such a death than men.
  • Community support seems to be a major reason for helping people grapple with existential distress.

In late April, the news hit us hard: Lorna Breen, an emergency room doctor in a Manhattan hospital flooded with coronavirus patients, committed suicide. According to her father, the emotional toll of treating these patients was too much for her to handle. Even though she previously exhibited no sign of mental health issues, witnessing so many people being rolled into her facilities already dead was overwhelmed.

It's hard to describe the chaos of an overbooked emergency room. I worked as a patient monitor at Robert Wood Johnson University Hospital for two years. The environment can transform from silent to slammed in a heartbeat. While my job was to ensure that patients didn't try to kill themselves, it was impossible to miss the emotional challenges of being a doctor or nurse working a 24-hour shift, or even an 8-hour shift.

New York City claps for their health care force nightly. It's a beautiful sentiment, yet when you're working in the thick of this virus, hoping to both help others and not become infected yourself, the weight is heavy. I recently talked to a friend who is an emergency room physician's assistant at a particularly hard-hit hospital. He told me that he recently yelled at someone in his neighborhood for not wearing a mask, and he is the last person I'd ever suspect of yelling at anyone. Your environment changes you. We are a different people now than just a few months ago.

Why religion is literally false and metaphorically true | Bret Weinstein

A unique new study at the Harvard T.H. Chan School of Public Health found an interesting link between mental health and health care workers: those who attend a religious ceremony once a week are less likely to suffer from a death of despair. These include dying by suicide and alcohol or drug overdoses.

The researchers collected data from 66,492 female registered nurses and 43,141 male health care professionals, including dentists, pharmacists, and optometrists. The women's data was collected from the large-scale Nurses' Health Study II, conducted between 2001-2017. The men's data comes from the Health Professionals Follow-up Study, conducted from 1988-2014.

The researchers note that life expectancy in the US has been decreasing since 2015. This coincides with an increased rate of midlife death from suicide, unintentional drug or alcohol poisoning, and alcohol-related chronic liver disease and cirrhosis. While "deaths of despair" was initially coined to describe the psychological effects of unemployment, the weakening of traditional support systems, such as religious services, are also implicated with higher drug and alcohol use and suicide. This is a particular challenge that we are navigating in the era of social distancing.

Buddhist monks wearing facemasks take their places for prayers inside the Wat Bowonniwetwiharn temple as Thais are encouraged not to gather inside places of worship, in an attempt to stop the spread of the COVID-19 novel coronavirus, on Visaka Bucha Day in Bangkok on May 6, 2020.

Photo by Lillian Suwanrumpha / AFP

Previous studies have shown that religion is a positive determinant in health and mental well-being. Lower risks of suicide, heavy drinking, depression, and substance abuse has been observed in the religious. As they phrase it,

"Religious participation may promote health and well-being through strengthening social integration, encouraging healthy behaviors, and providing a sense of hope, meaning, and purpose in life."

According to their research, religion tends to positively impact women more than men. The nurses had a 68 percent lower risk of death during the period studied. Men experienced a 33 percent reduced risk.

Research associate and data scientist, Ying Chen, who was first author of the study, notes that this is especially important information at this time.

"These results are perhaps especially striking amidst the present COVID-19 pandemic. They are striking in part because clinicians are facing such extreme work demands and difficult conditions, and in part because many religious services have been suspended. We need to think what might be done to extend help to those at risk for despair."

Religion might not be a cure-all, but for alleviating symptoms of despair, religious services appear to help. Whether seeking existential guidance or social support, we are social animals. Community matters.

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Stay in touch with Derek on Twitter and Facebook. His next book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."

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The surprise reason sleep-deprivation kills lies in the gut

New research establishes an unexpected connection.

Reactive oxygen species (ROS) accumulate in the gut of sleep-deprived fruit flies, one (left), seven (center) and ten (right) days without sleep.

Image source: Vaccaro et al, 2020/Harvard Medical School
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  • A study provides further confirmation that a prolonged lack of sleep can result in early mortality.
  • Surprisingly, the direct cause seems to be a buildup of Reactive Oxygen Species in the gut produced by sleeplessness.
  • When the buildup is neutralized, a normal lifespan is restored.

We don't have to tell you what it feels like when you don't get enough sleep. A night or two of that can be miserable; long-term sleeplessness is out-and-out debilitating. Though we know from personal experience that we need sleep — our cognitive, metabolic, cardiovascular, and immune functioning depend on it — a lack of it does more than just make you feel like you want to die. It can actually kill you, according to study of rats published in 1989. But why?

A new study answers that question, and in an unexpected way. It appears that the sleeplessness/death connection has nothing to do with the brain or nervous system as many have assumed — it happens in your gut. Equally amazing, the study's authors were able to reverse the ill effects with antioxidants.

The study, from researchers at Harvard Medical School (HMS), is published in the journal Cell.

An unexpected culprit

The new research examines the mechanisms at play in sleep-deprived fruit flies and in mice — long-term sleep-deprivation experiments with humans are considered ethically iffy.

What the scientists found is that death from sleep deprivation is always preceded by a buildup of Reactive Oxygen Species (ROS) in the gut. These are not, as their name implies, living organisms. ROS are reactive molecules that are part of the immune system's response to invading microbes, and recent research suggests they're paradoxically key players in normal cell signal transduction and cell cycling as well. However, having an excess of ROS leads to oxidative stress, which is linked to "macromolecular damage and is implicated in various disease states such as atherosclerosis, diabetes, cancer, neurodegeneration, and aging." To prevent this, cellular defenses typically maintain a balance between ROS production and removal.

"We took an unbiased approach and searched throughout the body for indicators of damage from sleep deprivation," says senior study author Dragana Rogulja, admitting, "We were surprised to find it was the gut that plays a key role in causing death." The accumulation occurred in both sleep-deprived fruit flies and mice.

"Even more surprising," Rogulja recalls, "we found that premature death could be prevented. Each morning, we would all gather around to look at the flies, with disbelief to be honest. What we saw is that every time we could neutralize ROS in the gut, we could rescue the flies." Fruit flies given any of 11 antioxidant compounds — including melatonin, lipoic acid and NAD — that neutralize ROS buildups remained active and lived a normal length of time in spite of sleep deprivation. (The researchers note that these antioxidants did not extend the lifespans of non-sleep deprived control subjects.)

fly with thought bubble that says "What? I'm awake!"

Image source: Tomasz Klejdysz/Shutterstock/Big Think

The experiments

The study's tests were managed by co-first authors Alexandra Vaccaro and Yosef Kaplan Dor, both research fellows at HMS.

You may wonder how you compel a fruit fly to sleep, or for that matter, how you keep one awake. The researchers ascertained that fruit flies doze off in response to being shaken, and thus were the control subjects induced to snooze in their individual, warmed tubes. Each subject occupied its own 29 °C (84F) tube.

For their sleepless cohort, fruit flies were genetically manipulated to express a heat-sensitive protein in specific neurons. These neurons are known to suppress sleep, and did so — the fruit flies' activity levels, or lack thereof, were tracked using infrared beams.

Starting at Day 10 of sleep deprivation, fruit flies began dying, with all of them dead by Day 20. Control flies lived up to 40 days.

The scientists sought out markers that would indicate cell damage in their sleepless subjects. They saw no difference in brain tissue and elsewhere between the well-rested and sleep-deprived fruit flies, with the exception of one fruit fly.

However, in the guts of sleep-deprived fruit flies was a massive accumulation of ROS, which peaked around Day 10. Says Vaccaro, "We found that sleep-deprived flies were dying at the same pace, every time, and when we looked at markers of cell damage and death, the one tissue that really stood out was the gut." She adds, "I remember when we did the first experiment, you could immediately tell under the microscope that there was a striking difference. That almost never happens in lab research."

The experiments were repeated with mice who were gently kept awake for five days. Again, ROS built up over time in their small and large intestines but nowhere else.

As noted above, the administering of antioxidants alleviated the effect of the ROS buildup. In addition, flies that were modified to overproduce gut antioxidant enzymes were found to be immune to the damaging effects of sleep deprivation.

The research leaves some important questions unanswered. Says Kaplan Dor, "We still don't know why sleep loss causes ROS accumulation in the gut, and why this is lethal." He hypothesizes, "Sleep deprivation could directly affect the gut, but the trigger may also originate in the brain. Similarly, death could be due to damage in the gut or because high levels of ROS have systemic effects, or some combination of these."

The HMS researchers are now investigating the chemical pathways by which sleep-deprivation triggers the ROS buildup, and the means by which the ROS wreak cell havoc.

"We need to understand the biology of how sleep deprivation damages the body so that we can find ways to prevent this harm," says Rogulja.

Referring to the value of this study to humans, she notes,"So many of us are chronically sleep deprived. Even if we know staying up late every night is bad, we still do it. We believe we've identified a central issue that, when eliminated, allows for survival without sleep, at least in fruit flies."

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