Suicide & Endometriosis

I think this topic is a very important one to talk about and what peaked my curiosity was the fact there are no statistics really for this. Yes people commit suicide because of Chronic pain, Depression, Bipolar etc however what percentage of those people had Endometriosis and was triggered by the disease, the amount of care and understanding they got or the Hormone med etc.

I have posted about this girl named Kristi An Rose before but I think it should be brought up more because there needs to be awareness raised about Suicide and Endometriosis and that her life was not taken in vain. She deserves recognition for the fight she went through as well all know can be so debilitating and painful. Her mother wants her story to be told and why she died so that no other female will go through what she did and now even 4 yrs later we are still no further with awareness.

Click on the photo for her story

I have suffered from Depression since I was 10-11 yrs old and that is when the chronic headaches started. By the time I was 13 the Chronic pelvic pain started, Migraines by 15yrs that would leave me hospitalized, Fibro by 17yrs old and finally after 14yrs of the onset of Menstruation Stage IV Endometriosis. I have contemplated suicide more times than I can even count whether it be the treatment from doctors, the massive pain from Endometriosis, Relationship deterioration because of the disease and sexual dysfunction, The hormone medications you are put on to supposedly "Help the Endo from Growing" make you feel so isolated and alone and no one could possible understand what you are going through unless they live it. This disease has robbed my life in more ways than one. Last August I was prescribed Visanne to "treat the endo" and by month three I was so far mentally out of it and depressed that I was sitting in my car wanted to die that moment. I sat there for an hour and cried and in the end my daughter is who I thought about and why I didn't take my life that day. I could never ever make her feel the pain of me committing suicide because I would have totally changed the course of her life and I know her personality I am her world but for that hour the thoughts would not leave me. I wanted to die, I was done, done with the pain, done with the doctors and how after 23 yrs I am still treated with absolutely no respect for my well being or quality of life this disease has left me with. I chose to live not for me but for my daughter and that is the only reason I am alive right now because if I did not have her I would have offed myself a very long time ago. 

What I have learned in the last year from Dr. Redwine has made me open my eyes and see the facts. Nothing except complete excision (cut out to the root) will give you any kind of relief, no medication, not laser surgery etc. The fact remains that we are still suffering and no one seems to care. We don't have the surgeons that are skilled with this disease. Hormones work for certain people and not all and some are worse off being on them and they do NOT stop Endometriosis from growing, they do NOT suppress Endo, the purpose for these meds is to stop ovulation and periods therefore hopefully stop the pain but if you do not have excision surgery the chances of that even helping are minimal and the side effects are just not worth it so you end up in debilitating pain unnecessarily. 

I asked this question about the stats on Suicide and Endometriosis on the great EndoMetropolis page on Facebook that is run by Dr. Redwine and Libby Hopton. Libby had some great information for me about this. Please read her response to me below. 

"No formal studies. Of the limited research undertaken into the comorbidity between endometriosis and psychopathology, a strong association has been found between endo and depression (unipolar and bipolar) and anxiety. Probably no surprise. I think several mechanisms are likely at play though (not 'simply' the emotional impact of this disease and the pain and debilitation it often causes)... the disease itself could potentially contribute to or underlie cytokine-induced depression"
"Here's part of a paper I wrote on the subject. I can send the accompanying reference list/literature separately if useful."

Research on the quality of life of women suffering from endometriosis reports a significant negative impact in all domains of life, including mental health (Nnoaham et al., 2011). Of the limited research undertaken into the prevalence of psychopathology in women with endometriosis, depression has been identified as highly prevalent among these patients (Ferrero, Giordano, Abbamonte, Ragni, & Ramorgida, 2006; Lorencatto, Petta, Navarro, Bahamondes, & Matos, 2006; Sepulcri & Amaral, 2009). Prevalence rates of depressive disorders in cohorts of women with endometriosis with associated pelvic pain range between 46% and 86% (Ferrero et al., 2006; Lorencatto et al., 2006). Even in women with endometriosis who are asymptomatic, the prevalence of depressive disorders has been observed at 38% (Lorencatto et al., 2006), markedly higher than the estimated prevalence among women in general (Weissman & Olfson, 1995).

Several possible mechanisms may be involved in the heightened tendency towards depression in endometriosis: Hormone therapies employed in the palliative treatment of the disease have been linked to depressive symptoms (Warnock, Bundren, & Morris, 2000); infertility, regardless of cause, is associated with repeated losses, feelings of guilt and reduced self-esteem (Abbey, Andrews, & Halman, 1992; Mahlstedt, 1985; Sbaragli et al., 2008); and the impact of chronic pelvic pain on a patient’s personal and social relationships, work, and leisure time could contribute to the emergence of depression (Fourquet, Baez, Figueroa, Iriarte, & Flores, 2011; Nnoaham et al., 2011).

Furthermore, the inflammatory response of the immune system triggered by the presence of endometriotic lesions may play a role in the onset and maintenance of depressive symptoms in these patients (Nasyrova et al., 2011). Intraperitoneal studies in women with endometriosis have found that ectopic endometriotic lesions secrete chemotactic molecules, which in turn instigate the activity of immune cells in the peritoneal fluid, triggering cytokine release (Gazvani & Templeton, 2002; Harada, Iwabe, & Terakawa, 2001; Oral, Olive, & Arici, 1996). Women with endometriosis have been found to have an increased concentration of proinflammatory cytokines in the peritoneal fluid and blood serum, including interleukin-1 (IL-1), interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and infereron- ɣ (Barcz et al., 2012; Nasyrova et al., 2011).

The role of cytokines in the aetiology of depression has received ongoing focus in the literature (for a review see Raison & Miller, 2011). Individuals with system-wide elevated concentrations of certain cytokines due to underlying chronic inflammatory disease commonly present with symptoms of ‘sickness behaviour’ (see table 1) (Dickens, McGowan, Clark-Carter, & Creed, 2002; Dunn, Swiergiel, & Beaurepaire, 2005; Foley et al., 1992; Minden & Schiffer, 1990). Likewise, the majority of patients undergoing IFN-α protocols involving sustained cytokine exposure for the treatment of Hepatitus C and certain cancers experience sickness symptoms shortly after commencing treatment (Gohier et al., 2003; Raison, Demetrashvili, Capuron, & Miller, 2005). There is considerable homology between some of the symptoms of sickness behaviour and the diagnostic criteria of idiopathic Major Depressive Disorder (Capuron et al., 2009). Several cytokines have been identified as possible markers in the emergence of sickness symptoms, including IL-1, IL-2, IL-8, LPS, IFN-α, IFN-β, and IFN-ɣ (Gohier et al., 2003; Kent, Bluthe, Kelley, & Dantzer, 1992; Levine et al., 1999; Maes, Bosmans, Meltzer, Scharpe, & Suy, 1993; Musselman et al., 2001; Nasyrova et al., 2011; Owen, Eccleston, Ferrier, & Young, 2001; Valentine, Meyers, King, Richelson, & Hauser, 1998).

Table 1
Sickness symptoms
Hypomotility (Lethargy)
Hyperthermia (Fever)
Hypophagia (Anorexia)
Hyperalgesia
Decreased interest in activities
Decreased sexual activity in females
Increased time spent sleeping
Physical symptoms (headache, muscle pain, nausea, and shivering)
Note. Adapted from Dunn et al., 2005