Epilepsy, Adoption, Pharmaceuticals: Suicide

Lorraine and daughter in 1982, happier times

National Suicide Prevention Week was earlier this month. Those who know my story know that my daughter committed suicide. This is one of the "Facts and Commentaries" from my recent book, Hole In My Heart: memoir and report from the fault lines of adoption. My hope is that those suffering with any of the maladies listed here, or their friends and families, will see this as a cautionary message, and get help before it is too late. I tried, but could not save, my daughter.--lorraine

A few days after the first anniversary of my daughter’s suicide, in December of 2008, the Federal Drug Administration announced that it would require makers of epilepsy drugs to add a warning about the increased risk of suicidal thoughts and behaviors to the products' prescribing information or labeling. Behaviors, I assume, means suicide attempts, some of them successful. Depakote, the drug Jane took, is on the list. The FDA actions are based on the agency's review of 199 clinical trials of 11 epilepsy drugs—released only a month after her death—showing that patients taking those drugs had almost twice the risk of suicidal behavior or thoughts than those taking a placebo.

But what was not answered was this: had the epileptics taking the placebo had their lives upended by as many seizures, great and small, as my daughter had?

I mentally add in the cocktail of drugs—an anti-depressant and Depakote—that Jane was taking. What about that? And what about the adoption?



SUICIDE AND ADOPTION

While there are no good statistics on adoptees who actually commit suicide in this country, Google “suicide and adoption” and what pops up is a 2001 entry from Pediatrics, “Adoption as a Risk Factor for Attempted Suicide during Adolescence.”[1] In 2013 the finding was further refined when researchers at the University of Minnesota reported that adopted teens were almost four times more likely to attempt suicide than those who lived with their natural parents, even after adjustment for factors associated with suicidal behavior, such as psychiatric disorder symptoms, personality traits, family environment, and academic disengagement. Girls were more likely than boys to attempt suicide. About 75 percent of the adopted teens (more than 1,200, all living in Minnesota) in the study were adopted before the age of two and were foreign-born—mostly from South Korea.[2]

Other studies have found the same: In 1990, the Search Institute of Minneapolis, which studies what factors help children succeed, found that teenagers who were adopted as infants are more at risk for suicide than non-adopted youth. [3] A 2005 Swedish study focused on international adoptees and found they clearly were at greater risk for suicide than adoptees from the same country, but both groups had increased risk when compared to those who were living with their natural families.[4] Researchers at the University of Cincinnati College of Medicine, in a large scale study of 6,500 students in grades seven through twelve, found that nearly eight percent of the adoptees had attempted suicide in the past year, compared with only three percent of their non-adopted peers.

B. J. Lifton wrote that at a seminar for adoptive parents when she voiced her opinion that the percentage of adoptee suicide was statistically high, a prominent psychiatrist asked if that nasty bit could be deleted from the tape, to be later sold as a record of the talk. B.J. agreed, but later wrote she was sorry she had.[5] When I mentioned adoption and suicide at a conference a few years ago, it was generally ignored. This is not a subject the adoption industry wants anyone to talk about. Adoption advocates like to dismiss it as “junk science,” but it is getting harder to do.

WHAT AGENCIES DON'T TELL YOU 

It is a subject certainly missing from adoption agency websites where they advertise “confidential, non-judgmental options” so you, the prospective mother,  can make an “informed choice.” A truly informed choice would include these hard facts, instead of gobbledygook about a better life with people who are almost always wealthier than the mother. My daughter did not have a better life. She had a different life. She had a life imprinted by being relinquished and not raised with her own people.

Google “suicide and epilepsy” and you get more than five thousand hits. “People with epilepsy are three times more likely to commit suicide than the general population,” conclude the authors of an article published in Lancet Neurology[6] in 2007. 

Google “PMDD and suicide” or “PMDD and suicidal thoughts” and another wealth of articles pop up. (NOTE: My mother, myself and my daughter Jane were all susceptible to serious, debilitating pre-menstrual syndrome, known in its more serious form as premenstrual dysphoric disorder, shortened to PMDD on diagnostic charts. Jane committed suicide when she was premenstrual.)

Add them up or take your pick.

From my daughter's adoptive father, Gary, who makes the call to the Epilepsy Foundation in Madison to tell someone what happened, I hear that the news was met with: She lasted longer than most.

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[1] G. Slap, E. Goodman and B. Huang, “Adoption as a Risk Factor for Attempted Suicide during Adolescence,” Pediatrics, August  2000, Vol. 108: 2, p. 30. http://pediatrics.aappublications.org/cgi/content/abstract/108/2/e30

The study included students who were living with their mothers, adoptive or biological, and had not been separated from them for more than six months. All mothers were in their first marriages in order to filter out children of divorce. Not surprisingly, teens who contemplated suicide were more likely to be depressed, smoke cigarettes, engage in delinquent behavior, have low self-esteem and—be female. More recently, Psychiatric Times (January 26, 2009; http://www.psychiatrictimes.com/display/article/10168/1367897) reported that researchers at the University of Minnesota found that adopted youth had a higher incidence of clinical disorders (such as ADHD or ODD) than the non-adopted. Any research showing that adopted individuals had a higher incidence of emotional trauma and related problems has always been controversial and met with disdain by many in the adopting community, and are generally attributed to the greater income of many adoptive parents, and their acute sensitivity to their children’s welfare.

However, the researchers found this not to be true, but due to the fact that the adoptees exhibited more of the problems for which parents refer their kids to therapy. The Minnesota study included 540 non-adopted adolescents born in that state and 692 domestic and international adoptees. The study participants ranged in age from 11 to 21 years, and the average age at time of placement was four months. From the Psychiatric Times: “The assessments were rigorous and involved use of the Diagnostic Interview for Children and Adolescents-Revised (DICA-R) and the Structured Clinical Interview for DSM-III-R (SCID-II). I’ve gone into detail here because this study has been attacked by adoptive parents on various blogs.

[2] Margaret A. Keyes, Stephen M. Malone, Anu Sharma, William G. Iacono and Matt McGue, “Risk of Suicide Attempt in Adopted and Nonadopted Offspring,” Pediatrics, 2013. 

[3] Lifton, Lost and Found, p. 311.

[4] Annika von Borczykowski, Anders Hjern, Frank Lindblad and Bo Vinnerljung, “Suicidal Behavior in National and International Adoptees,” Social Psychiatry and Psychiatric Epidemiology, Feb. 2006, Vol. 41: 2, pp. 95-102.

[5] Lifton, Lost and Found, p. 311.

[6] The Lancet Neurology (2007, July 8). Epilepsy Means Three Times Higher Risk Of Committing Suicide, Study Suggests. Science Daily, http://www.sciencedaily.com/releases/2007/07/070706143417.htm
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May be shared and reblogged with credit
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FROM FMF
Saying goodbye to adoptee L'Wren Scott

TO READ

Amazon review of Hole In My Heart:

"This riveting no-holds barred memoir is a must-read for anyone with ties to adoption in any way. Lorraine does not sugarcoat a thing as she tells us of her ups and downs through the years after giving up her daughter for adoption in the 1960’s. We are there with her every step of the way, experiencing and feeling all the raw emotions she feels, and the difficult (and happy) times she shares after eventually meeting her daughter Jane. She also shares with us important facts and information about adoption through the years, and how enormously difficult it could be to gain access to sealed records. ... I have 2 older siblings who were adopted in the 1960s, and look forward to sharing this book with them."

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