Overachievers at Higher Risk for Suicide

The quest for success can trigger a dangerous genetic predisposition for depression

Overachievers at Higher Risk for Suicide
Anthony Bourdain, seen in a 2016 file photo, was a celebrity chef and travel documentarian. Bourdain died by suicide in France on June 8, 2018. (Andy Kropa/Invision/AP, File)
Jingduan Yang
Alexandra Robbins is an overachiever. She graduated summa cum laude—the highest distinction—from Yale only to realize on the very day of graduation that it didn’t mean anything to her.

Being a typical overachiever, she had equated her self-worth to her goal to such an extent that it had taken precedence over everything else. Her pursuit of success did not lead to happiness, an understanding she details in her book “The Overachievers: The Secret Lives of Driven Kids.”

Robbins’ experience illustrates the negative side of overachieving, but there is an even darker side. In their quest for perfectionist success, overachievers may be literally stressing out their body’s biochemistry, causing something called under-methylation, which has been correlated with depression and suicidal thoughts.

Methylation disorders are triggered by lifestyle factors that turn on or off the expression of mutated genes that overachievers are genetically predisposed with. And research shows that 15 to 20 percent of under-methylating overachievers are likely to develop depression.
The worrying spate of young overachievers taking their own lives at top U.S. colleges in the past few years has drawn serious attention to the correlation between overachievers and suicide, but until now there has not been a satisfactory explanation for it.

Overachievers and Stress

Environmental stressors play a significant role in triggering depression, and college presents plenty of these, especially for overachievers. Pressure to meet the grade, get on the school team, win a place on the debate club, and so on, can feel crushing under certain circumstances, particularly for those who are driven to overachieve.
It is estimated that 1,100 undergraduate students commit suicide each year, according to a National Institutes of Health publication and nearly 24,000 attempt it. As competition, cost, and pressure to get into the best schools increases, suicide rates among young adults, ages 15-24, have tripled since the 1950s, according to an analysis of official data.
At the University of Pennsylvania in 2017, six students died from apparent suicide in a 13-month period, according to the Philly Voice. Cornell University had six suicides in the 2009-2010 academic year. In 2003-2004, five New York University students leapt to their deaths. In 2018, a fourth-year medical student and a resident physician at NYU committed suicide within five days of each other.
While suicide is statistically more likely to claim the lives of young people, among the entire U.S. population, depression and suicide rates have risen by 28 percent in the 17-year period between 1999 and 2016, according to the National Institutes of Health, and I have seen that overachievers are disproportionately affected.

The untimely suicide deaths of wildly successful celebrity food writer Anthony Bourdain and fashion icon Kate Spade are two high profile examples that shocked us this year, and left many questioning: Why would someone who appears to have it all commit suicide out of nowhere?

 <span class="s1">American fashion designer and businesswoman Kate Spade </span> arrives at the Council of Fashion Designers of America awards in New York on June 2, 2003, at the New York Public Library. Spade <span class="s1">died by suicide at 55-years-old in New York on </span><span class="s2">June 5, 2018. </span>( REUTERS/Chip East/File Photo)
American fashion designer and businesswoman Kate Spade  arrives at the Council of Fashion Designers of America awards in New York on June 2, 2003, at the New York Public Library. Spade died by suicide at 55-years-old in New York on June 5, 2018. ( REUTERS/Chip East/File Photo)
The CDC released a report about suicide trends the same week as Kate Spade’s death. Its lead author, Deborah M. Stone, emphasized in a media interview that suicide is more likely to occur among people who have never been diagnosed with mental illness than in those who are diagnosed with depression.

Like the examples above, many of these overachievers are high-functioning, yet when they find themselves in desperate circumstances, they don’t tend to seek help, because they may feel the risks to their reputations are too great. They are still able to perform, and so they just keep going.

According to a Business Insider analysis of data from The National Institute for Occupational Safety and Health, marine engineers, physicians, dentists, veterinarians, and finance workers are the most likely to commit suicide at work.

These people will be vastly different in their backgrounds, and the circumstances that led to their suicides, but I see that they have one thing in common. Workers in these occupations tend to be perfectionists since these are the skills the jobs require.

But overachievers working in these professions are also the least likely to seek help. As professionals that others trust and rely on for services, the stigma of mental illness takes on greater significance for them.

And for overachievers, reaching out for help looks like failure, which is something overachievers cannot accept. They would rather push themselves to work harder to overcome their weakness, which unfortunately would exacerbate their mental health problems.

Overachievers and Methylation Disorder

I have seen that there is new hope for overachievers. It requires shifting the way we see the problem and reducing the stigma around mental illness so they are more likely to seek help.

Steve G (a pseudonym) had worked extremely hard to achieve senior managing partner at an international investment banking firm. He was successful, but he had a dark secret that he kept for a long time from his wife and three children: haunting thoughts of ending his life.

He was fortunate to discover information online about a non-drug treatment for depression that viewed the problem through the lens of the body’s biochemistry, something called methylation disorder. He wondered if he had methylation disorder.

Steve G was very afraid of being labeled mentally ill, so he was was hopeful that his depression might have a reasonable explanation.

He was also attracted by the potential for avoiding the notorious sexual side effects of the antidepressants his family doctor recommended. Sex in his marriage was the only thing he still enjoyed.

Steve G had discovered this potentially life-saving information on the Walsh Research Institute website, which includes a directory of doctors that treat patients for methylation disorder.

Four years ago, I attended a workshop with Dr. William Walsh, where the influential doctor presented his findings, which are based on extensive research of 30,000 classes of mental illness.

His research establishes a clear link between depression and a biochemical imbalance in the human body known as methylation disorder. It shows that 38 percent of people with major depression were under-methylating, while another 20 percent are over-methylating with folate deficiency.

Dr. Walsh has also shown how targeted, non-drug vitamin therapy has the potential to repair the broken methylation processes. His groundbreaking research is published in a book, aptly named: “Nutrient Power: Heal Your Biochemistry and Heal Your Brain.”

After seeing his new doctor, Steve G learned he was indeed under-methylating. He felt relieved that he was consulted for a biochemical imbalance for his brain dysfunction, rather than a mental illness. In fact, he called his doctor his “vitamin doctor.”

He was prescribed a nutrient cocktail to restore his methylation to normal, and after about three months, he began to notice he was more relaxed. He was playing more with his children, and his suicidal thoughts became fleeting, instead of constant like before.

How Methylation Works

The body’s biochemistry is comprised of highly varied and complex chemical reactions that drive functions, like thought, digestion, and movement. Specific vitamins, enzymes, proteins, and so on, are like parts that must fit into specific slots to activate the chemical circuits.

If a part is missing, or if there is too much, or too little of a part, it means something isn’t working optimally in the body, and actual physical and mental illnesses are likely to manifest.

Methylation is one such biochemical process in the body that is critical for health. An estimated 30 percent of the general population has a methylation disorder.

Methylation affects how well DNA replicates and reproduces, how effective the liver is at removing toxins from the body, and how efficiently the brain functions to produce the neurotransmitters that are essential for normal mental health.

During methylation, one molecule donates a methyl group (CH3) to DNA, which then modifies the function of the genes and affects gene expression. Completion of this step requires the help of certain vitamins, minerals, and enzymes, including the MTHFR gene.

Missing or inadequate nutrients and genetic mutations of certain enzymes can cause the methylation process to be inadequate, a condition known as under-methylation.

An under-methylated person is characterized by low levels of serotonin and dopamine, high whole blood histamine, and elevated absolute basophils. There is also a tendency to be very low in calcium, magnesium, methionine, and Vitamin B6, with excessive levels of folic acid. Nutrient therapy restores the levels back to normal and restores normal methylation function.

Steve G’s doctor practiced integrative medicine, so he was also able to get acupuncture and neurofeedback treatments for his stress and chronic lower back pain. It helped him to feel better right away. Changes in diet and lifestyle that he implemented over time helped him reduce some of the environmental factors that were triggering his depression.

After two years, Steve reflected that he wasn’t sure he would have survived that period without the help. He also expressed his dismay about why mainstream psychiatric services don’t offer the kind of treatment he received.

It is a fact that the vast majority of medical doctors never look at their patient’s biochemistry. I hope this changes, but in the meantime, those seeking non-drug support for depression must find a doctor of integrative medicine that treats methylation disorders.

A Clear Link

At some point, I noticed that the biochemistry of someone who is under-methylated, especially low serotonin and dopamine, matches the personality profile of a typical overachiever, someone who is highly self-motivated, perfectionist, and competitive in sports and life in general.

I wanted to know what Dr. Walsh thought, so I presented my observation to him.

“Absolutely!” he said. “The characteristics of the under-methylators match the personality and clinical symptoms of overachievers.”

Dr. Walsh said overachievers can be helped with nutrients if they can stay in treatment for 6-8 months or longer to get the full benefits. But he warned they are the worst patients in terms of compliance.

For overachievers, compliance is a major issue.

In fact, Steve G complained at literally every appointment that he wanted to quit.

I have seen that inability to let go of the need for control, the desire for quick results, denial of depression, and the fear of pain, can all contribute to difficulties with the compliance issue.

This is an important consideration if you decide to pursue integrative medicine to treat depression, as the risk of suicide increases without persistent and consistent treatment.

Jingduan Yang, MD, is a leading physician, board-certified psychiatrist, foremost integrative medicine expert, and fifth-generation teacher and practitioner of traditional Chinese medicine. A sought-after speaker, author, and educator, Dr. Yang is known for pioneering a holistic approach to health that focuses on finding the root causes of disease in the physical, biochemical, bioenergetic, and spiritual dimensions of the human body. He is also the medical director of the eponymous Yang Institute of Integrative Medicine.
Jingduan Yang, M.D. F.A.P.A. is a board-certified psychiatrist specializing in integrative and traditional Chinese medicine for chronic mental, behavioral, and physical illnesses. He contributed to the books "Integrative Psychiatry," "Medicine Matters," and "Integrative Therapies for Cancer." Co-authored "Facing East: Ancient Secrets for Beauty+Health for Modern Age" by HarperCollins and "Clinical Acupuncture and Ancient Chinese Medicine" by Oxford Press. Dr. Yang is also the founder of the Yang Institute of Integrative Medicine and the American Institute of Clinical Acupuncture and the CEO of Northern Medical Center, Middletown, New York, since July 2022.