IU doc confirms more suicides during full moon, aims to help patients
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A Hoosier psychiatrist has proven what has long been “medical folklore”—that more people commit suicide during the full moon. The team, led by Indiana University School of Medicine Psychiatrist Dr. Alexander Niculescu, studied blood samples from suicide deaths collected at the Marion County Coroner’s Office to uncover the “significant increase.”
The study also revealed that September is the peak month for suicides, which underscores Niculescu’s message as the month draws near. “It’s all about prevention,” he says, because “once tragedy has occurred, it’s too late.”
Confirmation of this long-suspected phenomenon is also opening the door to the next innovation for MindX, an Indianapolis-based startup co-founded by Niculescu.
“In the medical field, there’s been this anecdotal impression that during the full moon, there’s a sort of exacerbation of mental illness and maybe suicides. But that was all just folklore,” says Niculescu. “We’re scientists, so we wanted to test that empirically to see, first, is it true? And second, what could be a potential biological explanation for it?”
As a practicing psychiatrist, Niculescu says the most practical application of the discovery is that doctors pay even more attention to patients who express suicidal ideation during the week of the full moon and err on the side of more rigorous evaluation or admitting the patient for observation during the timeframe. “And take them even more seriously,” says Niculescu, during the peak month of September.
Even Shakespeare suspected the mysterious correlation centuries ago when he wrote “[The moon] comes more nearer earth than she was wont, and makes men mad.” In a playful spin on science, Niculescu credits Shakespeare’s astute observation in his published paper, which also uncovers the fascinating biology behind the phenomenon.
Niculescu had already discovered years ago that certain blood biomarkers indicate suicide risk; the blood test is one of a handful that MindX has commercialized. The blood panel for suicide risk includes genes that regulate the body’s circadian clock, which is highly impacted by light. “Circadian clock genes” that “drive our whole biology and make us be awake or be asleep,” were found to be increased during periods of the full moon, as well as the month of September.
“We did this study initially just to see, ‘Is there anything to this folklore? The fact that we also found the biological basis supporting it was the really interesting part,” says Niculescu. “The full moon—light striking at night when things should be dark—activates vulnerable people and their biology and may lead to suicide. It makes them active when shouldn’t be.”
Niculescu suspects this sensitivity to light could even correlate to the use of electronics, which mimic a “full moon-type effect,” by creating light “at the wrong time and activating vulnerable people.”
“When you think about it, a lot of people—especially young people—have a full moon in their hand every night: the cell phone, which throws that light at night when it shouldn’t be there,” says Niculescu. “There could be some effect that we haven’t studied of having all these screens at night—like having a full moon all the time. Who knows if that’s one of the reasons why we’re seeing an increase in suicidality in teenagers and so on? It’s not that far-fetched to make an extrapolation from what we’ve done [in our study] to this. This is something we’d like to study more in the future.”
Niculescu says the full moon effect was less noticeable in young people because they “already have a full moon in [their] hand all the time.”
Niculescu is emphatic that the moon-based discovery “inform doctors in the real world.” This is the mission for MindX, which has commercialized blood tests for not only suicide risk, but also mood disorders (depression/bipolar), PTSD and memory/Alzheimer’s.
“We’re always very mindful of how to translate this to practice,” says Niculescu, “so we can help doctors and patients in a practical way and not just publish interesting studies.”
Later this year, MindX plans to add a circadian clock risk analysis component to its current suicide panel. Niculescu says blood tests offer the additional advantage of helping match patients to the most effective medication for their unique biology, and such connections were made when studying the circadian clock genes.
Niculescu says the study also revealed which medications would work best for patients who show an increase in circadian clock genes during the full moon.
“Suicide is a clear and present danger across age groups, demographics and populations. While we’re making progress in science, there’s a lot of progress to be made in translating these things to clinical practice, raising awareness, implementation and making these blood tests widely available,” says Niculescu. “The more risk factors [that are uncovered], the earlier you identify things…and the better the outcomes.”