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Brigham Young is sometimes referred to as the American Moses or the Great Colonizer. He emerged from the ranks of early Church leaders to lead thousands of religious refugees across the uncivilized western frontier of the United States. He took them into a harsh country, irrigated and cultivated it and established many successful settlements. As the first group of Latter-day Saint pioneers reached the Salt Lake Valley in 1847 after traveling 1,300 miles across the Great Plains, Brigham Young looked out over what was then a barren, dry desert and declared, "This is the right place."

Utah has a high number of men who die by suicide, and researchers have long drawn conclusions to the fact that high altitude may play a part.

Something that is often ignored, however, is that women are affected by the same brain chemistry issues caused by altitude, perhaps even more so, said University of Utah research assistant and professor of psychiatry Shami Kanekar. She said that her animal tests show that females are actually more vulnerable to behavioral changes caused by a lack of oxygen at higher altitudes.

"People are happy living here, they wouldn't live here if they were not," Kanekar said. But she believes the high rates of depression and anxiety, especially among women in Utah, shows something is off.

"The difference between being at sea level and being at altitude can actually change your brain chemistry," Kanekar said. Having less oxygen in the brain leads to a condition called hypoxia, which can make symptoms of depression and anxiety worse.

Women in general, Kanekar said, have lower levels of serotonin in their brains than do men, meaning the impact of living at altitude might be more detrimental for women.

"Low brain serotonin is linked to more depression, more anxiety, treatment resistance and other biological risks for suicide, including more impulsivity and aggression," she said.

Another factor, Kanekar's research shows, is that common treatments for depression and anxiety — selective seratonin reuptake inhibitors, or SSRIs — don't work as well in people at high altitudes. Utah is the third-highest state in the country, with an average elevation of 6,100 feet, though most of the population is at around 4,500 feet.

A report published by the Institute for Women's Policy Research and YWCA Utah indicates that more women in Utah died by suicide in 2018 than in 2016.

Utah ranks fifth in female suicide rates among eight states in the Mountain West, which includes Arizona, Colorado, Idaho, New Mexico, Montana, Nevada, Utah and Wyoming, according to the report.

In 2017, suicide was the leading cause of death for Utahns ages 10 to 17 and ages 18 to 24. It is the second leading cause of death for ages 25 to 44 and the fourth-leading cause of death for ages 45-64.

Overall, health department data show that suicide is the eighth-leading cause of death for all Utahns. Utah's suicide rate has been consistently higher than the national rate.

May 24, 2018 9:00 AM

(SALT LAKE CITY) – Three common antidepressants ­– Paxil (paroxetine), Lexapro (escitalopram), and Prozac (fluoxetine) – could be less effective at high elevations, suggests research involving lab rats and led by scientists at University of Utah Health.

When rats were placed in conditions that simulate moderate-high altitudes, the three pharmaceuticals failed to suppress behaviors that model human depression. By contrast, another antidepressant, Zoloft (sertraline), worked under these conditions. The results of tests with the four drugs – all of which fall in the class of antidepressants known as serotonin reuptake inhibitors (SSRIs) – are published in the May online edition of Pharmacology, Biochemistry and Behavior.

“Being at altitude can worsen levels of depression and lower the response to SSRIs,” said Shami Kanekar, Ph.D., research assistant professor of psychiatry and lead author on the study. “We may need to be more careful about which antidepressants are prescribed to people living at altitude.” Future studies will need to determine if these selective effects of SSRIs in animals are also seen in people.

Another factor, Kanekar's research shows, is that common treatments for depression and anxiety — selective seratonin reuptake inhibitors, or SSRIs — don't work as well in people at high altitudes.

The current study adds an important element to the discussion by demonstrating that of four SSRIs tested, only Zoloft significantly and consistently lessened signs of depression seen at altitude. Moreover, there were clear differences between females and males in both antidepressant response and depression-like behavior at altitude.

Despite being within the same class of antidepressants, individual SSRIs have different pharmacological profiles, potentially explaining their varied effects.

While the current study investigated short-term impacts of the drugs and changes in altitude, it remains to be determined whether responses to antidepressants also differ over the long-term in people.