Let's talk about Suicide

September 10th is World Suicide Prevention Day. Suicide is the third leading cause of death among young adults worldwide.The first act of suicide probably occurred before the beginning of written records. Historically society's attitude towards suicide reveals a wide range between a rational one of acceptance, an irrational one of superstition and a hostile one of punishment. Socrates felt that in some circumstances it would be permissible and even a necessity for a man to end his own life.

Plato supported the general philosophy against the suicide act, with the exception of suicide ordered by the state and in extreme cases of poverty and sorrow. Aristotle considered suicide a cowardly act and an offense against the state. The word suicide was initially used by Sir Thomas Browne (1642) in his treatise 'Religio Medici'. This word originated from SUI (of oneself) and CADES (murder). The word suicide breaks down into the Latin words sui and caedere, which together translate to 'kill oneself.'

Each suicide is a personal tragedy that prematurely takes the life of an individual and has a continuing ripple effect, dramatically affecting the lives of families, friends and communities. Every year, more than 1,00,000 people commit suicide in our country. There are various causes of suicides like professional/career problems, sense of isolation, abuse, violence, family problems, mental disorders, addiction to alcohol, financial loss, chronic pain, etc.

Despite the difficulties in identifying the risk factors in any individual case, there are useful guidelines available that outline major risk factors and which give guidance to individuals who may be concerned about their own suicidal thoughts and for parents and friends who may be concerned about the behaviour of a child or friend.

A risk factor is anything that increases the likelihood that a person will harm themselves. However, risk factors are not necessarily the cause. Research has identified the following risk factors for suicide (DHHS 1999):

• Previous suicide attempt(s)

• History of mental disorders, particularly depression

• History of alcohol and substance abuse

• Family history of suicide

• Family history of child maltreatment

• Feelings of hopelessness

• Impulsive or aggressive tendencies

• Loss (relational, social, work, or financial)

• Physical illness

• Easy access to lethal methods

• Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or suicidal thoughts.

Suicide without warnings is not uncommon. Many people who commit suicide never talk about what they are feeling or planning.Most experts on suicide agree that death by suicide often defies prediction. It is rather unfortunate that the people who are most intent on committing suicide know that they have to keep their plans to themselves to successfully kill themselves.Suicide almost always raises anguished questions among family members and friends left behind- What did I miss? What could I have done?

Factors that can put a person at a higher risk for suicide in the short term can be an illness that can effect mood like cancer, stroke or heart condition, an episode of depression, severe anxiety or psychosis, a significant loss such as death of a spouse or child or loss of a job, a personal crisis such as a financial crisis, break up with a loved one or divorce, loss of social support or exposure to suicidal behavior of others like friends, peers or celebrities, to name a few.

Suicide has a devastating effect on families, friends and communities. The loss of a loved one through suicide is like no other and the grief process can be very traumatic and complex. People coping with this kind of loss because of suicide often need a lot of emotional support and counselling.

By

Dr Joydeep Das

Clinical Psychologist

Consultant, MIND India

Ask Dr Sangeeta Goswami

Question. How can I recognize if someone is feeling suicidal?

It is difficult to accurately recognize the warning signs of suicide. However, there are certain signs which you can look for.

• A change in mood, behaviours, or appearance

• Expressing (through words or actions) about having no reason to live or no purpose in life

• Depressed mood

• Seeking access to pills or poisons, weapons or other means and also seeking information about possible suicide methods

• Expressing (through words or actions) that they feel trapped like there is no way out, or that they are unable to find an alternative solution to their problems.

• Setting their affairs in order like giving away valued possessions, or asking others to take on responsibility for the care of people or pets. (These are some signs)

If you see these signs, try to seek professional help immediately. It is important for people who the person has left behind to understand that they are not at fault or to feel guilty. There can be survivor's guilt at times post the incident. Grief has its own stages of healing process and as Elizabeth Kubler - Ross says these include denial, anger, bargaining, depressions and acceptance. It is not necessary that the stages will be in the same gradation but knowing the different stages will help to understand one's own process of healing and coping.

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