September 9, 2023
The word suicide originated from the Latin words “sui” and “caedere”, which together translate to “kill oneself.”
Suicide is an act done intentionally to cause death.
Worldwide 7.5 million people die yearly of suicide. In our country deaths last year due to suicide were 1.64 lakhs.
Suicide is the fourth highest cause of death among teenagers and young adults.
Ingestion of Pesticide, hanging and firearms are the commonest ways in which suicide is committed worldwide.
Past suicide attempt is the most predictable and deadly risk factor in someone who commits suicide
Every year World Suicide Prevention Day (WSPD) is observed on September 10. The theme for 2023 is ‘Creating Hope through Action’.
We Psychiatrists view suicide as preventable.
What are the risk factors for suicide?
Previous suicidal attempts
Clustering together of life stressors
Diagnosis of severe progressed illness
All of these are few of the factors which increase the risk of suicide.
What precedes suicide?
Many family members who have lost loved ones to suicide ask us what precedes the act of killing oneself?
When we interview patients who have failed suicidal attempts, many heart melting revelations are made. Most people view at the time of attempting suicide that suicide is the only way to end their agony. They feel hopeless about their future and so helpless that they decide that ending their life is the only answer.
In many cases there would have been an immediate stress or a cluster of stressful life events which the person is unable to overcome, eg death of a supportive spouse at the time of retirement, heavy financial loss leading to fall in social stature, exam failure, detection of life threatening illness such as advanced cancer or even revelations of a cheating spouse.
Susceptible individuals are usually either too impulsive or too stubborn. Some are non-resilient and have poor coping strategies. Sometimes it’s just a sudden impulsive act done under intoxication and in some rare cases even a mental health professional wonders “Why “?
As a psychiatrist, i often analyse events and behaviour leading to suicidal act. We also study at what levels it could have been prevented. Psychological autopsy is what we term it. This aids in managing other clients with suicidal ideation -to preserve life and prevent death!!
One of the most important things, is never to hesitate to ask this difficult question to a depressed individual - “Do you get thoughts of ending your life?” many of us presume that by asking this question we can induce these thoughts, but it doesn’t happen that way. So if you think someone near you is depressed and tells you he is, ask him if he has suicidal thoughts and if he says yes don’t waste any time to seek professional help. You may have just prevented a death!
Another vital thing is to see if a person who is depressed has attempted in the past. If yes, there are chances he will attempt again. Seek help ASAP.
To see if there are means of harm available and enough opportunity of being alone to execute, is required.
In USA firearms are freely available. Suicidal deaths are more due to gunshot injuries as it’s easy to procure guns there. In our agricultural economy it’s easier to get pesticide and hence that is the method chosen. Divorced, unemployed and those staying alone are more likely to kill themselves than those who have a good support system.
A person who takes alcohol and loses control is more likely to attempt in an intoxicated state that when sober as alcohol blurs logical thinking.
Sometimes we expect certain life events to push a person to end his life. Loss is one such state- it could be of a loved person, income, social status, reputation or health. Susceptible impulsive individuals may suddenly take this drastic step. This one is difficult to predict.
Copycat suicides are seen in a follower cult like phenomenon when after death of a celebrity, people who identify with that person may attempt similarly. A suicide in the neighbourhood or family can also trigger a similar response.
Suicide in certain populations deserve a mention.
Teenagers attempting suicide may often be impulsive in nature. Sudden unexpected stressors can lead them to attempt without much forethought of consequences. An acid remark from a parent stating she is useless has been a cause in some cases. Things like mobile being confiscated has also been published in some instances. It is important to note here that “was the child abusing mobile to self-medicate depression?”
Postpartum suicides in women who have just delivered are not uncommon. Depression in postpartum period is often missed. Women have ended their lives with the newborn. This is preventable if treated on time. There are lot of hormonal changes post-delivery and postpartum depression is seen in over 10% of the cases!
Suicide in elderly is often hushed and not spoken about due to the shame associated with it. Old age weakens our coping. Medical illnesses only add to the risk of suicide. Being lonely and widowed compounds it. “I have become a burden on others” precedes these attempts. Be wary when seniors wish themselves dead. They may act to take their own lives.
We also analyse protective influences against suicidal behaviour. Remembering a loved one or a person dependent on oneself like a child, deters suicidal behaviour. Religion is a protective influence in those who believe strongly in God. If my religion strongly says that committing suicide is a big sin and you will burn in hell if you die by suicide and I am a believer of that religion, it can deter attempting suicide.
Having a close friend or a life partner who is supportive are strong protective influences. Stable job and steady source of income also prevent suicide.
Another paramount but often stigmatised and underutilised avenue is seeking help for depression and suicidal ideations.
Asking for help in mental distress, seeking treatment for depression is wise. It takes courage to seek help for mental distress. It is not a sign of weakness.
Treating mental illness can prevent suicide. Depression causes a person to have suicidal ideation. The symptoms of depression are death wishes, suicidal thoughts and plans to kill oneself. Treating depression stops these thoughts from coming.
In my career it has been my sincere endeavour to reduce stigma against mental illness. Over years I have seen people’s mindset change drastically. Youngsters are coming up on their own stating issues troubling their mental health. Celebrities are talking openly about it on social media. Slowly but surely we are moving in the right direction. It is heart-warming to see.
My sincere prayer is that “Let no one die of suicide just because the family was in denial of his mental health needs.”
Prevent suicide and save lives!!!