#WSPD2020 – Working Together to Prevent Suicide
1. Understand what drives one to suicide
What leads a person towards suicide? We often ask ourselves this question, WHY? What possible situation can drive a person towards such an extreme conclusion that life stops being important for them? How can I prevent someone from committing suicide? What signs can tell me if my loved one is thinking of taking that final step of giving up on life?
These are ageless, timeless questions we have asked each other and ourselves over and over again, but rarely have we received a satisfactory answer. Other than the only constant of bewilderment, suicide has remained a myth best hushed into the secret and dusty corners of our minds.
Let’s understand the background of suicide by looking into some clinical and general terms.
Some generally used terms
The implication by speaking about or taking actions suggestive of ending one’s life is considered Suicidal Behavior.
A person takes action or intends to end life but does not succeed. An attempt means the person has acted on the idea and not just thinking about it.
A person thinks of ending life but hasn’t acted upon it yet. Any level of consideration or planning is also ideation.
The act of taking one’s life doesn’t just affect that person, but the immediate and surrounding society on the whole. Relatives, friends, family, colleagues, even a short acquaintance may suffer from the after-effects of a traumatic experience like witnessing or hearing about a suicide.
Government and private organizations have studied suicide epidemiology over the years. The National Crime Records Bureau (NCRB), India, has a record of pattern and distribution of incidence and other details that have been shared in the following sections.
2. Know the factors that pose a high risk of self-destruction
Understanding what drives a person to take their own life is not as easy as it’s usually not one but a combination of factors that influence one’s mind towards this.
The 2019 NCRB records show how reasons for death by Suicide among Indians vary, from social, economic, to even ideological issues.
- Bankruptcy / debt 4.2% 4.2%
- Marriage related issues 5.5% 5.5%
- Examination Failure 2.0% 2.0%
- Impotence/infertility 0.3% 0.3%
- Family Problems 32.4% 32.4%
- Illness 17.1% 17.1%
- Death of dear one 0.9% 0.9%
- Drug abuse / alcohol addiction 5.6% 5.6%
- Unknown causes 10.3% 10.3%
- Other causes not listed in the NCRB report 10.9% 10.9%
- Fall in social reputation 0.4% 0.4%
- Ideology / hero worship 0.1% 0.1%
- Love affairs 4.5% 4.5%
- Poverty 0.8% 0.8%
- Unemployment 2.0% 2.0%
- Property dispute 1.1% 1.1%
- Suspected/illicit relation 0.5% 0.5%
- Illegitimate pregnancy 0.0% 0.0%
- Physical abuse (rape etc.) 0.1% 0.1%
- Profession/career problem 1.2% 1.2%
A. Anybody with a Mental Health issue need to seek help if they have negative thoughts
This is one of the most ignored factors among any population in any country. Near and dear ones need to understand the gravity of this condition. No, depression isn’t “pessimism,” “just another low point of life,” or a brief moment of sadness. It’s a diagnosable and treatable condition and requires as much care and compassion as any other medical issue. Mental wellbeing is as necessary as physical health.
Depression can be life-threatening if left unnoticed for long.
Suicide attempts have been reported among patients with anxiety disorders, especially panic disorders and PTSD.
Anxiety and depression are often correlated in patients thinking or contemplating suicide. Anybody with diagnosed mental illness should be counselled to reduce the risk of suicidal tendencies. Those exhibiting warning signs should seek or be referred to seek professional help at the earliest.
Borderline Personality Disorder (BPD)
Being in a chronic condition lasting for years, BPD patients are reported to have suicidal ideations more than once. As BPD patients may have other mental comorbidities, the situation becomes far riskier. They may also resort to self-harm and substance abuse to escape emotional pain. Be it self-harm, suicidal ideation, or suicidal attempt comes, it is very import to seek Psychological counselling for long term conditions such as this.
A study shows that the suicide rate among patients with schizophrenia spectrum disorders (SSD) is 170 times higher than the general population. Considering the varied symptoms experienced by patients with this condition, psychosis was the primary focus of treatment. However, psychiatrists have stated that this study has made it evident that suicide prevention should become part of a schizophrenic patient’s therapy.
Bipolar Disorder (BD)
A major cause of fatality among patients of bipolar disorder is suicide. To reduce the risk of ideation or attempt to end their own life, a person requires regular clinical evaluation of their mental state.
Psychiatric intervention is a must in this condition.
Other mentally or emotionally stressful triggers
These are experiences or witnessing domestic violence, social isolation due to medical issues, being a victim of bully or harassment, family history of suicide, prior attempts.
Trauma or Related disorders
An event of trauma, no matter how much time has elapsed, poses a significant threat in a person’s psychology. An intense feeling of hopelessness may drive one to take a wrong decision.
Experiencing or witnessing sexual abuse (childhood, adolescent years), rape, physical abuse, war trauma, assault, or any event which may be difficult to process, can be potent triggers for suicidal thoughts in the future. Best preventive measure would be to seek professional help in handling such incidents.
B. Influence of substance abuse may be a risk factor
Drug and drinking disorders can influence a person to act on impulse. Substance abuse may be a powerful trigger in combination with situations like job loss, a broken relationship, etc. Substances and alcohol may increase the risk of suicidal acts if the patient has existing psychological disorders.
C. Loss, or the fear of loss, in terms of job, reputation, relationship, loved one
Failing an exam, facing ridicule from family or social acquaintances including bullying, shaming, or any act of humiliation, fearing ridicule due to medical condition can drive one towards severe depression and anxiety. Behavioral issues, sexual orientation, etc., losing financial strength (unemployment or business failure), imprisonment, broken heart, death of a loved one, all of these are life experiences that may influence negative ideas in a vulnerable state of mind.
D. Physical pain and long-suffering health
Patients with severe and chronic medical conditions often think that death is the only way to regain control over their life as they feel that they have lost their dignity due to the illness. Some patients with experience of chronic pain or terminal illness like cancer, disabilities, HIV, etc. may have depression which in turn may influence their thoughts of the near future.
It’s important to acknowledge that an attempt of suicide is a call for help. One would not wish to die, but their actions could turn out fatal by accident.
Primary causes were reported as domestic problems excluding marital issues in 32.4% cases, marital disputes among 5.5%, and 17.1% chose this drastic step due to diseases.
The highest suicide rate in age group: was 18 – 30 years, closely followed by 30 – 45 years group
Most common means people resorted to for suicide, were hanging and poisoning.
3. Learn the warning signs
These signs are discussed to help you understand if you or anybody close to you need professional help. Kindly refer to a registered mental health professional if you come across situations where a person is expressing signs of suicidal ideation or contemplating an attempt.
Common behavioral signs in a suicidal person
- Comments, sharing thoughts of or contemplating to end own life
- Avoiding social interaction
- Withdrawing from friends and family
- Being aggressive, impulsive, or reckless, not usual nature
- Dramatic mood swings
- Increased drug or alcohol use
- Little sleep
- Giving away personal possession
- A drastic change in food intake and weight
- Sudden change in personality
If you hear these often from a person exhibiting noticeable behavioral changes:
“No reason to live on.”
“Only way out.”
“I wish I were dead.”
Suggest professional help
4. Suicidal tendencies can be managed with expert help
Talk to a doctor who specializes in treating mental illness or other mental healthcare providers. Cognitive Behavior Therapy (CBT) is a talk therapy that can teach you to handle stressful events of life and work on your emotions to bring a sense of satisfaction with your life. You may be suggested lifestyle changes like avoiding alcohol and drugs, getting regular exercise and adequate sleep.
Reach out. A friendly ear or a loved one’s warm and positive presence can bring you back from that edge. You are not alone. You don’t need to be. Organizations, support groups, your employers, or family and friends can seek professional help for you. All you must do is to take that first step and ask for help.
Some medications can help. Your psychiatrist will decide if you do need one to help with your clinically diagnosable mental health conditions.
Work with your therapists and doctors. Do not skip medications or suggested therapy. Keep up with follow-ups.
“There will be many reasons for you to want to let go. When that happens, look around for a moment, and even one little reason you find to hold on is enough never to let go.”
-Ms Trisha Ray, Consultant Psychologist and Special Educator
5. Dealing with the possibility of suicide by someone you know
If you become aware of someone seeking to acquire means of committing suicide, find help.
If you sense any immediate danger, remove any object of threat, reach out to suicide helpline numbers or visit your nearest hospital emergency.
Listening is the best skill you can use right now. A person has gone through a lot to have come to such a point of giving up on life. Do not judge, argue, or antagonize. A patient and compassionate audience can bring back someone from that edge. If need be, escort the person to the emergency or a trained professional.
- Immediate visit to a Psychiatrist / Psychologist / Hospital – Emergency on noticing warning signals, especially attempts
- Subsequent continuous Psychotherapy with a Psychologist
- Visit a Psychiatric Social Worker if needed, later
Call RxDx for Personal and Corporate Psychological Counselling
Ms Trisha Ray, RxDx, Consultant Psychologist and Special Educator (Masters -Clinical Psychology, B. Ed – Special Education, CBT – USA, RCI – registered) is highly skilled in Psychological Consultation, assessment (up to 17 years), and psychotherapy for children, adolescents, and adults. Ms Ray is well-experienced in Corporate Counselling.