Suicide: Chasing death

Dr Meesha Haorongbam *

Suicide, the act of intentionally taking one's own life, literally means to "kill oneself". There is a quote which is often attributed to Mark Twain, "Everybody talks about the weather but nobody ever does anything about it". While I do not mean to make light of such a serious topic, this is sadly the case for suicide in our society.

We have been bombarded with numerous news and discussions about suicide. Yet misinformation and misinterpretations have been so tightly wrapped around the conversations regarding suicide that it's now hard to discern the facts enclosed inside.

The very mention of the word "suicide" invokes uncomfortable feelings in the majority of us. But we have to leave our discomfort aside and keep the conversations moving around this highly preventable cause of death. Year after year, suicide continues to remain one of the top 20 causes of death globally across people of all ages and it is the second leading cause of death in the 15-29 years age group.

Worldwide, one person dies due to suicide every 40 seconds. Which means, every year close to 8 lakh people die by suicide. Let us not forget that for every completed suicide, 25 suicide attempts are made, and numerous others have serious thoughts of suicide.

Closer home, the situation's not very different. We mourn and make #suicide prevention or #suicide awareness trend whenever a famous personality takes their life, but we often neglect the fact that every 4 minutes an Indian dies by suicide.

We never give more than a passing glace at statistics but the statistics of suicide should more than alarm us. Every life lost represents someone's child, parent, friend or colleague. Thus, one act of suicide has a ripple effect causing intense grief and suffering to countless others.

Suicide doesn't discriminate and no one is immune to it. It affects both genders, all religions, all age groups and across all socioeconomic strata. It does have certain risk factors such as: males, people between 15-25 years and above 60 years, those who are single/widowed/divorced, those with mental illness or excessive substance use, those with no social support, etc.

It is worth mentioning that not everyone with these risk factors attempt suicide. Conversely, even people without these risk factors may have suicidal thoughts and some may succeed in carrying out the final act.

So what pushes people toward suicide? What makes us, mortal beings, chase death, when death is inevitable anyway? There is no single easy answer. Suicide is the result of a convergence of genetic, psychological, social and cultural and other risk factors, aggravated with experiences of trauma and loss.

Almost everyone links depression to suicide and though it is well established that majority of those with suicidal behaviour are depressed, I'd like to impress upon the readers that depression does not always lead to suicide and it is not the only cause for suicide.

There could be various other reasons that media and professionals don't talk about- mental illnesses such as personality disorders or substance dependence, domestic violence, education related stressors, discrimination faced by LGBTQIA community, dowry, poverty, debts etc. Any event or environment that leads to an intolerable situation can be a cause of suicide.

A commonly held opinion is that suicide cannot be prevented; that suicide is a personal matter that should be up for the individual to decide; that the major determinants of suicide are factors over which an individual had little control. But this isn't always the case for suicide is often a permanent solution to a temporary problem. It is not an attention-seeking behaviour. It is a cry for help.

The only ray of sunshine in a topic as dark and serious as suicide is that suicide is preventable. It is a myth that once a person has suicidal thoughts, there is nothing anyone can do about it. Each one of us has a role to play in preventing suicides. Family and friends can be the first step toward helping an at-risk individual by recognizing the warning signs.

Some common warning signs are: talking about being a burden, giving away important possessions, making a will, withdrawing from friends and family, etc. Often fear of not knowing what to say and not knowing how to respond, prevents us from reaching out to someone who might be struggling with suicidal thoughts. But do reach out. This simple act can help alleviate suicidal thoughts.

Because a lot of social and environmental factors also come into play, suicide prevention involves interventions that occur in communities, social and policy reforms, and those that are delivered directly to individuals. Policy reforms such as decriminalization of suicide by the Indian government have helped in more people coming forward to seek help for suicidal thoughts. Various other interventions are required.

Here are some simple but highly effective steps that can be taken up:

- Blocking access to means of suicide like insecticides, firearms, providing railway barriers etc
- Responsible suicide-related reporting by media to prevent copycat suicides.
- Stopping the glorification of suicide and depicting suicide as an acceptable response to crises in movies and books.
- Promoting greater awareness about crisis intervention
- Improving the capacity of primary care workers and specialist mental health services
- Destigmatising mental illnesses and increasing health-seeking behaviour for such illnesses.

10th September is observed as World Suicide Prevention Day every year and this is the third time that the theme "Working Together to Prevent Suicide" has been chosen.

This theme highlights the key component for effective suicide prevention- collaboration. Collaboration is critical to preventing suicide. Everyone can be a key player in suicide prevention. Each one of us can make a difference- as a child, a parent, a friend or a colleague. You can raise awareness about suicide, educate yourself and others about the causes and warning signs for suicide, and help destigmatize suicide.

Last year, WHO launched the 40 seconds of action campaign which aimed at:
1. Making suicide prevention a global health concern
2. Improving knowledge of what can be done to prevent suicide
3. Reducing the stigma associate with stigma
4. Letting people who are struggling know that they are not alone.

It invited everyone to take just 40 seconds each day to show they care, in whatever little way they can. E.g.
1. 40 seconds to chat with someone in distress
2. 40 seconds to share a message on suicide prevention on social media
3. 40 seconds to generate awareness at one's workplace
4. 40 seconds to grief with a family who lost a dear one

The global response was highly encouraging but the work doesn't end there. World Suicide Prevention Day is a starting point and what we do after 10th September matters too.

COVID-19 pandemic has brought about a tremendous positive change in our knowledge about infectious agents, communicability, personal hygiene, etc. And the lockdown that was implemented saw a wave of increased awareness in mental health and maintaining mental hygiene too. If only we can maintain this new found awareness, imagine the massive change that would bring about in the future.

So, to the ones who know someone struggling with suicidal thoughts, reach out to them and lend your support. Reaching out is challenging, but the end-result is often life-changing. To the ones who've lost a loved one to suicide, sublimate your grief and energy towards increasing awareness about suicide so that no one else has to suffer the same pain.

And to all those who are currently toeing the line between continuing to fight the demons in your mind and ending your pain, remember suicide cannot end your pain; you will only be passing it on to your loved ones. Remember you are not alone, you won't always feel like this, and the bravest thing you can do is admit you need help and ask for it.

Under the initiative of National Health Mission, Manipur, a dedicated team comprising of psychiatrists, psychologists, and psychiatric social workers have been providing tele-counselling during this pandemic.

Please contact the following numbers if you're struggling with psychological issues:
8787457035 / 9402751364 / 7629943596.