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Understanding Suicide

Suicide is perhaps not the most easy topic to talk about, but it surely is an extremely important one to deal with.  And the reason why we need to have conversations on it is simply to prevent it. To identify suicidal tendencies in a person therefore becomes of immense necessity prior to helping him. When one says something like “I wish I were dead” or stockpiles pills and withdraws from all social contact, chances are that they may be having suicidal thoughts.  Being preoccupied with death, feeling hopeless, increasing alcohol consumption, doing self-destructive activities all are veritable signs of potential self-killing.  While medical help is the desirable solution in case such tendencies are identified, on our part we can at least try and talk to the person such that they feel a little ease and comfortable. Supporting them in whatever way possible, encouraging them to go forward with their own life-goals, cushioning them from unwanted criticisms are very small ways in which we can help them. Being respectful, offering them reassurance without ever becoming judgemental can indeed go a long way in saving a life. Of course, everybody is not a mental health expert, but we can do our bit in helping people out. 

 

SUICIDE AND CAUSES LEADING TO IT

Suicide refers to the act or instance of taking one's own life, most often as a result of depression or other mental illness. Various studies show that in addition to mental illness, genetic and neurobiological risk factors hold importance in predisposition to suicide.

A lot of clinical conditions (like depression, psychosis, substance abuse,etc.) and situational psychological changes affect a person's mental state, leading them to lose control over their actions.

Certain events and circumstances may increase risk of suicide include:

  • Previous suicide attempt(s)

  • A history of suicide in the family

  • Substance misuse

  • Mood disorders (depression, bipolar disorder)

  • Access to lethal means (e.g., keeping firearms in the home)

  • Losses and other events (for example, the breakup of a relationship or a death, academic failures, legal difficulties, financial difficulties, bullying)

  • History of trauma or abuse

  • Chronic physical illness, including chronic pain

  • Exposure to the suicidal behavior of others


The stigma around seeking help for mental issues is the major cause leading to increased cases of suicide and the sooner it curbs the better this world will flourish. WHO recognizes suicide as a public health priority. It aims to encourage and support countries to develop or strengthen comprehensive suicide prevention strategies in a multisectoral public health approach.

At an individual level, we must make sure to end the stigma around mental health and be empathetic towards our community.

 

RISK ASSESSMENT FOR SUICIDAL PATIENTS

In the Biodyne Model (Cummings & Cummings, 2012), suicide is viewed as a three-stage process, and this knowledge enables us to masterfully treat suicidal patients:

  1. Ideation stage is the first stage during which a depressed person finds him/herself thinking about suicide more and more. However, the fear of suicide still outweighs its attraction. Therefore, the person may be thinking dark thoughts People in Stage 1 are not imminently lethal, even though many are involuntarily hospitalized for expressing thoughts of suicide in this stage. 

  2. The planning stage is the second stage, during which the person’s dark thoughts begin to turn to formulating a specific plan for suicide. Friends and family may notice the person’s depression worsening, and observe their loved one begin to withdraw from touching others or from being touched by others, or they may stop verbalizing their pain and suffering while seeming to be in more pain than ever. 

  3. Stage 3 begins when the suicidal person makes the decision to suicide. The moment the decision is made, it goes “unconscious” and the person goes on what we call “auto-pilot.” People in Stage 3 are imminently lethal; however, they seem more “normal” than they have seemed in a long time.  Be alert when a depressed patient who doesn’t seem to improve after months of intervention suddenly seems to get better. 

When people are profoundly depressed and suicidal, the usual treatment includes antidepressant medications. Very few people (including mental health professionals) are aware of this, but the risk for suicide increases instead of decreases in the early stages of antidepressant treatment. 

 

SUICIDE HELPLINES

If you know anyone around you (or you for that matter) who is going through a stressful time and has suicidal tendencies, get help by calling these organisations who help others in distress.


1. Aasra Helpline- ‪+91 98204 66726‬

2. Fortis Stress Helpline- ‪+9183768 04102‬

3. Parivarthan Helpline- ‪+91 76766 02602‬

4. Cooj Mental Health Foundation- ‪+832 2252525 ‬

5. Sneha Foundation- ‪044-24640050‬

6. iCall- ‪+91 22 2552111, +91 91529 87821‬

7. Vandrevala Foundation- ‪+91 730 459 9836, +91 730 459 9837, 1860 2662 345‬

8. Jeevan Aastha Helpline-  1800 233 3330 

9. Roshni Foundation- ‪040-66202001, 040- 66202000‬

10. Sanjivini Helpline- ‪011-24311918, 011-24318883, 011- 40769002, 011-41092787 ‬

 

SUICIDE GRIEF

When a loved one dies by suicide, emotions can overwhelm you. Your grief might be heart-wrenching. At the same time, you might be consumed by guilt — wondering if you could have done something to prevent your loved one's death. As you face life after a loved one's suicide, remember that you don't have to go through it alone. A loved one's suicide can trigger intense emotions:

  • Shock. Disbelief and emotional numbness might set in. You might think that your loved one's suicide couldn't possibly be real.

  • Anger. You might be angry with your loved one for abandoning you or leaving you with a legacy of grief — or angry with yourself or others for missing clues about suicidal intentions.

  • Guilt. You might replay "what if" and "if only" scenarios in your mind, blaming yourself for your loved one's death.

  • Despair. You might be gripped by sadness, loneliness or helplessness. You might have a physical collapse or even consider suicide yourself.

  • Confusion. Many people try to make some sense out of the death, or try to understand why their loved one took his or her life. But, you'll likely always have some unanswered questions.

  • Feelings of rejection. You might wonder why your relationship wasn't enough to keep your loved one from dying by suicide.

You might continue to experience intense reactions during the weeks and months after your loved one's suicide — including nightmares, flashbacks, difficulty concentrating, social withdrawal and loss of interest in usual activities — especially if you witnessed or discovered the suicide. 
Facing a turmoil of emotions post the death of a loved one through suicide is normal - and you do not have to go through it alone. Reach out to personal and professional sources, share your grief, and do your best to process what has happened. You can make through it.

 

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Delhi, India

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