Suicide -Making sense of the Science & Signs

“She was such a spirited girl and had such leadership qualities. Cannot believe that she committed suicide.” “He was such a talented man and always so happy. Don’t know what drove him to take the extreme step.” These typical reactions show surprise and despair, bringing to the fore the curious case of—why do people who seem so successful commit suicides?

An act of ‘Suicide’ impacts the individual, the family, the community and the world at large. September 10^th is celebrated as World Suicide Prevention Day. Across the world, communities are gearing up to organize awareness camps, talks and drives, across schools, colleges and the society at large.

Suicide is globally the second leading cause of death among people in the age range of 15-29 years, reported the World Health Organisation in 2014. In India, the number of suicide deaths in this range is really high – 40% of suicide deaths in men and 56% of suicide deaths in women occurs during this time period, as reported in the 2012 Million Death Study in India. The WHO member countries have come together to put into motion, strategies to work towards suicide prevention in a more proactive manner, with a goal to reduce the incidence of suicides by at least 10% by 2020.

There are various risk factors to suicide. At the individual level, it is important to understand the subtle aspects of the mental health of the person, previous episodes of depression or anxiety; stress, pain related issues or substance abuse; family history of suicide and also family/relation based conflicts, genetic and biological factors. Dr. Dean Burnett, Guardian Science Blogger and Psychiatry tutor at Cardiff University brings to fore two important aspects of financial success and self-criticism. Dr. Burnett says that, “The capitalist and economic emphasis of much of modern society means that people are expected to show worth and acquire value, largely by financial means. The emphasis on this, coupled with the economic restrictions and transfer of wealth to the already wealthy, may well lead to increased despair, depression, futility, feelings of worthlessness etc., all of which can be strong factors in suicide.” He further adds that when people see how much others are achieving and become acutely aware of their own failings and limitations, people feel despondent and self-critical. All these can be factors that lead to suicide.

Prof. Nalini Dwarakanath, Counselling Psychologist & Therapist at the Centre for Counselling & Support, Indian Institute of Science cites various reasons that drive students to suicide in a competitive academic environment. The challenges of competition, the peer pressure, the stress of deadlines and the inability to cope often result in students experiencing low self-esteem and anxiety, coupled with self-doubt. The role of the institute in setting up a support system is vital here.  It is essential to do away with the stigma attached and encourage students to approach the on-campus counselling centre when they experience distress. Orienting new students to the campus culture, challenges of the academic environment and the available support system go a long way in helping those who experience stress and low self-esteem.  She says it is essential to believe that, “Help is available and every issue can be resolved. There is a solution for each and every problem.”

Can the science of suicides be explained in such a simple manner, just delineating the signs? While there are checklists that may help us understand whether a person could be prone to suicides, many a times people do not show any prior symptoms. In such cases, suicides may be impulsive, rather than a meticulously planned action. The recent incident of a Bangalore based theatre person ‘researching’ on ‘ways to die’ for over 48 hours prior to taking the plunge from a multi-storey building once again raised questions as to what can the community do to reach out to such individuals. A compassionate, thoughtful and human approach is essential. In a time and age when we are so engulfed in our own lives, it is essential to know people around us, to know our neighbours, to know ourselves.

How do we prevent suicides in communities? “One obvious method is to be available to people. Don't close others off or dismiss their concerns for reasons which may seem more important at the time. It's when people feel the most hopeless that they can be so vulnerable to suicidal thinking, so providing a space or at least the opportunity to find someone sympathetic to talk to, or even just someone enquiring as to their wellbeing, can be a big help”, says Dr. Dean Burnett.

There are various suicide helplines in India, some of which work 24*7. The SAHAI helpline for suicide prevention and emotional distress, set up in 2002 at the Medico Pastoral Association, Bangalore has now over a decade helped people in distress, through telephonic counselling. Mrs. Latha Jacob, Clinical Manager at the Medico Pastoral Association, talks about the role of suicide helpline in managing depression and preventing suicides.

“In the present societal scenario of need for instant gratification, helplines are useful for anyone who need information urgently or need to communicate distress. The role of suicide prevention helpline is primarily to provide an avenue to a person who is experiencing intense psychological pain to express the fears, anger or grief he/she may be going through”, said Mrs Jacob in an interview. “This also facilitates ventilation of the deep sadness, feeling of helpless emotions that a person with depression may be experiencing. A few pertinent questions will help the counselors at a helpline to identify the features of depression and help the caller to get the help they require.”

While we ponder about lives lost to suicide; let us work together to understand the signs, recognise the call for help, provide support and wash away the associated stigma. This is a battle that the community has to come forward to fight together, because even in their moment of greatest fear and despair, no one is really alone; someone somewhere is in their thoughts.

Suicide Helplines in India

·         SAHAI, Bangalore: 080-25497777

·         The Samaritans Mumbai: 022 3247-3267

·         Aasra Suicide Prevention Centre, Mumbai : 022-27546669

·         Sneha Suicide Helpline, Chennai:  044 - 24640050, 044 – 24640060

·         iCALL (a venture by TISS) : 022-25563291

·         Sumaitri Crisis Intervention Centre, Delhi :011-23389090

P.S: This piece was written a year back with an intention to publish it somewhere. Well, that never happened. So, here it finds a place on my blog. I am thankful to Dr. Dean Burnett, Mrs. Latha Jacob and Prof. Nalini Dwarakanath for their interactions and thoughts. Thank you to Sandhya Sekar who helped with the edits.