At the end of the dark tunnel
At the end of the tunnel, there is light. Yes or no is a choice; like hope is a decision.
Suicide is so paradoxical to the survival instinct! Why would someone choose such a shocking punishment for themselves? It’s something from psychiatrist, to psychologist to families & communities been pondering. – hopelessly. To find that single puzzle that will solve the problem. But the puzzle remains unsolved & suicides keep on increasing. We remain baffled … but we don’t give up! With this Mindset “World Suicide Prevention Day” is celebrated Worldwide on September 10th annually. Why celebrations … for two reasons – one obviously to increase awareness & collect data & second to bring in some positivity while bringing the discussion as due to Myths & Stigma the common man will have mindset of distancing themselves from topics which induce fear. Fear leads to denial & the eye don’t see what the mind doesn’t know!
Rather than having an attitude of Avoidance, Denial & Secrecy, we have to promote openness, Acceptance & Helpfulness. The attitude towards suicide becomes more important with alarmingly raising number, … PREVENTING SUICIDE has become everyone’s business. Knowledge & training the volunteers from community is especially required, due to gross deficiency of trained mental health professionals. Theme is also along these lines … “Lets change the narratives” – lets initiate a talk.
As far as our country is concerned, from 2018 to 2021 as per National Crime Bauru, the suicides “Registered” have been increased by 4.2%. Currently the rate is 12.4/ 1 lakh population. How many are not registered due to cultural factors is anyone’s guess, but behind one completed act, there are 25 attempts.
Some may be thinking – I have nothing to do with this. I & my family are safe. Well do you know who all are at risk of dying by suicide? Name any age, socio-economic status, gender, employment. ANYTHING – & you will find data for all. So its Anyone & anywhere.
It’s very important to know what all includes Suicidal behavior; thoughts threats, self-destructive acts, attempt to kill but not complete act, attempt to commit suicide & finally the dreaded outcome of completed suicide. At this stage of completed suicide – what intervention is left for the person in question? So, lets know who we need to focus on – our high-risk groups & the red alert signs.
Our high-risk groups are people with multiple adverse life events – indirect proportion to the event, lack of social support, poor social integration due to personality issues, people suffering from chronic medical illnesses, past / family history of suicidal attempt.
The adverse events thus can be summarized into death (especially of spouse or child), relationship issues, social status, financial issues, job status, – quite a lot bringing a sense of being a burden on significant others / society.
So psychiatric disorders as commonly believed are NOT THE only cause of suicide.
Also, the above factors if not dealt with can lead to Depression, substance abuse & various other mental disorders, which can further increase the risk of suicide – However its always better to nip the problem in the bud.
The Red alert signs are people who spoke about ending their life, or speak about death in such a manner, that it appears odd, who become reckless towards their safety, their occurs a gross change in their behaviours, who starts distributing their precious wordily materials & start writing a will while in this state.
The most important predictor of suicide is Hopelessness – No one can help me now, even God can’t do anything for me, Everyone will be better off without me, I can’t take it anymore, can’t stop the pain, now I know what “They” were going through.
This thus makes us aware that it’s not death that is chosen, but escape from unbearable psychological pain. So, suicide is not chosen; it occurs when the pain overrides the ability to deal with it.
Why the talk is important, because the first responder (the person who first recognize risk of suicide & respond) can be anyone. The person should at this time remember the acronym ACE – . A- ASK; if they are thinking about suicide.
No body commits suicide by your asking. Infect they be relieved & may tell you about what’s going on in their mind, which otherwise they maybe too embarrassed to tell.
C- Care; Listen to them empathetically, instill hope, don’t judge motive or challenge them because; your mindset is that those who want to commit suicide won’t tell about it.
E – Escort – to a safe space – a doctor, the family members. Don’t leave the person alone for heaven’s sake, for when you come back, there may not be anyone to save. Can you counsel the dead???
In brief for understanding for a common man about suicidology I have penned this article … with the aim that eventually SUICIDE HAS NO FUTURE… & people reach the light at the end of the tunnel.
Dr. HK Bedi
MD Psychiatry
