Dr Seram Chaoba Devi
Doctor! Doctor! Please save my only son, he is just 26 cried the lady in her late 60s. He was found hanging in his room…brought to the emergency room in an unconscious state, immediately shifted to ICU. In spite of all the efforts to save him, the young man lost the battle of his life after 3 days in the ICU. The mother recalled- his son had been keeping low since the past few days after a breakup with his longtime girlfriend.
A young girl in her early 20s came to the emergency crying. Her left forearm was wrapped by a cloth with blood all over it. Upon opening the cloth,there were fairly deep cuts on her wrist requiring 3 stitches and some hesitant cuts on the forearm. The girl stated that she had a fight with her younger sister over some issue and she couldn’t control her anger. She also had 2 such similar incidents in the past.
A middle aged male walked in the OPD room with a frowning face. On interviewing he said he had been feeling depressed since past 2 months, not able to perform his daily routine activities properly, has been eating less, feeling less confident, not able to enjoy anything recently, repeatedly had the thought that life was not worth living, feeling hopeless, constantly talking about dying and suicide to his family members, had even planned for the same.
AND the list continues…..
Every 40 seconds someone takes their own life, this means a total of more than 7 lakh deaths by suicide worldwide per year.
In India, there are 381deaths by suicide per day which means there will be around 16 deaths by suicide per hour.
For every suicide that results in death, there are as many as 20 attempted suicides.
Each and every suicide is devastating and has a profound impact on their loved ones.
On 10th Sept every year under the initiative of International Association for Suicide Prevention(IASP),world suicide prevention day is observed in order to provide worldwide commitment and action to prevent suicides.
EACH LIFE IS PRECIOUS
Struggling to bring up the topic of suicide?????
We know that someone is struggling or we are struggling ourselves still we are hesitant to talk about it.
Reason being: we worry that we won’t say the right thing or worse that we will say something that will cause the person to act on their suicidal ideation.
In reality, asking someone directly about suicide is often a way to both help the person feel heard and help them find the help and resources they need. Talking about this issue is an important first step in ridding society of the idea that mental health issues should remain hidden. If someone is thinking about suicide it should be taken seriously and non- judgmentally. Suicide is not just a health issue but a social issue and it is everyone’s duty to save the life. Help the individual seek a professional and do not leave them alone.
Suicide is PREVENTABLE
The best way to prevent suicide is to recognize warning signs and knowing how to respond to such crisis situation.
** Warning signs of suicide
· Often talking or writing about death, dying or suicide.
· Making comments about being hopeless, helpless or worthless
· Withdrawn from friends and family
· Frequent mood changes
· Talking about feeling trapped or being a burden to others.
· Expression of having no reason for living
· Talking about great guilt or shame
· Using alcohol or drugs more often
· Feeling unbearable emotional or physical pain.
· Giving away important possessions
Who are at risk?
90% of the individuals who took their own life suffered from some type of psychiatric disorder. Depressive disorder, bipolar disorder, schizophrenia, personality disorder, post traumatic stress disorder, substance abuse are associated with greatest risk of suicide.
Other risk factors include divorced, widow/widower, family history of suicide, stressful life events like legal troubles, financial difficulties, loss of loved ones, violence, chronic pain.
Depression alone has 20 times higher risk for suicide than any other disorder.
How can it be prevented??
· Proactively enquire about death wishes, suicidal ideation,simply making the time and space to listen to someone about their experiences of distress can help.
· Help them seek professional help.
· Give your free time in service for prevention of suicide.
· Support each other
· Do not stigmatize and discriminate any person with mental illness
· Preparing children for challenges for life.
· Reducing the availability of means for suicide
· Influencing media portrayal of suicide
· Educating the public about mental illness and its treatment
· Telephone helpline and internet based support.
The suicidality can be drastically reduced once the treatment starts. Many treatment modalities are available now
1. Many cost effective antidepressants are available and depression can be treated effectively and efficiently thereby reducing suicides.
2. ECT (electroconvulsive therapy) for quicker management of suicidal thoughts and attempts.
3. Supportive psychotherapies
4. Meditation, Yoga Ashan and relaxation therapy are adjuncts for keeping the mind healthy and also helps in suicide prevention.
5. Providing psychological first aid.
THEME 2021: ‘Creating hope through action’
This year theme is a reminder that every individual is a key player in suicide prevention. Our actions, no matter how big or small, may provide hope to those who are struggling. Your smallest action may be the only light in their darkest moments
Mental health act 2017 decriminalized suicide.
Any person who attempts to commit suicide shall be presumed unless proved otherwise,to have severe stress and shall NOT be tried and punished under 309IPC.
Lastly some myths about suicide:
Myth 1: Once someone is suicidal, he or she will always remain suicidal.
Fact: Heightened suicide risk is often short term and situation specific. While suicidal thoughts may return, they are not permanent.
Myth 2: Talking about suicide is a bad idea and can be interpreted as encouragement.
Fact: Talking openly about suicide can give an individual other options or the time to rethink his/her decision, thereby preventing suicide.
Myth 3: Most suicide happen suddenly without warning
Fact: The majority of suicides have been preceded by warning signs, whether verbal or behavioural.
Myth 4: someone who is suicidal is determined to die
Fact: Suicidal people are often ambivalent about living or dying. Access to emotional support at the right time can prevent suicide.
Myth 5: people who talk about suicide do not mean to do it.
Fact: people who talk about suicide may be reaching out for help or support. Majority of the people contemplating suicide are experiencing anxiety, depression and may feel that there is no other option.
Conclusion: To all those who are currently experiencing suicidal thoughts, I just want to say…
you cannot realize how much you would be missed by your loved ones if you were not here because of how badly you feel. There is help and hope available,your life is worth living even if it does not feel like it now.
The writer is a consultant psychiatrist at Shija Hospitals and Research Institute. The writer wants to thank prof. Dr N. Heramani Singh, senior consultant psychiatrist at Shija hospitals for his contribution in writing this article.
For any feedback the writer can be reached at [email protected]