By Dr Hamed Al Sinawi
The World Health Organization (WHO) has designated October 10 as a Mental Health Day. This year’s theme is dedicated to the prevention of suicide, given the significant increase in the number of suicides, which ranks as the second leading causes of death among young people aged 29-15 years around the world. This awareness Campaign aims to shed light on this phenomenon and explore ways to prevent it in different societies. Although suicide is an ancient phenomenon, the stigma surrounding it still prevents people from asking for help when they get to the point of giving up on life. In 2014, the 63-year-old American actor Robin Williams committed suicide. Investigations showed he had been suffering from depression for a long time, despite being in many films, some of which have won international awards. Many people wondered, why would a rich and famous person decide to take his own life?
Last week, I came across a video on social media discussing the rise in suicides around the world. The video showed that despite the high standard of living in most of the western countries in particular, some people feel like a small part in a large machine working around the clock to raise money and buy more consumer goods or secure their future due to the absence of social support in many modern societies, as family disintegration and the high divorce rate reduces family cohesion. There is also the absence of the belief in destiny and “God’s will”, which helps the individual to accept life with its sweetness and bitterness. These principles give the individual patients, resilience, and the belief that “what befalls you would not have missed you”.
From the scientific point of view, Psychiatrists and Psychologists proposed several theories in an attempt to answer the question “Why do people commit suicide?” And perhaps some answers are found by listening to people who survived suicide attempts many of whom said that they did not want to die as much as they wanted to stop living. This bizarre explanation sounds philosophical and does not provide a satisfactory answer, so psychiatrists and psychologists presented some possible factors that may explain why people end their lives. Those factors are:
- Depression, which is the most common cause of suicide in different countries around the world. Depressed patients suffer from negative thoughts about their past, present and future. At times they may feel like a failure and that they are a burden to those around them “everyone will be better off without me”. I had a discussion with a friend who experienced depression in the past and he told me that he suffered in silence as he feared if he talked to people they would call him “crazy” or “not a good Muslim” or even “seeking attention”. This is why when patients feel hopeless they may plan to commit suicide without anyone’s knowledge.
Schizophrenia, a disease that usually begins in the early years of youth and destroys the future of the patient and his/ her ability to study or find a job or have his own family. Most of the patients with schizophrenia experience hearing voices talking to them or about them without being able to see the source of the voices. Sometimes these voices order the person to kill him. It is worth mentioning that many patients with schizophrenia can lead normal lives when offered medications and psychological and family support.
Recklessness and impulsivity:
Recklessness is one of the main causes of suicide among people addicted to drugs and alcohol, especially when they are intoxicated, which may lead them to try to end their lives without prior planning. Usually, people feel guilty once they have calmed down, but could re attempt once they are intoxicated again. Psychologists estimate that the likelihood that an individual will commit suicide increases with every attempt, even if it is due to recklessness and impulsivity.
- Seeking help:
Sometimes people attempt suicide to tell those around them that they need psychological support. Occasionally, the goal may be to threaten or frighten someone who has caused them harm. The individual may choose ways that he or she does not think can cause death, but their calculations may be wrong leading to dangerous results. One of the most common examples we often encounter in emergency departments or psychiatric clinics is that of a teenage who, after an argument with a sibling or parent, swallow a large number of pills, without knowing that it will causes damage to their liver.
- The desire to die due to chronic disease: Sometimes, A person with an incurable illness such as dementia, cancer or paralysis after a car accident commits suicide because of frustration and lack of hope. The person believes that he is trying to control his destiny, alleviate his suffering, or use suicide as a means of rushing death that will happen anyway.
Can we prevent suicide?
The World Health Organization (WHO) recently released a report entitled “Suicide prevention is a global necessity.” The aim of this report is to raise awareness about the seriousness of suicide and suicide attempts and to give the issue of suicide prevention a higher priority. The report also aims to encourage and support countries in preparing or strengthen their strategies to the detection of mental illness and provision of help. One of the key recommendation of this report to the training of health care providers in the detection and early management of the suicidal patient as well as reducing the availability of the items that are often used to ends one’s life. A good example is the reduction of the availability of guns and the number of tablets one is allowed to buy without a doctor’s prescription.
Finally, while for some people, Suicide is the end of life, others continue self-distractive behaviors such as addiction to drugs, and alcohol or unhealthy relationships that leaves them feel for frustrated and shattered while appearing to others to be still alive. In my opinion, this is the worst kind of suicide, as it is a form slow and miserable death and is a source of constant distress to their loved ones.
Lets all be kind to each other and encourage those around us to talk about their distress without being judgmental.
Dr: Hamed Al Sinawi, Senior Consultant Psychiatrist-SQU