where are we going wrong??

Please see this post is meant to throw some light on how to approach a person who has expressed suicidal ideas or has attempted and fortunately survived.

I will not be discussing the causes and preventive measures, which is a very vast and debated topic. But one thing that every mental health professional will agree to is that it is extremely unpredictable and anyone can do it and every idea and every attempt has to be taken seriously

A few warning signs which i can think of right now are:

  1. Talking, writing drawing or in any way expressing about death.
  2. Talking or expressing hopelessness, having no reason to live, being a burden to others, or not being there for the next day.
  3. Looking for ways to attempt suicide.
  4. Expressing a feeling of being trapped, desperate.
  5. Giving away possessions.
  6. Talking about life after death.
  7. The person who has been suffering from depression(psychomotor retardation), suddenly becoming active.
  8. reckless behavior.
  9. Absenteeism from work .etc.

suicideawareness

“Arent we all stars , meant to fall for someone else’s purpose “he said.

“This is it,i cannot handle life anymore,i want to just get over with it.”she said.

“Please give me some poison ,i want to end it all.” she said

“I want to kill myself” they said.

These are all(of many other) clear cut ‘red flag signs’.

Taking any of these signs seriously,one should take immediate help.

  1. End the silence and ask the question: ask the person if he or she needs help,ask them if they are thinking of attempting suicide.Ask.         Yes ,it is a myth that talking about suicide puts the idea in a persons mind.No it doesnt at all,Rather it helps venting out and can help in preventing it.
  2. Donot leave the person alone: there is another disheartening myth regarding suicide ,that the one who actually dies does not express about it ,and the one who expresses it will not do it. THAT IS A BIG NO!!. Expressing about it means that is person is calling out for help and that is what we are supposed to do.
  3. Donot keep the warning signs a secret!: contact someone you trust who can help you. SEEK PROFESSIONAL HELP by professionals i mean,mental health workers,which include, qualified psychiatrists,psychologists,mental health nurses,mental health social workers.Well ,suicide helplines are some what helpful,but it is sad that the functioning of these helplines in our country is questionable. For the medical students who are reading this,you can contact any of us residents ,for you reaching to us is easier than general population.You can come in the casualty at any hour,and during OPD hours that is from 9 am to 3 pm you can come to our OPD (room no.132,new OPD building ,sir t hospital Bhavnagar.) or the ward. We will take care of confidentiality.

One patient of mine once said “by the time someone is considered to need suicide prevention,the world has already failed them” it is sad but somehow true,approximately 90% of suicide attempts are done by people suffering from some or the other psychiatric illness(i was supposed to not mention about the predecessor of suicide, but i am still learning to put my frustrations and emotions out of my writings,the recent increase in number of suicides has raised the level of frustrations amongst me and some of my fellow mental health workers,no body can be blamed for it, but we are struggling really hard to break the stigma and myths regarding mental illnesses and their treatments.Anyways this was not meant for venting my frustration.

Well, i understand that hearing the words that i want to die, commit suicide or kill myself can come as a shock to hear and we find it difficult to how to react to it. There are a few common responses which i would like to question here :

  1. You are just trying to get some or need some attention”: well not everybody wants attention and even if one wants what is wrong in doing that? someone confessing to you that he or she wants to end his life means that he is asking for help and questioning their intent is demeaning their faith on you.                                Yes i agree there are illnesses where people indulge into deliberate self-harm, but that also cannot be taken lightly as which attempt turns out to be fatal cannot be ascertained.
  2. suicide is cowardly, it is a sign of weakness“: How exactly can one define strength?? It is an adjective and is always meant in relative terms, calling someone who is expressing his ideas of suicide to you,weak is like serving ‘shame‘ in a platter to them.                                                            It does not really help, rather it pushes them away from you. Most of us fear death and overcoming the fear of death is not brave but not cowardly either.
  3. Oh! your life stresses are so less, or your life is so good, why do you want to die, learn from me, or are you stupid to have done so just for such a petty reason“???: this might be true, yes people with stresses ,who have better or different coping mechanisms ,can cope with things whihch the patient in distress cannot ,but that does not mean that he or she is not allowed to go through his pain in his way, every person has a different mental and psychological makeup and comparing with others (which the person might have already done, and blamed himself for being defective.)                                         Does a lot of harm so one can try to refrain from it. i would like to quote a metaphor, i heard in a movie, “after a storm, some trees fall while some don’t, why? because they are different some might be giving more fruits but are weak in the roots.”
  4. Suicide is selfish” this is an invitation for guilt, one of my patients reverted to this, how is it selfish to free people who are suffering because of, so no it is not helping at all, and might reinforce it!
  5. you are just saying this, you actually don’t mean it“: imagine someone telling you that the pain you are having after a fracture is “you are just saying it, you do not actually mean it”??                                  it is very demeaning and dismissing, instead can we not take everyone who says so seriously??.

Well, i have only had a little experience (4 years) of dealing with patients who express death wish and the only thing which i feel one can do it, taking it seriously, not judging the person, trying to understand his or her situation and just listening.

Of course, seeking help from professionals and taking the appropriate treatment for the underlying psychiatric illness cannot be missed.

The new mental health care act 2017 has decriminalized suicide i.e. “Notwithstanding anything contained in section 309 of the Indian Penal Code, 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 the said Code,” . So even the law has accepted it to be done under severe stress ,can’t we look at it that way?

A person who is accepting suicidal ideas is already very sensitive ,so we can try being a little understanding towards them and weighing what we say .

Your life is precious, you are wanted and you might not see it but there is always some solution available.

i request you to reach out.

p.s. : i am looking for reliable suicide helpline numbers,will update and add as soon as i find some.

https://woundedshrink.wordpress.com/2017/09/09/room-no-501-contd/

https://woundedshrink.wordpress.com/2017/07/12/room-no-501/


ROOM NO.501 (contd.)

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10th of September 2017 ,marks the 15th time the world health organisation is endorsing the idea of SUICIDE prevention.

suicide in Latin means “self murder”.

It ranges from thinking that life is not worth living to actually completing the act.

It is one of the very few Psychiatric emergencies we come across.

like time,suicide has a past ,a present and a future.

past implies to the previous mental illnesses (studies suggest suicide is almost always the result of a mental illness).

present implies to the act of committing it .

and with future i imply ,the devastating legacy it leaves for those who have lost a loved one to it.We refer to them as the SURVIVORS of suicide.

room no. 501 has left its paint on my mind,

it reminds me of allot ,

it reminds of both good and extremely bad times.

the beginning was the toughest ,it was a ‘house full’ of lonely nights , hopeless evenings and mundane Sunday mornings.

then with help it became easier, and coming out of the phase changed me immensely.

i came out as a more confident , less anxious , more forgiving ,less judging and a more positive being.

after the phase i understood my patients’ agony better ,may be it was purposed to happen ,so that i would come out stronger.

I now connect better with my patients,I listen more intently, observe more keenly and take more interest.

Just about last year i received a call from my mother ,in between my exams that one our known expired ,on inquiring she said it was a completed suicide.

this was the first time I came across someone who ,not related to my work background ,

had done so.It was perturbing.when other people in our circle discussed about it,

I understood suicide’ position in our society.

  1. most commonly people said “what was so bad in the persons life that she has to resort to such a huge step.”

to that i would usually say that it is very rare that suicide occurs as a result of a single factor,usually there are many.and it is very difficult to explain.

2.others would try to ignore suicide and just concentrate on the death part.it is a big taboo to talk about it.

to that i would usually surrender (my bad).

understanding the risk factors can help us all to curb the rising rates .

  1. age :over 45 yrs.
  2. divorced/widowed.
  3. unemployed.
  4. conflictual interpersonal relationships
  5. chaotic family backgrounds
  6. chronic illnesses.
  7. substance abuses
  8. hopelessness
  9. previous suicide attempt(the most important determinant).
  10. social isolation.

there are many others and it should be noted that anybody ,anytime of their lives can become suicidal ,and anyone ,anytime of their lives should be taken seriously if they report so.

action to be taken is i would say report to a doctor immediately ,preferably a person who is trained in the field of mental illness.

following is the link to my previous article on the similar topic.

ROOM NO.501

reach out.take help.your life is precious.all problems have a solution.your suffering can be lessened .it is an illness like any other physical illness that demands attention and treatment.