Suicide affects everyone. One of the most important aspects that comes up in research literature with respect to suicide is that it’s a preventable cause of death. Whether you are a parent, a child, a friend, a neighbor, a colleague, a member of society in general, any action big or small goes a long way to show you care.
The Sabeen Mahmud Foundation and Dr Ayesha Mian, a child and adolescent psychiatrist, conducted an online conference to help understand the despair which leads to suicide attempts and how we can support people who feel suicidal and/or people who have lived through the suicide of a loved one.
Using words mindfully
Consider the way we talk about suicide amongst ourselves, the language we use for people who have died by committing suicide, for people who have lost their loved one through suicide, and for people who are dealing with individuals who are thinking about suicide. This language is crucial because it can either create a stigma around the word suicide or reduce it.
For instance, when someone dies by suicide, you’ll see the media dismiss it as “they committed suicide”. The word ‘commit’ denotes that the person was guilty of a crime. Someone dying by suicide is NOT committing a crime and when you make it sound like a criminal offense, the whole thought process behind the act changes and, consequently, our attitude changes.
Another example is “a failed suicide attempt”. The act is not about success or failure; there is a greater need to understand the thought as to why someone even thought about self-harm.
The plight is such that it’s not just layman talking in this manner in his ignorance, unintentionally. It’s also the doctors and nurses, especially those in the emergency rooms, irrespective of private or public sectors, who treat these patients and attend to their loved ones. Instead of paying attention to the person who has harmed him/herself, the frontline workers insist the case needs to first deal with legal procedures, which leads to delay in the help we could offer them.
Also, if someone harming themselves repeatedly end up in hospital again and again, they are usually labelled as “attention seeker” or “faking it” that further belittles the patient and is not helpful for the anxious and concerned family members who are present there.
Understanding underlying causes
Literally, anyone can die by suicide, but there are some people who are at a greater risk. And if we look closely, there are points such as multiple attempts at self-harm or mental health conditions like depression and substance abuse, cues that can be picked up on if we are careful, to make a timely intervention to prevent suicide.
People who are chronically ill, like someone diagnosed with cancer or chronic diabetes, or someone who are in constant war zone some way or the other experience immense amount of trauma which makes them vulnerable. Moreover, people who are impulsive by nature do not think about consequences when they are taking decisions so it would be prudent to deal carefully with them.
Adolescence is yet another vulnerable population because a lot is changing in them as well as in their environment; there’s peer pressure and academic pressure, bullying or any form of discrimination, a new house, a new university – any and all changes can be quite stressful and a trigger point for them to succumb to.
The ongoing Covid-19 pandemic, too, has increased feelings like frustration and isolation with people losing livelihoods and not being able to meet their loved ones, making them more vulnerable to suicidal thoughts.
The sad reality is that the suicide attempts are not taken seriously neither by their family – who are weary of these routine ‘threats’ – nor by the attendants in the emergency room. Everything changes the moment when it’s a cut too deep or a pill one too many.
Most of the healthcare physicians are hesitant to initiate the conversation with the patient because of the notion that one will induce the thought of suicide if they ask about it, which is untrue. A majority of people who are thinking about it would be thankful that someone asked them if they feel depressed or if they thought about or are thinking about harming themselves, because it’s a very scary thought and they don’t want to reveal that they are thinking about suicide.
It’s possible that the healthcare professionals, too, consider asking this question stigmatizing, but the fact that a general physician in their respective areas would be the first point of contact; it is imperative that they feel comfortable asking whether the person is feeling okay, how they’ve been feeling for the past two weeks, and do they feel interested in the things that interested them before. Research says that a person who has hanged themselves would think about doing it nearly a hundred times before attempting it, so imagine if it’s the first time or the fiftieth time they thought about it while visiting a general practitioner and the latter would have asked them this question; imagine the kind of difference it would have made.
This is actually the moment to guide them to the right avenues. If they don’t feel comfortable talking to their family or friends about it, or there might be parents who are concerned about their kids but know not how to communicate, refer them to professional therapy or counselling so that they may be able to make life a bit more livable for their loved one. Just to bust another myth, therapy is not only talking. It’s about processing your emotions and thoughts, getting to know yourself better so that you can manage what is happening around you in a better way.
Last but not the least, let people experience loss and express their loss in whatever way or form they want to. And acknowledge their response, their feeling, without trying to change that. For example, if you see someone crying, don’t say “bas kardo, beta” (stop crying, son). In that moment, it would be better if you just understand their situation and be there with them without trying to change their sadness. People may cry or ask for help or maybe they won’t as each person is different and their reaction to a suicide will be different. It’s your responsibility to sense what’s needed rather than doing your own thing. If they want to cry, let them cry. If they don’t want to cry, don’t force them to cry.
In the society we live in, it’s difficult yet crucial for people to understand that sometimes not saying something is enough. People feel compelled to say something. A lot of people are like “I don’t know what to say, so I just said ‘it’s going to be ok’.” The thing is, it’s ok to say “I don’t have words, but let me know how I can be there for you and help”; it’s an honest response. This step is hard because it doesn’t come intuitively to everybody that the bereaved would prefer space after emotional turmoil. When you lose someone you loved dearly, the grief can be overwhelming to the point of suffocating. So provide them the kind of safety where they can just breathe and move on eventually.