Definition of suicide
Suicide is the act of intentionally causing one’s death. Mental disorders (including depression, bipolar disorder, autism spectrum disorders, schizophrenia, personality disorders, anxiety disorders), nihilistic beliefs, physical disorders (such as chronic fatigue syndrome), and substance use disorders (including alcohol use disorder and the use of and withdrawal from benzodiazepines) are risk factors.
Some suicides are impulsive acts due to stress (such as financial or academic difficulties), relationship problems (such as breakups or deaths of close ones), or harassment/bullying.
Those who have previously attempted suicide are at a higher risk for future attempts.
Factors That Influence The Risk of Suicide
1. Experiences of trauma or loss, and nihilism. Some may take their own lives to escape bullying or prejudice.
2. History of childhood sexual abuse – and time spent in foster care are also risk factors. Sexual abuse is believed to contribute to approximately 20% of the overall risk.
3. Significant misfortune early in life hurts problem-solving skills and memory, both of which are implicated in suicidality.
4. Mental disorders and substance misuse frequently co-exist.
5. Having previously attempted suicide, the ready availability of a means to take one’s life, a family history of suicide, or the presence of traumatic brain injury. e.g suicide rates are greater in households with firearms than those without them.
6. Socio-economic problems such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts.
7. Suicide might be rarer in societies with high social cohesion and moral objections against suicide. About 15-40% of people leave a suicide note.
8. War veterans have a higher risk of suicide due in part to higher rates of mental illness, such as post-traumatic stress disorder, and physical health problems related to war.
9. Genetics appears to account for between 38% and 55% of suicidal behaviors. Suicides may also occur as a local cluster of cases.
Major Perspectives on suicide in the world
Views on suicide have been influenced by broad existential themes such as religion, honor, and the meaning of life.
The Abrahamic religions traditionally consider suicide as an offense towards God due to the belief in the sanctity of life.
During the samurai era in Japan, a form of suicide known as seppuku ( harakiri) was respected as a means of making up for failure or as a form of protest.
Sati, a practice outlawed by the British, expected the Indian widow to kill herself on her husband’s funeral fire, either willingly or under pressure from her family and society.
Suicide and attempted suicide, while previously illegal, are no longer so in most Western countries. It remains a criminal offense in some countries.
In the 20th and 21st centuries, suicide has been used on rare occasions as a form of protest, and kamikaze and suicide bombings have been used as a military or terrorist tactic.
Suicide is often seen as a major catastrophe for families, relatives, and other nearby supporters, and it is viewed negatively almost everywhere around the world.
Stages of suicide
In the Biodyne Model (Cummings & Cummings, 2012) Dr. Cummings views suicide as a three-stage process, and this knowledge enables us to masterfully treat suicidal patients:
See the Three suicide stages as described by Dr. Cummings.
1. Ideation stage
In this stage, she says that a depressed person finds him/herself thinking about suicide more and more. However, the fear of suicide still outweighs its attraction.
Therefore, the person may be thinking dark thoughts (“my family would be better off without me”), obsessing over dark music (i.e., playing the same depressing song over and over again), or expressing thoughts of death, suicide, pain, and hopelessness through artistic expression, but has not yet begun to formulate a specific plan. she concludes.
2. Planning stage
In this stage, she says a person’s dark thoughts begin to turn to formulate a specific suicide plan.
Friends and family may notice the person’s depression worsening, and observe their loved one begin to withdraw from touching others or from being touched by others, or they may stop verbalizing their pain and suffering while seeming to be in more pain than ever. She adds.
People in Stage 2 are not imminently lethal, although they are in critical need of *effective psychological care*.
Dr. Cummings concludes that It rarely lasts longer than several months because it is a very psychologically painful place to be. The person feels compelled to decide to suicide (thus moving into Stage 3) or not to suicide at that time; a decision that most people do not discuss with loved ones and often wrestle with in isolation.
3. Stage 3
Dr.Cummings says that this stage begins when the suicidal person decides to suicide. The moment the decision is made, it goes “unconscious” and the person goes on what we call “auto-pilot.” They seem more “normal” than they have seemed in a long time.
At this point, the depression seems to suddenly lift because the person has made the decision to die and is no longer wrestling with the decision.
People on “auto-pilot” typically attempt suicide within the next 48 hours.
“Be alert when a depressed patient who doesn’t seem to improve after months of intervention suddenly seems to get better.
Instead of relaxing, we should become more vigilant when we see a sudden, overnight improvement,” says Dr. Cummings.
She also says that we should listen closely to any indication that the individual has decided to end their life and mobilize support among family.
Suicide prevention requires a campaign of continuous awareness and understanding, compassion, and willingness to take an active part in his career. Understanding some basic principles and awareness of the problem will go a long way in the cause of suicide prevention.
Precautions In A Potentially Suicidal Person
. Eliminate Access to Potentially Dangerous Weapons, Knives, and drugs.
. Speak Openly and Honestly with Those Who Are at Risk
. Ask What You Can Do to Help
. Don’t Quarrel, Threat, or Shout
Managing Suicide cases
1. Treatment of drug and alcohol addiction, depression, and those who have attempted suicide in the past, may be effective.
2. Some have proposed reducing access to alcohol as a preventive strategy (such as reducing the number of bars).
3. In young adults who have recently thought about suicide, cognitive behavioral therapy appears to improve outcomes.
4. School-based programs that increase mental health literacy and train staff have shown mixed results on suicide rates.
5. Economic development through its ability to reduce poverty may be able to decrease suicide rates.
6. Efforts to increase social connection, especially in elderly males, may be effective.
7. In people who have attempted suicide, following up on them might prevent repeat attempts. Although crisis hotlines are common, there is little evidence to support or refute their effectiveness.
8. Preventing childhood trauma provides an opportunity for suicide prevention.
Extend Constant Support
I) Be Receptive – Let your loved ones know they can talk to you about what they are going through.
ii) Don’t create an argument – now even when negative comments are made – try to provide positive support.
iii) Active listening– This will help your loved one feel validated – reflect on their feelings and summarize their thoughts.
iv) Reassurance – Reassure your loved ones that you care about their well-being and encourage them to count on you for their support.
Do you have a story to tell?
Sources; 1.Definition of Suicide – Wikipedia