When death feels like the only solution
IN many ways, suicide is one of life's perfect paradoxes. Scott
Anderson summarised this paradox in his New York Times article, The
Urge to End It All, thus: "Our contradictory reactions to the act
speak to the conflicted hold it has on our imaginations: revulsion
mixed with fascination, scorn leavened with pity.
"It is a cardinal sin - but change the packaging a little, and
suicide assumes the guise of heroism or high passion, the stuff of
literature and art."
But if there is one thing suicidologist and college counsellor Dr
Adnan Omar wants to remind us of, it is that no one is 100% sure he
or she wants to die. He may really feel like it, but there is
almost always a tiny little hope that something or someone will
give him a reason to live.
"Basically, when people are considering suicide, they always have a
wish to die and the wish to live. We just need to tip the balance
in favour of life," Dr Adnan says.
Knowing how to tip that balance requires an understanding of the
complex answer to a simple question: why do people think of and
eventually proceed to take their own lives?
Often, suicides are thought to be linked to depression or some
other sort of mental illness. We now know that not all people with
those conditions will think of killing themselves. Likewise, not
all people who have attempted suicide have histories of mental
illness or depression. What gives?
"If you don't have hope for
the future, you may think suicide is a solution when, in fact, it's
not. You may experience a sort of tunnel vision, where in the
middle of a crisis you believe suicide is the only way out."
- from MayoClinic's website
"Most often, suicidal thoughts are the result of an inability to
cope when you're faced with what seems to be an overwhelming life
situation - financial problems, a personal crisis, emotional
turmoil, and despair, for instance," says Mayoclinic.com.
As people who are mentally ill or depressed are usually already
having difficulty in dealing with issues in their lives, they may
tend to have suicidal thoughts. However, depression or mental
illness is usually not quite enough to push someone over the edge.
However, "the latest research indicates that depression, together
with hopelessness and helplessness, may speed up the tendency
towards suicide," says Dr Adnan.
In fact, you don't have to be mentally ill or depressed to feel
suicidal. Anyone facing a crisis in life can see suicide as an
option, particularly when they feel that tomorrow will never get
better and that nobody cares.
"If you don't have hope for the future," the Mayoclinic notes, "you
may think suicide is a solution when, in fact, it's not. You may
experience a sort of tunnel vision, where in the middle of a crisis
you believe suicide is the only way out."
The warning signs
While some of us might think that no one in their right mind would
have suicidal feelings (hence the tendency to associate mental
illness with suicides), it is actually not that uncommon.
In 2008, Befrienders Malaysia, a non-profit organisation which runs
community helplines for people to call in and talk about their
problems, received a total of 18,030 calls in their Kuala Lumpur
office. Out of that total, more than 3,700 (21%) callers expressed
suicidal feelings.
This is not surprising, because across societies, 20% to 25% of the
population think about suicide on any given day, says Dr Adnan. Out
of that, 20% will actually attempt it, and about 10% to 15% of
those who attempt it complete the act.
That means out of 1,000 people, at least 200 may be thinking of
suicide at any given day, and at least 40 will try killing
themselves, and about four to five will succeed.
"When someone
comes to you and expresses his intent to kill himself, the only
next question you should ask is 'do you have a plan?'" - Dr
Adnan
How do we know whether a person is feeling suicidal?
With some exceptions, suicides are often preceeded by warning signs
that range from the very obvious to those that are very subtle. One
of the easier ways to remember them is with this mnemonic by the
American Association of Suicidology: "Is Path
Warm?"
"Is Path Warm" stands for: Ideation (thinking
about suicide), Substance
abuse;Purposelessness, Anxiety, Trapped, Hopelessness; Withdrawal, Anger,Recklessness, Mood Changes.
You can detect these changes in a person's behaviour and
speech.
"Sometimes it could be in the form of actions, and sometimes it
could be in the form of words," says president of the National
Council of Befrienders Malaysia S Gangadara Vadivel.
"Sometimes you hear people saying 'I'm so fed up with life', or 'It
is difficult for me to wake up every morning' because it is very
difficult for a person to come out and say 'I'm feeling suicidal',"
he says.
"The ordinary person who is not trained to pick up these signs may
not read much into it."
Having lost a good friend to suicide, Gangadara realises that it
may not be easy for one to detect these signs.
"I wouldn't say it is easily recognisable because you are talking
about a very uncomfortable situation, where there is stigma
associated with it. And often, the fear comes from the thought that
even when we can recognise it, are we able to help?"
While this may be true, it is not too difficult for an untrained
person to notice these signs either, says Dr Adnan.
"It's just that sometimes we do not take it seriously when a person
actually says 'I feel like killing myself'. They think it's a
joke."
But even if it is meant to be a joke, this is not the time to take
chances.
"When someone comes to you and expresses his intent to kill
himself, the only next question you should ask is 'do you have a
plan?'," says Dr Adnan.
This may sound silly if he is indeed joking (and you will both
laugh and be done with it). But if he says he already has a plan,
and is very specific about it, you should be worried, says Dr
Adnan.
"The way to help is to remove the means of suicide and get help."
Otherwise, if he says he is just thinking about it, you can delve
into the reasons that trigger his suicidal thoughts, Dr Adnan
adds.
"Clearly, in any case, you should not make a joke out of it because
it's just a way a person is expressing his need for help and you
should acknowledge it."
Just another option
Though not all suicides can be prevented, the majority of such
cases can be prevented, says the World Health Organization in its
question and answer page on suicides.
"Most people who die by suicide do not want to die. They want to
escape the unimaginable pain they are experiencing. So, if we can
find relief for the pain, we can save lives," says Dr Sally
Spencer-Thomas, psychologist and executive director for the Carson
J Spencer Foundation, a Colorado, US-based non-profit organisation
dedicated to suicide prevention, social enterprise, and support for
emerging leaders.
"Tell them
yes, I know that suicide may be a solution to your problem, but
let's think of another solution and consider that for a week." - Dr
Adnan
This relief can come in the form of treatment, counselling, a
support group, an empathic ear, or a shoulder to cry on, Dr
Spencer-Thomas tells Fit4Life via email.
"Some suicides, especially among youth, are carried out in the heat
of the moment. If we can get the means of suicide away from a
despondent person during those white hot suicidal times, we can
save lives," she adds.
Things like erecting suicide barriers on bridges, limiting the
amount of some over-the-counter drugs that can be bought at one
time, and even putting up a simple "If you are feeling suicidal,
please call this number" sign on tall buildings can help people who
are considering making these impulsive decisions think twice.
And for those who have mental health issues, Dr Spencer-Thomas says
if we can also improve our mental health services, and give people
the chance to seek help before their mental health condition
becomes life threatening, we can save lives.
Sometimes, it is just a matter of helping people see another
solution to his or her problem, says Dr Adnan.
"Challenge the mind and challenge the way they think so that it
will change the way they feel and act," he says.
"Tell them yes, I know that suicide may be a solution to your
problem, but let's think of another solution and consider that for
a week. Eventually, and hopefully, they will see that there is
another way to solve their problems other than ending their lives,"
he adds.
