Depression Commonest Underlying Cause Of Suicide Attempted Successful Or Intended- Dr Sanjay Chugh
Every suicide is a tragedy and to some extent a mystery. While armchair analysis is easy and common, it is important to attempt demystifying and deconstructing an impending travesty before it takes place.
According to senior consultant Psychiatrist Dr Sanjay Chugh, “The commonest underlying cause of suicidal intent or attempted or successful suicide is depression.”
He expounds, “Essentially, a cognitive triad of hopelessness, helplessness, and worthlessness leads a person to start believing that the kind of life that he or she is leading is not worth living. If that person is otherwise physically ok there is no way in which a natural death is going to relieve him or her of the misery that they are facing and so the only the option left to the person becomes self-harm or committing or attempting suicide.”
Apart from depression, there is an entity called para-suicide, which Chugh explains, is seen in a condition called the borderline personality disorder.
“In para-suicide, the intent is not to commit suicide, it is only a threatened suicide and the threat is made with an intent to emotionally blackmail some other person. This phenomenon is termed as para-suicide.”
“In an illness like schizophrenia, suicide may be attempted or committed in response to voices in that person’s mind, what we call 'auditory hallucinations'. These are what are would be technically labelled 'command hallucinations' where they command a person to end his life. They tell them that they are a sinner, an abuser, they have no right to live, they are good for nothing, they should end their life or you take your life and the person performs that action in response to voices that he/she is hearing. It’s almost as if the complete actions of that person are being controlled by these voices,” he says.
On the subject of an impulsive suicide, Chugh says it can never be bereft of an underlying cause.
“Impulsive suicide is also seen with borderline personality disorder. Sometimes the threat can go wrong. Like for example a person threatening another and that person ignores their hints ignores. In that case, the person actually has no intent to commit suicide but it happens accidentally.”
Counselling psychologist Purnima Sahai highlights some warning signs to watch out for, that are telltale signs of a suicidal person.
She says, “There are often signs that someone may be thinking about or planning a suicide attempt.”
Here are some of them:
- Talking or joking about suicide or death in general.
- Preoccupation with death. Example: recurrent death themes in music, literature, or drawings. Writing letters or leaving notes referring to death or "the end".
- Unusual visiting or calling people one cares about - saying their good-byes.
- Giving possessions away, making arrangements, setting one's affairs in order.
- Suddenly appearing happier or calmer.
- Talking about "going away"
- Referring to things they "won't be needing," and giving away possessions
- Talking about feeling hopeless or feeling guilty, "Life is useless." "Everyone would be better off without me." "It doesn't matter. I won't be around much longer anyway." "I wish I could just disappear." “There’s no point.” “I’m done.”
- Pulling away from friends or family and losing the desire to go out
- Having no desire to take part in favourite things or activities
- Having trouble concentrating or thinking clearly
- Experiencing changes in eating or sleeping habits
- Engaging in self-destructive behaviour (drinking alcohol, taking drugs, or cutting, for example)
What can we do as individuals?
Her advice to anyone confronting the above telltale signs in another is to:
·Talk to the person - about the intent and plans.
·Do not keep it a secret – tell the parents/authorities and get help.
·Keep your advice or opinion to yourself. Do not increase his feelings of guilt or shame.
·If the risk of suicide is not immediate, validate the painful feelings of the person & offer support in getting help.
While there exist several helplines for mental health crisis centres, like Sanjeevani, Cooj, Maitreyi, Sneha India Foundation and Roshni, there is still no national helpline yet. With an epidemic of the proportions, we are dealing with it is surely an area the government should look at.
Being kind and compassionate towards your self and others whose paths you cross every day are acts that you can be sure will never go to waste. Sometimes an ear, when someone is on the brink, can jolt them back to reality. Anyone suffering any kind of mental health illness should know #youarenotalone
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