When death feels like the only solution
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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.
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The main thing that prevents me from killing myself is that... The bible says people who suicide goes directly to hell... LOL... I wanna go heaven. I have a job interview there for a postman position.
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Singing is the best cure for everything
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when death feels like the only solution, bear in mind, there is always a wooden box with opened doors welcoming you into the eternal embrace
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Death is a friend that would come sooner or later.
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