MENTAL ILLNESS AND SUICIDAL BEHAVIOUR

“Mental pain is less dramatic than physical pain, but it is more common and also harder to bear. The frequent attempts to conceal mental pain increase the burden: it is easier to say ‘My tooth is aching’ than to say ‘My heart is broken’.”

Mental illnesses are health conditions involving changes in emotion, thinking or behaviour. They are associated with distress and problems functioning in social, work or family activities. Some mental illnesses are associated with an increased risk of Suicide. On the other hand, Suicide means ending your own life. It is sometimes a way for people to escape pain or suffering. When someone ends their own life, we say that they “died by suicide.” A “suicide attempt” means that someone tried to end their life, but did not die.

Some people who end their own lives do not actually want to die but feel there is no other option to relieve them of their pain. Those who do take their own life may feel overwhelmed, seeking release from their distress. It is important to understand that suicide is the result of many factors in a person’s life and not one particular event or discussion. Suicide is very complex: there is no single explanation.

“It’s so common, it could be anyone. The trouble is, nobody wants to talk about it. And that makes everything worse.”

For family and friends, a suicide attempt can bring a range of intense and unexpected emotions that can change quickly and unpredictably. There is no right or wrong way to react. Supporting a person who has attempted suicide can be stressful and overwhelming. It is important to look after yourself. Catch up regularly with friends, family members and significant others, and make time for yourself. Access support services, groups or health professionals to talk about how you feel. Learn about suicide risk factors and behaviour to look out for. It is important to not blame yourself for the suicide attempt. If someone is determined to end their life, it can be very difficult to stop them.

Contributing factors to being at risk of suicide may include:

• mental health conditions
• substance abuse
• chronic pain or physical disability
• feelings of isolation or helplessness
• loss
• negative life events (abuse, significant loss, financial crisis) 
• Previous suicide attempt or exposure to suicidal behaviour in others.

Suicidal behaviour is closely connected with mental disorders. Virtually all mental disorders carry an increased risk of suicidal ideation, suicide attempt, and suicide. The psychiatric disorder may be an almost necessary, yet insufficient, risk factor for suicide. About 90 per cent of individuals who attempt or commit suicide meet diagnostic criteria for a psychiatric disorder, most often mood disorder, substance use disorders, psychoses, and personality disorders. The risk of suicidal behaviour in anxiety disorders and eating disorders, both having strong comorbidity with depression, is often underestimated. Under-treatment, comorbidity, treatment non-compliance and poor adherence, as well as a high frequency of non-responders, are common problems and challenges in the treatment of suicidal persons. On the other hand, there is growing evidence of lower risk of suicidal behaviour during closely monitored long-term treatment of suicidal patients, indicating that treatment adherence is an important factor in medical suicide prevention.

Some of the warning signs are given below:

• Excessive sadness or moodiness: Long-lasting sadness and mood swings can be symptoms of depression, a major risk factor for suicide.
• Sudden calmness: Suddenly becoming calm after a period of depression or moodiness can be a sign that the person has made a decision to end his or her life.
• Withdrawal: Choosing to be alone and avoiding friends or social activities also are possible symptoms of depression. This includes the loss of interest or pleasure in activities the person previously enjoyed.
• Changes in personality and/or appearance: A person who is considering suicide might exhibit a change in attitude or behaviour, such as speaking or moving with unusual speed or slowness. In addition, the person might suddenly become less concerned about his or her personal appearance.
• Dangerous or self-harmful behaviour: Potentially dangerous behaviour, such as reckless driving, engaging in unsafe sex, and increased use of drugs and/or alcohol might indicate that the person no longer values his or her life.
• Recent trauma or life crisis: A major life crisis might trigger a suicide attempt. Crises include the death of a loved one or pet, divorce or break-up of a relationship, diagnosis of a major illness, loss of a job, or serious financial problems.
• Making preparations: Often, a person considering suicide will begin to put his or her personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up his or her room or home. Some people will write a note before committing suicide.
• Threatening suicide: Not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it. However, every threat of suicide should be taken seriously.

Feeling suicidal means feeling more pain than you can cope with at the time. Thoughts of suicide are only thoughts. Having them does not mean you need to act on them. Try to remember that with help, you can feel better and keep yourself safe. People get through this. You can too.

Some ways to stay safe when experiencing suicidal thoughts include:

• Tell someone how you feel – a family member, trusted friend or teacher.
• Ask them to stay with you until you get help.
• Call your local hospital and ask for the Mental Health Team.
• Go to your GP, psychologist, psychiatrist or other mental health professional.
• Stay focused on the present – worrying about whether things will improve often just leads to feeling more overwhelmed. Try breaking up your day and planning a short activity that will distract you. Then plan your next activity once you’ve finished that one.
• Try relaxation techniques.
• Follow up with your health professionals. A change in any medication and treatment may help reduce any suicidal thoughts.
• Remember you do not have to act on suicidal thoughts. They will pass in time, despite how overwhelming they may feel.

 “I wish people could understand that the brain is the most important organ of our body. Just because you can’t see mental illness like you could see a broken bone, doesn’t mean it’s not as detrimental or devastating to a family or an individual.”