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Suicide Prevention: What Are the Warning Signs, Prevention measures?

 World Suicide Prevention Day: What Are the Warning Signs, Solution?

Suicide is the outcome of neurobiological breakdown. The process begins in severe stress and pain which has been generated by due to a serious life crisis

By Dr. Riddhish K. Maru

September 10, 2020 (IANSlife)  On World Suicide Prevention Day we look at the tell tale signs and symptoms you can watch out for incase you feel a friend, colleague or a loved one may be contemplating suicide. 

The act of killing or trying to harm oneself is called suicide. It is an action against a human's basic survival instinct or agains one's nature of procreation, this makes it an interesting subject interesting. Suicide is exclusively almost seen only in the human species and it’s been known off since immemorial time.

Suicide is the outcome of neurobiological breakdown. The process begins in severe stress and pain which has been generated by due to a serious life crisis. Suicide occurs when the stress induces unbearable pain that feelings of self-control and self-esteem are weakened & death is seen as the only relief.

Suicidal entails changes in the brain's chemistry and physiology, an imbalance in serotonin levels. Para suicidal behaviour is seen when there are attempts to deliberately harm self to gain attention.

 

Incidence:

Suicide is on the rise in this century, 258,075 people committed suicide in India in 2012. India's suicide rate was 21.1 per 100,000 people, according to WHO.

 

Psychology of Suicide:

Menninger believed that suicide is inverted homicide. Generally aggression is directed outward, at a person or an object. But when it is directed inwards, it becomes suicide. Freud beliefs were on similar lines but with the parameters of life force (Eros) and death force (Thanatos).

 

Suicide Warning Signs: F.A.C.T.

 

F for Feelings:

  • Hopelessness “It will never get any better' / “There’s nothing anyone can do.”
  • Fear of losing control, fear of going crazy, fear of harming oneself or others.
  • Helplessness, a feeling that “no one cares”, “everyone would be better off without me.”
  • Overwhelming guilt, shame, and self-hatred.
  • Pervasive sadness

 

A for Actions or Events

  • Drug or alcohol abuse
  • Themes of death or destruction in talk or written materials (letters, notes)
  • Nightmares
  • Recent losses through death, divorce, end of a relationship, separation, loss of job, money, status, pride, self-esteem.
  • Loss of religious faith or spirituality
  • Agitation, restlessness
  • Aggression, recklessness

 

C for Change

  • In personality - more withdrawn, tired, apathetic, indecisive or more boisterous, talkative, outgoing.
  • Different temperament than usual.
  • In thoughts - can’t concentrate on schoolwork, routine tasks, etc.
  • In sleep patterns - oversleeping, excessive sleeping, insomnia
  • In eating habits - loss of appetite, weight gain/loss, overeating, change in eating rituals
  • In activities - loss of interest in friends, hobbies, personal grooming, or other activities
  • Sudden improvement after a period of being down or withdrawn, “too euphoric”

 

T for Threats

  • Statements, e.g., “How long does it take to bleed to death?”
  • Threats, e.g., “I won’t be around much longer.”
  • Plans, e.g., putting affairs in order, giving away favourite things, obtaining a weapon.
  • Gestures, or attempts, e.g., overdose, wrist cutting.
  • In India, suicide was illegal and a survivor would face jail term of up to one year and fine under Section 309 of the Indian Penal Code but Government of India decided to repeal the law in 2014.

 

Solution:

If you have ever had suicidal thoughts or you know someone who has, the first thing you need to do is accept that it is possible to feel that way. Denial can only lead to more repression and a bigger outburst of events. Secondly, talk to someone about it. It could be your family, friends, colleague or a psychiatrist. And always when you feel things are going out of your control, don’t be ashamed to ask for help. These are few ways that suicidal ideas can be identified early and can be addressed. Electro convulsive therapy is the gold standard treatment of suicide.

Supportive psychotherapy is required in each case.

  • Reducing social isolation,
  • Preventing social disintegration, 
  • Treating mental disorders by Psychiatrist
  • Banning of pesticides & ropes

 

Additionally, a set of state led policies are being enforced to decrease the high suicide rate among farmers of Karnataka and Maharashtra.

 

(The author is a Psychiatrist, consultant at Practo)

 

 

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