To be or not to be
By Sanuj Hathurusinghe
Ceylon Today Features
Although there are traits of some animals exhibiting self destructive behaviour, humans are the only known animals who use weapons or go through elaborate plans to end their own lives. In the olden days, it sometimes may have been considered an act of courage to end life on one's own terms, evident by the historic accounts we hear about valiant kings, soldiers and Samurais who took their own lives in the battlefield but today, suicide is regarded as a grave public health problem.
Danger of suicide
According to the World Health Organization (WHO), suicide represents almost half of all violent deaths, worldwide. Every year, 800,000 suicide fatalities are reported and the number is expected to rise up to 1.5 million by the year 2020. Worldwide, more people die from suicide than from all homicides and wars combined and suicide is the second leading cause of death among 15 to 29-year-olds.
75% of global suicides occur in low and middle income countries such as Sri Lanka. According to police reports, there have been 3,058 reports of suicide cases in Sri Lanka in the year 2015, a large majority of them being male. Compared to the records a year before, a slight decrease is apparent but no solace should be found based in the decrease because suicide is considered a largely preventable public health problem in comparison with other causes of global decease.
What is suicidology?
A growing number of suicide cases worldwide have made knowing about suicides a timely necessity. A particular discipline called suicidology was derived, first in the mid 19 century, in order to understand more about suicidal behaviour and its causes. Senior lecturer at University of Ruhuna and consultant psychiatrist at Teaching Hospital, Karapitiya, Dr. Harshini Rajapakse elucidated to Ceylon Today about Suicidology in detail.
"Suicidology is the scientific study of suicidal behaviour and suicide prevention which involves a wide range of behavioural sciences related specialties such as anthropology, psychology and sociology" explained Dr. Rajapakse. "The study of factors leading to suicide and factors important in suicide prevention involves multiple disciplines of study. It cannot be handed over to one discipline. For example it cannot be handled by psychiatrists alone as there are many who will attempt suicide without a mental health illness. A separate study called Suicidology evolved due to the need to bring all disciplines of study together" added Dr Rajapakse.
Is suicide a mental illness?
Having a separate multi-disciplined study makes suicide appear as a mental illness but is that really the case? When asked whether all suicides are a result of mental illnesses, Dr. Rajapakse responded that it is not always the case.
Ceylon Today reached psychotherapist and Certified Clinical Hypnotherapist, Dr. Romesh Jayasinghe who had the following to add regarding the matter. "About 80% of all suicides can be caused due to some mental disorder like clinical depression, bipolar disorder, schizophrenia, and some personality and substance abuse disorders. These disorders can lead into suicidal behaviour if gone untreated"
What causes suicide and why suicide?
While there is a clear link between suicide and mental disorders, it can also happen impulsively in moments of crisis, breakdown or stress. Poverty, financial difficulty, unemployment, exam failure, relationship breakdown, sexual harassment, rape, chronic pain, illness, and other forms of family disputes lead to suicidal episodes. According to 2015 police reports, the most number of suicides were committed due to harassment by the husband and family disputes.
Suicide is a form of escape mechanism. All the reasons mentioned above put pressure on a person and create psychological or emotional pain. In coping with this pain, people tend to escape reality through various means such as drinking, gambling, drug abuse and binge-eating. Contemplating suicide also is a common coping mechanism. These methods do seem to have a temporary relief effect on psychological pain. Even the great German philosopher Friedrich Nietzsche once said "The thought of suicide is a great consolation; by means of it, one gets through many a dark night."
But the relief is short-lived and the troubled will over-abuse their escape mechanisms in hopes of prolonged solace until they reach a breaking point. "Every individual has a breaking point. Once the unbearable psychological pain reaches this point, rational thinking escapes from the mind and they think suicide is the best solution available for them" remarked Dr. Jayasinghe.
Identifying a suicidal
The news of a suicide death always comes as a shock. Relatives and close friends of the diseased could often be heard saying "If only we knew beforehand." A lay person who is not familiar with Suicidology might not be able to read the subtle indications suicidal persons give away but the chances are, in most suicide cases, the person shows certain behavioural patterns such as:
n A noticeable change in normal or routine behaviour
n Lack of interest in pleasurable activities
n Sleep disturbance/Insomnia
n Social isolation and wanting to be alienated
n Excessive consumption of alcohol
n Loss of interest in food and personal hygiene
n Self-destructive behaviour
n Refusing to study or work
n Mentioning suicide
"If one shows multiple signs of the above mentioned, the chances are he or she might be suicidal" said Dr. Jayasinghe. A lay person might not be in the best of positions to help out a suicidal person as the matter needs to be taken care of patiently, methodically and diplomatically but what could be done is informing the family, talk the person into counselling or to go to a psychiatrist or at the least, to a normal physician.
According to Dr. Rajapakse, medical treatment for suicidal behaviour is prescribed only if the patient has a psychiatric illness."Treatment is only if they have a psychiatric illness such as depression and schizophrenia. Problem solving skills can be taught if they have poor coping skills. If there are other issues such as physical or sexual abuse or alcohol dependence, they can be referred to a service or an organization which helps with that particular issue" said Dr. Rajapakse.
According to Dr. Jayasinghe, first on the agenda in treating a suicidal person is stress release and relaxation exercises. Then comes discussing alternatives with rational thinking and calming down of the patient. Different forms of therapy, even hypnotherapy, could be prescribed according to the patient. Closely monitoring a suicidal even after the initial threat is gone (postvention) is vital especially in patients who have attempted suicide as they are more likely to try again within the first year after the attempt.
Organizations such as Sumithrayo with trained volunteers and skilled professionals at their disposal island wide, has shared a fair amount of the burden of preventing suicides in Sri Lanka. Suba, a volunteer at Sumithrayo opened up to Ceylon Today about how they deal with suicidal persons.
"Initially, we listen to them. Then we ask what led them to this point, what is happening in their lives and so on. We try our best to help the caller to come over and have a one-on-one conversation if possible. We give them the opportunity to come out and reveal their plan. Some people actually say what they have planed. The revelation itself helps them to realize the whole picture"
"There is no guarantee but we do feel it if we have done a good job by the tone of the caller. In a nutshell, we listen to everything callers have to get off their chests. We don't advise or put guilt. We sometimes suggest and discuss actions with the callers if he or she is supportive but we never try to force our opinions on them" said Suba.
The stigma of suicide
Suicide carries a social and cultural blemish in Sri Lankan society. It is considered a taboo. No one likes to talk about it and it is considered a foolish option for the weak. But according to latest police data, the number of men who have committed suicide is almost four times higher than women. Shaming or guilt-tripping people, especially men, to not commit suicide has evidently backfired gravely as the numbers suggest higher suicide rate among males.
"We have an unhealthy level of competition in our society. The stereotypical view in our culture and society is that a man has to be successful. Men are supposed to be the bread winners of the family and are also considered as a symbol of strength. When men are unable to satisfy these expectations and think they are weak, they tend to bottle up these feelings not letting them out due to the stereotypes built around them which could eventually lead into suicidal behaviour" explained Dr. Jayasinghe.
Suicide should be talked about more
According to police data of 2015, almost 58% of reported suicide cases have been committed by people who had studied only up to grade eight or lower. Education might not be the only parametre but it certainly does play a big part in suicides. The least that could be done in preventing suicides among the lesser-educated is to create awareness about suicide. "More public awareness has to be made and the media has to be involved. They could do documentaries and hold discussions about suicide prevention. Suicide self-help groups and suicide survivor groups have proven helpful in other countries and could be introduced to Sri Lanka as well" mentioned Dr. Jayasinghe.
The media could also have a negative effect on suicide. According to Dr. Rajapakse, reporting a suicide or portraying one in a movie in meticulous details could result in copycat suicides. Sometimes media reports suicides with graphic content which put relatives and close mourners at unease and sometimes the media portrays the one who committed suicide as a hero."Common reasons should be addressed but going into details is not good. Sensitivity is needed when reporting a suicide without glorifying the act or making it gossip" said Dr. Rajapakse.
Sri Lanka, once a country with the highest suicide rate in the world, has come down to fifth on the list according to 2014 WHO reports. Receding numbers certainly is a plus but there is much more to be done, should be done and could be done, most important of all being providing hope and assurance when a suicidal thinks all hope is lost.
- China to provide 90 water bowsers worth Rs 1b 2184
- Wag the Dog 2195
- A brief look at FARC’s origins in Colombia 2145
- ‘Panama Papers’ bags Pulitzer 2168
- SAITM will cooperate with Govt 2170
- dead man was near fashion mall 2214
- Japanese MPs back Lanka’s development 2176
- CB Bond earnings whitewashed – JVP 2186
- Talks to extend Lanka’s Continental Shelf 2178
- Ex-DIG and son re-remanded 2193
- Government can be sent home 2728
- GMOA flogging SAITM for Mahinda– Rajitha 2192
- Ranil invites Japan to invest in S. Asia 2164
- Somali Pirates’ Captives Back Home 2179
- Customs in Rs 8 M bust 2176
- Redefining Rape 2279
- The march of folly Our mad Cabinet system 1819
- First adventures in Europe 1902
- Inspiration for writers 1882
- Sri Lanka’s sustainable development dream 2041
- Sinhala and Tamil New Year with Easter 2062
- Filipino Oconer wins overall title 1814
- Unsporty conduct by Joes 1861
- Bertie Wijesinghe, pre-Test era Sri Lankan cricketer, dies aged 96 1830
- CEAT revs up for 2017 1817
- Palace shock Arsenal 1807
- Argentina fire coach Bauza 1821
- BCCI postpones SGM to 18 April 1796
- Murray returns from injury 1806
- New mum Azarenka to return to WTA 1789
- Galle win by 188 runs 1793
- Keeping Cool 1812
- Do the right thing and do it now! 1821
- Ravi Jayewardene Pious son of a political giant 2406
- In the heart of the old country 2235
- Sarath Weerasekera’s Geneva adventure 2057
- No moral right to play with public funds 1977
- No need for fine if route permits are issued in fair, just manner 1868
- UDA incurs Rs 330M Loss 1810
- DOUSING A MEGA SHIP FIRE 1642
- Health authorities in denial? 2114
- Minorities’ frustration a powder keg – VIDURA 2161
- Administrative powers a must for the Plantation Tamils –Radhakrishnan 1419
- Rajapaksa sought advice from McGuinness– Indika Perera 2536
- I will lead SLFP to victory in future elections – President 1929
- Hang the ‘traitors’– RTD. REAR ADMIRAL WEERASEKARA 2318
- We oppose Nationalism and Federalism – Samarasinghe 3031
- SilkAir launches direct flights to Colombo 1866
- Rupee falls on thin volumes 1810
- SriLankan, Japan Airlines add new routes 1831
- Colombo Port box volume up 5.6-pct in Jan 1808
- Private sector to transform into main domestic growth engine 1838
- Oil eases from 5-week top, rising US production weighs 1800
- Tight fiscal and monetary policies constrain SL’s growth 1818
- Shell admits dealing with money launderer 1818
- Toshiba may sell chip business to Foxconn for $27bn 1814
- Asian shares pressured by geopolitical risks; Nikkei down 0.25% 1808
- SLIM launches Certificate in Digital Marketing 1812
- Microsoft Hosts Second ‘Device Day’ in Sri Lanka 1815
- Emirates named Best Airline in the World 1806
- Turkish Airlines and social media assist Somalia 1803
- Brain cell therapy ‘promising’ for Parkinson’s disease 1811
- Trump pushed into bombing Syria 1857
- Thailand discovers Power of Women Travellers 1825
- Economics of gambling 1707
- Trans National Aural Identity 3392
- Queen Anula The Shadow of Cleopatra 3418
- Poetry and its possibilities Part 2 3434
- The Enigma of Labyrinths 3545
- From Couture to Kutir 3427
- Hybrid Sources 4830
- Offering Riddles & Enigmas 4885
- Poetry and its possibilities 4925
- With a festive bang! 1047
- Easter Fun 1036
- Arrogance and crowing is the way of the doomed 1069
- Avurudu on the streets 1084
- Tick control 1062
- Sunny Sunday on the beach 1056
- It’s time to save the world 1118
- From viewer to YouTuber! 1119
- Expert skincare and makeup 1142
- Avurudu at Induruwa 1106
- Exo 1132
- Remembering our fallen heroes 2224