By Anita Anand September 2013 Suicide not just deprives the victim of his precious life, but also plunges his family and friends into trauma, grief and guilt. Anita Anand tells you how to recognise the telltale signs that indicate a possible suicide attempt and how to reach out South Korea’s Bridge of LifeBetween the years 2003-2011, 1090 people committed suicide by jumping off bridges spanning the Han River. The Mapo Bridge – nicknamed The Bridge of Death – had the highest death toll. To counter this, Cheil Worldwide, Samsung Life Insurance, and the Seoul City government transformed the Mapo Bridge into The Bridge of Life, making the bridge an interactive experience displaying happy thoughts and messages of hope as people walked by. The messages on the bridge were: “I love you” “Let’s walk together”, “You look worried. Are you okay?”, “For your kids”, “Tomorrow’s sun will rise”, “Did you eat anything?”, “Go see the one you miss”, “The best has yet to come”, “How would you like to be remembered as a father?”, “So many things have yet to happen”, and “Your mom”. There was also a statue of two friends called “Just Once Again”, pictures of smiling faces, families and general happiness. These messages were carefully curated by a team of psychologists and suicide prevention specialists, and the efforts paid off. According to the Seoul City government, suicides on the bridge have dropped by 77 per cent since the changes were made, and the bridge has now become a popular tourist attraction. Similar actions are being planned for other bridges in the area. (Seoul’s Bridge of Life curbs suicide attempts with happy thoughts …www.autoblog.com) My favourite Paulo Coelho novel is Veronika Decides to Die. In this, a lovely young woman decides she does not want to live anymore as something is lacking in her life. Her suicide attempt fails and she wakes up in a local hospital where she is told that her heart is damaged and she has only a few days to live. The story follows Veronika through these days, in which she discovers that every second of existence is a choice between living and dying. And, she chooses life. Unlike Veronika, others who attempt and succeed at suicide do it out of despair due to depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse. Financial difficulties and troubled interpersonal relationships often play a role. Globally, around 800,000 to a million people die by suicide every year, making it the 10th leading cause of death. Men rank three to four times higher than women in committing suicide. There are an estimated 10 to 20 million non-fatal attempted suicides every year, more common in young people and women. The more common methods of suicide are hanging, pesticide poisoning, and firearms. Suicide in India In June 2013, the actress Jiah Khan took her life. There was an outcry in the media, which soon died down as more pressing issues emerged. And so it is with most suicide reports. Farmers commit suicide by swallowing pesticides they use on their land and activists immolate themselves in protest – for a cause – as do desperate activists. “If I had no sense of humour, I would long ago have committed suicide.” -Mahatma Gandhi. In the last two centuries, self-immolation has been used as a medium of protest, and kamikaze and suicide bombings have been used as a military or terrorist tactic. Every instance of suicide I hear or read reminds me of how we fail as a society, and do not recognise telltale signs and intervene in time. In a study published in The Lancet in June 2012, the estimated number of suicides in India in 2010 was about 187,000 mostly between the ages of 15 years and 29 years. According to the National Crime Records Bureau (NCRB), on an average, there are 15 suicides an hour or 371 suicides a day. Of this, 242 are men and 129 are women. Eighty-four suicides were due to family problems. For men, the causes were social and economic and for women it was emotional and personal. Thirty-seven per cent hanged themselves, 29.1 per cent took poison and 8.4 per cent immolated themselves. In India, to add insult to injury, attempted suicide is an offence punishable with a one-year term or with fine, or with both. In a 2011 ruling, India’s Supreme Court asked the Parliament to consider quashing the law, but no action has been taken. Suicide in teenagers and the elderly Teenagers and the elderly are at a higher risk of suicide. Teenagers face pressures to succeed and fit in. They struggle with issues of self-esteem, self-doubt, and feelings of alienation, doing well academically, relationships with the opposite sex, sexual identity, dealing with peer pressure and living up to parental expectations. For some, this leads to suicide. Depression is also a major risk factor in teen suicide. In the elderly, a major contributing factor to suicides is depression, which is often undiagnosed and untreated. Other risk factors are the recent death of a loved one, physical illness, disability, or pain, isolation and loneliness, major life changes, such as retirement, loss of independence and loss of sense of purpose. Aasra, a Mumbai-based organisation, has been running a 24-hour confidential suicide prevention helpline since 1998. The Centre gets about 12,775 calls a year and most are from men who struggle more than women to express their feelings. Clinics addressing mental health issues like depression have opened in cities in recent years. But these are few in number and there is shortage of professionally trained staff. Also, there is a stigma in getting psychiatric treatment. In my therapy practice, I find there is a biased mindset related to mental illness, difficulty in frank communication in families and more faith in prayer, horoscopes and godmen and women. What the scriptures say In Catholic doctrine, suicide is against the ‘natural order’ and interferes with God’s master plan for the world. In Judaism, suicide is tantamount to denying God’s goodness in the world. Suicide is not allowed in Islam. In Hinduism, suicide is considered as sinful as murder but a person’s right to end one’s life through the non-violent practice of fasting to death, or Prayopavesa, is accepted for those who have no desire, ambition or responsibilities remaining in this life. Jainism has a similar practice called Santhara. Whatever the scriptures say, suicide-prone people are desperate to end their lives. In India, rapid change, rural urban migration, rising aspirations and changes in the family structure have led to situations in which people’s mental health is threatened. There are few support systems and seeking help is looked down upon. Timely intervention by family and friends could go a long way in suicide prevention. Prevention and interventions A suicide-prone person may not ask for help, but that doesn’t mean they don’t want it. Most people who commit suicide don’t want to die – they just want to stop hurting. Suicide prevention means recognising the symptoms and taking them seriously. Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. These signals are even more dangerous if the person has depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. Other signs are: Hopelessness: People who feel hopeless may talk about unbearable feelings, predict a bleak future, and say they have nothing to look forward to. Mood swings: Dramatic mood swings or sudden personality changes, such as going from outgoing to withdrawn or well-behaved to rebellious. Most people who commit suicide don’t want to die – they just want to stop hurting There could be a loss of interest in day-to-day activities, neglect in appearance, and changes in eating or sleeping habits. Talking about suicide: Any talk about suicide, dying, or self-harm, such as “I wish I hadn’t been born,” “If I see you again…,” and “I would be better off dead.” Seeking out harmful objects: Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt. Preoccupation with death: Unusual focus on death, dying, or violence. Writing poems or stories about death. Self-loathing, self-hatred: Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden, (“Everyone would be better off without me”). Getting affairs in order: Making out a will; giving away prized possessions and making arrangements for family members. Assisting the suicide-prone The best way to help is to offer an empathetic, listening ear. Let them know they are not alone and that you care. Suggest they practise breathing and meditation, walking in nature, engaging with things that interest them such as pets, children – something outside of themselves and their misery. Encourage them to have a healthier and more active lifestyle with regular exercise like walking, running, swimming, yoga, meditation and a balanced diet. You can suggest they write a journal detailing their thoughts, feelings and achievements and draw, paint or do photography. Energy healing techniques such as Emotional Freeing Technique (EFT), reiki, hypnotherapy can be helpful in alleviating the pain and getting down to the cause of the desire to end their life. If you feel they need professional help, make sure they get it, by consulting a doctor who could help or give
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