Mental Illness as a Risk factor to suicide

Suicide is defined as intentionally taking one’s own life and comes from the Latin suicidium, which literally means “to kill oneself.” most often as a result of depression or other mental illness. Therefore suicide is the successful act of intentionally causing one’s own death. It tends to carry different traits depending on the culture. But historically, and still today in most of the locations, suicide is considered a criminal offense and a sin in many religions. Islam views suicide strictly as sinful and detrimental to ones spiritual journey. The cognitive schemata follow the rulings of the Quran, that the humans were created for the main reason of worshipping Allah, and that life and death issues should be controlled by Allah not by self-destruction. This faith acts as a factor in preventing suicidal attempts, especially for those practicing their religious rituals. Suicide is the 10th leading cause of death worldwide and rates of completed suicide are higher in men than women—with men up to four times more likely to kill themselves than women. In youth its among the top three causes of death worldwide. According to the WHO, every year, almost one million people die from suicide and 20 times more people attempt suicide; a global mortality rate of 16 per 100,000, or one death every 40 seconds and one attempt every 3 seconds, on average. The rates of suicide have greatly increased among youth, and youth are now the group at highest risk in one-third of the developed and developing countries. The emerging phenomenon of “cyber-suicide” in the internet era is a further cause for concern;also because the use of new methods of suicide are associated with epidemic increases in overall suicide rates.Suicide is nevertheless a private and personal act and a wide disparity exists in the rates of suicide across different countries. A greater understanding of region-specific factors related to suicide would enable prevention strategies to be more culturally sensitive. Researchers believe that 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. Therefore such people who attempt to take their own lives sometimes display warning signs beforehand. Some warning signs include:
• Expressions of hopelessness or helplessness.
• An overwhelming sense of shame or guilt.
• A dramatic change in personality or appearance, or irrational or bizarre behavior.
• Changed eating or sleeping habits.
• A drop in school or work performance.
• A lack of interest in things previously important, and the future.
• Writing, speaking or joking about suicide, death or dying or intention.
• Giving away possessions and putting affairs in order.
• Increasing alcohol and drug use.
• Withdrawing from friends, family or society.
Among the various factors which tend to be closely related to suicide, mental illnesses are a particularly important risk factor. Since Mental health is the foundation for emotions, thinking, communication, learning, resilience and self-esteem. It is also key to relationships, personal and emotional well-being and contributing to community or society. Therefore such health conditions involving changes in emotion, thinking or behavior (or a combination of these) results in mental illness. Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. Mental illness does not discriminate; it can affect anyone regardless of your age, gender, geography, income, social status, race/ethnicity, religion/spirituality, sexual orientation, background or other aspect of cultural identity. While mental illness can occur at any age, three-fourths of all mental illness begins by age 24. Mental illnesses take many forms. Some are mild and only interfere in limited ways with daily life, such as certain phobias (abnormal fears). Other mental health conditions are so severe that a person may need care in a hospital. Here we shall discuss about some of the most common mental illnesses (Depression, Bi-polar disorder, Post-traumatic PTSD and Schizophrenia) Stress Disorder, and how they may increase risk of suicide. Depression is a state of mental illness. It is characterized by deep, long-lasting feelings of sadness or despair. Depression can change an individual’s thinking/feelings and also affects his/her social behaviour and sense of physical well-being. It can affect people of any age group, including young children and teens. It can run in families and usually starts between the ages of 15 and 30 years. Women and elderly people are more commonly affected than men. Depressed people may fail to live up to their potential, doing poorly in school and staying on the social margins. Depression is frequently ignored or untreated; the condition often prevents people from taking steps to help themselves. This is unfortunate, as effective help is available. A major cause of suicide is mental illness, very commonly depression. People feeling suicidal are overwhelmed by painful emotions and see death as the only way out, losing sight of the fact that suicide is a permanent “solution” to a temporary state—most people who try to kill themselves but live later say they are glad they didn’t die. Most people who die by suicide could have been helped.
The only reliable protective factor for suicide in patients with schizophrenia is provision of and compliance with comprehensive treatment. Prevention of suicidal behavior in schizophrenia should include recognizing patients at risk, delivering the best possible therapy for psychotic symptoms, and managing comorbid depression and substance misuse.
An individual considering suicide frequently confides in a friend, who may be able to convince them to seek treatment. When the risk is high, concerned friends and relatives should seek professional guidance. Suicidal thoughts may be fleeting or more frequent, passive (e.g., “What if I were dead?”) or active (e.g., thinking of ways to kill oneself, making a plan). Preparations for death, such as giving away possessions or acquiring a gun, are cause for great concern. A sudden lift in spirits in a depressed person can be a warning sign that they are planning to kill themselves. Any level of suicidal thinking should be taken seriously. Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives. The rate of suicide among BD patients is approximately 10–30 times higher than the corresponding rate in the general population. Extant research found that up to 20% of (mostly untreated) BD subjects end their life by suicide, and 20–60% of them attempt suicide at least one in their lifetime. Therefore as a preventive measure, in acutely suicidal patients the removal of access to obvious means for suicide is essential and, in severe cases, hospitalization may be justifiable as well. Prevention strategies should include the provision of psycho education (for example, via information leaflets and/or by the members of the health care staff) to the patients, as well as to relatives and friends, in order that they become able to recognize the warning signs of suicidal behavior. Reports have suggested that posttraumatic stress disorder (PTSD) is associated with elevated risk of a suicide attempt. It is unclear, however, whether only persons with the disorder or any persons who have experienced trauma are at increased risk of attempting suicide. Post-trauma disorder is A disorder characterised by failure to recover after experiencing or witnessing a terrifying event. The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions. Symptoms may include nightmares or flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood. Experiencing a traumatic event and/or developing PTSD can have a tremendous impact on a person’s life. The symptoms of PTSD can make a person feel constantly afraid and isolated. A person may feel as though there is no hope or escape from their symptoms, leading them to contemplate suicide. It is important to realize that even though it may feel as though there is no hope, recovery and healing is possible. Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia. Schizophrenia is characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions and disorganized thinking. Other symptoms include social withdrawal, decreased emotional expression and apathy. Symptoms typically come on gradually, begin in young adulthood, and in many cases never resolve. Throughout the first decade of their disorder, patients with schizophrenia are at substantially elevated suicide risk, although they continue to be at elevated suicide risk during their lives with times of worsening or improvement. Having awareness of symptoms, especially, awareness of delusions, anhedonia, a sociality, and blunted affect, having a negative feeling about, or non-adherence with, treatment are associated with greater suicide risk in patients with schizophrenia. Comorbid depression and a history of suicidal behavior are important contributors to suicide risk in patients with schizophrenia. The only reliable protective factor for suicide in patients with schizophrenia is provision of and compliance with comprehensive treatment. Prevention of suicidal behavior in schizophrenia should include recognizing patients at risk, delivering the best possible therapy for psychotic symptoms, and managing comorbid depression and substance misuse. It is pertinent mention here that If someone indicates they are considering suicide, listen and take their concerns seriously. Don’t be afraid to ask questions about their plans. Let them know you care, and they are not alone. Encourage them to seek help immediately from a knowledgeable professional. Don’t leave them alone.
( The auth a resident of Wagoora Baramulla is a freelancer. Views are his own)
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