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Is It Really What It Is? What 18 years of Suicide Prevention Days should teach us.

On September 10th every year, World Suicide Prevention Day is observed by the International Association for Suicide Prevention. It aims to spread awareness about the epidemic of suicide, to shed light on the discussion surrounding suicide and suicidal behaviors, and to encourage help-seeking behaviors.

There is no denying that there has been great effort put into spreading awareness about suicide and mental health-related issues in the last couple of decades, yet the data completely contradicts any efforts which should have helped the case. As shown in the chart below, the suicide rates have been only increasing, at an alarming rate to say the least.

So the question arises, why is this the case?

I think one famous line from Bukowski sums it all up:

“You begin saving the world by saving one person at a time, all else is grandiose romanticism or politics.”

-Charles Bukowski

Perhaps it is time we start interrogating how we approach the subject at a fundamental level. Visualize your average suicide victim. Give her a name (we know it’s a ‘her’). How old is she? How sad is she? And what, to the point, the reason she is taking her own life is?

Congratulations, you have it all wrong.

Why not her?

As is clear by the chart above, men have it much harder in this case, with four to five times the rate of suicide than women.

What was the age? Mid-twenties?

According to NVDRS, men over 40 years of age are most likely to die by suicide.

What type of depression did she have? A lingering one, like dysthymia? Or clinical depression?

According to US Department of Health and Human Services about 7 percent of men with a lifetime history of depression will die by suicide, and 1 percent of women with a lifetime history of depression will die by suicide.

While this is certainly not a small number, comparing this to something like personality disorders like EUPD or BPD where up to 10% of people would die by suicide while an alarming 90% of patients attempted suicide.

And about the reason behind suicide, according to ImagineMD, it is not usually as to-the-point as one would like to think (though it can be) reason why one commits suicide, rather there are various reasons like psychosis, loneliness, mental illness, and even philosophical inquiry backed by some illness.

These statistics and data show that it is not just we need to have a discussion and spread awareness for suicide prevention, but we need to spread the right kind of awareness in the right way, as regardless of the country, the former has clearly not been working. Empathy is not just morality and virtue-signaling, it is especially not that. It is taking the toughest pills to swallow and still trying to put yourself in the shoes of other people, no matter how different they might be. People tend not to educate themselves about what things like ‘psychosis’ or ‘neurosis’ is, and how these illnesses actually impact people with mental disorders. It is evident from the data above that people with ‘psychotic’ symptoms have higher mortality by suicide rate than those whose illnesses fall under the neurotic category (like most common depressions, although some may have psychotic symptoms). I have tried to make conversations with people on the suicide bed, and have been left messages from the dead. Forums like r/suicidewatch are perfect to start this for the internet-generation. A general lingering theme here is not of sorrow, but of feeling ‘done’ with effort. This is usually due to constant rejection (in jobs, families, and love), and the ‘desperation’ arises more from what is not accessible to one rather what is. When it turns into a mental disorder, it often becomes too specific for other people to put effort into understanding, and more for the person to keep explaining to everyone. Before giving hope, we need to understand is there really any? This is what suicide prevention is about, not ‘saving’ people from committing suicide, as often it is indeed when one is at an absolute lack of hope that they choose to take their own lives. But ‘prevention’ is about accepting and understanding before such a situation can even arrive.

So, where should one start, if the question is to care or not to care?

If as a neurotypical you really wish to understand, start by asking and not Googling. Ask someone diagnosed with a disorder, someone who is showing symptoms (and these symptoms are usually beyond that of apparent sorrow), and study. We have been doing this for too long, telling ourselves that we are spreading awareness and helping people, whereas (speaking as a person who has at one point attempted suicide) it usually has the opposite effect, where people will keep posting on their social media stories and groups to ‘spread awareness’ are the same people causing one to feel insufferable torment. If you truly want to know, ask, and educate yourself.

And if that is not possible, not bothering is better than doing active or passive damage in the name of advocacy.

By Rishaj Dubey, President, MANAS CVS

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