Suicide through the Lens of Psychiatry and Psychology
“Sometimes even to live is an act of courage.”(Lucius Annaeus Seneca)
By: Fayaz Ahmad Paul
Youth suicide constitutes a major public mental health problem. Young people especially adolescents are by nature a vulnerable group for mental health problems. While suicide is relatively rare in children, its prevalence increases significantly throughout adolescence. Suicide may be defined as a fatal self-injurious act with some evidence of intent to die. It is a major health problem and a leading cause of death worldwide. Various reports informs that around a million people die by suicide annually, representing an annual global age standardized suicide rate of 11.4 per 100,000 populations, more men than women die by suicide. Sometimes suicide is not acknowledged or reported, due to its sensitive nature and the taboo that still surrounds it.
Too often, suicide attempts and deaths by suicide, especially among the young, become family secrets that are not investigated and dealt with in ways that might protect others from a similar fate. The death of a child is parent’s worst nightmare made even worse when it is self-inflicted. This very tragedy has become increasingly common among young people in some years and adults, parents, Psychiatric social workers, Clinical Psychologists, Psychiatrists and Clinicians should be asking why and what they can do to prevent it. The estimated global annual prevalence of self-reported suicide attempts is approximately 3 per 1,000 adults. About 2.5% of the population makes at least one suicide attempt during their lifetime. Considering a time perspective from 2000 through 2021, the age adjusted suicide rate has grown by 30%, these rates are only the tip of an iceberg. For every suicide, there are many more who attempt suicide every year.
A cautious estimate suggests that more than 20 million people engage in suicidal behavior annually. Moreover, it is estimated that in the future, the suicide rates are expected to rise. From the perspective of mental health, suicide among young people is one of the main issues to address through effective preventive measures. Therefore it is important to gain as much insight as possible in the risk factors contributing to suicidal behavior in youth. Suicide is a highly complex and multifaceted phenomenon, with many contributing and facilitating variables. It may be determined by the interaction between various factors, such as neurobiology, personal and family history, stressful events, and socio cultural environment.
Behind each suicide and attempt there is a long-term struggle of these individuals as well as experiences of trauma and distress among their relatives and friends. It is evident that suicide prevention comprises a global priority. As Psychiatric social workers, Psychiatrists and researchers, we must make every effort to enhance suicide prevention in order to improve our identification, intervention, and, subsequently, prevention of suicide and suicidal behavior.
The key factor leading to suicide is unbearable mental pain. It can be seen as a behavior motivated by the desire to escape from unbearable psychological pain. Other psychological factors like personality traits, emotional characteristics, and dysregulation also seem to play a role, with emerging importance to decision-making deficit among suicidal individuals. Lack of care and psychological abuse were significantly associated with suicide risk, and this association was partially mediated by the maladaptive personality dimension of self-criticism. Patients were particularly prone to suicidality if adversity, trauma was followed by the development of depressiveness. About 90% of people who commit suicide have suffered from at least one mental disorder.
Substance abuse is also strongly associated with suicide risk, especially in older adolescents and males. Among 30% of people who die by suicide had personality disorders, such as borderline or antisocial personality disorder. Suicide is often the cause of death in young people with eating disorders, in particular anorexia nervosa, as well as in people with schizophrenia, although schizophrenia as such accounts for very few of all youth suicides. Finally, associations have also been found between suicide and anxiety disorders, but it is difficult to assess the influence of mood and substance abuse disorders that are also often present in these cases.
Young people who committed suicide were also found to have had poor problem-solving skills than their friends. Their behavior was characterized by a rather passive attitude, waiting for someone else to solve the problem for them, for simple problems as well as for more complex interpersonal problems. It is estimated that in 50% of youth suicide cases, family factors are involved one important factor is a history of mental disorders among direct family members themselves, especially depression and substance abuse. Poor communication within the family is also found in many cases of suicide, not only with the child or about the child’s problems, but in general between family members. Furthermore, violence at home often seems to be found in the background history of young suicide cases, not only specifically against the child, but more as a way of dealing with problems between family members
Author is a Research Scholar in the Department of Psychiatry
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