(16/09/2019) NB: Information presented here is only for educational purposes. While the information is accurate and up to date, it should NOT be used for self-diagnosis; only a trained psychiatrist is able to offer a mental illness diagnosis.

Since September is national suicide prevention month, we here at Project AKILI have decided to collect facts and narratives to share with you and raise awareness on suicide, its prevention and how to deal with it’s grief. This first article will discuss about the causes and signs of suicidal thinking, and ways to help someone undergoing suicidal thinking.

What is Suicide and what are suicidal thoughts?

Suicide is the act of taking one’s own life. Suicidal behavior refers to talking about or taking actions related to ending one’s own life. Suicidal thoughts are thoughts about ending one’s own life.

Nearly everyone experiences suicidal thoughts at one point or another throughout their life. A simple fact about life is that many people consider committing suicide at some point in their lives. If you’re having suicidal thoughts, know that you’re not alone. You should also know that feeling suicidal isn’t a character flaw, and it doesn’t mean you’re crazy or weak. It only signifies that you’re experiencing more pain or sadness than you can cope with right now. In the moment, it may seem as though your unhappiness will never end. But it’s important to realize that with help, you can overcome suicidal feelings.

Causes of Suicidal thoughts and suicide:

While the cause of suicidal thoughts and suicide is unknown, some common risk factors include:

  1. Mental Illness: Among the most common causes of suicide is that of mental illness (anxiety, depression, bipolar disorder, schizophrenia).
  2. Traumatic Experience:Any type of traumatic experience can lead a person to feeling helpless, guilty, and/or ashamed. If you were victim of physical abuse, sexual abuse, and/or dealt with trauma in war, you are much more likely to end up with post-traumatic stress disorder. This disorder and the feelings associated with traumatic experiences can lead a person to become suicidal. Read more on Trauma and PTSD
  3. Bullying: Bullying can have a profound effect on the way people think and how they feel. Most people that are bullied end up feeling extremely depressed, worthless, and hopeless to change their situation. Unfortunately in many cases, bullying goes completely unrecognized until the victim can’t take it anymore and sees suicide as the only way to escape the pain that they are experiencing. Some kids view bullying others as a way to fit in and/or prove themselves in regards to social hierarchy. Kids that get bullied are often viewed as being either physically weak and/or socially weak to not come up with witty responses.
    Additionally, now there is a phenomenon called “cyber bullying” in which people fall victim to being bullied online. This happens on social media sites, comments sections of websites, and various blogs that aim to ruin people’s reputations and make people feel ashamed. When a person is bullied online and/or has privacy exposed online, they may view a ruined reputation as the end of the world and feel helpless to change their situation – which could lead to suicide.
  4. Personality Disorders: Personality disorders can be closely related to mental illness but are considered a set of traits that make it difficult to function within society. People with a personality disorder may have trouble maintaining relationships, holding down a steady job, and/or coping with life. For example, someone with dependent personality disorder may be too afraid to leave an abusive relationship. This “dependency” may lead the person with this disorder to consider suicide as an escape from their circumstances.
  5. Drug Addiction/ Substance abuse: People that are addicted to drugs and/or abuse drugs or alcohol on a consistent basis are more likely to become depressed. Many people use drugs to escape painful feelings of depression and hopelessness of their current life situation. Being addicted to drugs or alcohol may provide some short-term relief from the pain that they feel, but over the long term, it could lead to feelings of deep depression, where one feels helpless to overcome the addiction and see suicide as the only way out.
  6. Unemployment: Being unemployed can lead to feelings of isolation and make your life feel as if it is void of purpose. With a poor economy, many people lose their jobs and look for new work, but since the competition is fierce, landing a new job can be difficult. In many cases being unemployed not only makes people feel as if they have no purpose in life, it can lead to depression over lack of an income as well. Being unable to earn money and provide for yourself and/or a family can result in significant depression and anxiety.
    In addition to unemployment, hating your current job can also lead to suicidal thoughts and possibly actions if you feel as if there is no alternative option.
  7. Loneliness: Being socially isolated from society can take a toll on mental health and lead a person to become depressed and consider suicide. Socializing and interacting with other people is a basic human need. If social needs are not met, a person can start to feel lonely which leads to depression and possibly suicidal thoughts.
  8. Relationship problems: Many people struggle with relationships including: being in abusive relationships, not feeling appreciated, and/or going through break-ups. There are many different types of relationships that a person could struggle with. Some people may have difficulties making friends and maintaining a close group for socialization. Others may struggle with staying in abusive relationships just so that they can avoid feeling isolated and lonely.
  9. Genetics / Family History: A lot of suicide risk has to do with genetics and family history. Those who are from a family in which suicide is common are more likely to commit suicide themselves. Additionally if a mental illness is inherited such as major depression, this can further increase risk of suicide.
  10. Existential Crisis: When life seems void of meaning, people tend to question why they are even living and/or the entire purpose of their existence. This is often referred to as an “existential crisis” and can be difficult to overcome because people dealing with this issue often think themselves in circles of logic as to why there is no point to life. In many cases, people facing an existential crisis consider suicide because they feel as if their entire existence is void of purpose.
  11. Terminal Illness: Many people with terminal illnesses (such as various types of cancer) that have no hope of improving their situation based on current science and medicine may become depressed. This depression is usually a result of feeling powerless to one’s condition.
  12. Financial Problems: People who are struggling financially sometimes see no end in sight to their debt and bills. In a difficult economy, unemployment is linked to increased financial stress, but even if you are employed, you may still have financial problems.Those who have accumulated a serious amount of debt as a result of an unforeseen emergency, excessive shopping, and/or medical bills may panic and feel suicidal when they can’t pay their bills. The stress of having a debt and constant phone calls from bill collectors may make some people feel ashamed and hopeless to change their financial situation. Although most people in financial troubles eventually end up working their way out of debt, some people are afraid to deal with this situation. In the event that a person becomes embarrassed about their finances and feels depressed about their debt, they may consider suicide as a way to escape this situation.
  13. Symptoms of Suicidal thinking:

    You can’t see what a person is feeling on the inside, so it isn’t always easy to identify when someone is having suicidal thoughts. However, some outward warning signs that a person may be contemplating suicide include:

    1. Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born"
    2. Getting the means to take one’s own life, such as buying a gun or stockpiling pills
    3. Withdrawing from social contact and wanting to be left alone
    4. Having mood swings, such as being emotionally high one day and deeply discouraged the next day
    5. Being preoccupied with death, dying or violence
    6. Feeling trapped or hopeless about a situation
    7. Increasing use of alcohol or drugs
    8. Changing normal routine, including eating or sleeping patterns
    9. Doing risky or self-destructive things, such as using drugs or driving recklessly
    10. Giving away belongings or getting affairs in order when there's no other logical explanation for doing this
    11. Saying goodbye to people as if they won't be seen again
    12. Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

    Diagnosis:

    A psychiatrist may do a physical exam, tests and in-depth questioning about one’s mental and physical health to help determine what may be causing suicidal thinking and to determine the best treatment. Assessments may include:

    1. Mental health conditions: In most cases, suicidal thoughts are linked to an underlying mental health issue that can be treated. If this is the case, one may need to see a doctor who specializes in diagnosing and treating mental illness (psychiatrist) or other mental health provider.
    2. Physical health conditions In some cases, suicidal thinking may be linked to an underlying physical health problem. One may need blood tests and other tests to determine whether this is the case.
    3. Alcohol and drug misuse. For many people, alcohol or drugs play a role in suicidal thinking and completed suicide. A doctor will want to know whether you have any problems with alcohol or drug use — such as bingeing or being unable to cut back or quit using alcohol or drugs on your own. Many people who feel suicidal need treatment to help them stop using alcohol or drugs, to reduce their suicidal feelings.
    4. Medications. In some people, certain prescription or over-the-counter drugs can cause suicidal feelings. Tell your doctor about any medications you take to see whether they could be linked to your suicidal thinking.

    Treatment:

    Treatment of suicidal thoughts and behavior depends on your specific situation, including your level of suicide risk and what underlying problems may be causing your suicidal thoughts or behavior.

    Emergencies: If you've attempted suicide and you're injured, or are at risk of harming yourself:

    1. Call 999 or Call a suicide hotline number – in Kenya, call Befrienders Kenya at 0722178177.
    2. Have someone else call if you're not alone.

    If you're feeling suicidal, but you aren't immediately thinking of hurting yourself:

    1. Reach out to a close friend or loved one — even though it may be hard to talk about your feelings, your loved ones can be both a source of support and conflict. Involving them in treatment can help them understand what you're going through, give them better coping skills, and improve family communication and relationships.
    2. Contact a minister, spiritual leader or someone in your faith community
    3. Call a suicide hotline – in Kenya, call Befrienders Kenya at 0722178177
    4. Make an appointment with your doctor, other health care provider or a mental health professional -- In psychotherapy, also called psychological counseling or talk therapy, you explore the issues that make you feel suicidal and learn skills to help manage emotions more effectively. You and your therapist can work together to develop a treatment plan and goals.
    5. Addiction treatment: Treatment for drug or alcohol addiction can include detoxification, addiction treatment programs and self-help group meetings.

    How to talk to someone who is feeling suicidal:

    If you have a loved one who has attempted suicide, or if you think your loved one may be in danger of doing so, get emergency help. Don't leave the person alone.

    If you suspect that a family member or friend may be considering suicide, talk to them about your concerns. You can begin the conversation by asking questions in a non-judgmental and non-confrontational way.

    Do not hesitate to talk about suicide. If you think that someone you know is considering suicide, raise the subject. People are often relieved to talk to somebody about it. Recognizing their agony helps to ease the distress of carrying the burden of pain alone. It is important to listen to what somebody has to say without passing judgment on their feelings. Keep in mind that having no opportunity to talk about how badly they feel will only make a person feel more isolated.

    Talk openly and don’t be afraid to ask direct questions, such as “Are you thinking about suicide?”

    During the conversation, make sure you:

    1. stay calm and speak in a reassuring tone
    2. acknowledge that their feelings are legitimate
    3. offer support and encouragement
    4. tell them that help is available and that they can feel better with treatment

    Make sure not to minimize their problems or attempts at shaming them into changing their mind. Listening and showing your support is the best way to help them. You can also encourage them to seek help from a professional.

    Offer to help them find a healthcare provider, make a phone call, or go with them to their first appointment.

    It can be frightening when someone you care about shows suicidal signs. But it’s critical to take action if you’re in a position to help. Starting a conversation to try to help save a life is a risk worth taking. Supporting a loved one who is chronically suicidal can be stressful and exhausting. You may be afraid and feel guilty and helpless. Take advantage of resources about suicide and suicide prevention so that you have information and tools to take action when needed. Also, take care of yourself by getting support from family, friends, organizations and professionals.

    If you’re concerned and don’t know what to do, you can get help from a crisis or suicide prevention hotline. (Numbers provided at the bottom of this page)

    Lifestyle and home remedies:

    There's no substitute for professional help when it comes to treating suicidal thinking and preventing suicide. However, there are a few things that may reduce suicide risk:

    1. Avoid drugs and alcohol. Alcohol and recreational drugs can worsen suicidal thoughts. They can also make you feel less inhibited, which means you're more likely to act on your thoughts.
    2. Form a strong support network. That may include family, friends or members of your church, synagogue or other place of worship. Religious practice has been shown to help reduce the risk of suicide.
    3. Physical exercise. Physical activity and exercise have been shown to reduce depression symptoms. Consider walking, jogging, swimming, gardening or taking up another form of physical activity that you enjoy.

    Need help? In Kenya., call this suicide hotline for Befrienders Kenya at +254722178177

    To life,