“This blog delves deeply into the topic of suicide and suicidal thoughts, with the goal of educating readers, increasing awareness, and encouraging prevention initiatives. If you or someone you care about is experiencing suicidal thoughts, it is crucial to reach out to a mental health professional or contact a crisis hotline right away. Remember, you are not alone—support and assistance are always within reach.”
Table of contents
I. Introduction
– Definition of Suicide
– Contributing Factors and Causes – Overview of Suicidal Behaviour – Suicide – Social Burden
II. Historical and Cultural Perspectives on Suicide
Early Historical References (e.g., Pyramus and Thisbe)
Suicide in Ancient Religion
– Ancient Greek Philosophy and Religion
– Ancient Roman Beliefs
– Hinduism (aspects of Prayopavesa, (Sanskrit: प्रायोपवेशनम्, prāyopaveśanam)
– Jainism and the Practice of Sallekhana
– Samurai and Bushido (Japan)
– Buddhism
Religion Most Focused on Ritualized Suicide: Jainism
III. Bhagavad Gita and Its Insights on Suicide
– The Dialogue Between Krishna and Arjuna
– Key Teachings Related to Duty, the Soul’s Immortality, and Karmic Implications
– Understanding the Restless Mind (Chapters 2, 6, and 15)
IV. Modern Perspectives on the Mind and Emotional Turmoil
-The Modern Mind and Emotional Challenges
– Identity, Belief Systems, and Social Conflicts
– Moving Forward: Balancing Head and Heart
V. Ritualized Death Practices in Hindu Tradition
Prayopavesa: The Hindu Legacy
– Conditions and Guidelines
– Differences from Despair-Driven Suicide
Comparison with Jainism’s Sallekha
VI. Psychological and Sociological Perspectives
Inner Conflict and the Role of Mediation
Mental Health, Suicide, and Historical Contexts
Émile Durkheim’s Theory of Suicide
– Overview and Significance
– Types of Suicide: Egoistic, Altruistic, Anomic, Fatalistic
VII. Definitions, Causes, and Risk Factors
• What is Suicide?
• What Constitutes a Suicide Attempt?
• Why Do People Consider Suicide?
• Risk Factors and Protective Factors
• Passive Suicidal Ideation
VIII. Breaking the Stigma and Seeking Help
• Recognizing Warning Signs
• Treatment and Support Options
• How to Help Someone in Crisis
IX. Global and National Perspectives
– Global Statistics and the Public Health Impact
– Preventive Measures and National Responses
– Impact on Individuals, Families, and Society
– The Path Forward: Collective Responsibility – Why Suicide is so important
X. Mental Illnesses and Suicidal Behaviour
• Bipolar Disorder
– Manic and Depressive Phases
• Borderline Personality Disorder (BPD)
– Symptoms and Complications
– Comparison with Bipolar Disorder
– Gender Considerations
• Post-Traumatic Stress Disorder (PTSD)
• Major Depressive Disorder (MDD)
• Substance Use Disorder (SUD)
– Stages Leading to Addiction
• Schizophrenia
XI. Suicidal Thoughts and Behaviours
• Underlying Emotions and Contributing Factors
• Recognizing Behavioural Warning Signs
• Treatment, Emergency Care, and Therapeutic Approaches
XII. Suicide Prevention Initiatives
• World Suicide Prevention Day
• Suicide Prevention Programmes in the Indian Context
– National Strategies and Policy Initiatives
– Government and Community Efforts
XIII. References
Suicide Unmasked: Navigating Crisis and Embracing Hope in the darkness
Introduction
Suicide is often seen by those in despair as a way to escape insurmountable struggles. Yet, it is crucial to understand that suicide is not a solution—it is an irreversible escape from a world that still holds the potential for healing, growth, and connection. In this blog, we explore the deep emotional, psychological, and social factors that lead to suicidal thoughts, and why facing these challenges with support is the key to finding lasting solutions. Life can be overwhelming, but there is always hope, and help is available for those who reach out. Let’s embark on a journey toward understanding, compassion, and the belief that there is more beyond the darkness. for 4 seconds
In moments of overwhelming despair, the thought of ending one’s life might seem like the only escape. However, suicide is not a solution but a route for escape—one that sidesteps the possibility of healing and genuine recovery. In this blog, we explore the intricate layers of pain, isolation, and hopelessness that can drive someone to seek an exit, while also shedding light on the profound potential for hope and transformation when support and understanding are embraced.
Suicide occurs when a person deliberately chooses to end their own life. It is a complex and tragic event often resulting from a combination of psychological, social, environmental, and biological factors. Individuals who die by suicide typically experience intense feelings of hopelessness, unbearable emotional pain, and a perceived lack of alternative solutions to their problems.[2]
Suicide can stem from various contributing factors, including mental health conditions (such as depression, anxiety, bipolar disorder, and schizophrenia), substance abuse, exposure to traumatic events, chronic physical illnesses, and significant life stressors like financial hardship, relationship problems, or loss.
The person who decides to commit suicide is often enduring an immense and relentless amount of emotional, psychological, or situational stress. This stress can stem from a variety of sources—such as unresolved trauma, mental illness, overwhelming life challenges, or a profound sense of loneliness. Over time, this burden becomes so heavy that it clouds their ability to think clearly or see any hope for change.
To the person on the verge of suicide, it feels as though all possible options have vanished. It appears to them as if every door that once led to help, healing, or escape is now firmly shut. They may feel completely isolated, as if no one truly understands their pain. In this state of despair, suicide may seem like the only way to end the suffering—a final act to escape what feels like an inescapable reality.
Suicidal behavior includes suicidal ideation (thinking about, considering, or planning suicide), suicide attempts (engaging in potentially self-harmful behavior with the intent to die but surviving), and completed suicide.
Prevention efforts focus on addressing mental health concerns, promoting social support networks, limiting access to means of self-harm, and increasing awareness of warning signs, such as withdrawal, drastic mood changes, and talking about wanting to die.
According to the Centers for Disease Control and Prevention (CDC) [32] and the National Institute of Mental Health (NIMH) [33] , suicide is a significant public health concern, with ongoing initiatives aimed at reducing its incidence through education, intervention, and improved access to mental health resources
Suicide has been documented across all cultures, regions, and ethnic groups throughout history. One of the earliest recorded instances involves Pyramus and Thisbe, star-crossed lovers from Babylonia (in present-day Persia), whose tragic deaths date back to around 2000 BC. [9]
Suicide – Social Burden
Suicide is not merely an individual tragedy; it is a profound social burden. The loss of life resonates far beyond the personal, affecting families, communities, and even the fabric of society. The emotional, economic, and psychological toll of suicide creates ripples of grief and disruption, often leaving behind unaddressed wounds and a collective sense of loss. Recognizing suicide as a social burden underscores the need for a community-based approach—one that fosters open dialogue, supports mental health, and promotes preventive measures to protect not only individual lives but the well-being of society as a whole.
Suicide in ancient religion
The Bhagavad Gita, a sacred Hindu scripture, was composed approximately two millennia ago, yet its teachings remain pertinent in today’s AI-driven era. Presented as a dialogue between Prince Arjuna and his charioteer Krishna, an incarnation of Lord Vishnu, the Gita delves into the intricate nature of the human mind, illustrating how it is shaped by both external environments and internal physical conditions.
As human civilization progresses, our lifestyles have evolved and will continue to do so in pursuit of improved living standards. This quest often leads to intense competition within our social spheres, resulting in increased mental stress and tension. In the contemporary materialistic world, consumerism dominates, fuelling ever-growing aspirations, expectations, and desires.
While advancements in science and technology have enhanced comfort and extended life expectancy, they have also escalated levels of stress, anxiety, depression, and various other mental health issues. Consequently, there has been a noticeable rise in self-inflicted deaths, commonly referred to as suicides, within our society.
In ancient times, different religions and philosophical traditions had varying views on suicide, often influenced by cultural, spiritual, and moral perspectives.
Ancient Religions and Suicide:
- Ancient Greek Philosophy and Religion:
- While Greek religion did not focus on suicide as a religious act, philosophers like Stoics believed suicide could be a rational choice under circumstances where life conflicted with personal dignity and virtue. For example, the Stoic philosopher Seneca argued that ending one’s life to avoid dishonour or intolerable suffering could be morally acceptable.
- In contrast, Plato generally disapproved of suicide unless ordained by the gods, while Aristotle saw it as an offense against the state.
- Ancient Roman Beliefs:
- Influenced by Stoicism, Romans often accepted suicide as an honorable escape from disgrace or suffering. Roman generals and statesmen, like Cato the Younger [35], chose suicide to avoid capture and humiliation.
- Hinduism (Ancient India):
- While generally discouraging suicide as it disrupts the cycle of karma and reincarnation, certain forms like Prayopavesa (a ritual fasting to death by elderly ascetics) were permitted under strict conditions, seen as a spiritual practice rather than an act of despair.
- Jainism:
- Jainism uniquely places significant religious importance on Sallekhana [34], a ritual fast unto death. Practiced by monks and sometimes devout laypeople, it is viewed as a peaceful and voluntary path to spiritual liberation when one’s life duties are complete.
- Samurai and Bushido (Japan):
- While not a religion, Bushido, the samurai code influenced by Shintoism, Buddhism, and Confucianism, endorsed seppuku (ritual suicide) to preserve honor.
- Buddhism:
- Generally, condemns suicide as it contradicts the principle of ahimsa (non-violence), but historical interpretations varied. Some texts discuss monks seeking rebirth through self-sacrifice, but mainstream Buddhism focuses on alleviating suffering through mindfulness and ethical living.
Religion Most Focused on Ritualized Suicide:
Jainism stands out among ancient religions for its structured, ritualized approach to suicide (Sallekhana), framed as a spiritual and ethical choice rather than an act of despair or escape. Unlike impulsive or despair-driven suicides, Sallekhana is performed with calmness, mindfulness, and consent, with the goal of purifying the soul.
While many ancient traditions acknowledged or discussed suicide, Jainism uniquely integrated it into spiritual practice under strict ethical guidelines, making it the ancient religion most focused on a form of ritualized, voluntary death.
Bhagavad Gita and Suicide:
The Bhagavad Gita, a revered spiritual text of Hinduism, is a philosophical dialogue between Lord Krishna and Arjuna that addresses profound questions of life, duty (dharma), and spiritual wisdom. While the Gita does not explicitly discuss suicide in direct terms, its teachings strongly emphasize the importance of facing life’s challenges with courage and fulfilling one’s responsibilities rather than seeking escape through self-destruction.
Key Teachings of Bhagavad Gita Related to Suicide:
The holy scriptures of Hinduism Srimad Bhagavad Gita were written five thousand years ago, but the message is still relevant even after five thousand years in the age of AI. The Bhagavad Gita is presented within a narrative structure, consisting of a dialogue between Arjuna, the Pandava prince, and Krishna, who serves as his charioteer and guide, and is also an avatar of Lord Vishnu. for a few seconds
The Bhagavad Gita is presented within a narrative framework that features a dialogue between the Pandava prince Arjuna and his charioteer guide Krishna, an avatar of Lord Vishnu.
The Bhagavad Gita describes the complex nature and characteristics of our mind. And clearly says how our mind is influenced by external (environments) factors and internal factors (physical conditions) as well.
As the progress and developments of human civilization is a dynamic concept, our life style changed a lot over time and will keep changing in future as well in the name of better living. This betterment in our living standard actually pushes us to face cut-throat competition in our social circle. As a result, the mental state of human beings are subject to stresses and strains. In today’s materialistic world, consumerism is the keyword, with ever increasing aspiration, expectation, desire etc.
No doubt today’s life has given us more comforts and higher longevity due to progress in science and technology but it also increases our stress, anxiety, depression and several other mental illnesses. And the result of mental illness is, as observed, ever increasing self-inflicted deaths commonly known as suicide in our society.
- Emphasis on Duty (Dharma) and Courage:
- Arjuna, overwhelmed by despair on the battlefield, initially expresses a desire to withdraw from his duty, which can be metaphorically seen as a form of escapism.
- Krishna counsels him to rise above weakness and fulfil his righteous duties without attachment to success or failure.
- “ O Arjuna, do not give in to fear—it is beneath you.. Cast aside this trivial fearfulness and rise, mighty vanquisher of your foes.” – Bhagavad Gita 2.3
- Soul’s Immortality and the Futility of Death:
- The Gita teaches that the soul (atman) is eternal, indestructible, and beyond physical death. Taking one’s life does not end suffering but continues the cycle of rebirth and karmic consequences.
- “The soul experiences neither birth nor death. Once it exists, it endures forever—unborn, eternal, ever-present, and timeless.” – Bhagavad Gita 2.20
- Condemnation of Escapism:
- Krishna warns against seeking refuge in escapism, encouraging individuals to face their struggles with equanimity.
- The Gita promotes self-discipline, resilience, and spiritual introspection rather than succumbing to despair.
- Suicide and Karmic Implications:
- While not directly mentioned, the Gita’s karmic philosophy implies that taking one’s life prematurely disrupts the natural progression of karma and spiritual growth.
- Facing life’s difficulties with patience and performing one’s dharma leads to purification of the mind and eventual liberation (moksha).
While the Bhagavad Gita does not address suicide outright, its overarching message is to confront life’s challenges with strength, perform one’s duties without attachment, and seek inner peace through spiritual wisdom. Despair is to be overcome through knowledge, devotion, and right action, not by abandoning life.
“O Krishna, the mind is fiercely restless, turbulent, mighty, and unyielding. It seems to me that controlling it is more challenging than taming the wind. – Chapter 6 Verses 34, Srimad Bhagavad Gita
In the Bhagavad Gita, Arjun eloquently expresses the universal struggle with the restless mind. He describes it as ever-changing, constantly shifting from one thought to another. Its turbulence disrupts inner peace, giving rise to emotions like anger, hatred, lust, greed, envy, anxiety, fear, and attachment. The mind’s strength lies in its ability to overpower reason, sweeping away the intellect’s power of discernment with its relentless currents.
Moreover, the mind’s obstinacy becomes evident when it clings to harmful thoughts, refusing to release them despite the intellect’s protests. It repeatedly dwells on negativity, much to one’s dismay. Recognizing these challenging traits, Arjun concludes that controlling the mind is even more difficult than taming the wind—a powerful comparison, for who can imagine holding back the mighty gusts that sweep across the sky?
Chapter 15, Verses 7 Srimad Bhagavad Gita
‘Within this material world, every embodied soul is an eternal fragment of Mine. However, due to its bond with material nature, it constantly contends with the six senses, including the mind’
In Chapter 15, Verse 7 of the Bhagavad Gita, the mind is described as the sixth sense—our faculty of thought and memory. Unlike physical organs made of flesh and blood, the mind is an intangible collection of our thoughts, experiences, and perceptions. It serves as a vessel for ideas, opinions, emotions, memories, and willpower. Our thoughts, which form the essence of the mind, are deeply rooted in past experiences and future anticipations.
The mind possesses immense power, capable of shaping a person’s destiny for better or worse. By its very nature, it is restless, constantly flitting from one object of interest to another. This inherent instability has often led to comparisons with a drunken monkey, aimlessly leaping from branch to branch—unpredictable, unsettled, and difficult to control.
Chapter 6, Verses 33, Srimad Bhagavad Gita –
‘Arjuna said This Yoga of Equanimity, taught by thee, o slayer of Madhu, I see not its enduring continuity, because of restless (of the mind)
Chapter 6, Verses 35, Srimad Bhagavad Gita –
‘Lord Krishna said: “ “O mighty-armed son of Kunti, your words are true; the mind is exceptionally hard to tame. However, through consistent practice and a spirit of detachment, it is possible to control it.”
Arjuna, in Shlokas 6.33 and 6.34 of the Bhagavad Gita, vividly describes the nature of the mind. He portrays it as inherently unsteady—fickle, restless, turbulent, strong, and obstinate. These qualities render the mind unpredictable and challenging to control.[14]
This inherent restlessness leads to a conflict between the intellect (brain) and emotions (heart). The mind, being deeply connected to material nature, is transient and constantly shifting. Its fickleness stems from its outward orientation—drawn by the senses rather than guided by higher intelligence and the inner self. As a result, the mind becomes a source of inner turmoil, unless disciplined and directed inward through conscious effort.
Chapter 2, Verses 67 Srimad Bhagavad Gita
‘For, the mind, which follows in the wake of wandering senses, carries away his discrimination, as the wind carries away a boat on the waters’
Understanding the Restless Mind: Lessons from the Bhagavad Gita and Human Behaviour
The Bhagavad Gita offers profound insights into the nature of the human mind and its struggles. In Chapter 2, Verse 67, it states that when even one of the senses becomes fixated on an object, it can lead the mind astray. This attachment triggers a chain reaction, ensnaring the mind in a web of selfish desires, ultimately leaving it restless and unsettled. Conflicting thoughts and emotions further agitate the mind, causing turbulence fueled by fear, anger, lust, and greed.
The mind’s strength lies in its ability to overpower intelligence with impulses rooted in sensory attachment, clouding judgment and diminishing one’s ability to discern right from wrong. Obstinacy is another trait of the mind—it clings to beliefs even when they are evidently false or harmful. Arjuna, recognizing these challenges, admitted to Krishna that controlling the mind seemed more difficult than taming the wind. In response, Krishna acknowledged the mind’s restlessness but emphasized in Chapter 6, Verses 35-36 that with self-discipline, sincerity, and the right methods, one can achieve mental calmness and clarity.
Krishna’s guidance underscores a step-by-step elevation of consciousness: from controlling the senses to mastering the mind, refining intelligence, and ultimately connecting with the self.
The Modern Perspectives of Mind and Emotional Turmoil
While the Bhagavad Gita provides timeless wisdom, the struggles it describes are highly relevant today. The human mind often prioritizes emotions over intellect, leading to internal conflicts. These unresolved emotions can give rise to mental health issues and, in extreme cases, to self-destructive behaviors like suicide.
Suicidal tendencies are complex, influenced by a combination of individual and societal factors. In modern society, understanding the cause-effect relationship behind human behavior is vital. Behavior stems from the interplay between the heart (emotions) and the head (logic), making it an internal battle between thoughts and feelings.
Identity, Belief Systems, and Social Conflicts
A human being’s identity is multifaceted, and the way one prioritizes these identities can lead to confusion and conflict. Today, people often associate themselves with particular clans, religions, or belief systems without embodying the true teachings of those traditions. This superficial identification can cause divisions—clan versus clan, religion versus religion, and even conflicting interpretations within the same tradition.
At its core, conflict arises when emotions and thoughts override moral judgment, creating feelings of fear, anger, confusion, and loneliness. These emotional disturbances, if left unchecked, can deeply affect one’s mental health.
Moving Forward: Balancing Head and Heart
To effectively overcome these challenges, it is essential to:
- Cultivate self-awareness to recognize when emotions are clouding judgment.
- Practice self-discipline and gradually raise awareness from sensory indulgence to higher consciousness.
- Embrace the core teachings of spiritual and moral traditions, focusing on their essence rather than mere labels.
- Seek support when overwhelmed, acknowledging that vulnerability is a strength, not a weakness.
Ultimately, the path to peace of mind lies in harmonizing the heart and head, aligning emotions with wisdom, and elevating one’s consciousness. By doing so, one can find clarity amidst confusion, calm amidst chaos, and purpose amidst uncertainty.
Ritualized Death Practices in Hindu Tradition
Prayopavesa: The Hindu Legacy
Prayopavesa [34] is a voluntary and ritualistic form of fasting to death in Hinduism, undertaken by individuals who have fulfilled their worldly responsibilities and seek spiritual liberation (moksha). Unlike suicide, which is often driven by despair or emotional distress, Prayopavesa is conducted with calmness, detachment, and spiritual intent, making it a respected and spiritually sanctioned practice in Hindu tradition.
Conditions and Guidelines:
Hindu scriptures outline strict conditions under which Prayopavesa is considered acceptable:
- Completion of Life’s Duties:
- It is only permitted for those who have fulfilled their family, social, and spiritual responsibilities.
- Health and End-of-Life Circumstances:
- Typically undertaken when a person is terminally ill, extremely aged, or suffering from irreversible conditions that make life duties impossible to perform.
- Mental Clarity and Consent:
- The individual must be mentally sound and act of their own free will, free from emotional turmoil.
- Public Declaration:
- The decision is usually made publicly, allowing for community and family consultation to ensure it’s not an impulsive act.
- Spiritual Preparation:
- The process involves prayers, meditation, and recitation of scriptures, helping the individual focus on spiritual detachment rather than physical suffering.
Difference from Despair Driven Suicide:
- Motivation:
- Prayopavesa is motivated by spiritual goals and detachment, whereas suicide often stems from despair or escape from suffering.
- Approval and Regulation:
- Prayopavesa follows strict religious and ethical guidelines with community oversight, unlike the often impulsive nature of suicide.
- Spiritual Significance:
- It is seen as a final act of self-purification and acceptance of the natural end of life.
Historical Examples:
- Acharya Vinoba Bhave, a prominent Indian spiritual leader and disciple of Mahatma Gandhi, undertook Prayopavesa in 1982, choosing a peaceful and spiritual departure from life.
Comparison with Jainism’s Sallekhana:
Prayopavesa is similar to Sallekhana[34] in Jainism, which also involves voluntary fasting unto death. Both practices are based on non-attachment and spiritual liberation, but they arise from distinct religious frameworks.
Prayopavesa represents the Hindu philosophy of accepting death with dignity, peace, and spiritual awareness, contrasting with the impulsiveness and negativity associated with suicide. It reinforces the idea of detachment from the physical body and focuses on spiritual evolution in the final stages of life.
- Psychological and Sociological Perspectives
Inner Conflict
Jacqueline T. Hill, a writer and blogger, defines inner conflict as a persistent struggle that often impedes clear decision-making. These internal conflicts typically arise from personal experiences and the complex interplay between nature and nurture. When making decisions, it is essential to consider the influence of friends, family, and societal expectations.[16]
Role of Mediators and Mediation:
In clinical and psychological contexts, mediators play a crucial role in resolving internal conflicts. Mediation serves as an effective tool to alleviate confusion and foster clarity. Key psychological factors—such as trauma, mentalization, shame, and group identity—significantly shape the state of mind of individuals in conflict. Successful mediation relies on skills like countertransference awareness, emotional attunement, and empathic mutual positioning. These techniques help mediators better understand and support conflicting parties. [25]
Mediators are encouraged to reflect on their personal experiences and emotional investment in the process. It is equally important to acknowledge the potential emotional toll mediation can have on the mediator’s well-being.
Mental Health, Suicide, and Historical Perspectives:
Mental disorders are undeniably distressing, and individuals with such conditions have higher suicide rates compared to those without. However, it is crucial to recognize that suicide is not solely linked to mental illness; neurological disorders can also create perceptions that suicide is a viable escape. [17]
Historically, the earliest recorded suicides date back to around 2000 BC with the tragic deaths of Pyramus and Thisbe in Babylonia. Suicide has been documented across all cultures, regions, and ethnic groups. For over a millennium, major religions like Islam and Christianity have condemned suicide as a sinful act. In the Western world, the early 19th century marked a shift in perspective, treating suicide as a medical issue rather than solely a religious one. Although the World Health Organization (WHO) in 2014 challenged the notion that suicide is predominantly a medical problem, research continues to focus on mental disorders as significant contributing factors, with many experts advocating for treatment as a key preventive measure.
Émile Durkheim: Theory of Suicide
Émile Durkheim, a pioneering French sociologist, conducted the first systematic study of social facts in relation to society. His work Suicide, published in 1897, remains a landmark in sociological research and continues to be relevant today. Durkheim defined suicide as a death resulting from an individual’s actions, undertaken with the awareness of its likely outcome, whether driven by positive or negative motivations. [11]
Durkheim’s study was groundbreaking because it analysed suicide not as an individual act of despair but as a phenomenon influenced by broader social factors. One of the central concepts in his theory is social integration—the extent to which individuals feel connected to their community or society. According to Durkheim, a lack or excess of integration can lead to higher suicide rates. For instance, minority groups striving to assimilate into mainstream society may face intense peer pressure and social challenges, increasing their vulnerability to suicide.
In his broader sociological framework, Durkheim introduced the concept of social facts—values, cultural norms, and social structures that exist outside the individual but exert significant influence over behavior. He emphasized that sociology should be an empirical study of these social facts. Durkheim described them as “manners of acting, thinking, and feeling external to the individual, which are invested with a coercive power.” These forces, he argued, shape individual actions in ways that transcend personal choice.
Durkheim viewed sociology as “the science of social facts,” distinguishing them from biological or physical phenomena. Social facts, according to him, “consist of representations and actions” that cannot be reduced to individual consciousness alone. By framing suicide within this sociological perspective, Durkheim demonstrated that individual behaviours are deeply intertwined with societal structures and collective norms. [12]
Emile Durkheim’s Theory of Suicide: An Overview
Emile Durkheim, a pioneering sociologist, identified four distinct types of suicide, each reflecting varying degrees of social integration and regulation. His work aimed to explore the social causes behind this individual act, emphasizing how societal factors can profoundly influence personal decisions.
- Egoistic Suicide
Egoistic suicide occurs when individuals feel disconnected from their community. This form of suicide arises from a prolonged sense of isolation and the absence of social bonds. Those affected may experience feelings of meaninglessness, apathy, melancholy, and depression. A lack of belonging and support network leads them to perceive life as devoid of purpose. [4]
- Altruistic Suicide
Altruistic suicide, in contrast to egoistic suicide, stems from excessive integration into a group. In such cases, individuals subordinate their personal needs to the collective goals and beliefs of their community, sometimes to the point of sacrificing their lives for the greater good. This form of suicide is always intentional and is often seen as a selfless act performed to benefit others, preserve societal traditions, or uphold communal honour.
Altruistic Suicide in India
India has a long history of altruistic suicide, with mentions in ancient religious texts such as the Dharma Shastras. Two notable forms practiced in ancient India include:
- Jauhar Brata: A mass suicide conducted by women when their male protectors were defeated in battle.
- Sati: The self-immolation of a widow on her husband’s funeral pyre or following his cremation. [10]
While the practice of Jauhar diminished with the end of certain historical periods, Sati persisted until the 19th century. Raja Rammohun Roy, a notable social reformer, played a crucial role in advocating for its abolition. Despite strict laws against Sati and its glorification, isolated incidents still occur, though contemporary society now regards it as a criminal act rather than an altruistic sacrifice. [31]
- Anomic Suicide
Anomic suicide results from a breakdown of social norms and moral guidance, typically following significant social or economic upheaval. Individuals experiencing this form of suicide face moral confusion and uncertainty about their place in society. Such disorientation arises when traditional values erode, and societal changes outpace individuals’ ability to adapt. Durkheim linked this phenomenon to the failure of economic development or the division of labor to foster what he called “organic solidarity.” People struggling with anomic conditions often feel lost, lacking direction and purpose.
- Fatalistic Suicide
Fatalistic suicide occurs under conditions of extreme regulation and oppression. When individuals feel that their future is hopelessly constrained by rigid rules or harsh discipline, they may choose to end their lives to escape suffering. This form of suicide is the opposite of anomic suicide, as it stems from excessive control rather than a lack of it. Durkheim cited examples such as prisoners facing relentless abuse or individuals trapped in oppressive circumstances. However, he considered fatalistic suicide largely theoretical and believed it was less prevalent in real life. [13]
Durkheim’s Contribution to Understanding Suicide
Through his comprehensive study, Emile Durkheim sought to demonstrate that suicide, often seen as a purely individual act, is deeply rooted in social causes. By examining how varying degrees of integration and regulation affect individuals, Durkheim’s work underscores the profound influence of societal structures on personal choices. His insights remain pivotal in understanding the complex interplay between individual agency and social environment.
VII. Definitions, causes and Risk Factors
What is Suicide?
Suicide occurs when an individual intentionally harms themselves with the goal of ending their life, and death results from their actions. It is a tragic response to overwhelming stress or life challenges and, importantly, it is preventable. By recognizing the warning signs and knowing how to seek help, lives—your own or someone else’s—can be saved.
What is a Suicide Attempt?
A suicide attempt refers to self-harm with the intention of ending one’s life, but without resulting in death. Terms like “committing suicide,” “successful suicide,” or “failed suicide” should be avoided, as they carry negative connotations and can perpetuate stigma. [1]
Why Do People Consider Suicide?
Suicide stems from a complex interplay of vulnerabilities, risk factors, and triggering events. While it often occurs in the context of major depressive episodes, it can also arise from:
- Substance use disorders
- Other mental health conditions (e.g., bipolar disorder, psychotic disorders)
- Social or economic challenges
- Physical health decline
- Bereavement or significant loss
In some cases, suicide occurs without any diagnosable psychiatric disorder, particularly in individuals facing untenable life situations. [3]
Risk Factors for Suicide
While anyone can be at risk, certain factors increase vulnerability:
- Mental health disorders (depression, bipolar disorder, psychosis, substance dependence)
- History of childhood abuse (physical or sexual)
- Feelings of hopelessness
- Impulsivity and difficulty solving problems
- Perfectionism and high self-expectations
- Family history of suicide
- Social isolation or lack of support
- Significant life stressors, including financial hardship or relationship breakdowns
Older men with low socio-economic status, particularly those who are single, divorced, or widowed, are statistically at higher risk.
Protective Factors
While less studied, protective factors are crucial in preventing suicide. These include:
- Robust networks of support from family, friends, or community
- Access to mental health care
- Development of coping and problem-solving skills
- Sense of belonging and connectedness
- Cultural or religious convictions that deter suicide
Passive Suicidal Ideation
Passive suicide refers to behaviours that may be self-destructive but lack direct suicidal intent. Examples include neglecting basic needs like eating or personal hygiene. These actions can signal underlying distress and should not be overlooked. [5]
Comprehending the factors that compel someone to commit suicide is not easy, especially for individuals who have never encountered such powerful feelings. Accurate information about suicide is important in order to identify those who may need more support and to debunk some common myths about suicide. [6]
VIII. Breaking the Stigma and Getting Help
Recognising Warning Signs
Social stigma refers to the negative labels, stereotypes, and prejudices that society attaches to certain conditions, behaviours, or groups of people. It often leads to discrimination and exclusion, making it difficult for individuals to seek help or fully participate in community life. This persistent societal judgment not only deepens the emotional and psychological burden on those affected but also hinders progress in addressing issues like mental health, addiction, and other social challenges. Overcoming social stigma involves education, empathy, and open dialogue to foster a more inclusive and supportive environment for all.
Understanding what drives a person to consider suicide can be challenging, especially for those who have not experienced such profound despair. However, accurate information helps in identifying individuals who may need support and in debunking common myths about suicide.
Treatment and Support Options
Should you or someone close be struggling with suicidal thoughts::
- Reach out to someone you trust—a friend, family member, or medical professional.
- Contact emergency services or a crisis hotline immediately for help
- Advocate for professional care and continuous support.. [25]
You Are Not Alone – How to Help someone
Suicide is preventable. Compassion, understanding, and timely intervention can make all the difference. Reaching out, listening without judgment, and offering support are small steps that can have a life-saving impact.
- The Reality of Suicide – Global & National Perspective
According to the World Health Organization (WHO), suicide remains a significant global public health concern. Every year, more than 703,000 people take their own lives, with many more attempting suicide. Each suicide is a profound tragedy that impacts families, communities, and entire nations, leaving lasting emotional scars on those left behind.
Key Global Statistics:
- Over 700,000 deaths occur annually due to suicide. – WHO
- For every suicide, there are many more attempts, highlighting the urgency of preventive measures. – who
- Among people aged 15–29, suicide ranks as the fourth most common cause of death.
- Approximately 77% of all suicides worldwide take place in low- and middle-income countries.
- The most common methods include pesticide ingestion, hanging, and firearms.
Suicide is a global phenomenon, not limited to high-income countries. In 2019, over three-quarters of suicides occurred in economically disadvantaged regions, underscoring the need for targeted interventions worldwide.
Preventive Measures and National Responses
Despite the gravity of the issue, suicide is preventable with timely, evidence-based, and cost-effective interventions. Effective national strategies require a comprehensive, multisectoral approach involving healthcare, education, social services, and community organizations.
India’s Initiatives:
The Indian government has implemented several initiatives to address the growing mental health crisis, including:
- Tele MANAS Programme: A mental health helpline offering 24/7 support.
- 24×7 Helpline Numbers: Immediate access to mental health assistance.
- Decriminalization of Suicide Attempts: Under a 2017 law, attempts at suicide are no longer treated as criminal acts, fostering a supportive rather than punitive response to those in distress. [30]
Other Asian nations are following suit by implementing similar programs to address mental health issues, most of which are treatable with proper care.
Impact on Individuals and Society
Suicide and suicide attempts have far-reaching consequences:
Personal Impact:
- Survivors may endure serious injuries with lasting health implications.
- Many experience ongoing mental health challenges, such as depression and anxiety.
Societal Impact:
- Families and friends often face prolonged grief, shock, anger, guilt, and even develop mental health concerns themselves.
- Communities and workplaces are affected, with the ripple effects extending to economic productivity and social cohesion. [3]
The Path Forward: Collective Responsibility
While suicide poses a serious public health challenge, it can be prevented. This necessitates collaboration among governments, healthcare systems, and communities to:
- Increase awareness and education on mental health.
- Reduce stigma surrounding suicide and mental illness.
- Ensure accessible support and intervention programs for at-risk individuals.
By fostering open conversations about strengthening mental health services, reduce stigma, ensuring supportive resources – we can save lives and create a more supportive, resilient society.
The following table highlights no. of suicides in 2021 and the segment of Indian society exposed to suicide
Why Suicide is so important
Suicide is a leading cause of death in both developed and developing societies, posing a significant public health challenge. Its impact extends far beyond the individual, deeply affecting families, friends, and entire communities.
By definition, suicide is the intentional act of taking one’s own life. Suicidal behaviour encompasses any action intended to result in death, such as deliberately overdosing on drugs or purposefully causing a car crash.
The causes of suicide are complex, often stemming from a combination of vulnerabilities, risk factors, and personal triggers. Social and economic circumstances, along with cultural and individual experiences, can also play a critical role in influencing suicidal thoughts and behaviours.
For those who have never faced such overwhelming emotions, understanding what drives someone to consider suicide can be challenging. However, spreading accurate information about suicide is essential. It enables us to better identify individuals who may be at risk and helps dispel common myths, paving the way for more effective support and prevention efforts. [6]
- Mental Illnesses and Suicidal Behaviour
Certain mental health conditions are closely associated with an increased risk of suicide and suicidal behaviour. Below are some of the most common mental illnesses that may contribute to such outcomes: [7]
Bipolar Disorder
Bipolar disorder is characterized by extreme emotional swings, with individuals experiencing both elevated moods (mania or hypomania) and periods of depression. These mood episodes can last from days to weeks and significantly affect a person’s energy, behaviour, and ability to function. With proper treatment, many individuals with bipolar disorder can lead fulfilling and productive lives. [18]
Symptoms of the Manic Phase:
During a manic episode, which can last from days to months, a person may experience:
- Difficulty focusing or being easily distracted
- Engaging excessively in activities, often to the point of recklessness
- Reduced sleep requirements without feeling tired
- Poor judgment and impulsive decision-making
- Difficulty controlling anger or mood swings
- Risky behaviours (e.g., excessive drinking, drug use, reckless driving, unsafe sexual activities, or financial irresponsibility)
- Inflated self-esteem or delusions of grandeur
- Rapid speech and racing thoughts
- False beliefs or concerns not rooted in reality (delusions)
Symptoms of the Depressive Phase:
Depressive episodes are often more prevalent and might include:
- Persistent feelings of sadness or hopelessness
- Difficulty concentrating, making decisions, or remembering things
- Fluctuations in appetite, which can result in weight loss or gain,
- Fatigue or loss of energy
- Feelings of worthlessness, excessive guilt, or despair
- A reduced enthusiasm for activities that were once enjoyed
- Low self-esteem
- Thoughts of death or suicide
- Trouble sleeping or oversleeping
- Social withdrawal and isolation
Substance Use and Bipolar Disorder:
People with bipolar disorder may turn to substances like alcohol, stimulants, or hallucinogens to cope with their mood swings. Unfortunately, substance use can worsen symptoms and heighten the risk of suicidal behaviour.
Variations in Mood Patterns:
- Mixed State: Symptoms of both depression and mania occur simultaneously.
- Rapid Cycling: Episodes of depression and mania occur in quick succession without stable periods in between. [19]
Borderline Personality Disorder (BPD)
- Borderline personality disorder (BPD) is a mental health condition characterized by long-term patterns of emotional instability, impulsive behaviours, and difficulties in maintaining stable relationships. Individuals with BPD often experience intense inner turmoil that can lead to impulsive actions and turbulent interactions with others.
Symptoms of Borderline Personality Disorder
People with BPD often struggle with self-image and self-confidence, leading to rapidly shifting interests and values. They tend to view situations and people in extremes, perceiving things as either entirely good or completely bad.
Common symptoms include:
- Intense fear of abandonment: Difficulty coping with real or perceived rejection.
- Inability to tolerate being alone: A strong reliance on others for emotional stability.
- Feelings of emptiness and boredom: Persistent sense of void or dissatisfaction.
- Inappropriate anger: Sudden and intense outbursts of anger or irritability.
- Impulsivity: Engaging in risky behaviours, including substance abuse or unsafe sexual activity.
- Self-harming behaviours: Actions such as cutting, burning, or intentional overdosing.
Potential Complications of BPD
Without proper treatment, BPD can lead to various challenges, including:
- Depression
- Substance abuse
- Struggles in work, family, and social relationships
- Suicide attempts or completed suicide [15]
Comparisons : Borderline Personality Disorder vs. Bipolar Disorder
While both BPD and bipolar disorder involve mood fluctuations, they differ in key ways:
- Mood Patterns:
- BPD: Mood changes are typically quick and triggered by external stressors, especially in interpersonal relationships.
- Bipolar Disorder: Mood episodes (mania or depression) last longer and are less reactive to immediate situations.
- Energy and Activity Levels:
- BPD: Mood shifts do not usually come with significant changes in energy.
- Bipolar Disorder: Mood episodes are accompanied by noticeable changes in energy and activity levels.
Who Is Affected by Borderline Personality Disorder?
Most personality disorders, including BPD, begin during adolescence or early adulthood, with most diagnoses occurring after age 18 when personality traits become more established. [23]
Risk Factors:
- Genetic predisposition, evidenced by a family history of BPD or other mental health challenges
- Presence of anxiety, depression, or eating disorders
- Traumatic life experiences or childhood adversity [20]
Gender Considerations:
- Approximately 75% of BPD diagnoses occur in individuals assigned female at birth (AFAB).
- Research suggests that individuals assigned male at birth (AMAB) may be equally affected but are sometimes misdiagnosed with conditions like post-traumatic stress disorder (PTSD) or depression.
Why Gender Considerations Are Important in Borderline Personality Disorder (BPD)
Understanding gender considerations, such as Assigned Female at Birth (AFAB) and Assigned Male at Birth (AMAB), is essential in diagnosing, treating, and researching Borderline Personality Disorder (BPD) for several reasons:
- Differences in Symptom Presentation
- AFAB individuals with BPD often display symptoms like emotional instability, self-harm, and intense fears of abandonment.
- AMAB individuals may exhibit more externalizing behaviours, such as aggression, substance abuse, or impulsivity, which can lead to different clinical interpretations.
Recognizing these differences ensures accurate diagnosis and helps avoid overlooking BPD in populations that present symptoms differently.
- Risk of Misdiagnosis
- AFAB individuals are more likely to be diagnosed with BPD due to the prominence of emotional symptoms.
- AMAB individuals may be misdiagnosed with other conditions like Post-Traumatic Stress Disorder (PTSD), antisocial personality disorder, or depression, as their symptoms can manifest differently.
Accurate diagnosis is critical for effective treatment and reducing the stigma associated with misdiagnosed conditions.
- Tailored Treatment Approaches
- Gender-specific factors can influence how people respond to treatment.
- AFAB individuals may benefit more from therapies focused on emotional regulation, while AMAB individuals might need interventions addressing anger management or substance use.
Understanding gender-related needs ensures that therapy is customized for maximum effectiveness.
- Social and Cultural Influences
- Societal expectations of gender roles can shape how individuals express distress.
- AFAB individuals may be socialized to internalize emotions, leading to self-harm or depressive symptoms.
- AMAB individuals may externalize emotions due to cultural norms discouraging emotional vulnerability.
Recognizing these influences helps healthcare providers approach treatment with greater empathy and cultural competence.
- Impact on Access to Care
- Gender biases in the healthcare system can affect who receives appropriate mental health care.
- AMAB individuals with BPD may face barriers due to stigma around seeking help for emotional issues.
- AFAB individuals may have their symptoms dismissed as “overly emotional” or “attention-seeking.”
Addressing these disparities ensures equitable access to mental health services for all genders.
- Importance in Research and Data Collection
- Gender considerations like AFAB and AMAB help researchers understand how BPD affects different populations.
- Inclusive research leads to more comprehensive mental health policies and interventions.
Better data leads to improved care and more effective public health strategies.
Gender considerations are vital in understanding the complexity of Borderline Personality Disorder. By acknowledging the differences between individuals assigned female or male at birth, healthcare providers can offer more accurate diagnoses, tailored treatments, and compassionate care that respects each person’s unique experiences.
Ultimately, recognizing gender-related nuances helps reduce stigma, improve patient outcomes, and promote mental health equity.
Borderline personality disorder is a serious mental health condition that significantly affects emotional regulation and relationships. Early diagnosis, therapy, and a supportive environment are crucial in helping individuals with BPD manage their symptoms and lead fulfilling lives.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. [22]
It is classified as an anxiety disorder and is characterized by persistent negative emotions and heightened anxiety. PTSD occurs when the body’s stress response fails to return to normal after the traumatic experience, causing prolonged release of stress hormones.
Causes and Risk Factors
PTSD can affect individuals of any age following events that involve actual or perceived threats to safety. Common triggers include:
- Physical or sexual assault
- Car accidents
- Domestic violence
- Natural disasters (e.g., earthquakes, hurricanes)
- Incarceration
- Acts of terrorism
- Military combat and war experiences
Symptoms of PTSD
PTSD symptoms are typically divided into four primary categories:
- Intrusive Memories
Individuals may experience:
- Recurrent, distressing memories of the trauma
- Flashbacks: Episodes where the person re-experiences the trauma, feeling as though it is unfolding in real time.
- Nightmares related to the trauma
- Severe emotional or physical reactions to reminders of the event [21]
- Avoidance
Those with PTSD may:
- Avoid thinking or discussing the traumatic experience, places, activities, or individuals connected to it
- Refrain from fixating on the traumatic event or letting it dominate your thoughts.
- Negative Changes in Thinking and Mood
Symptoms in this category may include:
- Recurring pessimistic thoughts about oneself, others, or the broader world
- Feelings of hopelessness
- Memory difficulties, particularly regarding details of the trauma
- Difficulty maintaining close relationships
- Emotional detachment from loved ones
- A diminished interest in activities that used to bring happiness or a sense of purpose
- Inability to experience positive emotions
- Emotional numbness
- Alterations in Bodily and Emotional Responses (Arousal Symptoms)
These symptoms may involve:
- Reacting abruptly to unexpected stimuli or consistently feeling tensed
- Hypervigilance or always being on guard
- Engaging in risky behaviours (e.g., substance abuse, reckless driving)
- Trouble sleeping or concentrating
- Irritability, anger outbursts, or aggressive behaviour
- Intense feelings of guilt or shame
Special Considerations for Children
Children aged six and younger may show signs of PTSD through:
- Re-enacting the trauma during play
- Having nightmares, which may not directly reference the traumatic event
When to Seek Help
Severe PTSD symptoms, especially those involving self-destructive behaviours or suicidal thoughts, require immediate medical attention. If you or someone you know is dealing with PTSD, reaching out to healthcare professionals is essential for both recovery and overall well-being.
Gaining a clear understanding of PTSD is the crucial first step toward effective management.. With proper treatment and support, individuals can learn to cope with their symptoms and lead fulfilling lives.
Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD), commonly referred to as depression, is a prevalent mental health condition characterized by a persistent low mood or a significant loss of interest in previously enjoyable activities. Unlike occasional feelings of sadness that everyone experiences, MDD involves more intense and long-lasting symptoms that can disrupt daily life and physical well-being.
Difference Between Common Depression and Major Depressive Disorder
While it’s normal to feel down occasionally—often described as feeling “blue” or “down in the dumps”—Major Depressive Disorder is more severe and persistent. MDD occurs when prolonged feelings of sadness, loss, anger, or frustration interfere with daily functioning and overall quality of life.
Causes and Risk Factors
Depression can stem from a variety of factors, including:
- Stressful life events: Loss of a loved one, divorce, or serious illness
- Childhood experiences: Abuse or neglect
- Loneliness: Especially prevalent among older adults
- Relationship issues: Breakups or prolonged conflicts
- Medical conditions: Chronic illnesses or significant health challenges
Common Symptoms of Depression
Although Major Depressive Disorder symptoms may differ among individuals, they commonly include:
- Agitation, restlessness, and irritability
- Chronic ( Persistent) sensations of sadness, emptiness, or hopelessness.
- Withdrawal from social activities and relationships
- Angry outbursts over minor matters
- Fatigue and lack of energy, making everyday tasks feel overwhelming
- Feelings of worthlessness, guilt, or self-loathing
- Reduced involvement in hobbies or activities that were once a source of enjoyment.
- Marked alterations in appetite that may result in weight loss or gain.
- Difficulty concentrating, making decisions, or remembering things
- Changes in sleep habits, including difficulty falling asleep, staying asleep, or sleeping excessively
- Thoughts of death or suicide
Recognizing Teenage Depression
Depression in teenagers can be more challenging to identify. Instead of overt sadness, signs may include:
- Declining academic performance
- Behavioural issues at home or school
- Increased use of alcohol or drugs
- Social withdrawal or changes in friendships
If you or someone you know is showing signs of depression, obtaining professional help is essential. Prompt intervention can greatly enhance recovery and overall well-being.
Substance Use Disorder (SUD)
Substance Use Disorder (SUD) occurs when the use of alcohol or other substances leads to health complications or negatively impacts an individual’s work, school, or home life. It often coexists with mental health conditions such as depression, attention deficit disorder (ADD), post-traumatic stress disorder (PTSD), or other psychological challenges. A chaotic lifestyle, chronic stress, and low self-esteem are also common contributing factors.
Children raised in environments where drug use is prevalent face an increased risk of developing SUD due to both environmental influences and genetic predispositions.
Causes of Substance Use Disorder
While the exact cause of SUD is not fully understood, several factors may contribute to its development, including:
- Genetic predisposition
- Drug effects on brain chemistry
- Peer pressure
- Emotional and environmental stress
- Simultaneous mental health issues like anxiety and depression [24]
Commonly Used Substances
- Opiates and Narcotics:
Powerful painkillers that induce drowsiness and, in some cases, intense feelings of euphoria and happiness. These substances are often obtained illegally. - Stimulants:
Drugs that activate the brain and nervous system, such as cocaine and amphetamines, increasing alertness and energy. - Depressants:
Substances like alcohol, barbiturates, and benzodiazepines (e.g., Valium, Ativan, Xanax) that slow brain activity, reduce anxiety, and cause drowsiness, which can lead to addiction. - Hallucinogens:
Drugs such as LSD, mescaline, psilocybin (“magic mushrooms”), and phencyclidine (PCP, or “angel dust”) cause hallucinations and can lead to psychological dependence. - Cannabis:
Known as marijuana or hashish, this substance affects mood, perception, and cognitive function.
Stages of Substance Use Leading to Addiction [8]
Substance use typically progresses through several stages, with young people often advancing through them faster than adults:
- Experimental Use:
Often involves peer influence and recreational curiosity, with users seeking to defy authority. - Regular Use:
- Increased absenteeism from work or school
- Using substances to cope with negative emotions
- Withdrawal from family and non-using friends
- Heightened tolerance to the substance
- Problem or Risky Use:
- Loss of motivation and interest in responsibilities
- Behavioural changes and secrecy
- Legal issues may arise due to substance use or distribution
- Escalation to stronger substances
- Addiction:
- Inability to function without the substance
- Denial of the problem despite consequences
- Deterioration of physical and mental health
- Severe financial and legal challenges
- Isolation from family and friends
Signs and Symptoms of Substance Use Disorder
Recognizing the symptoms is crucial for early intervention. Common signs include:
- Confusion or disorientation
- Persistent substance use despite adverse effects
- Violent outbursts or increased hostility
- Inability to reduce or stop usage
- Skipping responsibilities (work, school, personal care)
- Drastic changes in physical appearance and hygiene
- Secretive or solitary substance use
- Neglect of eating and daily routines [26]
Prevention and Education
Preventative measures, including drug education programs, are vital. Parents play a pivotal role by:
- Openly discussing the dangers of substance use
- Setting clear expectations and boundaries
- Encouraging healthy coping mechanisms
By fostering supportive environments and raising awareness, communities can mitigate the risks associated with substance use disorders.
Schizophrenia
Schizophrenia is a mental disorder characterized by delusions (false beliefs), hallucinations (seeing or hearing things that aren’t there), unusual physical behaviours, and disorganized thoughts and speech. People with schizophrenia often experience paranoid thoughts or hear voices, believing that someone is controlling their mind or intending to harm them. These psychotic episodes can be terrifying, disorienting, and isolating.
Schizophrenia makes it challenging to distinguish between reality and hallucinations. It also affects the ability to think clearly, respond emotionally, and behave appropriately in social situations. This disorder can significantly disrupt a person’s life, hindering their ability to attend school or work, maintain a routine, socialize, complete daily tasks, or take care of themselves. However, with consistent treatment—comprising medication, therapy, and social support—individuals with schizophrenia can manage their condition and lead fulfilling lives.
What Causes Schizophrenia
The exact cause of schizophrenia is still unknown, but genetics and brain chemistry are believed to play a role. Millions of people around the world suffer from schizophrenia. When symptoms first appear, individuals might not seek treatment for various reasons, such as not recognizing they are unwell or fearing the stigma associated with serious mental illness.
Schizophrenia is a complex illness. Mental health experts are uncertain about its exact causes, but genetic factors may contribute. The disorder affects men and women equally and typically begins in the teenage or young adult years, though it can start later in life. In women, the onset tends to be slightly delayed. Childhood schizophrenia, which usually starts after the age of five, is rare and often difficult to differentiate from other developmental issues.
What Causes Schizophrenia
The exact cause of schizophrenia is still unknown, but genetics and brain chemistry are believed to play a role. Countless individuals globally experience the challenges of living with schizophrenia. When symptoms first appear, individuals might not seek treatment for various reasons, such as not recognizing they are unwell or fearing the stigma associated with serious mental illness.
Schizophrenia is a complex illness. Mental health experts are uncertain about its exact causes, but genetic factors may contribute. [27]
The disorder affects men and women equally and typically begins in the teenage or young adult years, though it can start later in life. In women, the onset tends to be slightly delayed. Childhood schizophrenia, which usually starts after the age of five, is rare and often difficult to differentiate from other developmental issues.
Symptoms:
Schizophrenia is a chronic mental health condition characterized by significant psychological symptoms. It affects how a person perceives reality and influences behaviour in the following ways:
- Persistent Delusions: Individuals hold fixed beliefs that are untrue, despite clear evidence to the contrary.
- Persistent Hallucinations: Individuals may experience sensory perceptions that are not present, such as hearing, smelling, seeing, touching, or feeling things.
- Influence, Control, or Passivity Experiences: Individuals may feel that their feelings, impulses, actions, or thoughts are not their own, are being manipulated or withdrawn by others, or are being broadcast to others.
- Disorganized Thinking: This often manifests as jumbled or irrelevant speech.
- Highly Disorganized Behavior: Individuals may exhibit behavior that appears bizarre or purposeless, or show unpredictable or inappropriate emotional responses that interfere with their ability to organize their actions.
- Negative Symptoms: These include very limited speech, restricted emotional experience and expression, lack of interest or pleasure, and social withdrawal.
- Extreme Agitation or Slowed Movements: This can include maintaining unusual postures or experiencing significant agitation.
People with schizophrenia often also experience persistent difficulties with their cognitive or thinking skills, such as memory, attention, and problem-solving which sometimes, in chronic cases may lead to suicidal thought.
People with schizophrenia often face persistent challenges with their cognitive abilities, such as memory, attention, and problem-solving. In chronic cases, this can sometimes lead to suicidal thoughts.
Around one-third of individuals with schizophrenia experience complete remission of symptoms. Some may go through periods of worsening and remission throughout their lives, while others may experience a gradual worsening of symptoms over time. [28]
Schizophrenia cannot be prevented.
However, symptoms may be managed by taking medication exactly as prescribed by a doctor. If medication is stopped, symptoms are likely to return. Changes to medication should only be made by the prescribing doctor.
Contrary to popular belief, schizophrenia is slightly more common in men than in women, and the outcome is not uniformly poor. Symptoms can be divided into positive, negative, and disorganization syndromes, as supported by factor analysis. Catatonic symptoms are not specific to schizophrenia, and so-called first-rank symptoms are no longer considered diagnostically significant. Cognitive impairment is now recognized as an additional clinical feature of the disorder. [29]
Two additional factors that might contribute to suicidal thoughts are:
- Experiencing a past of physical, sexual, or emotional abuse.
- Stressful life circumstances, such as major financial or relationship issues.
- Suicidal Thoughts and Behaviours
Suicidal thoughts often stem from overwhelming emotional pain or situations that seem impossible to handle. Many individuals who attempt suicide are seeking relief from distressing feelings, such as:
- Shame, guilt, or feeling like a burden
- Feelings of victimization
- Rejection, loss, or loneliness
These emotions can intensify when a person faces difficult life events or circumstances, including:
- Aging (suicide rates are highest among older adults)
- Loss of a loved one
- Substance abuse (drugs or alcohol)
- Emotional trauma
- Chronic illness or severe physical pain
- Financial difficulties or unemployment
Risk Factors
Certain factors can heighten the risk of experiencing suicidal thoughts and behaviors:
In Teenagers:
- Access to firearms
- Family history of suicide
- Previous self-harming behaviours
- History of abuse or neglect
- Recent suicides within their community
- Romantic relationship breakups
Gender Differences:
- Men are more likely to die by suicide, often choosing more lethal methods such as firearms.
- Women are twice as likely to attempt suicide, often using methods like poisoning or overdose.
Recognizing Warning Signs
While not everyone shows signs before a suicide attempt, some common indicators include:
- Difficulty concentrating or making decisions
- Giving away personal belongings
- Mentioning thoughts about “going away” or organizing personal matters.
- Exhibiting sudden calmness following a phase of distress.
- A diminished interest in activities that used to bring happiness or a sense of purpose.
- Displaying self-destructive behaviours (e.g., excessive drinking, drug use, self-harm).
- Withdrawing from friends, family, or social engagements.
- Experiencing a sudden decline in academic or work performance.
- Conveying a sense of hopelessness, guilt, or worthlessness
- Discussing death or making direct statements about wanting to die
- Changing eating or sleeping patterns
- Making plans to end their life (such as purchasing a weapon or stockpiling pills)
Treatment and Support
People experiencing suicidal thoughts may hesitate to seek help due to:
- Believing that nothing can improve their situation
- Apprehension about being judged or perceived as weak
- Not knowing where to find support
- Thinking their loved ones would be better off without them
Emergency Care:
If someone attempts suicide, they may need immediate medical attention, including first aid, CPR, or emergency psychiatric care. Hospitalization can help ensure safety and provide access to comprehensive treatment.
Therapeutic Approaches:
- Talk therapy (psychotherapy): Vital for addressing underlying emotional issues.
- Transcranial Magnetic Stimulation (TMS): A modern, non-invasive therapy option for certain individuals.
- Treatment for underlying mental health conditions:
- Major depression
- Bipolar disorder
- Borderline personality disorder
- Schizophrenia
- Post-traumatic stress disorder (PTSD) [21]
- Substance abuse issues
How to Help
It’s crucial to offer compassion and understanding rather than blame. People struggling with suicidal thoughts often believe they are relieving their loved ones of a burden. Providing support, encouragement, and understanding can help guide them back to a fulfilling life.
Your support can make a difference. If you or someone you know is struggling, reach out to a mental health professional or crisis hotline in your area. Compassion, patience, and a listening ear can save lives.
XII Suicide Prevention Initiatives
World Suicide Prevention Day
World Suicide Prevention Day (WSPD) was established by the International Association for Suicide Prevention in 2003, in collaboration with the World Health Organization (WHO). It serves as a vital advocacy and communication event aimed at engaging national organizations, governments, and the general public, with the unified message that suicide can be prevented. The inaugural World Suicide Prevention Day was launched successfully in Stockholm on September 10, 2003.
WSPD is recognized as an effective tool in these prevention efforts. The WHO’s report, ‘Preventing Suicide: A Global Imperative’ (WHO, 2014), acknowledges it as a significant policy achievement, stating: ‘This day has spurred campaigns both nationally and locally and has contributed to raising awareness and reducing stigma.’
Year after year, WSPD continues to grow. In recent years, it has been observed in more than 60 countries, with hundreds of events ranging from educational and commemorative activities to press briefings and public conferences.
Suicide Prevention Programmes in Indian Context
Indian Govt. in recent times has acknowledged suicide is a social problem and a national loss.
In November 2022, the Ministry of Health and Family Welfare unveiled India’s first-ever National Suicide Prevention Strategy, aimed at reducing suicide mortality by 10% by 2030 through time-bound action plans and multi-sectoral collaborations.
Key goals include:
- Establishing effective surveillance mechanisms for suicide within three years.
- Setting up psychiatric outpatient departments to provide suicide prevention services through the District Mental Health Programme in all districts within five years.
- Integrating a mental well-being curriculum in all educational institutions within eight years.
- Formulating guidelines to ensure responsible media coverage of suicides and limiting access to means of suicide.
India introduced the National Mental Health Policy (NMHP) in 2014, and a rights-based (for patients) Mental Healthcare Act in 2017, which replaced the Mental Healthcare Act of 1987. The NMHP, National Health Mission, National Adolescent Health Programme, and Ayushman Bharat have the necessary components to address the mental health issues of all sections of the population.
Collaborative effort
In a statement, Health Minister Mansukh Mandaviya emphasized the importance of prioritizing suicide prevention as a public health issue. He noted, “Suicides affect every segment of society and demand unified and cooperative efforts from both individuals and the broader community.”
In India, over one lakh lives are lost to suicide annually, with it being the leading cause of death among the 15-29 age group. The suicide rate has risen from 10.2 to 11.3 per 1,00,000 population in the past three years. Family problems and illnesses are the most common reasons, accounting for 34% and 18% of suicide-related deaths, respectively.
Psychiatrist Lakshmi Vijayakumar, founder of Sneha Foundation and author of the first draft of the strategy, highlighted, “The most crucial aspect is the government’s recognition of suicide as a significant issue… We now have a well-conceived plan involving multi-sectoral collaborations, as a strategy can only succeed by involving various sectors.”
She emphasized that the strategy should be handed over to the States to develop locally relevant action plans, which would then cascade to the district, primary health, and community levels.
Referrences:
[1] ^ National Institute of Mental Health,
[2] ^ WHO, Suicide, updated August 2023
[3] ^ Suicide and suicidal thought, Mayo clinic
[4] ^ American Psychological Association, APA dictionary of Psychology, Attempted S
[5] ^ American Psychological Association, passive
[6] ^ Everymind: Understanding suicide
[7] National Library of Medicine, Medline plus
[8] ^ Types of substances, Table courtesy: Addiction Policy Forum
[9] Saxby Pridmore,1,* Jamshid Ahmadi,2 and William PridmoreIran J Psychiatry. 2019
Apr; 14(2): 182–183., Iranian journal of Psychiatry, PMC
[10] ^ Altruistic Suicide in India, by Lakshmi Vijayakumar, page 73-80, Taylor & Francais
on line,
[11] ^Thompson, Kenneth (1982). Emile Durkheim. London: Tavistock Publications. pp.
[12] ^ https://en.wikipedia.org/wiki/Social_fact#cite_ref-Rules_1-0
[13] ^ Suicide (Durkheim book)
[14] ^ Essential nature of the human mind, Vijay singal, The pioneer
[15] ^ BPD, Medline Plus, National Library of Medicine
[16][16] ^ How To Deal With Inner Conflict And Free Yourself, Jacqueline T. Hill
[17] ^ States of Mind in Conflict: Offerings and Translations from the Psychoanalytic
and Psychosocial Fields, Irene Bruna Seu, Birkbeck, University of London
New England Journal of Public Policy
[18] ^ Bipolar disorder, American Psychiatric association
[19] ^ National library of Medicine, Medline plus
[23] ^ Dekel S, Gilbertson MW, Orr SP, Rauch SL, Wood NE, Roger K. Pitman Trauma and posttraumatic stress disorder. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 34.
[24] ^ Depressive disorder, who
[25] ^ Preventing suicide, a global imperative WHO
[26] ^ Substance use and disorder
[27] ^ Schizophrenia, Substance Abuse and Mental Health Services Association. USA
[28] ^ WHO, sympoms,Schizophrenia
[29] Sameer Jauhar , Mandy Johnstone , Peter J McKenna, PubMed, NLM
[30] ^ RAMYA KANNAN, Union Health Ministry rolls out country’s first suicide prevention policy, The Hindu
[31] ^ Émile Durkheim book, wikipedia
Debasis Chaudhuri
