Suicide in India has been on the rise and accounts for more than 1.5 Lakh deaths each year. The number of deaths due to suicide is similar to the deaths due to road traffic accidents in men and maternal mortality deaths in women every year. Depression is one of the most common causes of suicide, and the majority of patients with completed suicide express depression and suicidal thoughts preceding the suicidal attempts. Hence, anyone expressing sadness and suicidal thoughts needs evaluation by a psychiatrist to help them recover from the silent slayer.
Depression is a common mental health issue which affects nearly 20% of adults once in their lifetime. Depression is a medical illness, characterised by symptoms like loss of interest, loss of appetite, loss or gain of weight, and suicidal thoughts/ attempts. Peopleexperiencing depressive illness have a significant impact on their work and relationships. Severe depression is frequently associated with death due to completed suicide.
National Mental Health Survey published in the year 2016 revealed that the occurrence of depression in India was around 10 % of the general public and has significantly increased since the COVID-19 pandemic. People who have lived through abuse, loss or other stressful situations are more likely to develop depression. Younger women are more affected by depression than men.
Men and Suicide
Men have been significantly more in terms of completed suicide compared to women, with the ratio of 3: 1. Men who are depressed have difficulties in paying attention in their academic activities and their professional work. Hence, they tend to be inattentive and have poor concentration abilities, leading to suboptimal learning and engagement in their work. Eventually, this leads to poor performance and failures in their workplace. Men with depression have low motivational levels, leading to reduced involvement in activities; hencethey quickly drop out while facing minor setbacks, leading them to take the serious step of suicide. Work stress, unemployment, and an unpredictable professional life, such as that of farmers, are among the major stressors identified in psychological autopsies.
Impact of Depression individual self and family life
People with depression have a core problem of losing pleasure in activities. Experiencing pleasure in activities is known as the hedonic feeling, which is natural to all individuals and helps keep them constantly engaged in these activities. For persons suffering from depression, there is a disturbance in this feeling, and the person fails to experience pleasure in all the activities they are involved. Hence, routine activities do not bring them joy, and they are irregular in their daily routines, while struggling to maintain a clean environment. When depression is severe, these individuals are unable to attend to their basic self-care needs.
The sadness and loss of interest extend to personal relationships, where they do not feel good being with family and close friends. People with depression have difficulty connecting with their family and friends and slowly isolate themselves. They avoid social situations and eventually drift away from the family. This can become a serious issue when they do not disclose their feelings and eventually may act on their negative thoughts of ending their life. On many occasions family will not be aware until the person suffering from depression presents with a suicidal attempt, which may lead to the death of the individual. Hence, depression is a silent epidemic in our society.
How to prevent suicides
Identifying early and allowing individuals to converse about suicide is the first step towards further prevention of death due to completed suicides. The suicide prevention theme is very apt in that it encourages individuals to care for their near and dear ones by allowing them to express their thoughts and feelings, and treat them like individuals having a cardiac illness, which has the same outcome as that of suicide. Suicidal tendencies are a symptom of illness, primarily depression needs to be addressed by individuals at home and office, which requires medical attention by a psychiatrist! Training everyone about early recognition of the same, encouraging them to seek consultation and reducing the stigma in consulting a psychiatrist will certainly reduce death by a significant proportion.
Treating Depression will help reduce the occurrence of suicide. AntidepressantMedications and counselling are the first line of treatment. Antidepressants are non-addictive and safe, but it has to be used under the supervision of a psychiatrist.
Psychotherapy, also called talk therapy, is a form of treatment where trained psychologists engage with the patient to help understand and support the patient during the phase of depression, while using various techniques to cope with depression and replace better coping methods to deal with stress. Psychotherapy can only be conducted by trained professionals, such as psychologists or psychiatrists.
Newer Treatments
Brain stimulation is another mode of treatment for depression and suicidal behaviour,and the commonly used methods include rTMS and mECT. Repetitive transcranial magnetic stimulation (rTMS) is a procedure that utilises a strong magnetic field to stimulate nerve cells in the brain, thereby reducing symptoms of depression. It is novel and has been proven to show significant improvement in depression over the 1 to 2 weeks of treatment. The treatment is non-invasive and with minimal side effects, and may even reduce the need for medications. When depression is severe, modified electroconvulsive therapy (MECT) helps in quick recovery from depression. MECT involves a brief electrical stimulation of the brain while the patient is under anaesthesia.
Suicide is one of the leading causes of death among young individuals, particularly more in men compared to women. Depressive illness has been silently affecting, causing significant stress in individuals’ personal and professional lives, while it is also becoming one of the leading causes of death by completed suicide. It is important to recognise individualswith suicidal thoughts and depression early, and initiation of treatment helps patients to recover from depression and prevent suicides.
