Sunday 10 September was World Suicide Prevention Day, established in 2003 by the International Association for Suicide Prevention in conjunction with the World Health Organization (WHO). It is estimated that there are currently more than 700 000 suicides per year worldwide, and we know that each suicide profoundly affects many more people. Below is an opinion editorial by Sandy Lewis, Netcare compassion coach, and insight from a survivor. 

The unbearable weight of being – Don’t judge, anyone can feel suicidal

By Sandy Lewis, clinical social worker and Netcare Compassion Coach

Suicide is the final symptom of a brain that is no longer able to cope, just like any other type of organ failure, it is the result of an illness that has become terminal.

Some people die by suicide without necessarily showing their intentions. If you have an uneasy feeling that someone may be thinking about suicide, it is very likely that by this time, the person is already well advanced with their plans to die.

For a person to consider suicide, the distress and suffering they are experiencing seems inescapable and endless, exceeding their perceived capacity to cope. Suicide may seem like the only way to escape the pain when a person feels their heart is broken, their soul is shattered, and their body can no longer fight. A person’s mind may beg for release, even at the expense of life itself.

The risk factors for suicide are a combination of biological, psychological and social factors, often all coming together at once in a potentially lethal mix that leaves a person buckling under the unbearable weight of their pain, worry, fear, grief, and despair.

Any one of us could find ourselves in a suicidal frame of mind if faced with a set of personally tragic and unfortunate circumstances that could threaten to break us. It is part of our shared humanity that we find ourselves in dark spaces at times, therefore no one has a place to judge a person for feeling suicidal. Instead, this is the time to offer compassion and kindness.

Suicide is a worrying, growing global phenomenon. People of all ages and from all walks of life take their own lives, and it is naïve to imagine it could not happen in your family, social circle, or workplace. According to the Global Health Estimates Report 2019, South Africa has a suicide rate of 23.5 deaths per 100 000 population compared to a global average of nine per 100 000.

The local statistics for teenagers are deeply concerning, as the South African Depression and Anxiety Group (SADAG) reports that 17.6% of teens have considered attempting suicide, and as many as one in five 18-year-olds have had one or more suicide attempts.

Suicide can result from factors like mental health concerns, grief, trauma, physical illness, bullying, abuse, serious relationship troubles, work and financial problems, loneliness, burnout, and a family history of suicide.

Men and boys are at higher risk of completing suicide, and it has been suggested that outdated notions of what it means to be a man, as in “cowboys don’t cry”, contribute to this as males may find it more difficult to talk about feelings of emotional distress and ask for help due of shame and stigma. Substance use and financial pressures are also believed to be significant factors driving male suicide globally.

Never dismiss, brush off, shame, minimise, invalidate, or turn away from a suicidal person when they are trying to communicate their distress and their intentions. It is a myth that talking about suicide will increase the chances of it happening. We should never avoid having a conversation that could save a life.

It can be difficult to find the words to open these conversations, and a helpful start could be, “It must be so very hard for you to be feeling like this, I would really like to understand and offer my help to you”. Most importantly, let the person know they are not alone.

Always seek help from a mental or medical healthcare practitioner who is professionally trained to assess and treat this particular emergency. Be proactive, don’t wait. The suicide warning, or even a para-suicide attempt, is always a powerful communication of desperation and seeking help. Some people have lived to regret regarding a loved one’s threat of suicide as “attention seeking” or “manipulative behaviour”.

Judgment simply alienates the person in their loneliest hour and cuts off sorely needed potential support. Please take notice and extend a hand to anyone who might be at risk. Treat the warning signs of suicide as a medical emergency, and do not leave the suicidal person alone. We should never underestimate the power of a kind presence when a person is in despair. Loneliness often tips a person from holding on to life to the decision to die.

Seven potential warning signs that a person could be suicidal:

• Long lasting feelings of sadness or hopelessness
• Extreme mood swings
• Loss of interest in previously pleasurable activities
• Risky and self-harming behaviours, such as driving under the influence
• Making preparations to die, such as getting personal affairs in order and giving away possessions
• Talking about dying as bringing relief to self and others
• Arranging to have lethal means available like a gun, pills, razor blades, rope.

Professional support available:

If you are feeling suicidal or having thoughts of harming yourself or need advice for assisting a loved one, Netcare Akeso offers a 24-hour crisis line on 0861 435 787. Trained counsellors are available to talk to without judgement and can guide you on the various options for assistance.

The South African Anxiety and Depression Group (SADAG) also provides a 24-hour suicide crisis helpline on 0800 567 567.

Lived experience: A survivor’s insights

Reaching for life

By Melissa Kemp

When I was in that really dark place, I would have thoughts that would scare me and find myself doing things without thinking, especially when alone. If you find yourself alone with the means to harm yourself, try to get out, even if just to the shops, as a temporary escape from that frame of mind.

When you are depressed, you don’t feel like socialising, but the situation can escalate quickly when you are isolated. It is hard to reach out to talk to people, but that really helped me. Nobody wants to air all their dark scary, intrusive thoughts, but when you do, you are surprised how many people struggle with something similar or can relate to how you feel, so you realise you are not entirely alone. Often, other people can share their coping strategies, too.

Family and parents can sometimes be blind or deaf to signs of suicidal thoughts or mental health problems, which stems from a lack of understanding. Trying to open up to someone, and they respond by dismissing you with “you can’t be mentally ill because…” is not helpful – it only adds to the suffering because it makes you question yourself even more.

It is hard to explain to others what it is like to feel suicidal. It felt like I was losing control of the thoughts in my head. Writing down what you want to say is helpful, it gives you time to reflect on how you can frame your thoughts in a way that will be understandable for your parents or whomever you can talk to about what you are going through. This can take some of the pressure off.

Going into 21 days of inpatient therapy was the hardest and best thing I have ever done. It is a life-changing experience to realise mental health difficulties don’t make you defective, it is an illness. I feel like I’ve gone from seeing the world in black and white like an old TV and now I have full-colour HD.

If you find yourself struggling with suicidal thoughts or don’t know why you are feeling numb with a complete sense of apathy towards everything and everyone, the first step is to reach out to someone. It is hard, but whether in-person, online or via a telephone support line, please ask for help until you are heard. Talking about how you are feeling is not a magic fix, but it lessens the burden when you feel like you can’t breathe, and it is the first step back to the life you want to live.