As you read this, suicide has become one of the leading causes of death around the world, especially for people between the ages of 17-35 years. This becomes even more conecrning when we realise that this age group usually does not suffer from any other forms of mortality. Now more than ever, with the excess of resources available to us, it is crucial that this issue is talked about. While most of us probably have a rough idea of whay suicide is, still much isn’t known about the common causes that lead to suicidal tendencies. Much lesser is known about the way in which we should approach someone wrestling with suicidal ideation.

First, let us look into the various terms associated with self-harm and they apparent meanings to ensure we don’t mislable people.

Self-harm- any action done by an individual to the self with the intent of causing harm to themselves. Can be associated with severe mood disorders and anxiety disorders. Here, the action itself might not cause a lot of harm or damage to the physical self, but the intent behind it is always guided with the sentiment to harm or punish oneself. People that engage in it tend to report it as a way of reducing their anxiety or depression, where the harm acts as an escape from their sympotms and makes them feel in control. These can range from pinching oneself to cutting and bashing one’s body. It is possible that self-harm develops into suicidal ideation or tendencies, but is not the same as these.

Suicidal ideation- This is seen more commonly with mood disorders, where the individual’s ability to manage mood and emotions is severely compromised. The individual becomes taken with the idea of ending one’s life as a means of permenant escape from all the trials and tribulations of everyday life. The ideas become more and more realistic and intricate with time, which leads to an increased risk of an attempt. It is important to understand that ideation is just as significant to be treated as an actual attempt, just because they are simply thinking about it doesn’t mean that there is no danger. Usually compulsive ideation develops when a person has lost all hope and motivation to look forward to anything in their personal life, hence they look forward to ideating about escaping their problems through suicide.

Suicidal tendencies- Here, the individual has moved beyond simply thinking and contemplating this as a viable option. They have made their decision and are simply preparing to follow through. People that are said to have suicidal tendencies have developed some ritualistic and systematic patterns of self-harm that keep growing in their intensity of harm to the point they can endanger their life. These can include deliberate cutting, substance abuse and reckless dangerous behaviour. Here, the idea of ending one’s life has been established as a viable option to act upon, it is only delayed by temporary setbacks and situational factors.

Seeing the various forms of self harming behaviours, we can question what drives a person to the point of suicide. The truth is that there is no simple, sinlge answer to this. Every person reaches the point of self harm and suicide due to their own uniquely challenging set of circumstances that they feel they cannot deal with on their own. A very heavy sense of isolation and helplessness is typically seen in these cases. Other than that, here are the most commonly causes that are associated with self-harming behaviour, either as a single driving factor or a combination of two or more causes.

Loss of someone through suicide- this can create deeply complicated feelings with regards to emotional regulation, loss can create unhealthy coping mechanisms, which lead to suicidal ideation in the individuals themselves.

Mental health issues– Disorders like schizophrenia, bipolar depression, anxiety can cause suicidal tendences.

Access to lethal means- This can include access to any situation where one can easily hurt oneself, like ammunition, secluded spaces and devices that can be used to harm oneself.

Traumatic experiences of abuse and/or loss of life – These, especially during one’s childhood leaves a profound impact on the person’s mental health.

Socially victimising factors- like having a non-conformitive gender identity, being a racial minority, isolation due to class or caste.

Chronic health conditions – terminal illnesses like cancer, chronic health condition or handicap can lead to emotional disregulation.

Anti-depressants- this might seem contradictory, but prolonged exposure to antidepressants can lead to suicidal thoughts as a side-effect, especially if the dosage of the medicine has not been optimized for the individual.

No matter the reason or set of reasons, the fact that suicide has become one of the leading causes of mortality shows that from various walks of life are strugging with it. What’s more concerning, is that people tend to appear ‘normal’ or ‘stable’ in the words of their families and friends. There is a clear gap between people struggling with suicidal thoughts and the support that they can avail, which can only be filled with community outreach from friends and family of the affected. This can majorly happen in two avenues- identifying the signs of suicidal ideation and then connecting them with the resources that can serve as their support.

People don’t usually say explicitly that they are thinking about ending their life. Rather, there are very minute and subtle shifts in their behaviour and demeanor that signal that something is not right. This can range from talking bleakly about the future or about themselves, they might also talk along the lines of there being no solution to their problems or that they might be better off dead. They also tend to focus on more grim aspect of life, like all the death and suffering around them. Similarly, individuals tend to start getting their affairs in order, withdrawing from their friends and family, this is a way for them to silently brace everyone for their demise. They might also engage in self-destructive behaviour, like substance abuse, parttaking in reckless behaviour. Finally, some people can just break into a sense of calm, completely unaffected by setbacks or annoyances around them.

It is possible that after reading these signs, you might think that someone around you might be suicidal. The challenge then becomes to communicate with these individuals in a respectful and effective way. The first step is to put the concern out in the open. Whether the person might be suicidal or not, reaching out to them out of genuine concern and respect would only make them feel better. We should always try to be ourselves and be genuine about our conern, focus more on listening to what they have to say, we should also try to be hopeful. However, it is crucial that while approaching someone with this conversation, that we maintian a calm and caring demeanor, especially if they admit to thinking about it. We should never try to argue with or guilt-trip them especially by blaming yourself, neither should we try to solve their problems or belitte them.

Only once we establish some kind of connection with the individual about their problems that is driving them to contemplate suicide, can we actually move ahead to get them support. Here, the severity or intensity of their ideas needs to be evaluated in brief to understand the level of support they might need. The things to keep in mind here are –

The severity of intent to die by suicide is classified broadly into – mild, moderate, high and severe. usually mild and moderate cases can be referred to mental health professionals so that they can get the help they need to get off the ledge. In cases of financial issues, there are clinics like Connected Minds, that offer pro bono therapy. High and extreme cases need to be referred to a suicide hotline as soon as possible. Here are a few numbers that can be used-

AARSA- 022 2754 6669

iCall- 9152987821