What’s It Like to Be Suicidal? This Is My Experience, and How I Got Through It

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How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

At times, I’ve struggled with suicidal thoughts, even on a weekly basis.

Sometimes I’m able to ignore them. I might be driving to meet a friend for brunch and briefly think about driving my car off the road. The thought might catch me off-guard, but it quickly passes through my mind and I go about my day.

But other times, these thoughts stick around. It’s like a huge weight is dropped onto me, and I’m struggling to get out from underneath it. I suddenly get an intense urge and desire to end it all, and the thoughts can start to overwhelm me.

In those moments, I’m convinced I’ll do anything to get out from under that weight, even if it means ending my life. It’s like there’s a glitch in my brain that’s triggered and my mind goes haywire.

Even if that glitch is actually temporary, it can feel like it will last forever
With time, though, I’ve become more aware of these thoughts and found ways to manage when things get tough. It’s taken a lot of practice, but simply being aware of the lies my brain tells me when I’m suicidal helps to combat them.

If this last year has taught me anything, it’s that no matter what depression tells you, there’s always hope.
Here are four ways my suicidal ideation shows up, and how I’ve learned to cope.

1. When it feels impossible to focus on anything other than my pain, I look for a distraction
When I’m suicidal, I struggle to listen to reason — I only care about relief. My emotional pain is intense and overwhelming, so much so that it’s hard to concentrate or think about anything else.

If I find that I can’t focus, I sometimes turn to my favorite TV shows, like “Friends” or “Seinfeld.” They bring me a sense of comfort and familiarity that I need in those times, and it can be a great distraction when reality gets to be too much. I know all of the episodes by heart, so I’ll usually lay there and listen to the dialogue.

It can help me pull back from my suicidal thoughts and refocus on getting through another day (or just another hour).

Sometimes all we can do is wait for the thoughts to pass and then regroup. Watching a favorite show is a great way to pass the time and keep ourselves safe.
2. When I’m convinced that everyone would be better off without me, I challenge those thoughts
My loved ones would never want me to die by suicide, but when I’m in crisis, it’s hard for me to think clearly.

There’s a voice in my head that tells me how much better off my parents would be if they didn’t need to support me financially, or if my friends didn’t have to take care of me when I’m at my worst. No one would have to answer the late-night calls and texts or come over when I’m in the midst of a breakdown — isn’t that better for everyone?

But the reality is, I’m the only one that thinks that.

My family wouldn’t recover if I died, and my loved ones know that being there for someone when things get tough is a part of life. They would rather answer those late-night calls than lose me forever, even if I struggle to believe that in the moment.

When I’m in this headspace, it usually helps to spend some time with Petey, my rescue dog. He’s my best friend and has been there through it all this past year. On most mornings, he’s the reason I get out of bed.

I know he needs me to stick around and take care of him. Since he was already abandoned once, I could never leave him. Sometimes that thought alone is enough to keep me hanging on.

Challenge your thoughts about loved ones being better off without you by not only thinking through the reality, but spending time with loved ones — pets included.
3. When I struggle to see my other options, I reach out to my therapist — or I go to sleep
Being suicidal is, in some ways, a form of total emotional exhaustion. I’m tired of having to force myself out of bed each morning, having to take all of these medications that don’t seem to be working, and crying constantly.

Struggling with your mental health day in and day out is very tiring, and when I’ve reached my limit, it can feel as though I’m just too broken — that I need a way out.

It helps to check in with my therapist, though, and be reminded of all of the progress I’ve made so far.
Instead of focusing on the step backward, I can refocus on the two steps forward I took just before that — and how other forms of treatment I haven’t tried yet can help me get back on my feet again.

On the nights when the ideations are most intense and it’s too late to check in with my therapist, I take a couple of Trazadone, which are antidepressants that can be prescribed as a sleep aid (Melatonin or Benadryl can also be used as sleep aids, and purchased over-the-counter).

I only take them when I feel unsafe and don’t want to make any impulsive decisions, and it helps to ensure that I make it through the night. In my experience, those impulsive decisions would’ve been the wrong choice, and I almost always wake up the next morning feeling a little better.

4. When I feel completely and utterly alone, I push myself to reach out
When I’m dealing with suicidal ideations, it can feel like no one understands what I’m going through, but I also don’t know how to articulate it or ask for help.

It’s hard enough to try and explain to someone why you feel the desire to die, and sometimes, even opening up just leads to feeling misunderstood.

Even if it can feel awkward or scary at first, it’s important to reach out in these moments and keep yourself safe
If I’m feeling suicidal, I know the worst thing I can do is try to go it alone. It took me a long time to work up the courage to call someone when I was feeling this way, but I’m glad I did. Calling my mom and best friends has saved my life multiple times, even if in the moment I wasn’t convinced it would.

Sometimes you have to ignore the part of your brain that tells you it isn’t worth it, and pick up the phone anyway
Now when I’m feeling suicidal, I call a friend I trust or my parents.
If I don’t feel like talking, just having someone on the other side of the phone can still be comforting. It reminds me that I’m not alone, and that I (and the choices that I make) matter to someone.

If you don’t feel comfortable talking to a friend, text the crisis hotline by texting HOME to 741741. I’ve done this a few times, and it’s nice to just get my mind off things by texting with a compassionate person.

When you’re in a depressed state, you’re not in a position to make permanent decisions, especially when there’s no one there to offer perspective. After all, depression doesn’t just affect our moods — it can affect our thoughts, too.

Suicidal ideation can be extremely scary, but you’re never alone and you’re never without options.

If you’ve run out of coping tools and you have a plan and an intent, please call 911 or go to the nearest hospital. There’s absolutely no shame in that, and you deserve to be supported and safe.

If this last year has taught me anything, it’s that no matter what depression tells you, there’s always hope. No matter how painful it can be, I always find that I’m stronger than I think I am.

And chances are pretty good that if you’ve made it this far, you are, too.

Suicide Survivors Share Their Stories and Advice in These Photos

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Suicide rates in the United States have increased dramatically over the past 20 years. There are 129 deaths by suicide nationwide every day.Discussed less often, there are around 1.1 million attempts at suicide every year — or over 3,000 a day, on average — many of which do not end in death.Nevertheless, we often struggle to bring up suicidal thoughts with those we love, even when we know someone might be struggling, or we’re struggling ourselves.

I believe it isn’t that we don’t care, rather that we don’t have a common language to discuss such topics or an awareness of when we should reach out and how. We worry that we won’t say the right thing, or worse, that we’ll say something that’ll cause the person to act on their ideation.

In reality, asking someone directly about suicide is often a way to both help the person feel heard — and help them find the help and resources they need.

Too often discussions around suicide are controlled by those who have no personal experience with suicidal ideation or mental health.

SUICIDE PREVENTION’S MISSING VOICESWe rarely get to hear directly from those who have experienced suicidal ideation or survived a suicide attempt.

Hoping to shift that paradigm, Healthline teamed up with Forefront, a social impact center at the University of Washington that focuses on reducing suicide, empowering individuals, and building community.

Jennifer Stuber, the cofounder and director of Forefront, spoke about the program’s goals, sharing, “Our mission is to save lives [that would otherwise be] lost to suicide. The way that we think we’re going to get there is by simultaneously treating suicide as both a mental health and a public health issue.”

Stuber discussed the importance of every system, whether metal health care, physical health care, or education, having an understanding around suicide prevention and how to intervene if needed.

When asked what she’d say to those who are currently experiencing suicidal thoughts, Stuber said, “You can’t possibly realize how much you’d be missed if you weren’t here because of how badly you feel. There is help and hope available. It doesn’t always work the first time around, it might take several different tries at it, but your life is worth living even if it doesn’t feel like it now.”

For those who’ve attempted suicide, it’s often difficult to find spaces to tell their stories, or people willing to listen.

We wanted to hear directly from folks personally affected by suicide in order to give a face, name, and a voice to a much too common experience.

Gabe

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Gabe shares his experience with deep depression and suicidal thoughts, and how you can help a friend in need.

On their experience with mental illness

I feel like suicidality is something that’s been an inherent part my entire life.

I think that we live in a culture that values strength and perseverance and has this very naive belief that everyone is born in the same circumstances with the same bodies with the same chemicals in their brains that work the way they’re supposed to work.

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On recovering

It’s been ultimately just being lucky enough to have good enough people in my life that are willing to talk to me till 3 a.m. or give me advice and honest feedback on stuff.

For me, if I give it time, eventually I’ll will not feel like dying and that’s time — doing the best you can.

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On how you can help people experiencing suicidal ideation

Just listen to them. Be really honest and make good boundaries about what you can and can’t hear. Be wary of silence when you know that people have been doing bad, even when people seem to be doing good.

Simone

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“No one in my family talked about depression,” Simone tells Healthline. She also talks about the added pressure of being a professional who’s both black and a woman.

On learning about depression

I think almost every single day since I was 16 until maybe earlier this year, I thought about killing myself. I didn’t understand what depression was because no one ever talked about it.

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On being a black woman with depression

There have been plenty of days where I can’t physically move from depression… [but] I can’t call out, because I’m a black woman in a professional career. I’m not allowed to be depressed. I feel like I don’t get a pass.

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On how to respond to people who are experiencing depression

[Depression] can take on so many different forms [for different people]. So you can’t just apply a blanket solution.

Jonathan

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“I’ve had plenty of suicidal thoughts over the past seven years,” shares Jonathan, who has survived two suicide attempts.

On experiencing mental illness

I’ve been in the hospital three times for depression [and suicidal thoughts] and two times after suicide attempts in the last seven years.

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On the upside of mental illness challenges

There’s a stigma with mental illness. [But] I’m definitely not ashamed of my past! If I’d never dealt with this stuff, I wouldn’t be the person I am today and I wouldn’t have figured out who I am or the person I want to be.

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On advice to people who experience suicidal ideation

I think doing what makes you happy in life is the most important. That’s why I dress the way I want. I want to show others it’s okay. Don’t let other people tell you how you should live your life.

Tamar

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“We didn’t even know the term mental health. Nobody discussed it,” Tamar reflects about her childhood. She experiences suicidal thoughts and has survived a suicide attempt.

On mental illness, homelessness, and poverty

Because I grew up homeless and lived in a lot of homeless populations, we didn’t consider people sick. Drugs, alcohol, being suicidal, being schizophrenic — that was all just normal to us.

At the time it felt like the only way out was suicide. That I didn’t have any other options, there wasn’t anybody coming to save me, there was no system that was going to swoop in and take me away from the things that were causing me pain.

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On barriers to getting help for people living in poverty

I didn’t have a framework around what [it meant] to be mentally healthy, what [it meant] to get help.

Everybody says there’s help, get help. What does that mean? There was nobody who said, “Hey look, if you don’t have the money, here’s volunteer organizations.” I got no information when I was discharged from the hospital [for attempting suicide] besides don’t do it again, find help.

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On receiving affordable help for the first time (from Open Path)

It was the first time in my life that mental health was in reach.

It was the first time someone articulated to me that [following through on suicidal thoughts] wasn’t an imperative. I didn’t have to listen to it. That was life changing for me.

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On healing

It was actually when I decided to attempt sobriety that I first even learned that idea of having a toolbox of coping mechanisms and then starting to shift it. I didn’t know there were other ways to cope with these feelings that I had.

Having an alternative to feeling suicidal was a whole new world, it was a game changer. Even if I was too depressed to get off the floor, I had a mental health tool box and a language to talk to myself that I’d never had before.

I had to learn that too, that I had become one of my own abusers. That was a revelation. I was just following in the footsteps of everyone else… Yet I want to escape from the cycle.

Making those connections made me feel like my body is a worthy vessel and that I am worthy to live in it and stay on this planet.

Jo

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Jo lost her husband, who was a veteran, to suicide in 2011, when he was 45. She now works with veteran-run organizations that work to create a community for veterans in need.

On losing her husband to suicide

My husband had post-traumatic stress disorder (PTSD) and he also had what we call a “moral injury,” which I think is really important when talking about veterans. The way I’ve heard it described is that it’s basically having performed acts during your time of service that were required by your service but that go against and violate your own moral code or the code of society at large.

I think my husband suffered from tremendous guilt and neither he nor I had the tools to figure out how to process this guilt.

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Jo shares pictures of her husband and of their wedding.

On the isolation of survivors

About a year and a half after he died I quit my job as a lawyer and began to do photography because I needed something to do for my own healing.

What I experienced was profound isolation and that sense that you know, the world was out there, and everyone was moving on with their daily life, and I was on what I used to refer to as “planet my husband died by suicide.”

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On her life as a survivor of suicide

What I have come to discover is that it’s actually pretty common when you have a first-degree suicide loss like that to continue to have [suicidal] feelings yourself.

I know what’s helped me is spending a lot of time particularly with my veteran friends who have been trained in peer support and suicide prevention. It’s so helpful to have someone who can check in and say, “Are you thinking about harming yourself?” but to go further and say “Do you have a plan and do you have a date?”

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On advice to those affected by suicide

We are very antiseptic in the way we think about death and grief, particularly the taboos around suicide. When someone says “You’re very young to be a widow, what happened,” I’m always honest.

If he were around with what I know now, my message to him would have been, “You are loved unconditionally even if you never feel better than you do right now.”

There is always hope

Through organizations like Forefront, the National Suicide Prevention LifelineCrisis Text Line, and others, there’s movement towards shifting our approach to suicidality, reducing stigma, and breaking the silence.

Our hope is that the brave individuals you met above can help be a part of that movement and that breaking of silence, bringing light to a topic that is too often avoided, ignored, or stigmatized.

For those experiencing suicidality, you’re not alone, and there is always hope, even if it doesn’t feel like it now.

If you or a loved one are experiencing thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255, check out this list of resources, or send a text here.


Caroline Catlin is an artist, activist, and mental health worker. She enjoys cats, sour candy, and empathy. You can find her on her website.

+ 4 sources

Medically reviewed by Timothy J. Legg, PhD, CRNPon February 14, 2019 New — Written by Caroline Catlin

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At work the other day, a sickening howl came out of an office near mine. It was guttural. Primal. Unfortunately familiar. A few years ago, it was me making that sound at work and I had made it many times before. It is the howl of those left behind after a suicide. It is a […]

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9 Thoughts That Can Prevent You From Confronting Depression

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One of the many difficult things about mental illnesses is that an illness can construct a narrative in your head that isn’t necessarily true. With depression, a combination of stigma and difficult-to-pinpoint symptoms may make diagnosis difficult. But the symptoms of depression are well-documented, and the first step is paying attention.

Since depression can alter your thoughts, it can be hard to differentiate when the illness is talking, versus when you are “When we are depressed we are viewing the world through a lens that isn’t congruent with our external reality, but during a depressive episode, our internal reality changes so it seems like things can be hopeless which often leads us to feel helpless,” Travis McNulty, LMHC, GAL, of McNulty Counseling & Wellness, tells Bustle. “ […] Usually depression manifests its form in a cycle of negative thoughts, negative emotions, and negative behaviors that further perpetuate one another.” These negative influences can actually start to convince you that you aren’t dealing with depression.

Some of these self-doubting thoughts may begin to dissipate when you acknowledge that depression is a serious diagnosis, and that you deserve help for the things you’re struggling with. Finding a mental health professional you can trust may help get you there even sooner.

Here are nine thoughts that can mask depression for what it is, according to experts.

1. That It’s Not “That Bad”

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If you’ve been noticing yourself feeling worse and worse for a while, but have a narrative of “I’m fine” running through your head — you may want to examine that thought further.

“One of the biggest lies that depression tells us is that we are OK,” licensed clinical social worker Melissa Ifill, tells Bustle. ” […] Unfortunately, we are often slow to give credibility to [any changes] or are truly unaware of how the depression is impacting us.” So if you find yourself minimizing your feelings, remind yourself that you don’t have to be at absolute rock bottom to deserve help.

2. “I Can Deal With This On My Own”

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Depression is a serious illness, not a burden you have to bare alone. Even if you have been through blue spells before, you deserve help this time around.

“One of the major thoughts people often have when experiencing depressive symptoms is that they do not need help,” Ifill says. “They believe that the mood, feelings or thoughts will go away by themselves or if they keep behaving as if things are OK, they will be eventually.” While some wounds may heal with time alone, it’s OK to admit that you may need the support of friends, family, or a professional, for what you’re dealing with.

3. That Everything Is Bad

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While it’s harmful to downplay your symptoms, it can also be harmful to catastrophize what you’re feeling as well.

“Black and white thinking is a classic thought pattern for those who are experiencing depressive symptoms,” Ifill says. “[…] Having a good supportive network (which should include a helping professional) can assist you in challenging some of these thought patterns and help you to see the more varied perspectives that life has to offer.” Many people have felt like there’s no way out before, and there are a plethora of resources to help.

4. That It Doesn’t Matter Anyways

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Another harmful way depression can try to trick you into thinking you’re not depressed is by telling you that it doesn’t matter either way.

“Depression causes helplessness and hopelessness,” Lara Schuster Effland, regional managing director of clinical operations for Eating Recovery Center’s Insight Behavioral Health Center, tells Bustle. “One may believe they are the problem and [that they are the reason] why they feel lonely and lost.” Blaming yourself for causing the consequences of your depression is hurtful. Finding a therapist or psychiatrist may help you break out of this thought pattern.

5. That You “Just Need A Vacation”

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Minimizing your symptoms does not always take the form of self-blame. Even telling yourself that you “just need a vacation” can be a way that the depression can get ahead.

“Feeling overworked, under-rested, and overwhelmed when depressed [is common],” Effland says. If you have a sense that you’re unable to get ahead, reaching out for support on that level is likely more helpful than a few days off could be.

6. That You’re Fine Because You’re In A Relationship

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Depression doesn’t discriminate. Having depression doesn’t make you ungrateful, either. So if you’re equivocating by telling yourself that you’re fine because you’re in a relationship, have a good job, or have great friends, you may actually be minimizing a serious illness.

“People who have the ‘perfect’ situation aren’t immune to depression, and often depression can come when everything is going well, because it often can’t be explained,” LGBT-affirming therapist Katie Leikam, LCSW, LISW-CP, tells Bustle. It’s important not to discredit your need for support just because things seem good on the outside.

7. That You Don’t Cry Much, So It Doesn’t Count

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While depression can cause symptoms like excessive or easily-triggered crying, that doesn’t mean you should discount all of your other signs of the illness just because you haven’t been experiencing this.

“Depression can present itself in a lot of ways and only one of those ways is tears,” Leikam says. “Depression can also present itself in feeling lonely or numb of emotions and often people who feel numb, aren’t always able to cry.” If you’ve noticed that you’re feeling more apathetic than usual, then it’s a good first step to talk to your doctor.

8. That Excelling At Work Discounts Your Feelings

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Depression doesn’t always take away your ability to function. Many people with depression are still able to go about their daily lives. Just because you’re excelling at work doesn’t mean you don’t have depression.

“You can be on top of your game at work and still have clinical depression,” Leikam says. “Successful people can still have depression. Depression can be a chemical imbalance so it doesn’t discriminate against who has it and who doesn’t have it.” You deserve help even if you’ve been noticing symptoms, but are ignoring them because you think being high-functioning disqualifies you from the support you need.

9. That You’re Just Not “Normal”

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Mental health stigma can be incredibly powerful, especially if you’ve internalized it to the point that you believe something is wrong with you for feeling this way.

“Without an understanding of mental illness individuals often believe that depression is an indication that they’re not normal anymore, and that they are somehow different,” Dr. Neeraj Gandotra, MD, chief medical officer at Delphi Behavioral Health Group, tells Bustle. Reminding yourself that you’re still you, and that any changes to your health are worth taking care of, may help you get the boost you need to seek help.

Separating yourself from the symptoms of your depression can help you from being tricked by negative self-talk. “I like to help my clients refer to their depressive symptoms as ‘the depression,'” Ifill says. This way, you may be able to externalize the symptoms and emotions associated with depression, potentially making it easier to find a professional to support you.

I Don’t Want to Do Anything – What’s Wrong with Me?

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By Marie Miguel

There are times in our lives when we feel down, and we can’t figure out what the source of the problem is. There’s a difference between feeling sad and being depressed. When you don’t want to do anything – not even simple things that you enjoy – there’s a problem. When you find yourself with no motivation, it’s time to seek help because you may be depressed. When you’re thinking “I don’t want to do anything,” there’s something inside of you that’s telling you that life isn’t worth enjoying or pursuing, and that’s not true. You have individual interests and motivation, and there’s inside you. You have things that make you happy, but you can’t see them at the moment. That’s the problem; when you feel stagnant and lack positive emotion. It’s a symptom that shouldn’t be ignored, and it’s important to know that you can get through this time.

Pushing past the “I don’t want to do anything” feeling

One way to push past this feeling is to pursue therapy, but getting to that point is difficult because your brain is telling you that there’s no point in doing anything; including going to therapy. It’s essential that you work past those feelings of stagnancy. It’s vital to remember that what your brain is telling you isn’t true; there is a point to live, and you do have things that you enjoy. It’s about pushing through and remembering that the thoughts going through your mind are attributed to depression; they aren’t a reflection of who you are as a person.

Depression lies

Depression isn’t who you are. Depression is a mental illness that has symptoms such as lacking motivation, sleeping too much or not sleeping enough, changes in appetite, thoughts of emptiness or hopelessness, and thoughts of suicide or a plan to end one’s life. If you’re having thoughts of suicide, please call 911 or go to the emergency room. Contact a mental health professional and get medical attention immediately. Depression is a legitimate illness, and it needs to be addressed. If you’re feeling an emptiness inside, it could be because of this mental illness. It is treatable, it isn’t your fault, and there’s nothing wrong with you.

There is nothing wrong with you

Hear this now: there is nothing wrong with you. If you have depression, you are not alone. You’re struggling with a medical condition that many people, in fact, millions of people in the US alone, battle every single day. If you look at it that way, you’ll be more apt to seek help. It’s okay to acknowledge that you feel hopeless, as long as you pursue something that’ll help you move past this feeling. You’ve got this. Things will not be this way forever, and you will be able to move forward, no matter how hard it seems. Remember a time when you felt emptiness or sadness and were able to push past it and keep going. If you’re reading this article, you are alive. If you’re reading these words, you are strong, and you deserve to seek help.

Online counseling

Online counseling is an excellent place to seek help for feelings of emptiness and that “I don’t want to do anything” feeling. You are allowed to feel lost, but your online counselor is there to help you push through these feelings and find a way to cope. You might feel helpless, but your online counselor believes in you. Don’t be afraid to reach out for help.

This is a featured post by site sponsor Better Help.

 

India’s Suicide Capital: Sikkim

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By Diwash Gahatraj

Despite a booming economy, Sikkim has the highest suicide rate among all Indian states, second only to the Union Territory of Puducherry.

Gangtok: For Sukhrani Limbu of Sordung village, about 120 km from Gangtok, 29 May 2016, was just another usual day at work. But upon her return home, she found her eldest son, 30-year-old Aitey Singh Limbu, hanging from the ventilation shaft in his room.

Life somehow went on for the grieving mother. But then came 29 May 2018, when her third son, 27-year-old Aitey Hang Limbu, hanged himself from the same ventilation shaft in the same room.

“There was no suicide note, no signs of sickness… I am still clueless about what triggered their suicides,” Sukhrani says, fighting back the tears.

Sukhrani is not the only mother or family member in Sikkim who’s searching for answers. A National Crime Records Bureau study reported that the landlocked Himalayan state witnessed 241 suicides in 2015, 2.1 per cent of all the suicides in India that year.

But in terms of suicide rate in the last decade, Sikkim has the highest (37.5) among all states, and the second highest in the country after the Union Territory of Puducherry (43.2). Suicide rate is the number of suicides per one lakh population. According to the 2011 Census, Sikkim’s population was 610,577.

The West district, where Sukhrani lives, is Sikkim’s worst-affected region. Between 2008 and 2018, 278 cases of suicide were reported here.

Underbelly of the ‘golden state’

Sikkim joined the Indian republic in 1975, and has gradually become the poster child for development and a booming economy. Between 2004-05 and 2011-12, the state witnessed the highest net state domestic product in the country, and was the third richest state in India according to the 2015-16 Economic Survey.

In September 2018, Sikkim got its first airport at Pakyong near Gangtok, and in October, it was awarded by the United Nations for becoming the first state in the world to become 100 per cent organic. Literacy and cleanliness are high, and it’s often referred to as a ‘golden state’.

Yet, it has a sordid underbelly, which is manifesting itself in suicides and the questionable mental health condition of its residents. Regardless of age, gender, rural-urban divide, economic or health status, suicide looms everywhere.


Also read: What the history of foreign invasions tell us about suicides across India


A number of factors

“It would be very difficult, and even unfair, to pinpoint a particular reason for why Sikkimese people are turning suicidal. There are several factors: A long history of alcohol and drug abuse, unemployment, high aspirations, ignorance of mental health illnesses and changing family structures,” said Yumnam Suryajeevan, assistant professor of sociology at the Sikkim Manipal University.

Social worker Dr Satyadeep Chhetri adds three more factors — lack of socialisation, loneliness and high rates of adultery.

“Around 70 per cent of people who have committed suicide were loners — either they were separated couples, aged people living away from their children, or kids from broken families. There is no study to connect suicide with adultery or other factors, but many people have committed suicide due to marital discord,” Chettri said.

A case in point is that of a 12-year-old girl who committed suicide on 26 June 2017 because she longed for parental love.

The seventh grader from Timberbung village in West Sikkim used to live with her old grandparents after her parents drifted apart and started living with their respective lovers, said an investigating officer from Soreng police station.

Drugs and alcohol

Many Sikkimese youth are high on pharmaceutical drugs like Nitrosun 10mg, Spasmo Proxyvon (SP) and cough syrups like Corex and Phensedyl, which are smuggled into the state from the neighbouring Siliguri in West Bengal.

“Drug users are very vulnerable to suicide,” said Prashant Sharma, member of the Sikkim Drug User Forum.

Former drug user Robin Rai recalls trying to kill himself during one of his weak moments nine years ago. Rai, who works as a counsellor at a suicide helpline centre in Gangtok, said he gets numerous calls from drug users with suicidal tendencies.

The state’s climate, geographical location, and the easy availability of alcohol has made it vulnerable to alcohol abuse as well.

Sikkim’s history with alcohol dates back to 1954, when Sikkim Distilleries was set up in Rangpo to ensure quality liquor for its citizens at a reasonable price. The then Chogyal (king) agreed to give the company absolute monopoly for the manufacture of alcohol, on the condition that the government was given 47 per cent of its shares. The state earns considerable revenue every year from alcohol sales — in 2013-14, the figure stood at Rs 120.64 crore.

K.C. Nima, a public health activist, shared the story of Suresh (name changed), a 40-year-old chronic alcoholic who had attempted suicide twice.

“The Sikkim High Court had to order the state to provide rehabilitation for him. There are many such cases,” Nima said.

Charvi Jain, a Kolkata-based psychotherapist, said that dysfunctional families, loneliness and drug and alcohol abuse are all interconnected. “It can be a deadly cocktail for suicide,” she said.


Also read: Suicides high among married women: Crisis in Indian marriages or mental health stigma?


Unemployment

According to a report by the Labour Bureau of the Ministry of Labour & Employment, Sikkim has the second highest unemployment rate in India.

Prawesh Lama, guitarist for the popular local band Tribal Rain, said the rush for government jobs had something to do with it.

“The problem of educated unemployed youth is high here. Sikkimese youth focus only on government jobs. But such jobs are for just a few who have the ‘right’ contacts,” Lama said.

“People are not willing to compete in the private sector. In this struggle to grab a government job, many youth get frustrated-some fall victim to drug and alcohol abuse, while a few even lose the urge to live.”

Cultural stigma of mental illness

Historically, the rulers of Sikkim have had no record of suicidal deaths. However, according to local tribal myth, adultery in a past life could lead to unnatural deaths, said L. Khamdak, professor of Limbu cultural studies at Namchi Government College in South Sikkim.

Tshering Tamang, a shaman based in Pelling, West Sikkim, added: “Every person has a predestined time to live. If someone kills themselves before time, their soul turns into Sian (evil spirit).This Sian can take lives of other people known to him or her in the similar way. More suicides will take place till the spirit completes its life-circle.”

In Sikkimese religious practices, mental health is often misunderstood. People with serious mental health illness approach religious gurus and shamans rather than coming to a doctor, said a psychiatrist based in Geyzing, West Sikkim, who did not wish to be named.

What has the administration done?

Other than an unpublished study conducted by Sikkim University, the state government has done very little research on the issue. ThePrint repeatedly tried to contact state health minister Arjun Ghatani, health secretary Vishal Chauhan and other senior officials, and emailed them questionnaires on the issue. But the only official response was an email from the health department, acknowledging receipt and saying it would take time to reply to the questions, “as this is a government procedure”.

However, that’s not to say there haven’t been efforts to curb suicides. A senior health department officer said on the condition of anonymity that the state was trying its best to combat the growing problem.

“The Sikkim Mental Health programme is operational since 2011, and we are conducting many awareness campaigns across the state,” the officer said.

In 2015, a state-funded 24×7 suicide helpline centre (03592-2021111, 18003453225) equipped with trained counsellors was started from the psychiatric department of the Sir Thodup Namgyal Memorial Hospital in Gangtok. However, the centre has received just 182 genuine calls so far, because hardly anyone seems aware of it. There were no advertisements for this number in Gangtok or West Sikkim, and helpline head Dr Jigmee K. Topgay said the reason was a lack of funding for promotion.

Hardly any local psychiatrists or health department officials were willing to speak on record when contacted for this report, because when a few of them spoke to a national daily on this issue, they were transferred from Gangtok to far-flung regions of the state.

One exception was Dr Satish Rasaily, a psychiatrist who has worked closely in the past with the government on suicide awareness programmes.

“The state has done several suicide prevention campaigns in Gangtok,” he said.

But outside the state capital, the track record of awareness programmes gets a bit murky. On the one hand, health department officials claim they conduct regular camps, as do local government officials like Hemant Limbu, vice-president of the Darap village near Pelling.

“We have a conducted a community level awareness programme where doctors, psychiatrists and suicide counsellors from Gangtok visited our area on the occasion of World Mental Health Day on 10 October 2018,” Limbu said.

But on the other hand, people in many other villages in West Sikkim said such camps were a rarity.


Also read: One in every 3 women who commit suicide globally is an Indian


How to fix this problem

Parul Agarwal, a Siliguri-based counsellor and psychotherapist suggested that the Sikkim government should work on spreading awareness about mental health.

“Forming a team of well-trained counsellors and psychiatrists who can work at the grassroots level can be a good start. Regular workshops, seminars in schools and colleges and a compulsory HR policy on mental health awareness at workplaces can be helpful,” she said.

Among all the religious groups in the state, incidents of suicide are least among the Christian community, and that’s because of a conscious effort that others could emulate, said Father Moni Clement Lepcha of St Mary’s Catholic Church, Geyzing.

“We regularly hold conversation with our parish members. When we talk about our problems, it helps a lot in venting out,” he said.

Social worker Chhetri added: “We have to tap the emotional quotient of Sikkim’s citizens. We have to tackle this situation as a society. We need to be more open to talk to each other, create occasions to meet and socialise.”

How To Help A Friend Who’s Suicidal Without Sacrificing Your Own Mental Health

See Author Link Here

As of 2017, the United States alone saw an estimated 1.3 million suicide attempts. Needless to say, suicide, often misunderstood and stigmatized, is a desperately urgent issue in America—and not solely for the people battling it firsthand. Supporting a suicidal friend can be a taxing, often frightening, stressful, and heartbreaking experience. But, being the best support system possible requires you to put yourself and your own needs first.

Easier said than done, though. As any caring and thoughtful friend would be, you’re likely worried about the wellness and safety of the person who you suspect to be in crisis. This situation can lead to bouts of self-doubt (“Am I doing and saying the right things?” or “Am I making things worse somehow?”), but Christine Moutier, MD, chief medical officer for the American Foundation for Suicide Prevention, says to trust your instincts. “Asking about suicide will not make someone suicidal if they do not already have those thoughts. Usually people feel relieved to share, especially if you are respectful and compassionate,” she says.

While you should open the lines of communication by asking your friend what they need, know what your own boundaries are, says Dese’Rae L. Stage, suicide awareness activist and creator of Live Through This. “If you’re not in a position where you can help, be honest. Say, ‘I’m not doing too well myself, but here’s a way we can find you help.” Going this route is not only best for you and your own sense of wellness, but it can also make you more approachable to your friend. “It shows how much you truly care about your friend and also allows you to be human and acknowledge you don’t have all the answers either,” says therapist Amanda E. White, MA, LPC, adding that this dialogue can come as a relief to someone who is suicidal, because so many people tend to walk on eggshells around them.

“If you’re not in a position where you can help, be honest. Say, ‘I’m not doing too well myself, but here’s a way we can find you help.” —Dese’Rae L. Stage, suicide awareness activist

Another option for helping your friend without sacrificing yourself is to call in additional support. Stage suggests tapping other friends, especially if you are in a tight-knit group, to make it a team effort of sorts. “Take shifts if you can,” Stage says. “See what [your friend] needs. Are they having trouble in their living space? Do they need help with laundry or dishes? Do they need someone to sit there and watch TV with them and order a pizza? Do they need to get out? [Helping with] things like that are good starters.”

If that arrangement—or any other, for that matter—doesn’t work for you, one thing that certainly can is honesty. Tell your friend you are there in the capacity you can be, whatever that may be, and that you love them. “Let them know they’re supported, even if you can’t necessarily be the one to do it,” Stage says. When you’re having this chat, or any conversation around suicide, it’s best to be direct, open, and a good listener. “People who are suicidal just need to be heard and validated. Even if you don’t agree with them, just say, ‘I hear you, and that sounds really hard.’”

“Focusing on your own health and wellness is important when you are trying to support someone in your life. If you are not well, you won’t be able to be a support to someone else who is struggling.” —Christine Moutier, MD

Dr. Moutier echoes that your time and attention alone can be a huge help. “Know that by simply caring and offering a listening ear and a feeling of support, you are providing them with everything a friend should.”

That said, you yourself may benefit from talking through this ordeal with someone who can guide, support, listen to you. “You are not alone—whether you’re the one struggling or the friend supporting them.” says Dr. Moutier, who says seeking therapy or support groups could be a smart avenue to explore for self-preservation. “Focusing on your own health and wellness is important when you are trying to support someone in your life. If you are not well, you won’t be able to be a support to someone else who is struggling.” In addition to seeking counseling for yourself, she recommends getting regular exercise, eating healthy foods, “and doing whatever you can do reduce your own stress.”

To be your best self—for the sake of your own well-being and ability to be source of support for a friend in crisis—you must always take care of yourself. And doing so, White says, is anything but selfish. “The most important thing is to make sure you are spending time with people who empower you and provide you with energy and love.”

If you or someone you love is suicidal, please contact the National Suicide Prevention Lifeline at 1-800-273-8755 or visit suicidepreventionlifeline.org.

UK Appoints First World Minister For Suicide Prevention

See Fox 17 Article Here

British Prime Minister Theresa May has appointed what is thought to be the world’s first minister for suicide prevention.

The move, intended to tackle the tragedy of 4,500 people taking their own lives in England each year, comes on World Mental Health Day.

Jackie Doyle-Price, a Conservative MP and current health minister, has been appointed to lead the government’s efforts to confront the issue, which is the leading cause of death in men aged under 45.

The new role will head up a ministerial taskforce, working with experts in suicide and self-harm prevention, charities, clinicians and those personally affected by suicide.

May said: “We can end the stigma that has forced too many to suffer in silence. We can prevent the tragedy of suicide taking too many lives.”

Doyle-Price, in her new role as minister for mental health, inequalities and suicide prevention, said: “In my time as health minister I have met many people who have been bereaved by suicide and their stories of pain and loss will stay with me for a long time.

“It’s these people who need to be at the heart of what we do and I welcome this opportunity to work closely with them, as well as experts, to oversee a cross-government suicide prevention plan, making their sure their views are always heard.”

May has also pledged more support for mental health services for children and young people, as well as funding for the Samaritans’ helpline — a confidential 24/7 freephone service.

Royal support

The measures come as London hosts the first ever Global Ministerial Mental Health Summit, organized together with the OECD and supported by the World Health Organization (WHO).

Tuesday’s opening session was attended by the Duke and Duchess of Cambridge, who previously launched the Heads Together mental health campaign with Prince Harry. Organizations, ministers and representatives from more than 50 countries will continue to discuss the many issues surrounding mental health in the capital today.

They are likely to debate the findings of a new report from WHO, which states that mental health should be explicitly included in global policy as mental health problems kill more young people than any other cause worldwide.

Suicide is the second leading cause of death globally for young peope aged between 15 and 19, according to the report, which also suggested there is little difference reported in mental health services and support between countries of low and middle average incomes and those of high incomes.

Mental health disorders have “dramatically risen” around the world in the last 25 years, according to Dr. Pattel of Harvard University, who presented his findings in The Lancet and described the global mental health situation as “extremely bleak.”

May’s announcement comes a day after the National Audit Office said the UK government may be “even further away than it thought” from achieving its goal of equal access to physical and mental health services for young people.

While the UK’s move was welcomed, critics blamed shortfalls affecting mental health services on the government’s austerity drive.

Barbara Keeley, mental health spokeswoman for the opposition Labour Party, told the Press Association: “A focus on suicide prevention is long overdue given the appalling increase in suicide rates since 2010, particularly among young people, but it also needs proper funding of front line services.

“Mental health services are still being underfunded by the Conservative government.”

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5 Possible Signs of Suicidal Intent to Watch For in Your Loved Ones to Save a Life

See Author Article Here
There’s nothing more heartbreaking than Pknowing a loved one feels that death is the only way to solve their difficulties in life.

People who commit suicide are often undergoing a tumultuous mental episode. Suicide is not, in fact, about truly desiring death, but about periods of depression so severe that death seems like the only way to escape the pain. They’d rather die than continue to suffer from the mental—and sometimes even physical—anguish that they’re dealing with.

The best way to help a loved one who is seems at risk is to help them seek out professional help, but it’s equally important to keep an eye out for those who are struggling silently. There are a number of warning signs that loved ones can keep an eye out for, that may indicate suicidal thoughts—and can help save a life.

If you see any of these warning signs exhibited in behavior from a friend or family member, do your best to reach out without any judgement. Provide a listening ear or a shoulder to lean on, and try to come prepared with resources and options for counseling or other professional services if possible.

According to the American Psychiatric Association, there are many psychiatric symptoms indicating a risk of suicide—so the image of a depressed, disheartened teen shut away in their room isn’t the only one that should come to mind. Just because a loved one isn’t refusing to get out of bed in the morning doesn’t mean that they aren’t in need of help.

Here are 5 general indicators to be aware of:

1. Self-Harming Behavior
One of the clearest warning signs that someone is battling with suicidal thoughts is evidence of self-harm.
(Shutterstock)
This may not always come in a clear form. Visible cutting is usually an easy-to-spot sign of self-harm, but it’s not always done as a cry for help. For some, actions like cutting or other forms of physical self-abuse are done in an attempt to distract from mental anguish by replacing it with a manageable, more distracting form of physical pain. If a loved one is trying to transfer their pain from their brains to their bodies, they may fear judgement more than the risk that self-harm can cause—and in those cases, the self-harm is often hidden.

Keep an eye out for anything that seems physically amiss. If a loved one starts to cover their body with sweaters and long pants, particularly if it seems out of character or season, or they seem to be concealing something, it may be time to have a talk about what’s causing the changes.

2. Anti-Social Attitudes
Suicidal thoughts and a decision to die may not mean that a loved one has stopped caring about others, but that doesn’t mean that they won’t withdraw from their families and friends as they contemplate the end of their lives.
(Shutterstock)
Depression can cause a myriad of mental distortions. As one author wrote, even the periods of time when the “fog lifted” made it difficult to tell whether their depressed state or uplifting state was their true reality; they never knew whether their depression was their mind lying to them or their cheerful periods were all just a ruse.

When a loved one is planning to commit suicide, they often stop spending time with others. That may be due to the exhaustion caused by their depression, but could also be their way of trying to ease the heartbreak that they know their death will cause others. Suicide, as described by patients with depression, isn’t wanting to die—rather, it’s not wanting to be alive anymore. So when someone starts to pull away, try to reach out and keep them engaged. Don’t let them forget about their will to live.

3. Violent Mood Swings
The chemical imbalances in the brain that cause severe depression and suicidal behavior can cause more than just feelings of hopelessness. In some cases, they can also cause periods of mania, so keep an eye out for extreme highs and lows.
(Shutterstock)
Most people associate depression with only anti-social attitudes and sad, withdrawn behavior, but manic-depressive disorders can be just as harmful to an individual’s mental state—and can often cause suicidal thoughts and behaviors when a loved one is experiencing a period of severe lows after experiencing great highs.

If a loved one seems to be acting out of character—spending a lot of money, taking risks you wouldn’t normally expect from them, or bouncing between ideas aggressively—and then going through periods of withdrawal in between, don’t simply assume they’re acting quirky. They could be dealing with manic depression, or they could simply be trying their best to pull themselves out of the depression by aggressively seeking out joy. The chemical imbalances that cause these behaviors aren’t something a loved one can overcome on their own, and they’ll need your help to identify the problem and seek professional help before they harm themselves.

4. Impulsive Actions
Be wary of impulsive choices when a loved one isn’t prone to those kinds of behaviors. There can be multiple reasons that a suicidal loved one starts to act impulsively. Sometimes, it is related to a manic episode, which is always a red flag.
Illustration (Pixabay)
Other times, though, it can be caused by the absence of fear that a suicidal individual experiences. They may want to spend their money before they die, or give someone a gift. They may want to experience things that they had always been too afraid to, or they may be desperately seeking out a way to feel happy again.

Whether a loved one is no longer afraid of consequences or trying to find their way out of the darkness, always keep an eye out for behaviors that appear to be out of the ordinary. If a meticulous planner starts to fly by the seat of their pants, it may be time to sit them down and talk.

5. Reckless Decision-Making

Illustration (Shutterstock)
If a loved one starts to drink a lot, take illegal drugs, or participate in other reckless or impulsive behaviors, keep in mind that this can be just as obvious a warning sign of suicidal thoughts as a mopey teenager or locked bedroom door.

There can be other factors that cause someone to behave recklessly, but there’s rarely a good reason behind this kind of change. Even if a loved one isn’t contemplating suicide, they’ll almost certainly benefit from hearing from you if they’re engaging in dangerous, reckless behaviors like this.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice.

Which Mental Illness Is Most Disabling?

Psychology Today Link Here

While there is no consensus on the exact definition of disability (especially psychological disability), there is greater recognition these days that, like physical disease, psychological conditions can cause functional impairment and dysfunction—some more so than others. In a paper, published in the November issue of Social Psychiatry and Psychiatric Epidemiology, Edlund et al. conclude that among the 15 mental health conditions examined, mood disorders (e.g., depression) are associated with the greatest functional impairment and disability.1

The Mental Health Surveillance Study
Data for the present research came from the Mental Health Surveillance Study (MHSS). The MHSS is a sub-sample of 2008-2012 National Survey on Drug Use and Health (NSDUH), an annual survey of non-institutionalized US civilians 12 years or older. MHSS, however, includes only individuals aged 18 and over.

For the Mental Health Surveillance Study, researchers conducted phone interviews with participants, utilizing the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV-TR. Of the original NSDUH 2008-2012 sample of 220,000 adults, 5,653 completed the MHSS interview (48% men; 67% White, 14% Latino/Hispanic, and 12% Black).

Using these interviews, researchers attempted to determine if participants met the criteria for any of the following 15 psychiatric conditions:

Mood disorders (major depressive disorder, mania, and dysthymic disorder), anxiety disorders (post-traumatic stress disorder, panic disorder, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, and generalized anxiety disorder), alcohol use disorder, illicit drug use disorder, intermittent explosive disorder, adjustment disorder, and psychotic symptoms.

Other conditions (e.g., eating disorders) were not examined because of their low prevalence in the sample.

Three measures of disability
Functional impairment was assessed using three measures (modified for this investigation):

Global Assessment of Functioning (GAF)
Days-out-of-role (DOR)
World Health Organization Disability Assessment Schedule 2.0 (WHODAS)
Scores for GAF range from 0 to 100 (higher means better functioning). GAF scores are based on both functional impairment and symptom severity (whichever happens to be worse).

StockSnap/Pixabay
Source: StockSnap/Pixabay
Unlike GAF, which is determined by clinical judgment and thus has a subjective element, WHODAS and DOR are based strictly on objective criteria and the patient’s responses.

DOR measures the number of days in the past year when an individual could not function at all because of mental health issues.

WHODAS assesses cognitive abilities (e.g., memory, concentration), social relations, social participation, self-care, and ability to do one’s duties (whether related to work, home, or school). In this study, a 0-24 score range was used, with the higher score meaning worse functioning.

Mental illness and disability: Results
Descriptive statistics revealed the sample’s average…

GAF = 74.1 (median 75)
WHODAS = 3.5 (median 1)
DOR = 6.7 (median 0)
Researchers performed a series of regression analyses, and concluded that among 15 mental health conditions, mood disorders were associated with the greatest functional impairment; anxiety disorders, with intermediate functional impairment; and substance use disorders, with less functional impairment.

For instance, in the fully adjusted model, the greatest decrease in GAF scores was seen in psychotic symptoms (22), followed by depression (16), and mania (13). In WHODAS modeling, mania (9), depression (6), and social phobia (5) had the largest coefficients. And, in the final analysis, only depression, adjustment disorder, and panic disorder, had a significant association with DOR.

These results are comparable with those of a 2007 study, which also included a nationally representative sample, used DOR, and employed similar statistical methods. In that investigation, mood disorders resulted in higher days-out-of-role than most other disorders examined.2

Commentary on use of disability measures
Aside from suggesting that mood disorders are associated with the greatest disability among conditions examined, the present investigation highlights the importance of using multiple measures in determining disability.1

Employing a single measure paints a misleading picture. For instance, as mentioned above, the median value for days-out-of-role was zero. Indeed, 70% of participants with one mental disorder, and over half of those with two disorders, had zero days-out-of-role. Only 3/15 disorders were statistically linked with DOR scores (8/15 with WHODAS; all 15 with GAF).

Therefore, DOR was the least sensitive of the three measures used. If we were to rely only on days-out-of-role numbers, we would miss significant dysfunction and disability.

darkerstar/Pixabay
Source: darkerstar/Pixabay
While GAF is likely the most sensitive of the three measures, it does not always assess functional status. As mentioned, GAF scores depend on functional impairment and symptom severity; when there is disagreement between the two values, GAF score is determined by the worse of the two. For instance, if symptoms are severe but functioning is okay, GAF scores will still be low.

Thus, it is important to use complementary measures of disability; doing so allows clinicians to achieve greater accuracy in determining a patient’s needs and in monitoring a patient’s progress. Use of complementary measures can also inform public policy and resource allocation. Physicians, politicians, and the public cannot make informed decisions about how to improve functional impairment if they fail to recognize disability in the first place.

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