“Why do we see suicide as the only option?” questions Sandhya Menon, a journalist and mental health advocate. “My attempts tell me that it is because it feels like there is absolutely no other solution and somehow it becomes the only way to be relieved of the incessant burden that living seems to be.
“It feels like there is no other solution, it’s not the truth, but it’s all I was able to feel in that one moment. It’s a complex feeling. When things are fine, suicidal ideation is at bay but when things get rough, it becomes unrelenting,” she adds, as part of her Twitter thread on Tuesday.
Sandhya isn’t alone in her journey; according to the World Health Organisation (WHO) suicide is the 18th leading cause of death globally.
Manoj Chandran, CEO of White Swan Foundation, an organization which works to raise awareness about mental health, points out that not all suicides are due to underlying mental health reasons. However, mental health issues contribute to a significant proportion of suicide cases, and suicidal thoughts don’t always manifest in similar ways. This is also why there is no one size fits all approach when it comes to dealing with them.
We asked some people who have experienced suicidal thoughts, and what worked for them.
One day at a time
For Sandhya, an effective technique that works for her is that rather than letting the idea of suicide consume her, she allows herself to experience the emotions and thoughts.
“I let it rattle in my head. I don't act on it. I let myself feel the tension. The pull to do something to end my life. The push back from myself saying, it's ok. Hold on,” she says.
What also works for her is just focusing on making it through one day at a time. “It doesn't get better the next day. Neither the next but telling myself one more day, takes me through a week, a fortnight, a month and before I know it, I am avoiding people who ask what plans for New Year’s Eve. I got through a year. Even when I didn't think I would. Even when I didn't think I wanted to. And this is important,” she writes on Twitter.
25-year-old Abhinav*, an IT professional based in Bengaluru, has been struggling with depression and anxiety from the time he was in college. He had been on medication for more than three years before he realized what it meant to be suicidal.
“I never realized that I was suicidal, even though I’d fantasized about being free of the pain and ending it all so many times. Often times when we discuss suicide or hear about someone who has taken their life, the image we get is far from what reality is like. It took me so long to understand that I was suicidal because it wasn't as though I was having these thoughts every day; they kept interspersing with good and bad days,” he says.
Abhinav found a mental health support group in the city. After attending a few meetings, he confided in a friend from the group, who he ended up reaching out to during moments where he felt himself closing in.
“Soon I ended up creating a ‘lifeline’ of sorts for myself,” he says, “I had three people whom I trusted immensely and who I had discussed my mental health with extensively. They were the people I could call up or text at any time. We had a code phrase, which I repeat to them when I wasn’t doing well. It was my way of alerting them so they knew I needed help.”
Therapy, and acceptance
Having your doctor or therapist on call, available in case of emergencies, makes a huge difference too.
“If you have a therapist and you are suicidal, a plan to manage this feeling and ideation is something you absolutely need to talk about,” says Sandhya.
A mechanism that has worked for her is using her children as motivation to live, though therapists have discouraged her from relying on that. “I'm not going to force myself to find another reason to live,” wrote on Twitter. “If some other motivation comes, it comes. Meanwhile I will find a way to figure it out each day.”
How can you help someone who is feeling suicidal?
There is no sure-fire way to determine whether a person is currently feeling suicidal. However, experts do note that there may be some subtle indicators.
“Personality or behavioural changes, irritability, change in sleeping patterns, are all factors to keep a lookout for. Features of their basic personality may be exaggerated and persistent,” says Dr Vinod, Psychiatrist and Head at Mpower for Mental Health centre in Bengaluru.
In addition, many individuals may experience increased anxiety, start substance abuse, have sleep changes, feelings of hopelessness, severe mood changes, and might even start withdrawing from those who are close to them, whether friends or family.
“Unless we address the elephant in the room, we cannot wholly address mental health issues,” Dr Vinod tells TNM. “Of course, it is an extremely sensitive matter, but shying away from the topic is not the solution. If someone you know opens up to you about feeling suicidal, stay calm. They don’t necessarily need you to offer them a solution, rather listen to what they have to say and what they are feeling.”