September 10, 2024
“Not all persons who commit suicide want to die and not all persons who want to die commit suicide” (Shneidman, 1985, p.13)
Suicide is a significant public health concern in India, with the country accounting for over 30% of global suicide deaths. According to the National Crime Records Bureau (NCRB), India reported around 1.53 lakh suicide deaths in 2020, and around 1.71 lakh in 2022, with a suicide rate of 12.9 per 100,000 population. According to estimates, approximately 1 in 60 people in India are directly or indirectly affected by suicide, including family members and friends of those who have attempted or died by suicide.
Males account for 68.5% of suicide deaths, while females account for 31.5%. (NCRB, 2024)The highest number of suicide deaths occurs among young adults (18-30 years), accounting for 34.5% of total suicide deaths. 71% of suicides occur under the age of 44. Unmarried individuals account for 57.1% of suicide deaths, while married individuals account for 42.9%. Students and daily wage laborers are among the most vulnerable groups. In 2022, male and female student suicides increased by 6% and 7% respectively (Pti, 2024).
Signs to look out for:
Individuals experiencing suicidal thoughts or ideations will always somehow bring the topic into the conversation. People around them may think that they are just seeking attention but it is important to notice it because it can result in them actually acting on it. Individuals can be so troubled by their thoughts that they are unable to eat the meals, even those that they usually love. Sleep also comes rarely and they might remain awake throughout the night.
Due to abnormal thought pattern, they may act out of ordinary, like suddenly becoming calm after an emotional outburst. This can be very concerning because it usually means that the person has decided on ending their life. They may also start withdrawing from their friends and family. They lose interest in socializing, in activities they previously found interesting, their jobs, education and hobbies. They may also lose interest in how they look, often appearing unkempt and shabby. They turn devoid of anything that made them who they were.
Individuals may start making final arrangements like getting closure with people, gradually becoming emotionally detached from loved ones, writing their will and giving away their precious belongings. This can indicate that the person has decided on ending their life and is preparing for it.
It is also necessary to look out for people who have already made a previous attempt at suicide since they are more vulnerable to doing it again. They may engage in behaviours that put them in risk of harm or death like over speeding, driving when drunk, drug abuse, sabotaging their own relationships, ignoring or taking excessive medications, not abiding by traffic rules etc. We also need to keep an eye on someone who has recently lost a loved one, finds it difficult to come to terms with it even after months which is affecting their daily life. (“Suicide Warning Signs,” 2024).
Psychological techniques to help oneself:
- By Journaling:
Journaling is like having a conversation with oneself on paper. Taking some time each day to write down one’s thoughts, feelings, and experiences is a great way to process emotions, gain insight, and reflect on one’s values and goals. One need not worry too much about grammar or spelling - just let the thoughts flow! One can use bullet points, write freely, or even try prompts to get started. Journaling is a powerful tool to help understand self-better and feel more calm and centred.
2. By Using Grounding Techniques:
Grounding techniques can help when feeling anxious or overwhelmed by one’s troubles. They're simple yet powerful tools that bring one back to the present moment. The steps involved in grounding are:
a) Take slow deep breaths.
b) Focus on one’s five senses: List five objects one can observe, four sounds one can hear, three scents one can smell, two things one can taste and one thing one can touch. Grounding can help one calm both their mind and body, reducing anxiety, stress and feeling of being overwhelmed. One can try it whenever they need a little calm in their life. (Rethink Mental Illness, n.d., “Suicidal Thoughts: How to cope)
3. By Reframing Negative Thoughts:
One can have negative thoughts sometimes, but they can be really harmful if one lets them control their behaviour. Reframing is a way to challenge those thoughts and replace them with more balanced ones. One can ask self: "Is this thought really true?" "Is there another way to look at this?" or "Would I say this to a friend?"
Write down three things that went well in one’s day, three things that one’s grateful for in life. One can also write down two negative things they've experienced and then find two positive outcomes of it. For example, the negative thing can be: “I missed the last bus today.” and two positive outcomes of it can be, “I took the cab and enjoyed the scenery.” and “I made a new friend with the person who shared the cab with me”
One need not look at the world in a black-and-white lens, there are times when situations fall under a gray light, which means that a situation can be both good and bad depending on how one looks at it. Negative thinking can distort our view of reality and make us feel depressed. (Rethink Mental Illness, n.d., “Suicidal Thoughts: How to cope”)
4. By Practicing Gratitude:
Gratitude is essential for one to be happy in his lifetime. One can take a little time each day to reflect on the good things in their life - no matter how small they may seem. One may do so when they just wake up, which will help them go about their day in a positive mood or one can do so when their about to sleep, so that they go to bed content. Write them down, share them with others, or simply take a moment to appreciate the beauty around oneself. Focusing on what one already has, rather than what's lacking, can shift one’s whole perspective and bring more joy into their life.
Adopt the equation; (Gratitude+Forgiveness)/Love=Happiness, which suggests that happiness is a product of gratitude (focusing on the positives), forgiveness (letting go of negativity) and love (sharing kindness and joy). (Mosco, A., & Ferguson, D.L. (2014))
5. By Building Resilience:
Resilience is the ability of an individual that allows him to bounce back after a trauma, distress, or adversity. It can be understood as the capacity with which one can adapt to different and novel situations. One can build their resilience by developing and maintaining positive social relationships, developing a mindset that nurtures growth and improvement, being aware of their own needs, feelings and desires, developing healthy coping strategies like journaling and meditation, taking care of oneself physically, mentally and spiritually, focusing more on the present than the past or future, etc. (Cornell Health, n.d. Building Resilience)
6. Stop Think Go method:
The "Stop, Think, Go" method is a helpful technique for building resilience and managing stressful situations.
STOP: When one feels oneself getting overwhelmed, they can stop whatever their doing and take a pause.
THINK: Take a moment to reflect on one’s thoughts, feelings, and physical sensations. One can ask oneself questions like:
- What am I thinking and feeling right now?
- Is this thought helpful or unhelpful?
- What are my values and goals in this situation?
- What would I say to a friend in this situation?
GO: Once one has taken a moment to reflect, choose a constructive course of action. They can ask themselves:
- What small step can I take right now to move forward?
- What self-care do I need to prioritize?
- What support do I need to seek out?
- What positive actions can I take to build resilience?
By using the "Stop, Think, Go" method, one can reduce stress and anxiety, increase self-awareness, improve problem-solving skills, enhance resilience and make more intentional decisions. (Southwest Mental Health and Substance Abuse Organization [SMHO-SMSO], n.d.)
7. By Using the Circle of Control:
The circle of control is a diagram that helps one to identify the different areas of responsibility and levels of control that one has in their life. It is represented by two circles: the inner circle consists of things one has control over and the outer circles has things that one cannot control but has an influence over. One can write down the things they can control inside the inner circle and those things they can only influence on the outer circle. This leads to giving more prioritisation for the inner circle. It can give them an idea about how they can use time effectively in solving our troubles. By identifying the controllable stressors, we use lesser time and can arrive at solutions quickly. (Scotland, n.d., "The Circle of Control...")
National Suicide Prevention Policy (2022):
The NSPP launched in 2022 aims to reduce the rate of suicide by 10% by 2030. Under this policy are primary, secondary and tertiary strategies: Primary Strategies include surveillance of suicidal behavior, restriction of means, and media's portrayal of suicide. It also includes training, education, awareness, and stigma reduction. Secondary strategies are crisis intervention. This is used when it's too late to use primary strategies. Tertiary strategies include treatment of attempted suicide, postvention, oversight and coordination. There is also a need to improve the capacity in mental health services and maintain consistency in prevention efforts. (Ransing, Ramdas, et al., 2023, "National Suicide Prevention Strategy of India...")
Conclusion:
Suicide prevention in India is a pressing concern that demands our attention. With alarming statistics highlighting the need for urgent action, it's crucial to recognize the warning signs and take proactive steps to prevent suicides. By embracing simple yet powerful techniques like journaling, grounding, and reframing negative thoughts, individuals can take the first steps towards healing. Additionally, cultivating gratitude, building resilience, and leveraging the "Stop, Think, Go" method can help individuals navigate challenging times. Furthermore, the National Suicide Prevention Policy (2022) aims to reduce suicide rates by 10% by 2030, paving the way for a supportive and inclusive community. By fostering a culture of understanding and compassion, we can work together to create a brighter future where happiness and well-being thrive.
Helplines to seek:
Yenepoya Psychiatry Helpline (24/7): 91089 19025
