S is not for Suicide but for S.O.S (Save our Souls)!

This blog is dedicated to my aunt :) Thank you!

I have come up with a new mantra; S is for S.O.S (Save Our Souls) and not for Suicide. Let’s see how we can flip S for Suicide to S for S.O.S shall we?

87% of individuals who die by suicide have a mental illness. Isn’t that worrisome? Individuals who may be suicidal often don’t seek help for many reasons be that stigma, shame, fear of consequences (being fired from their job for e.g.), and a belief that their situation is hopeless and that nothing can help.

According to the World Health Organization, 'Suicide accounted for 1.4% of all deaths worldwide, making it the 17th leading cause of death in 2015. The American Foundation for Suicide Prevention estimates that for each person who dies from suicide, 25 more make a suicide attempt. While suicidal behaviors are more common in females in developed countries, completed suicide is 3.5 times more common in males.' Suicide is also more common in certain groups including indigenous people, the unemployed, prisoners and gay, lesbian and bisexual people.

Not too long ago, a friend of mine told me that she had had suicidal ideations since her teens. (Whenever anyone says something even remotely close to this, one must always take it seriously.) I went to meet her and asked her head on what exactly was going on. She hadn’t even told her family about it. I was then showed a deep cut near the wrist. We talked and I empathized and listened non-judgmentally (which is key) and by the end of the discussion, my friend felt slightly better and hopeful. Before leaving I made her promise me that she would seek professional help and that we would send each other a message every day to see if the other person is alive and well. We are doing that till date.

When I started to research for this blog, I came and continue to come across many articles about suicide and how chronic illnesses play a part in pushing one over the edge. My parents worry when they see me reading these articles and ask if I have any thoughts about suicide especially because they know what I have been through and what I continue to experience.

A few months ago, I started to have suicidal tendencies and felt completely despondent (sometimes still do). I wrote to a close friend at that time, hoping that she could help. But that individual shut me out and said she didn’t have time for me. That’s the worst thing anyone can do at that moment because what ensued was a severe panic attack, and me locking myself in the bathroom, looking for something sharp to cut myself with. Luckily my parents barged in and calmed me down. That day was an eye opener. I wrote to a few people about this episode just to understand their reaction. The response was interesting. Some friends, who I thought were closest to me, couldn’t be there for me the way I had hoped for. But on the other hand friends who I thought weren’t very close replied immediately. One even called my parents to see if I was okay when I didn't respond to her messages. My aunt, who is miles away, asked if I wanted her to fly down to me (which she did by the way as a surprise, along with my uncle and cousin brother!); my yoga instructor and psychiatrist also said: “Don’t lose hope Parneeta! We are here for you and we will figure something out together!” I felt reassured and grateful that I do have some people I can reach out to when I am in a crisis.

My advice for individuals who have suicidal ideations is to make a list of people who they can rely on when in crisis. I certainly have. A caveat though; this list can be fluid. You may have to delete or add people as you go along, and that is okay; as long as you have someone on that list. A physician's perspective and advice: My Father Killed Himself: Advice from a physician and suicide survivor: https://www.medpagetoday.com/psychiatry/depression/74589?xid=nl_mpt_DHE_2018-08-18&eun=g1152396d0r&pos=11111&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-08-18&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days

Media is a huge player when it comes to mental health:

Have you heard of the Netflix show '13 Reasons Why?' It’s a controversial teen drama about a high school student who dies by suicide. According to a study, John W. Ayers, PhD, of San Diego State University, and colleagues found that internet searches linked to suicide spiked following the airing of the show. Although it has increased suicide awareness, it has also unintentionally increased suicidal ideation amongst teens. Ayers said, “While teen suicide should not be considered off-limits by Hollywood, filmmakers should work within the WHO guidelines to offer a message those contemplating suicide need to hear. This is where '13 Reasons Why' misses the mark." What about online games? You must have heard of the ‘Blue Whale’ or the ‘Blue Whale Challenge’ which consisted of a series of tasks assigned to players by administrators over a 50-day period who introduced elements of self harm with the final challenge requiring the player to ‘commit’ suicide. It spread like wildfire all over the world claiming more than hundreds of lives! In May 2017, Russian authorities arrested 21-year-old Philipp Budeikin, who claimed to have invented the game to "cleanse society" of "biological waste." Other supposed perpetrators have been arrested as well. I have posted a video of how the game worked on the ‘Videos’ Page: https://parneetascorner.wixsite.com/mindovermatter/videos

Now a new game has come to light called the ‘Momo Whatsapp Challenge’ that follows in the footsteps of the ‘Blue Whale Challenge.’ To read more click here: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/after-blue-whale-it-is-momo-whatsapp-suicide-game-thats-risking-your-teens/articleshow/65335762.cms

What kind of a twisted world are we living in? How can parents help, monitor and protect their children more than they already are? Government bodies do seem to be tracking and tackling these kinds of online activities as efficiently and as strictly as possible.

With suicide rates rising and an alarming number of teens and young adults at serious risk of suicide, researchers at the National Institute of Mental Health recently came up with the ASQ Toolkit (Ask Suicide Screening Questions) for health professionals to help identify and help at risk youth. If a patient answers "yes" to any of the questions, it's a red flag for the medical professional to consider the patient at risk for suicidal thoughts and behaviors. From there, the toolkit offers guidance on the next steps that will be most helpful for the patient. For more information click below: https://www.medpagetoday.com/nursing/nursing/71067?xid=nl_mpt_DHE_2018-02-12&eun=g1152396d0r&pos=0&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-12&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days

While the above toolkit is useful for health care professionals to identify and help their patients, how do health professionals take care of themselves? Health care providers are one of the most depressed and suicidal populations in the world. With the constant pressure of needing to perform efficiently, working long hours, not enough sleep, poor eating habits, lack of exercise and a social life, we are definitely more prone to mental health ailments, especially those who are empathetic and sensitive like me. It’s ironic because as health care professionals we are aware of the necessity to address this issue, yet do not, in the fear of being stigmatized. By denying and not seeking help, because we might jeopardize our career, only makes the situation worse. We become more depressed, prone to breakdowns and some may also entertain suicidal ideations. Sadly, one of my own classmates died by suicide. Our entire school was shocked. We, as in the medical society, need to do more to help our own kind, who suffer from mental health ailments.

On a side note, we now use the phrase ‘died by suicide’ instead of ‘committed suicide’ as the latter implies that it is a crime or a sin. We do not refer to past suicide attempts as ‘failed’ or ‘unsuccessful’ as it implies that death would have been a favorable outcome. The person in question is already feeling worthless, lonely, depressed, guilty, and the last thing you want to do is worsen the situation by using language that promotes stigmatizing attitudes.

Every year, an estimated 400 physicians die by suicide. Here’s an article by Dr. Pamela Wible MD who discovered 34 reasons why health care practitioners are more prone to suicides: https://www.kevinmd.com/blog/2017/10/ive-learned-547-doctor-suicides.html

However there might be some hope according to this article:

Hospitals, Med Schools Act to Prevent Physician Suicide: Marks a culture shift:

https://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/66849?xid=nl_mpt_DHE_2017-07-26&eun=g1152396d0r&pos=2

After the death of two doctors in New York, medical educators partnered with other stakeholders, including the Accreditation Council for Graduate Medical Education, to develop a national response to this crisis in medicine.“As a result of these efforts, physician training programs that began on or after July 1, 2017, must now follow new requirements that provide access to confidential, affordable healthcare, including counseling and urgent care, 24 hours a day and seven days a week.” However it seems that so far only the Oregon Health and Science University, has built a Resident and Faculty Wellness Program. All states, all countries need to follow their paradigm if we are going to de-stigmatize mental health and help health care providers receive the care they deserve and need. An interesting and emerging piece of news: Did you know that supposedly MRIs can determine suicidal ideations? This is a new approach but ground breaking especially for those individuals who deny that they have suicidal thoughts and may harm themselves. With the help of this technology, health care practitioners will be able to recognize such individuals and help them accordingly. To read more click here: https://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/68878?xid=nl_mpt_DHE_2017-10-31&eun=g1152396d0r&pos=1

As a community what can we do about suicide? How do we protect our loved ones?

First and foremost, learn to identify a few tell tale signs such as sudden change in mood, individuals talking about killing themselves, withdrawing from family and friends, increasing alcohol or drug use and/ or stating that they have no purpose or reason for living. Individuals may show one or more of these signs while others may show none. If you are concerned that a certain person is at risk for suicide, you need to approach them and have a conversation immediately. Always take suicidal threats seriously. Suicide can be prevented. Most suicidal people do not want to die. They simply do not want to live with the pain be it from a physical or mental ailment. Mostly attempts are a cry for help. That’s why I believe S is not for Suicide but for S.O.S. Ask the person directly about their suicidal ideations, and the questions should be unambiguous for e.g.: Are you having thoughts of suicide or are you thinking of killing yourself? Do not push religious or cultural beliefs onto them. Do not guilt trip them into saying what will their family do if they go ahead with it. Do not make promises you cannot keep and do not trivialize the suicidal person’s problems. Appear confident as your body language instills reassurance. Work collaboratively to keep the individual safe for now, and then connect with other professional help. Learn how to empathize with the individual and show you are listening non-judgmentally by summarizing what the suicidal person is saying. Please do not shut these people out. Do not underestimate your abilities to help a suicidal person, even to save a life. However if you are unable to help for whatever said reason, please help them find someone who can. It’s the least you can do.

The Mental Health First Aid Course (MHFA) that I wrote about in my previous blog is something that you can definitely do. To read more click here: https://parneetascorner.wixsite.com/mindovermatter/single-post/2018/08/02/Mental-Health-First-Aid-Have-you-heard-of-this-before Find a local chapter that offers the course. It’s an amazing experience.

Some Great Images, Suicide Prevention Resources and Tools:

1. www.suicide.org : This website is a treasure trove replete with resources for traumatized individuals and caregivers.

2. www.samaritans.org: Read about this wonderful campaign in the UK about how striking up a conversation with someone can save their life. Read about such stories and what you can do to help, or if you need help. For e.g.: Small talk saves lives campaign: Preventing railway suicides and beyond.

3. Communicate with loved ones. The right people do care if you give them the chance to let them.

1. Self Compassion! You are your own best friend and in order to help your best friend you have to learn how to love yourself. Refer to my Self Care blogs. I believe every country would or should have a Suicide Prevention Lifeline. Make a note of the one where you currently reside. The ones below are for the US:

2. National Suicide Prevention Lifeline 1-800-273-TALK (8255)

3. Crisis Text Line: Text HOME to 741-741 Suicide Prevention Resource Center

4. National Institute of Mental Health Substance Abuse and Mental Health Services Administration

5. Suicide Prevention Resource Center

6. Substance Abuse and Mental Health Services Administration

7. Mental Health on The Might: Its Facebook Page. This has been a heavy read so I would like you to now enjoy a wonderful song by ABBA called S.O.S.: https://www.youtube.com/watch?v=89w-L3aICj4 If you would like to share an experience with me, message me through the Contact Page. I am always willing to listen.

To read more medical and non medical articles related to suicide click on the page Articles: Further Reading: https://parneetascorner.wixsite.com/mindovermatter/articles-resources References: 1) World Health Organization. Mental Health: Strengthening Mental Health Promotion (Fact Sheet No. 220). Geneva: WHO; 2007. 2) American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. 3) Identifying Youth at Risk for Suicide: Toolkit from the National Institute of Mental Health can help https://www.medpagetoday.com/nursing/nursing/71067?xid=nl_mpt_DHE_2018-02-12&eun=g1152396d0r&pos=0&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-12&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20daysIs 4) '13 Reasons Why' Helping Kids Kill Themselves? Researchers see link between upswing in suicide info searches and Netflix show https://www.medpagetoday.com/psychiatry/depression/66974 5) What I’ve learned from 547 doctor suicides: https://www.kevinmd.com/blog/2017/10/ive-learned-547-doctor-suicides.html 6) Hospitals, Med Schools Act to Prevent Physician Suicide: Marks a culture shift: https://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/66849?xid=nl_mpt_DHE_2017-07-26&eun=g1152396d0r&pos= 7) Can MRI Determine Suicidal Ideation? Brain responses to six words revealed suicidal thoughts: https://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/68878?xid=nl_mpt_DHE_2017-10-31&eun=g1152396d0r&pos=1 8)Images from: http://www.sosamitiesudlorraine.fr/sos-amitie/9-la-prevention-suicide