Suicide

People understand suicide differently. A person's understanding of suicide can be influenced

by various factors such as mental health through science, religion and spirituality, culture
and traditions, the community, personal thoughts, attitudes and opinions or lived experience.
There could be a combination of these factors influencing a person's perspective and
understanding of suicide.

Suicide is a taboo topic. People talk about it in hushed voices in whispers through
half-sealed lips behind closed doors. There might be a need to pull down the curtains for
enhanced privacy but not literally. Suicide is talked about privately a little distance away from
other people while being on the lookout for any eavesdropping. It's like they are plotting a
crime. I might have exaggerated but suicide isn't talked about as openly as the weather.
People still die.

The silence and secrecy preventing open and meaningful discussions about suicide stem
from the shame and stigma surrounding suicide. It might be easier to talk about private
affairs like intimacy than about suicide. If suicide is a real issue, there is a crucial need to
deal with the stigma and the shame which enforce the silence.

There's a question worth addressing: if people aren't silent about suicide, does this mean
they are having constructive discussion about it such as prevention and support? This isn't
always the case. Sometimes, when people talk about suicide, it's about judgement and
condemnation. This perpetuates the stigma and the shame, and it is no more helpful than
silence. So, as much as there should be effort to break the silence, there should be care that
stigmatizing notions don't replace the silence.

I was in class one in 2007, and I can remember in hindsight the stigma that surrounded
HIV/AIDS. If HIV/AIDS was still stigmatized in my childhood, it must have been worse in
earlier years. I can remember reading publications aimed at destigmatizing HIV/AIDS. I was
in fact, a one time victim of the misinformed fear of contracting the virus but I learned. There
were public awareness campaigns to reduce the stigma. Lessons on HIV/AIDS have
remained a part of the primary and secondary education curriculum. The efforts to
destigmatize HIV/AIDS since my childhood have been largely successful, though some
stigma remains to be addressed. The progress in destigmatizing HIV/AIDS was not achieved
in silence. I am not correlating stigma against HIV/AIDS with stigma against suicide. I am
imagining that if nearly the same comprehensive effort put in reducing stigma against
HIV/AIDS was applied to destigmatizing suicide, similar progress and improvements could
be achieved.

Efforts to destigmatize HIV/AIDS have generally been more comprehensive compared to

efforts to destigmatize suicide. This is despite the global number of suicides being higher
than deaths from AIDS-related illnesses. I was skimming through the statistics in the
morning:
1.In 2019, around 690,000 people died from AIDS-related illnesses
worldwide (UNAIDS Data 2020)
2. In 2019, an estimated 703,000 people died by suicide (WHO, Suicide worldwide in
2019, Global Health Estimates)

Reporting of suicide statistics is slower compared to HIV statistics. For instance, the latest
data closest to an official report on global suicides I could find was an inference of 717,000
suicides in 2021 from World health statistics 2024: monitoring health for the SDGs. In
contrast, “630,000 people died from AIDS-related illnesses in 2023” (UNAIDS Fact Sheet
2024)

In my opinion which could be very flawed; initiatives to reduce stigma around HIV/AIDS
being more comprehensive than efforts to reduce stigma against suicide while both
epidemics are quite close in fatalities reveals the entrenched nature of the shame and
taboos surrounding suicide. Efforts to reduce stigma and discrimination of HIV are
praiseworthy and should continue as they are or even boosted to achieve WHO’s goal of
“eliminating all forms of HIV-related stigma and discrimination”. Destigmatizing suicide might
involve unique challenges but with effort, engagement and commitment, progress can be
made. Stigma against suicide funs the flames which prevent people from seeking help.

I think that efforts to destigmatize suicide could be misunderstood as attempts to justify or

condone suicide but in reality, it’s about creating safe spaces for people in crisis to reach out.
Being in a suicidal crisis with the shame and condemnation of suicide is like being in two
burning rooms, none is significantly better than the other but one might be more
manageable. Some people prefer to suffer in silence than risk the shame, condemnation and
invalidation of their struggles. It’s actually more of an involuntary circumstance than a
preference. It’s like suffering from thirst standing next to a poisoned well. The fear of being
judged for having suicidal thoughts causes anxiety about opening up. The stigma against
suicide distorts seeking help to be a risk - a risk of being judged and invalidated. This is
usually an anxious risk to take and it enforces the silence. I think it’s very unfortunate that
seeking help is undermined by fear and anxiety. This is the reason why seeking help is
considered a ‘strength and not a weakness’. The fact that it’s considered a strength is quite
telling of why it’s a strength. What qualifies it to be a strength?

There is always a reason behind a person’s suicidal thoughts. I think it would be

exceptionally improbable for suicidal thoughts to exist in a person’s mind without any reason
at all. There are reasons and exacerbating factors even if they aren’t always apparent. Not
knowing the reason or being unable to articulate it doesn’t diminish or invalidate thoughts of
suicide. The anxiety in reaching out is heightened in such a situation because, ‘how will it be
explained?’ The distress in being unable to understand the reasons for one’s suicidal
thought starts inwardly and it sometimes takes the route of self-stigmatization because,
‘what do I have to be suicidal about’? But suicidal thoughts remain. It’s better to
acknowledge the reality of suicidal thoughts and workout the reasons later than dismiss the
case entirely. Acknowledging suicidal thoughts and offering support offers better chances of
finding the reasons behind them even if it might take some time and a little effort. It’s like a
splinter beneath the skin. Being unable to see it doesn’t mean it isn’t there, the person can
still feel it.

There is a tendency to discriminate reasons behind suicidal thoughts. There is a perception

that some problems are more valid and significant enough to cause suicidal thoughts than
others. A terminal diagnosis or chronic pain might be considered more valid reasons for
suicidal thoughts if they indeed cause them, than suicidal thoughts stemming from a
romantic breakup or failing an exam. Suicidal thoughts are still suicidal thoughts regardless
of the cause. They are distressing, serious and dangerous all the same. A wildfire caused by
a spark isn’t less serious than a wildfire caused by a gallon of gasoline. Whatever might be
the reason for suicidal thoughts, it’s important to see them as they are: thoughts that can risk
a life, and deal with them accordingly with support and compassion.

Dismissing and invalidating the reasons why a person might be suicidal fuels the stigma
against suicide. It waters seeds of shame, judgement and condemnation and they bear the
fruit of isolation and silence. People have different levels of resilience and sensitivity. People
feel things differently and I don’t think it's a choice anyone can make. What might be a
pebble in my hand might be a heavy sack of jagged rocks on another person’s shoulder.
What might be a hill to one person might be a mountain to another. What might be a bruise
to one person might be an avulsion to another. Mindset as a motivational tool can only go so
far. There is a point where distress becomes real and downplaying it doesn’t ease the pain.

There are times when challenges in life are subjectively perceived to outweigh the benefit of
living. This opens the window for suicidal thoughts. There is usually a factor - a challenge, a
problem or a negative circumstance that triggers thoughts of suicide. It's not just any
problem that can trigger suicidal thoughts. The problem must be perceived as
insurmountable, inescapable and distressing enough to impede one's appreciation of life.
When pain, distress and suffering outweigh the value of life, suicidal thoughts start trickling
in a person's mind.

Some problems which cause suicidal thoughts might have started as relatively minor issues
which went unaddressed but they never resolved on their own. They fester unnoticed and
branch into other less apparent issues. They might merge with other problems leading to a
complicated and worse situation overtime. By the time suicidal thoughts are showing up,
there is a complex history of issues which need to be addressed. It's sometimes despairing
when self-awareness reveals the extensive range of the issues causing suicidal thoughts
and their interconnectedness. Some people might need another person to help them trace
the problems. Professional psychologists and counselors are better equipped for this task
than the average person.

Even though the problems causing suicidal thoughts might be complicated, there is usually a
general problem which is given as a reason for the suicidal thoughts. This general issue
might conceal deeper interconnected problems. A generalized example might be a suicide
stated to have been caused by poor academic performance. The general label and reason of
poor performance might conceal other significant underlying factors behind the suicide.
There could have been an impairment in coping mechanisms, self-hate, extreme
disappointment in oneself, self-deprecating distress of being a disappointment to others,
anxiety about the future, shame, a sense of being a failure and a distorted perspective
hooking the person to their distress.

Some people might think that a suicidal person can simply stop having suicidal thoughts at
will. Sometimes, suicidal thoughts are inaccurately seen as a choice and the seriousness of
the matter is dismissed. It's something like ‘just stop having suicidal thoughts’, ‘you are
stronger than that’ and ‘you are what you feed your mind’. It becomes an oversimplified case
of perspective while ignoring the issues behind the suicidal thoughts. Before a discussion of
suicidal thoughts is quickly wrapped and discarded, people should know that they
themselves cannot consciously choose to have suicidal thoughts and have them. Similarly,
suicidal people cannot consciously choose to stop having suicidal thoughts. This is not to
catastrophize the issue, it's acknowledging the need for help and support. If the conclusion is
that one can simply snap out of suicidal thoughts at will, the need for help and support is
dismissed.

Thoughts of suicide don't automatically condemn a person to a death by suicide. Being

suicidal doesn't always mean an imminent risk of an attempt. Suicidal thoughts vary in
intensity and it's not always possible to tell the severity of a person's suicidal thoughts. It's
therefore important to take any mention of suicide seriously and find out the intensity through
gentle communication. Some people reveal their suicidal thoughts in a measured manner to
gauge the kind of support they'll get. How they are responded to might determine if they'll
continue sharing or vaguely end the conversation which they might never start again.

Suicidal thoughts have limits in terms of duration and intensity though in a moment of crisis
they might feel endless. It's similar to how emotions are bound to fluctuate overtime no
matter how intense they are at the moment. It is possible to recover from thoughts of suicide
and live an entire life free from them but the memory of the experience might remain.

Suicidal thoughts to some people are recurrent and intermittent varying in duration and
severity. At one point they might be mild and go away quickly, at another time they might
persist longer with either mild or moderate intensity. At another time they might be intensely
severe with acute distress and a profoundly distorted perception of reality. The distress is
all-consuming, blinding and capable of overwhelming all coping mechanisms and survival
instincts. Sometimes, the distress is so severe that it can be felt physically. There is a high
risk of an impulsive suicide attempt in such a crisis. After such a moment of intense distress,
there might be a fear of living through it again. In such a moment, seeking help could be
literally life saving.

Seeking help isn't the end of it - the response is just as crucial. There is a critical need to
respond with empathy, compassion, patience and understanding. Due to the precarious
nature of an acute suicidal crisis, it is important to involve professional assistance. Saving a
life from an acute suicidal crisis is sometimes a team effort between those who are reached
out to and the professionals. The person who has been reached out to is a lifeline providing
the safety and compassion needed until the crisis subsides.

Even if a person's suicidal moments are mild and feel manageable, there's a need to talk
about it as it could indicate issues that need attention. Suicidal thoughts are never pleasant
unless they are providing the altered perception of relief from this life. Dealing with passive
suicidal thoughts now reclaims the peace and joy they would rob down the line. It's also a
risky gamble to assume that passive suicidal thoughts won't worsen overtime. Whenever
mild and passive suicidal thoughts come and go, they live minimal traces which attach to the
experiences and challenges that caused them. These traces leave an opening for the
suicidal thoughts to return whenever such challenges are experienced again. In this way,
suicidal thoughts provide themselves with a basis and a foundation to always return under
their association with certain challenges and experiences. A generalized example might be
passive suicidal thoughts from cyberbullying. Under the pain of cyberbullying, a person might
judge life as ‘horrible and not worth living’. This might not even register as a suicidal thought
but the more the person suffers from cyberbullying with the same kind of thoughts, they start
gaining the recognizable form of suicidal thoughts. As time goes, the passive suicidal
thoughts of preferring death over life may evolve into a dangerous understanding that death
is attainable. This is one reason why ‘Early identification and support for everyone affected
by suicide and self-harm’ is a key point in some suicide prevention guidelines such as
WHO's.
“Early identification, assessment, management and follow-up ensure that people who are at
risk of suicide, or who have attempted suicide, receive the support and care that they need.”
(WHO, LIVE LIFE, An implementation guide for suicide prevention in countries)

I think it's important to address the issue of access to suicide prevention resources. An
internet user who has occasionally seen the suicide prevention hotlines might have noticed
that most are US based, particularly the ‘988’ number but what use is it to people outside the
US? Many countries have suicide prevention lifelines but they might not be as widely known
as they should be. There is also the fact that suicide rates are highest in developing
countries which might have lower access to mental health resources. If a social experiment
was conducted in a developing country asking a random person how to access professional
help for a suicide crisis, what would be found out?

Even if professional mental health services might not be available or reliable in some places,
people should not despair about it. Since crises won't stop to wait for improvement in mental
health access and suicide prevention, it is important to think of alternatives while making
effort to deal with whatever has impeded the establishment or improvement of mental health
care. One alternative might be educating the community about mental health and suicide
prevention. This shouldn't even be an alternative but a key part in improving any country's
mental health. Another strategy might be partnering with religious institutions to advocate for
mental health awareness and suicide prevention. Religions have a huge following and the
positive impact they could have in improving mental health would be significant. However,
there would be a need to balance religious beliefs and concepts with established mental
health understanding.

No one chooses to have suicidal thoughts. Suicidal thoughts don't ask for permission to
enter a person's mind, they come uninvited and the person is dragged into a mental fight
they never asked for. It's mostly an invisible battle in the mind but no one ever goes down
without a fight.

It is often a vicious and ruthless fight but people can't directly see it or perceive it. They can
only see the effects. Suicidal thoughts are a singular challenge on their own, then there are
the factors causing them and if one is unlucky there might be worsening factors as well. A
generalized example might be a student struggling with thoughts of suicide and self-harm
from being bullied at school. Not only do they have to face the challenge of suicidal thoughts
which are highly unpleasant but they also have to face the challenge of the bullying itself. A
worsening factor might be lack of help from teachers or uncaring parents at home.
A common thing people do when fighting suicidal thoughts is seeking a distraction until the
thoughts subside. Such distractions can be found in music, movies, games, eating, sleeping,
walking, sports, art, writing, reading, walking, work etc. The distraction can be in anything the
person finds an escape. Some distractions are quite counterproductive and harmful. For
example, drug abuse, reckless indulgence and self-harm.

The coping mechanisms and distractions people use to deal with thoughts of suicide aren't
flawless. They may provide some shelter against suicidal thoughts but they have their limits.
A generalized example might be suicidal thoughts triggered by sensitivity to harsh treatment
in a setting where one cannot access their ‘escape’ activity such as walking or music. Such a
setting could be at work, school or home. Without the distraction, the person is exposed to
the full experience of their suicidal thoughts. It doesn't necessarily mean that the person will
be actively suicidal but they will experience a greater range of the distress than if they had
access to their coping mechanism. Distractions and coping mechanisms should ideally not
be substitutes for external support. Besides, suicidal thoughts are not guaranteed to remain
at their manageable level of intensity. An unexpected wave of suicidal crisis could be severe
enough to overwhelm the distractions.

There are times when suicidal thoughts get an upper hand and the situation becomes nearly
unbearable. This sparks a strong wish to talk to someone about the struggle, it's almost a
compulsion, or a pressing need to communicate. There's an urge to share the pain but the
mind is selective about who will be talked to. The person's mind rapidly scans for the person
who is most likely to listen, show patience and be comfortable to talk with. Finding such a
person is one thing, starting the conversation is another.

The person most likely to listen and understand is also most likely to be affected and worried
by the pain shared with them. This understanding casts a person into a dilemma, whether to
share or not. There might be a thought that opening up will cause too much sorrow for the
other person. Some people experience a strong reluctance to cause that sorrow; they
hesitate to share their struggles but the urge to talk still remains. A generalized example of
such a thought in narration might be, “I could talk to the mechanic about this. The tailor is
also a thoughtful and kind person. They will care more than I wish them to and they will feel
the pain. They will be too concerned. They will continue being worried about me longer than
I wish them to. I should probably wait”.

Some people end up choosing silence even when the people they don't wish to burden with
their problems would really want them to confide. The anxiety of burdening others has a
hidden and false belief that the people who care will continue being worried because nothing
will get better. The truth is that reaching out is a part of getting better and that is what people
who care would want to see. Their worry and concern will fade when they see the person
getting better. But the desire not to burden others twisted by the despair of suicidal thoughts
prevents one from seeing it.

The difficulty of reaching out does not end the desperate need to talk. Something in the mind
keeps pushing for communication and connection. Out of this need to talk and the difficulties
of talking about suicide, people may make vague and indirect statements or comments that
hint at their desperation. Generalized examples of such statements and comments might be:
“What is so wrong about dying?”, “I don't mind getting hit by a car unless i'll survive”, “I don't
believe I'll make it to 30”, “There’s a possibility that I won't be here next Christmas”. If
someone catches on to the hidden meaning in such comments, the suicidal person might
reveal their mind or dismiss any concerns and seriousness.

The internet offers anonymity and a powerful pooling of interests. The anonymous nature of
the internet enables people to overcome the difficulty of talking about suicide to an extent. It
is tragically easier to type ‘I am feeling suicidal’ on the internet than to say the same thing in
real life. The internet bringing together people with similar interests creates some digital
spaces where the common interest is suicidal thoughts and weariness of life. Such a space
can be the comment section of a post related to suicide or hopelessness. The general
sentiment in such internet groups can vary. Some spaces are about despair and giving up.
Some have a general sentiment and attitude of resilience, encouragement and healing.
Other spaces have a unified voice of condemning suicide and might have great potential to
stigmatize suicide and mental health. It is not easy to predict what a suicidal person will feel
after going through these digital spaces and experiencing their overall setiment. One might
feel a sense of relief to know that other people go through similar challenges. One might feel
a close connection with despair and hopelessness. One might feel encouraged and
strengthened. One might feel like an outsider when hearing of how others are getting better
yet seeing no change in their own life. One might feel shattered after going through an online
group judging and condemning suicide.

People who have struggled with thoughts of suicide are very receptive to suicide related
topics. Just the mention of the word ‘suicide’ is enough to attract their attention. Suicide is
more than a topic to them, it’s an issue central to their mind every now and then. Their
automatic attention to any mention of suicide can be likened to seeing a floating log when
one is being swept by a strong current in a river. All interest and focus is on that log. Suicide
is a topic they would want to engage with almost any time but there are limiting factors.
Suicide is a headline in the news or a title to an article or video on the internet. People can
post their comments but what about personal discussions? The keen awareness and
attention people struggling with thoughts of suicide have towards the topic can be leveraged
to break the silence and start the talk because they would want to talk about it.

There are many fears and anxieties that cause suicidal people to hesitate sharing their
problem. Some of these fears and anxiety are founded on the uncertainty of knowing how
the other person will react. There is fear of an overreaction. There is fear of being gossiped
and talked about. There is fear of being committed to a mental health institution. There is
fear of being seen as a mad or insane person. There is fear of worrying others. There is fear
of being misunderstood and invalidated. There is fear on how one will be perceived long
after they open up about their problem. There is fear of strained relationships if the talk won’t
go well. Not all suicidal people will experience these fears. These fears are worse when one
has directly lived through them or when one has reasons to believe that they will come true.

Some people might have open communication as a quality in their life and it would be
somewhat easier to share their suicidal struggles with somebody. They might have a clear
understanding and acceptance of their emotions and a sense of freedom to share what they
feel. Other people might be more guarded in their communication. Their ability and
willingness to share what they feel might be more suppressed. If they find it difficult to
express regular emotions, opening up about a sensitive case like suicidal thoughts would be
more difficult.

More than 720 000 people die by suicide every year. For each suicide, there are an
estimated 20 suicide attempts (WHO) More than 700,000 suicides are far too many. “All
ages, sexes, and regions of the world are affected. Each item of data here (the statistics)
represents a life that has been lost to suicide; each loss is one too many.”(Suicide in the
world: Global Health Estimates) The World Health Organization has set a target to reduce
global suicide rates by one-third by 2030. “Global target 3.2: The rate of suicide will be
reduced by one-third, by 2030” (WHO, Comprehensive Mental Health Action Plan
2013–2030) Everyone is needed to achieve this goal. And it’s not just a goal, it’s a human
thing about care and love. It’s a challenge to care and showing love that makes a difference.

Communication is an indispensable element in suicide prevention. It starts with

communication and it’s sustained by communication. There are some things that could
breakdown communication with a suicidal person. Sometimes, one might not even be aware
of the effect of their words and reactions.

If we are upset at someone for revealing their suicidal thoughts and we request or demand
that they should not speak such things again, our request might be fulfilled. But it won’t
mean that their struggle is over just because they no longer talk about it.

If we respond to a confession about suicidal thoughts with anger and rebuke, the person
might be driven further from us and closer to their despair.

If our basis for dismissing a person’s struggle with thoughts of suicide is because someone
somewhere has it worse, it only serves to invalidate their experience. The echo in their mind
is that their problems are irrelevant and mean nothing to no one.

If our response to someone opening up about their suicidal crisis is the concept of hell and
eternal damnation, we should try to distinguish fear from hope and encouragement. It is
unlikely that the person will share their struggles with us again if hell is all we have to offer.

If we make a person’s suicidal confession the talk of the town, we break their trust and it’s
quite unlikely that they would confide in us again. This doesn’t mean promises to keep their
matters secret but it doesn’t also mean gossiping about it.

If we turn a suicidal confession into a beatdown lecture of what life is all about, we might lose
sight of the pain and challenges that burden them.

If we make it our point to show a suicidal person the pain and devastation their decision
would cause the people they care about, guilt becomes our focus rather than understanding
what could cause one to consider such a decision.

If we overreact to a suicidal confession and make a scene out of it, the person might
suddenly get better and dismiss their own problems. But they never got better, they were
only escaping our overreaction and there’s a chance that we will never see their vulnerability
again.
If our response to someone sharing their weariness of life is a judgement of cowardice and
selfishness, we condemn their struggle and miss the chance to know the root of their
despair. The person is also less likely to seek help where they once found judgement instead
of understanding.

If something alien to our character and hostile to our values causes us to dare a person in
crisis to go ahead and kill themselves, we should look into ourselves to see if that is who we
are. It might seem like a tough love approach or advanced reverse psychology but we might
never understand the pain caused by that insensitivity.

Listening is the bridge to the mind of a person troubled by thoughts of suicide. Listening
facilitates and encourages communication. Listening is an empathetic response from love. It
shows care and willingness to understand. Opening up about thoughts of suicide can be
very challenging. There might be a need to create a comfortable atmosphere conducive for
such a talk. Keeping calm is a part of creating that comfortable presence. Calmness
counters the tension in the person’s mind. It shows them that it is safe to continue talking
and that such a talk is welcome again in the future. Patience is another part of that
comfortable presence. Patience allows one to listen to all that needs to be said. Patience
allows one to follow the talk at the person’s own phase, through all their indirect statements
and euphemisms until they are comfortable enough to say that suicide has been on their
mind. Listening does not mean silence; complete silence can be quite uncomfortable.
Listening is about having a normal conversation with the person with the intention to
understand, and to offer compassion and support. Effective listening achieves the person’s
trust and they can honestly share deeper things that might have been waiting for that level of
trust.

Suicidal thoughts are not definite tasks in a to-do list that can be checked off in one sitting.
There is a need for ongoing support and checking in on the person to see how they are
doing. Because the first talk happened, it becomes easier to talk about it again and even
more directly. The person knows that they have found a refuge and a safe place in another
person’s mind.

Concern and worry are normal responses to a suicidal confession. It can be quite
challenging to know that a person one cares about has been considering death as a way out
of their misery. The people who listen need help too from someone else. They also need to
talk about what they are feeling. Offering emotional support to a suicidal confession can be
draining and it’s understandable considering the gravity of the situation. Feeling drained
does not mean that one doesn’t care. If professionals can be burned out while operating
from an objective, professional and empathetic stand point, how much more so a
non-professional going through it at their maximum emotional capacity? This shows the
importance of self-care and the need for professional support.

Tragically, not everyone wins the battle in their mind. In a moment of overwhelming distress
under a dense fog of hopelessness, a person’s light goes out. The survival instinct is a
powerful force and it takes an equal or greater force to subdue it. A person who lost their life
to despair may have silently grieved for the people and things they loved before they are
grieved for. A suicidal person may look at their family, their children, their friends, their
workmates, their life and understand how much they are losing. They might be aware of the
pain their decision will cause but the fangs of suicidal thoughts don’t loosen their grip. The
love they have for the people in their life becomes a reason to keep fighting. Some live for
others and not for themselves but the battle rages on in their mind. Their grief may have
never been known and it might never be known. A person could win the battle in their mind a
hundred times but the single loss that claims their life might be what they are remembered
for. There is more to the life of a person who died by suicide than how they passed away.