(World Suicide Prevention Day is observed every year on 10 September. We are publishing this story in this context.)
In India, suicide is a leading cause of death according to a Lancet study. While there are many reasons that lead to suicide, depression being one, what exactly happens inside the mind of a person who is about to end their life? What is happening to them at a chemical level? Are some people genetically more inclined to be suicidal than others? And lastly, what is that final tipping point or trigger that pushes people off the edge?
We got doctors to break it down for us.
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What’s Going on on a Chemical Level?
One of the most common causes for suicide is depression. According to this report, depression affects two thirds of the people globally who die by suicide. Additionally, a Canada-based research found out that among those battling depression who went ahead with the act of suicide, there was an unusual presence of the chemical GABA, a neurotransmitter in the brain.
When the GABA levels were compared between people with depression who took their lives and non-depressed people who died of other causes, researchers concluded that there was a significant difference in the representation of GABA receptors in the frontopolar cortex of the brains of the two groups.
People who frequently engage with suicidal thoughts also have increased levels of another chemical, quinolinic acid, in the fluid surrounding the central nervous system, according to this report.
Another chemical which is believed to play an important role here is serotonin, the chemical which controls your positive moods. According to a report published in the Journal of Epidemiology and Community Health, people who show suicidal patterns are also marked by low serotonin levels in their brain.
This is further confirmed by Dr Sameer Malhotra, Director, Department of Mental Health and Behavioral Sciences, Max Hospitals, who says that low levels of serotonin are often found in the brains of those with suicidal behaviour and thoughts.
Other Than Societal, Cultural Reasons, What Can Lead to Suicide?
Dr Nikita Rajpal, Consultant Psychiatry, Mental Health and Behavioural Sciences, Aakash Healthcare Super Specialty Hospital, Dwarka, too emphasises the role of serotonin when it comes to suicidal thoughts and patterns.
Results from a range of studies using diverse designs, post-mortem and in-vivo techniques show impairments of the serotonin neurotransmitter system and the stress-response system when it comes to suicidal behaviour.Dr Nikita Rajpal
Dr Malhotra adds to this and mentions mood and mental disorders that leads someone down the path of self-harm and self-inflicted death.
Suicidal behaviour is linked to underlying depression, mood disorders, schizophrenia, alcohol dependence and impulse dyscontrol.Dr Sameer Malhotra
What is the Final Trigger that Pushes Someone Off the Edge?
When it comes to the eventual trigger that takes someone to the side where suicide is an accepted reality, neither doctors mention any single factor or a neatly cut category, perhaps because there isn’t one. Along with what’s going on in the brain, emotional inclinations, personality types, life experiences and lived reality - all have a role to play.
Dr Rajpal lists it down in the following manner:
Suicidal behaviours and suicide lie in a continuum. Genetic and biological factors of an individual may interplay with the personality factors (aggression/impulsivity) and psychological construct (perfectionism/low optimism), which when faced with any negative life events or psychiatric disorder or any type of psychological distress/hopelessness, may lead to development of suicidal ideation.
Once the idea of suicide enters someone’s mind, or what Dr Rajpal calls ‘suicide ideation’, it might lead someone to consciously harm themselves physically and thereby set another cycle in motion.
Suicidal ideation further prompts an individual to carry out any self-harm attempt. The outcome of self-harm attempt can either be non-fatal or fatal. Indulgence in any form of nonsuicidal self-injury increases the risk of suicide attempt, which further increases the risk of completed suicide.Dr Nikita Rajpal
How to Address Suicidal Tendencies in Someone?
The first step is identification. If someone has found themselves or a loved one exhibiting suicidal tendencies, they need to realise that a solution is available that takes them away from this path.
Dr Malhotra says it’s a sense of hopelessness that leads someone in this direction. However, there are ways available to instill hope. The first step, he adds, is to understand that biological and environmental factors have a big role to play in making someone suicidal. Because of the significant presence of these external reasons, it’s important to realise that there is nothing essentially ‘wrong’ or ‘broken’ with the person in question.
Dr Rajpal lays down a path for someone looking to seek help.
When patients present to us with self-harm, we do a thorough assessment. This assessment helps us identify the risk factor/reason. The suicidal behaviour and self harm behaviour is then addressed by pharmacological intervention, psychological intervention and psychosocial intervention.Dr Nikita Rajpal
The key, as both doctors suggest, is the identification and acceptance of the problem first, followed by reaching out and asking for help.
If you or your love one needs help, reach out to this list of curated specialists and helpline numbers.
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