I would have been happy to die the most painful death,” writes Andrew Solomon, in his book, The Noonday Demon: An Atlas of Depression, “though I was too dumbly lethargic even to conceptualize suicide.”
On Thursday, the 21st of April, 2016, we saw one of our own – a student at a renowned university in Pakistan – taking his life by hanging himself from the ceiling fan. In the same week, which happened ironically to be Depression Awareness Week, we have seen multiple incidents of students either committing suicide or attempting to do so: one student self-immolated whereas another threatened to commit suicide by climbing atop a water tank in his university.
Perhaps, this is the time for Pakistan as a community to wake up and understand what depression is and what the main causes of suicide are. After all, suicide is a one-way ticket away from consciousness, with no return options included. It is also that very same consciousness that needs to be looked at to understand what the problem really is.
Andrew Solomon in his writing posits that suicide and depression are closely linked, but that the two are not necessarily causes for each other. While the DSM (Diagnostic and Statistical Manual) lists ‘suicidality’ as a symptom of depression, it can well work the other way around as well. As he states, “Suicide, in its many forms, is a complication of depression; it is critical to understand how a depression can become fatal.”
Suicide, or the act of taking one’s own life, currently holds a global mortality rate of 16 people per 100,000, according to the World Health Organization. Global suicide rates have increased by 60% in the past 45 years; if the rate remains constant, there will be one suicide every 20 seconds by the year 2020.
In a world where mental health awareness is starting to slowly take off from the tarmac of hushed taboos and silenced conversations, Pakistan remains a state where in its supposed commitment to Islamic ideology, suicide remains a crime, punishable under the Pakistan Penal Code (PPC). Section 325 of the PPC states,
“Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year, or with fine, or with both.”
There are very few institutionalized mechanisms in Pakistan that cater to the psychological needs of individuals, especially students.
Schools and universities are considered centers for education. However, while they may do immaculately well on imparting textbook education, they seem to lack in providing a holistic understanding of life and the complexities one may face in it.
Students are the most prone to facing issues relating to stress, and those facing the highest risk within the student community are medical students (according to a research conducted in Canada and USA). Prolonged and untreated episodes of stress have the ability to turn into a mental disorder known as anxiety and as Andrew Solomon points out, “Depression exacerbated by anxiety has a much higher suicide rate than depression alone, and it is much harder to recover from.” Anxiety attacks are perpetuated by the body’s inability to regulate certain hormones and it results in an extended and prolonged sensation of fright and flight – the very same mechanisms created to defend our bodies from external (and internal) threats.
There seems to be a veil of ignorance behind which the masses are choosing to position themselves, pretending as if they are not complicit or party to a suicide attempt that is taken place, allowing them to shake off any and all burden. What we fail to realize is that the prevention of suicide lies in a communitarian effort and not in individualistic pockets of awareness.
There are a number of parties at play here, that need to work collectively and inclusively to help each other towards achieving the bigger goal – no person should ever feel as if they must take their own life as the only means of ending their misery, pain, frustration, depression or anxiety.
Due to the taboo that surrounds suicide and the criminal nature of the ‘offense’, there are no reported cases of suicide attempts in Pakistan.
However, three attempts, of which two were successful, within the span of a week, carried out by an identifiable age group (20 – 30 year olds) and a particular ethnographic trend (students studying in medical colleges) needs to be regarded more seriously than a one-off occasion. This year alone, the Sindh Government is planning to spend Rs. 13 billion to carry out 120 development schemes for the eradication of the more visible problem that Pakistan faces – dengue. There seems, however, to be no budget allocated to mental health awareness in Pakistan, save for that being carried out by the private sector.
In this collective effort, there is a great onus that falls upon (educational) institutions to first understand mental health issues, and subsequently to address them responsibly with their communities. It is equally important for faculty members to be aware of the nature, realistic quality and severity of mental health problems as it is for students to be aware of their ability for support and empathy.
As Kevin Breel points out, it is the stigma that surrounds mental illnesses that makes people run away from them and it is the same lack of stigma that brings people closer and instils in them a want to sign their friend’s cast when he or she breaks their leg. It is high time that we understand the problems of the mind to be realistic problems, rather than works of fiction.
Kevin Briggs, once a member of the California Highway Patrol, spent a large part of his time in service dealing with suicide attempts at the Golden Gate Bridge. I leave you with his words – words that resonate with experience, “I pose these questions to you: What would you do if your family member, friend or loved one was suicidal? What would you say? Would you know what to say? In my experience, it’s not just the talking that you do, but the listening. Listen to understand. Don’t argue, blame, or tell the person you know how they feel, because you probably don’t. By just being there, you may just be the turning point that they need. If you think someone is suicidal, don’t be afraid to confront them and ask the question … Confronting the person head-on may just save their life and be the turning point for them.”