Suicide: When taking one’s life seems the best option

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By Ebele Orakpo

This is the concluding part of the report which began on Friday and continued on Saturday. Yesterday,  an expert explained that suicide could be a genetic phenomenon traceable to family members of suicide -prone individuals.

IF a woman was a virgin and she was   raped or violated in any way, rather than going on, she will kill herself. That is where you get the phrase, Vestal Virgins. Vestal was the goddess of virginity in charge of virgins. The women who killed themselves were honoured. As a matter of fact, there was a nun who killed herself because she was raped and she was given sainthood,” noted Rawlins.

Suicide could be genetic

Continuing he said: “There is something I have studied; it is not scientific but I have noticed that to a great extent, if there was someone who killed himself or herself, if you trace that family, there was a family member who did it. So I think it is genetic. If you take someone whose family member committed suicide, just trace that family member back in his family, and you will see that there were others who had done it before.

For example, if there is a mentally ill person in your family, there will definitely be another one coming in future. Or if you go back in the past, you run into four or five mentally ill grandparents, aunts or uncles. It is passed on to you.

“If either a mother or a father is mentally ill and they have five children, at least two of them are going to be mentally ill or they will have the mental illness gene; they will be a little odd and when they have their children, the gene will be passed on. So it’s good to check up family histories before getting married. “Most societies do that. They tell

you, ‘no, no, don’t marry from that family; they have some mentally ill people there.’ Some carry out blood tests to ensure there is no disease and no crazy things going on. You can’t actually tell if someone is mentally ill from blood tests but people have their own ideas of what they can do with blood tests.”

Copycat killings: “A lady killed herself in the UK because someone called her ugly on social media. Another lady killed herself also for same reason. That is what we call copycat killing. They did it in England, maybe I will do it here and make all the people angry. You call me fat and ugly, I will kill myself. Here is where Nigerians have a point because no Nigerian can kill him/herself because someone called them ugly; only White people do that and to a great extent, I agree.

“Black people do commit suicide but it usually has to be something more painful, more stressful and more agonising like socio-economic reasons. Telling them they are fat or ugly will never make then commit suicide, they would rather give you a serious beating if they can.”

Suicide, third leading cause of death in 15-24-year-olds: “Suicide has to do with age. In the past, it was mostly the elderly; people who were retired and those who don’t feel useful anymore. An elderly man or woman who was sick and felt they have become a burden to their children may kill himself or herself. But the number has been found to be higher among the 15 to 44 years age group in recent years.

“If you notice, most of the people in Nigeria who are committing suicide are within that age group, may be not 15 but 20 years to early 40s. It is a new phenomenon and some people blame it on the fact that they are watching a lot of television and seeing things that are happening. There is a culture of copycat, where if you see a movie star or an entertainer killing himself, you might do it too or if you have popular friends in school or college, you do it because you want to get that moment,” stated Rawlins.

Suicide, a taboo in some societies: “People commit suicide but the reason you don’t hear about it is because it is a taboo. You don’t tell people that your grandmother killed herself; you tell them she was sick. In developing nations, it is always the best to hide the fact that a family member committed suicide to avoid stigmatisation. It was that way all over the world in the past but people in developed world understand now that it is nothing to be nasty about; it is a sickness; something drove that person to kill himself or herself.

It is something we have to deal with,” said Rawlins. He added that people don’t talk about suicide because it is an embarrassing thing. “In my Island of St Kitts in the Caribbean, we laugh and say it is only White people that kill themselves; we are too small to be killing ourselves. But when I got older, I began to hear that so and so persons killed themselves.”

Agreeing, Boyo said: “When we hear a person had died, there is no follow up to find out what actually killed the person; people traditionally are not given to post-mortems even when a death is homicide and suspicious, people would just say, his/her time is up.

The key persons in African society that easily commit suicide are the depressed, the terminally ill,  like cancer patients and those with illness like HIV/AIDS and  feel abandoned and stigmatised as well as those with frequent unresolved epilepsy, very severe and recurrent asthma attacks (status asthmaticus) which can last for days, who feel like dying because of frequent breathing problem. If people with such chronic illnesses in Africa don’t have a good family backup and care, they can kill themselves either by refusing to take the drugs or excessive overdose.”

Risk factors associated with suicide: “The risk factors associated with suicide are things like an attempted suicide. If you have made an attempt before, more than likely, you may probably do it again. That is a risk factor that tells you to watch that man or that woman. Watch people who talk a lot about committing suicide – whether jokingly or not – they are likely going to do it.

“If I called you last night and you didn’t pick up, you don’t know why I called but tomorrow you hear I killed myself, for the rest of your life, you are going to carry that guilt with you because you should have picked up the call. Maybe I was calling out for help, that is: if I do not leave a note,” advised Rawlins.

Internally displaced women

Sharing her experience with some rescued victims of the Boko Haram terrorists, Ms. Blessing Douglas, the founder of Kintsukuroi Foundation, a non-governmental organisation with a vision to rescue children caught in self- victimisation, depression, abuse, neglect and all other forms of mental illnesses or disorders, said that majority of the internally displaced women the foundation worked with, had lost at least one family member to the Boko Haram crises.

“Some had already been diagnosed with post-traumatic stress disorder, and were on medication. Some others just repeat a particular routine – wake up in the morning, take a bath, isolate themselves and look into thin air or soliloquise. There was a 10-year-old girl that lost her mind and all she does is walk round the IDP camp, picking and playing with dirt whilst talking to herself.

“Most of the men on the other hand barely showed pain or any form of emotion, but they were always willing to share their experiences of the Boko Haram crises when asked. Practically, most of them could explain how they felt, but they didn’t know there was a medical term for it; ‘depression’.

Present humiliation: “I did not get to meet the girl that committed suicide because she was already dead. However, I got to meet her family members who revealed that she was abducted by Boko Haram, and two years later, she returned with a baby she had with one of the terrorists. She was stigmatised in the host community, and her baby died from poison two weeks after her return.

“Her mother mentioned that she thinks her daughter was dealing with so much because she was always crying in her sleep, until the day she did not wake up and they found rat poison under her pillow. They believe she took her own life because she couldn’t live with the trauma of the past and the present humiliation.”

Take suicide threats seriously: Boyo advised thus: “If someone tells you he wants to commit suicide, it is important to take him seriously. Research has shown that people that are suicidal often tell someone close to them they want to die because they feel they have no future and would be better off dead.

“Don’t panic. Knowing that a loved one is suicidal can be emotionally distressing; don’t make him feel guilty for confiding in you, instead discuss with him. Ask him what exactly is happening to him. In most cases, he will feel relieved.

“Don’t mock him or tell him off, just show empathy; avoid interrupting him until you are certain he has finished speaking, then offer your support and listen to what he has to say. Let him know how much you care, enquire about how you might be able to best support him. Help to keep him distracted from suicide and get him socialised. Don’t let him spend a lot of time alone without having something constructive to do. If possible, encourage him to contact a local clinic with suicide crisis help line but never be judgmental.”

Rawlins also believes that if someone is joking about suicide, “it is not a joke; it might be a joke to them but it should not be a joke to people who are hearing it because a lot of times, people say things as a joke just to deflect what the true feelings are.

When tomorrow morning you hear the person had committed suicide, you’ll say ‘but I thought he was joking.’ There is evidence to show that majority of suicides that had taken place, that somewhere along the line, the person mentioned it, gave signs and signals. For example, if in the middle of a man’s life, he starts making preparations for burial; that is an indication that something is wrong.

“If all of a sudden he is telling you he is making his funeral arrangements, or you notice he is talking to a funeral home, you may wonder why he would be doing that. Or if he is readjusting his will…mostly for old people but there are young people who plan their funeral, who decide how they want to be buried. When I say young, I mean people about 25, 26 years. People have a clear idea of how they want to be buried if they know they are going to kill themselves.”

Leave a note

Advising would-be suicides, Rawlins said: “If you want to commit suicide, at least, leave a note; let people know why because you destroy families and friends when you don’t do that. If you kill yourself without leaving a note to give the reason why you took that action, everyone will start wondering what happened, what could we have done? Was it something I did or did not do?

Was it something I said? Was it something I did not give him/her? Am I a bad father, mother, brother, sister or friend? For the rest of your life, you will be tormented by those thoughts. If he left a note and say: ‘I am doing this because I stole money or I owed money or I failed in school, so I figured the best thing to do is to kill myself,’ then I don’t feel so bad because I wasn’t the cause.

“Sometimes a victim might be murdered and the murderer leaves a suicide note to make people think the victim killed himself. He could do that but investigations will reveal it wasn’t the victim that wrote the note. Those who know the victim’s hand writing will know he didn’t write the letter.”

In the case of a printed suicide note, Rawlins said: “Investigators or family members will know the victim’s handwriting and if the note is typed, they will carry out investigations and say ‘, no, this is not the font he uses, he never used this font.’

They will go to the victim’s computer to see if he used his computer to type that letter or from what printer he printed the letter. They do deep investigation…’this printer is nowhere close to the victim, it is not in his house or office, it came from somewhere.’ So they can trace it and ask a lot of questions. They will look at the wordings of the letter and discover those are not the type of words the victim would use. So, smart investigators would be able to figure out that the victim did not leave that note.”

What victims do: “However, here is what the victims do: a victim can actually write a letter because he is very upset at you and may want to set you up or make you feel guilty for the rest of your life. You see a lot of that in relationships that went bad and a woman kills herself because her boyfriend or husband dumped her for a younger woman. She writes that letter and can actually accuse her husband of doing this or that. She may say something like: ‘The reason why I killed myself is because my husband whom I put through school, after he got successful, left me for a woman he didn’t know,’ and so forth.

That is how they can set you up or they can say you drove them to death. She knows that when the information gets to the public, you will have to spend the rest of your life defending yourself,” he said.

Inside the mind of a suicide: Speaking on what goes on in the mind of a suicide, Rawlins said some of them are just nasty. “I heard about a man who hanged himself after his two children went to bed. The body was found by one of the children the next morning. That was a terrible thing to do; to hang yourself so your children can find your body. If I am to do a good psychoanalysis on that, I would say he is sending a message to somebody, may be the children’s mother. ‘It’s a get-back at you. I am going to hang myself before the children and you will have to deal with those children after they have been traumatised.’ It is a selfish and nasty thing to do. He had a nasty mentality.

“I once worked on a case where a 16-year-old girl hung herself from the ceiling of their kitchen. The next morning when the father went to the kitchen to make his coffee, he saw the body of his daughter hanging there. When we did the investigation, we found out that the father was sexually molesting the girl so that was her way of getting back at him. It was revenge. She killed herself in a manner that really got back at the father.

But then, here in Nigeria, a young man hung himself because Manchester United did not win the pendant. He had bet N100,000 on that match. So many funny things happen that drive people to suicide. Everybody has their own demons,” narrated Rawlins.

Precautions against suicide: “The person who is experiencing thoughts of suicide usually does not know what to do. The only thing he knows is that things are not going well with him. Whatever world they are living in is the only world they see.

So, when you see a picture of someone who is depressed, they are tight and tensed because they are in a world that no one else can experience, so they cannot come to you for help; they think their world is real. It is up to us to notice these behaviours and attitude change in family members and friends and just let them know you are there to help,” Rawlins said.

Moderate intervention: “You have to go find help quickly too because you are not an expert, you can only offer moderate intervention. In hospitals, you might find psychiatrists or psychologists, or go get an imam or a pastor, priest, an elder from the village or somebody whom the person looks up to and respects, to intervene.

“Always try to help them; whatever it is they are going through, try to help. If it is financial, you have to come together to help them because it can be overwhelming when someone can’t take care of the family and do the things that are necessary,” advised Rawlins.

“In that moment of desperation and utter hopelessness, what people need is a listening ear and support to help them choose to live on. Many of those who are so saved have come to thank God they did not take their lives. This is why we must keep trying to reach them, especially at that moment by encouraging them to speak up and not feel ashamed,” said Ogbolu.

On his part, Boyo believes that availability of social network one can rely upon when one feels like committing suicide and the extended family system where people care for each other in a natural African setting, could help reduce incidences of suicide. He, however, regrets that these things are becoming very rare with rural-urban drift. “I have met people in the course of my practice that live all alone in Lagos.

“A man came to the clinic with severe heart failure, it was proven he was going to die. He brought money and said I should admit him. I told him he was too ill to be admitted alone, and that he should get somebody to stay with him. He said he had no one.

“There is a lot of disconnect. Nobody tries to find out what people are going through. In Church, pastors are more interested in people coming to church than finding out how individually they are doing.

“People should be told that ‘look, things are very tough, and be shown how to survive in this kind of economic situation. The Church should be a harbinger of hope; they can provide a kitchen for the poor where food is served daily; so that the hungry can come to church and have something to eat; they can help people get jobs. Those welfare schemes are now very insufficient and very rare so people can easily commit suicide within a Church environment.”

Suicide and religion: “In developing nations, many see suicide as a demonic attack and so it is treated as such. Said Boyo: “Most pastors ascribe it to demonic attacks. It is possible but the issue is they should try and find out why the demonic attack came in the first place. Find out how these people are living; are they living with friends or alone? Are they exposed to dangerous objects that they can use to kill themselves?

“What we normally do is to let people live in denial. When they have suicidal thoughts, we tell them to stop thinking about it, we don’t address these suicidal feelings, we just tell them that it is the devil tempting them or that they are possessed, so nobody counsels them. Counselling takes a lot of time and even the doctor is in a hurry. He asks you to go and do medical tests but these things don’t have medical tests, you must sit down with the patient for hours to talk but most doctors don’t have such time.

“So, the fact that suicidal thoughts and attempted suicides are attributed to demonic attacks make pastors go for deliverance to cast out the demon making the patient feel like committing suicide. Then the situation is worsened if the person hears voices which in medical terms is called thought broadcasting (when you feel someone is reading your thoughts, which may not be true.)

There is visual hallucination, auditory hallucination; you just feel there are many people in the room. These are symptoms of schizophrenia and even in some depressive illnesses, you can begin to hear voices but people allude these to demonic attack. Again, people feel as if psychiatric treatment is demanding, stigmatising and prolonged.

“So instead of carrying the patient to a psychiatric hospital, they keep him at home and treat him with herbs and bring in pastors to pray for him. Most Africans believe that orthodox medicine doesn’t cure psychiatric problems. They cure, but the point is that with orthodox medicine, there is a high level of recurrence. If it runs in your family, you are likely to have it and then they will want you to be coming to the hospital regularly; they give you drugs that may be considered very overwhelming and may make you look so dull.”

Way forward: On the way forward, respondents called for better and closer relationships, love, care which could help prevent suicide, and then early detection and prompt treatment.

Said Ogbolu: “Suicide is preventable; the problem is a lack of prevention strategies in most countries, including Nigeria. One way to prevent suicide is to take care of our mental health, especially because depression is a very significant cause of suicide.

Terminal medical illnesses:  Apart from depression, suicide risk is also associated with substance abuse especially alcohol, chronic painful medical conditions, terminal medical illnesses, social isolation and lack of support and other major mental health problems. It is important to note that suicide ideation and risk affect not only adults but can also affect adolescents. Stakeholders and the general public can effectively work together to help reduce the rate of suicide in line with WHO’s goals of reducing it by 10 per cent by 2020,” said Ogbolu.

“First thing is prevention. Pastors should have genuine person-to-person fellowship. People should be close to one another, let true love be seen in the Church. In true love, you are concerned about one another, you visit, you know what is going on. Don’t just visit for purpose of evangelism; as you visit, you discover those who are less privileged, you find a way to help out,” said Boyo.

Harmful things

Early detection: “When people are having suicidal thoughts or ideas, you catch them early and remove harmful things from around them, ensure they don’t stay alone or walk alone. Send people to rally round them. Find out what precipitated the thoughts and try to tackle it. Example: if the problem is unemployment and he knows that someone is trying to get him a job, even if it is just a promise, that can change his whole life.

“You need to get money to get the person treated promptly. To see a psychiatrist is very expensive and if you send them to a General Hospital, they are stigmatised. As a result, most people want to be treated in private hospitals to avoid people telling them: ‘Oh, I saw you the other day at the psychiatric hospital.’ At the same time, keep on praying for him and talking to him about the word of God.

“Let them join an active club in the church where they are constantly looking after his welfare. The treatment should be a combined effort of the church and the doctor. The doctor should be able to tell them certain things to watch out for. Example: When his mood changes, when he no longer bathes, brushes his teeth, combs his hair, looking lost or starts sitting at the back of the church or comes late.

“People who feel suicidal engage in risky and dangerous behaviour like driving against traffic, excessive feeling of guilt, self-blame, subjective sense of failure and suddenly feeling better,” submitted Boyo.

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