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What drives a person to the brink? Renu Warnasuriya and Priyanwada Ranawaka report
The end of the line
There is no suicide for which all society is not responsible.
- Cyril Connolly
Ten years ago, Sri Lanka had one of the highest suicide rates in the world. Every hour at least one person was in imminent danger of committing suicide. In the past few years, the numbers have declined due to awareness campaigns, and various organisations dedicated to helping those in need, but suicide still remains a huge problem in our society.
Why do some people seek to end their lives? Is suicide a personal choice, or do societal factors tip the scales?

Balancing acts
Dr. Subhangi Herath, Senior Sociology Lecturer at the Colombo University believes there are many sociological factors contributing to the high suicide rate in the country. With life becoming more and more complex, lifestyles are changing rapidly. "One sector is able to adjust, but the other is not," she says.

This inability may at times be due to various outside forces and at times because of certain personality flaws inherent in people. Such people find that they are unable to keep pace with the rest of society.

Dr. Herath believes that there are some factors in our social structure that propel people to direct aggression towards themselves. "If it is a solely individual phenomenon; how can we account for the large numbers?" she says explaining that it is an individual desire created by some social issues.

Society today is going through a transition period where it is embracing new social values without completely letting go of the old. "We are gearing towards a more individualised society, where individual success is important," says Dr. Herath. At the same time people have the added obligations of seeing to their extended families, as is the tradition in our country. Faced with so many responsibilities, people are highly vulnerable to frustration.

They are also expected to adjust fast and face every challenge in life. "It becomes a question of fight or flight," explains Dr. Herath adding that with this kind of pressure people sometimes find it difficult to accept failure.

Between the lines
Having worked with Sri Lanka Sumithrayo for many years, its Director Mass Dane explained that there are three main reasons for suicide; a person's state of mental health, substance abuse and the inability to handle one's problems. There could be others who do not strictly fall into these categories.

Despite the popular belief that one commits suicide due to a specific event which is beyond the control or acceptance of that person, suicide is usually the end result of a prolonged issue. Though there could be one particular incident that triggered the thought, in most cases it is not the sole cause for the suicide attempt.

"A person leading a difficult life could one day decide to commit suicide after a particularly bad incident. This doesn't mean that this incident was the cause of death, it was simply the trigger that made him take the final decision," says Mr. Dane, adding that in some cases there need not even be a trigger.
Though it is relatively rare, there are also people who end their own life on impulse.
On a personal level, suicide could be perceived as an immediate solution, while on a social level it could be a method of expressing their disappointment in life and society in general.

Beginning early
Psychologist Romaine Weerasinha puts it all down to childhood. "It has a deep root related to childhood," she says adding that in the first ten years a child goes through five stages of development; sensory, motary, social, emotional and cognitive.

Comparing these stages to pieces of a jigsaw puzzle, Mrs. Weerasinha explains that if they don't fit into each other properly, the child could later develop certain personality flaws. "Parents play an integral role in their child's development," she says adding that parents need to make a special effort to help their child through this crucial period. Seeing things from the child's point of view is vital, spending quality time together, responding to the child and having a positive attitude are important.

If this decisive stage in a child's life is in some way disrupted, there is a possibility that the child will have difficulties in coping with different environments. During their adolescence such children tend to show signs of depression, frustration and of an inability to cope.

Behavioural changes
Depression can be detected through various behavioural changes. "Negativity, irritability and irrational behaviour could be the initial signs of depression," says Mrs. Weerasinha adding that if not identified and treated this could turn into severe depression, which could lead to suicidal thoughts. Severely depressed people tend to lose all interest in themselves, even neglecting their appearance and health. "They spend a lot of time by themselves and sometimes don't bother to eat or even bathe," says Mrs. Weerasinha adding however that not every depressed person considers suicide.

A suicidal person, as Mr. Dane explained, also exhibits certain outward signs. "A punctual person starts coming late, a neat person becomes sloppy, a cheerful person becomes melancholy," says Mr. Dane explaining how they go from one extreme to another.

"They usually show signs and signals of asking for help, though it may not be verbally or directly," says Mr. Dane adding that helping them to identify a support system could be vital. "People or even material things could be support systems," says Mr. Dane. If for instance, you remind the person that there is someone who loves them, it will give them some confidence and hope. Showing undivided attention to the person will also help them believe that they are not alone. "You could set up a strengthening agenda, by calling the person frequently or arranging for him/her to call you," says Mr. Dane adding that emotional support is essential during this period.

"Talking is therapy for a suicidal person," says Mrs. Weerasinha explaining that the best way to help such a person would be to listen to them. While a long conversation would delay the suicidal thoughts, it would also provide the opportunity for the person to better understand himself and to consider available options.

Backtracking
Some who attempt suicide realise their mistake. Suicide being her area of study and research, Dr. Herath has come in contact with numerous people who have attempted suicide and related the story of a young mother of two who decided to take her life because of unending harassment by her husband. Fortunately she escaped death and had the chance to reconsider her decision. "She told me that when she woke up and saw her children, she realised her mistake and decided never to try again," says Dr. Herath. But one who attempts suicide could try again if the situation remains the same.

"Attempted suicide is the ultimate cry for help," says Dr. Herath explaining that the intensity of the method used reflects the intention. Unfortunately there are cases where the person deliberately having used a less intense method has succumbed to his injuries despite the fact that he/she did not really intend to die.

One of the many people Dr. Herath spoke of was a teenager from a slum area in Colombo. The youngest in his family, he was the centre of attention. After his brother's marriage, the family's attention shifted to the new bride and unable to adjust to the change, the boy attempted suicide. It was however not a rash decision as the method was well planned, so that he would get injured but not die. "This kind of attempt is done purely for attention," says Dr. Herath explaining how tragic it is that many people have died when all they wanted was to get some attention.

Bequeathed traits
There is also the issue of suicidal instincts going down from parent to child. This could happen sometimes if the parent suffers from a form of clinical depression, a medical condition, which could at times pass down to the child. This, however, does not mean that the inclination to attempt suicide is passed on along with the illness. It is simply that those who suffer from clinical depression are at a higher risk of committing suicide than those who do not.

Availability of a method can also be a leading cause for suicide. According to Mr. Dane, the urge to do harm to oneself is not one that remains with you at all times. For most people the thought lasts for around 48 hours. If within this period a method is clearly available, the chances of using them are higher.

Bringing to end
Mentioning another case study, Dr. Herath spoke of an old farmer who had been going through a rough patch. On a particularly bad day he had gone out to his hut in the fields, where he had seen a bottle of poison. In the state of mind he was in, the man consumed it and was admitted to hospital. Speaking to Dr. Herath later, he confessed that he had never really wanted to take his life. "He told me that when he saw the poison he saw an easy escape," she said adding that the man ultimately died of his injuries. Her opinion is that if the means was not available, he may not have acted rashly.

"For every one person who commits suicide, five others attempt it," says Mr. Dane. The ambivalence prevails because they are not certain if they want to live or die.

Suicide myths
Various misconceptions persist regarding suicide, says, Director, Sri Lanka Sumithrayo, Mass Dane. *Those who constantly threaten suicide will never actually attempt it. FALSE. Anyone who talks about it is liable to act on their words.

*Those who have attempted suicide once don't try again. FALSE. "Attempters are at a higher risk than other people. "They feel that they are different from everyone else and they suffer from a social stigma, which makes them even more withdrawn," says Mr. Dane adding that such people need a lot of care and attention.

Listening for 30 years
The leading suicide prevention organisation in Sri Lanka, Sumithrayo, celebrates its 30th year. This non-profit organisation operates a 24-hour hot line, 365 days a year, run by non-professional volunteers who work with a great deal of anonymity and confidentiality. They have 11 crisis centres around the country, run by volunteers trained in the art of befriending people in crisis.

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