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Suicide is a side effect of a much misunderstood illness that can be fatal, much like cancer is, and like with cancer, conversation around it needs to be normalised.
Social media (like it rightfully should) is flooding with posts on Sushant Singh Rajput’s suicide and as a broader discussion, on mental health.
Most of what is being said – with men and women coming forward sharing their own experience – is both powerful and helpful. But a lot of it is also not. So there’s a need to try and summarize, and consolidate if you will, the noise into some structure to establish the key tenets.
I have written about mental health consistently, and in personal life have tried to make it a point to keep shame aside and be upfront about my issue.
*Trigger warning for depression, suicidal thoughts
~ I have lost the closest person I have ever had and numerous others to suicide.
~ I have been suicidal myself as a result of both diagnosed clinical conditions and situational worsening (I will talk about this in a little detail to establish point one).
~ I have struggled with (and still struggle with) both forgiveness and anger towards someone close who died of suicide, guilt for my own thoughts (the potential selfishness of it all especially since I have a young daughter), and the acceptance and understanding that I want others to have if someone chooses to end their life
~ I have gone through extensive counseling and medication-based treatment plans, and I have witnessed the same as a partner very closely.
~ Because of my constant writing and speaking out on mental health, I have had several (mostly women but also men) share with me their struggles. I have learned from their journey too and in some cases, have had very close views of their treatment (success and challenges).
I am stating these here because if needed, I am happy to share details of treatment plans and journeys to help disperse doubt, stigma, and misconceptions around this topic.
So with that, here is what I’d like to gather and summarize. For each of the points here, I will try to illustrate with comparison to a physical ailment. None of these comparisons will fit apple to apple of course, but they fit close enough to help guide our thought process slowly towards framing mental ailments (esp. ones which can have high functioning manifestations and have situational variants) as conditions – just like physical ailments are.
This point can be stated with a single sentence, but needs to be explained with multiple examples, for this is a key contributor to the misunderstandings around mental health.
Situational conditions (say sadness or even depression, or a sudden anxious phase) caused by a life event need to be separated from clinical conditions. So when someone like Sadhguru advises on controlling our minds or we look into our past and find examples of how we were able to overcome situations much worse, we are quite possibly talking non-clinical conditions.
To additionally confound this, it is not that clinical conditions can’t benefit from mind modulation. Counseling and redressal techniques – from cognitive behavioural therapy to EDMR therapies – to well-known findings on meditation and the comparatively recent findings of neuroplasticity – all support this.
However, mental health is a spectrum. So this doesn’t imply that all clinical conditions can be remedied or ‘cured’ by mind management (or as more often put through self-belief and confidence). Clinical conditions have a plethora of causes – from neurological to hormonal, and there are examples of situational conditions triggering clinical onsets.
Long story short: mental science is complex and nascent. We need to learn the facts (whether it affects us or not) especially today when we can find veritable, scientific information online before making statements on ‘mental weakness’, ‘power of positivity’, and ‘the need to push through’.
An easy to understand parallel in physical illness terms
So here comes the one for this point: some cancer patients do extremely well with a healthy lifestyle, routine chemo, and have no remission. But there are also patients who despite best of efforts, have their cancer metastasize.
My uncle survived two years on stage four lung cancer but I wasn’t surprised when I heard of my friend’s father getting detected at a same stage yet passing away in two months.
As I stated above that there is a huge unknown middle/ overlap in the case of depression, and huge unknowns in general when it comes to mental ailments.
I know of at least two individuals who had situational conditions morph into serious clinical manifestations – including psychosis – and I also know of many for whom situational conditions got better and are now their symptoms are more like seasonal ailments they have learned to manage.
Clinical depression needs to be ‘managed’
In my personal experience with depression too, I have learned and accumulated ‘tools’ over the years to be able to manage a clinical condition to the extent that it’s immaterial. But it hasn’t gone away – I am not ‘cured’. It’s managed. (Note: most of these conditions – like diabetes – can be managed, not cured).
Also, most mental health medication is still by trial (I have psychiatrists who will vouch for this and several online mental health forums I can direct folks who might challenge this to). So, just because I go see a doctor and get prescribed SSRIs (Seratonin Inhibitors) for example, doesn’t mean that
a) the known functional dose (which for most drugs is a range) will work for me as well as it did for person X,
b) will have side effects that are mirrored to someone else.
I was, for example, put on a particular medication that I should have done well with, given my history, but instead, I got extremely suicidal.
About getting suicidal
One important point to note here is that getting suicidal (or having suicidal thoughts) has stages/degrees of intensity.
There can be long-lasting periods of such a deep urge that it’s akin to compulsion. At such times, the option of ‘stopping and thinking to call a friend or helpline’ doesn’t exist.
Again, this can be neurological/ hormonal/ or other physiologically manifested clinical condition brought about by medication, event, or just something that happens as part of the disease.
Clinical conditions most often than not will also worsen with life events (situations). The phases can also worsen with progressive years or get better. So, although I am not in any way speculating that any of what I am writing here applied to Sushant (because I don’t know), it is quite possible that the reason for ‘Sushant Singh was so strong during his engineering exams’ and ‘how can someone so happy in past years be suicidal’ is this.
I have been an incredibly cheerful, not a care in the world, class topper, yet I have, in much happier and easier years of her life, struggled severely with my clinical condition. I have had triggers in the form of personal loss or life events and have struggled to be the person I was before.
Let me close this with a physical ailment example so that we can continue reframing our thoughts on mental health.
I have migraines, which I know how to manage. But ever since moving to an arid climate, I get severe sinusitis which triggers a migraine, and then, in a terrible Catch-22 situation, the migraine triggers sinusitis back. I now don’t know how to manage my migraine anymore, and have days when I can’t get up from the bed.
All the medications that worked for migraine, don’t work anymore for the combined worsened condition. And again, I have many friends who have migraines and sinus and both. I see them faring much better, reacting much better to medications, and just, in general, being better with pain management. And on the days I don’t have migraines, I laugh, work and party hard. None of this makes my new experience with worsening migraine something that can be questioned or doubted.
I am not trying to make things too simplistic. I am trying to point out how ridiculously simplistic the most common and immediate reactions we have on mental health are.
Mental health experience, and how one functions with it, varies. Just because ‘I’ am strong, doesn’t mean everyone is. And just because I am battling, doesn’t mean ‘I’ am broken.
Because I have hopefully established the premise of this swim lane through the earlier two points, I will just continue with my migraine example to explain this too.
Just because I know ‘Y’ can cook all day with a migraine, I don’t feel bad (or am not made to feel bad) if I can’t. Because it might be that I am indeed less tolerant to pain (which is something I doubt very few people will fault anyone else for, when the pain is not a beyond any doubt band-aid boo-boo situation). But it might also be because my condition is indeed more severe, and/or my physiological reaction to it is different.
Any two people with depression aren’t linearly comparable
So just because we have gone through terrible loss and have pulled through, we can’t measure someone else’s plight in an x-y comparison plot.
Someone’s reaction to severe devastation might be much calmer than my reaction to the loss of my house and that might be so because of my underlying clinical condition, a completely new condition triggered inexplicably by this loss, or because I have less mental strength/ thought management power/ value and support system to pull me through.
We don’t ‘expect’ depression in a person who is functional
Also, just because someone is battling clinical conditions doesn’t mean they are non-functional or dysfunctional. They can mostly, and at most times, be high functioning, and that seems to surprise us.
Because of this assumptions most people can’t help making on mental health, they will most possibly not be able to make their conditions public. Just like we won’t doubt it if we hear that an ever-smiling someone we knew died of severe colon infection which they never had made public and were fighting a silent battle instead, we shouldn’t assume people owe us a real-time update on their mental health.
Continuing on the above point, the reason most folks, including myself, will not be sharing our underlying condition or inner thoughts every time we smile and have a good time with you, is because
a) There’s a high chance you will not understand and not know what to do with the information. We don’t blame you for that. But we don’t want to discomfort you.
b) There’s a high chance you will not be able to get what was shared out of your mind and will talk about it behind our backs. And you will not talk about me having depression the same way you would about me having diabetes. Again, we don’t judge you for this, but this is why we will feel further inhibited in sharing our mental plight with you (call it shame if you would like to, or just discomfort – that doesn’t matter).
c) There’s a high chance that you will not get the magnitude and intensity. For example, you might understand when I am feeling sad and with best of intentions, provide some guiding thoughts; but you won’t understand why I can’t stop thinking of the ceiling fan (obsessive thinking merging onto depression) when everything in my life is well.
d) If you share this, there might be implications on my job, the opportunities I get, and even relations I can have in life. This point doesn’t require elaboration. The only way around it is by demonstrating again and again that just because there’s a mental condition, doesn’t mean there will be an extrapolation into dysfunctional.
So in sum, talking to friends or close relations won’t work because they won’t understand, will be unnecessarily worried, and would make it worse. Even with the best of intentions, most of us will fail. I have had several trained coaches give up, overwhelmed, and helpless.
What about talking to a therapist?
Talking to a therapist or counselor is also easier said than done, and I will possibly write a follow-up piece outlining fifteen years of personal and close contact experience in multiple countries to outline why. But for now, I will just leave it by noting the key problems:
So yes, everyone going through a severe situation should reach out is a piece of advice we shell out, but we need to understand that that option doesn’t exist for most. A friend whose daughter shot herself in her head said this best: she was so surrounded, yet so alone.
Lastly, the acceptance of suicide doesn’t mean encouraging or role-modeling suicide. But acceptance needs to happen.
The last, and most difficult point to make on suicide is the ask of forgiveness and healing in place of looking at it as a selfish and cowardly act. We have perpetuated this by making attempted suicide a criminal offence and by touting the idea of suicide being a sin.
That all would be valid if it would be a black and white matter of an individual (with responsibilities and loved ones presumably) really ‘choosing’ to take this path of ultimate abandonment. However, as we hopefully have established, the act of suicide, albeit self-initiated, is a side effect of an ailment causing the loss of life.
Suicide doesn’t happen because someone is ‘weak and selfish’
One of the most hurtful posts on Sushant Singh’s suicide I saw circulating on Facebook is a comparison of a martyred army officer to Sushant Singh calling for the celebration of real heroes who demonstrate bravery in place of weak, selfish folks who are hailed as heroes despite their cowardice.
I have been in a place where I had harbored tremendous resentment towards someone for ‘choosing’ such an act. But I am writing this piece today so that posts like the above stop one day. So that everyone who falls off the cliff, losing the battle with their selves (and trust me, they have fought tooth and nail) are understood by their loved ones. So that their end is accepted. Just like we would accept the death of a loved one by a fatal accident or from a terminal physical ailment instead of harboring resentment towards them.
If you or anyone you know is feeling suicidal, here are some of the helplines available in India. Please call.
Aasra, Mumbai: 022 27546669
Sneha, Chennai: 044 2464 0050
Lifeline, Kolkata: 033 2474 4704
Sahai, Bangalore: 080 25497777
Roshni, Hyderabad: 040 66202000, 040 66202001
Image source: unsplash
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Manages supply chain teams in Intel Corp. Blogger, writer and poet. Founder and Director Her
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