Do you really want to die? No one commits suicide because they want to die. Then why do they do it? Because they want to stop the pain.

- Tiffanie DeBartolo -

"Doc, what do I live for?"

"I'm useless"

"Death might be a better choice"

"There was a voice telling me to kill myself"

That is the expression of several patients who finally decided to seek help for their desire to end their lives.

Can they be helped?

Yup... suicide can be prevented!

Even with a simple step of "talking"

Recently we have been shocked by very sad cases of suicide because it seems like there is no help or prevention that can be done. Suicide prevention is a universal problem that requires collaboration from all of us. Every suicide phenomenon always leaves us all with contemplation, feelings of shock, sadness, disappointment, anger, fear, anxiety, raising questions about why it happened and also the enthusiasm to take precautions so that it doesn't happen again.

The impact caused by the phenomenon of suicide is also not light, the loss of someone you love/admire, the traumatic feelings resulting from this event for the family and those who witnessed the suicide incident and also for every one case of suicide there are 135 people who are affected. .

According to the World Health Organization (WHO), the number of suicides every year is 800,000 people, so in 40 seconds 1 person commits suicide. The highest number of suicide incidents is in the age range 15-29 years. As many as 1.4% of deaths worldwide are caused by suicide.

Signs and symptoms

A person who commits suicide or is still trying to commit suicide does not really want to end his life. They actually want the suffering/conflict they are experiencing to end quickly. Unfortunately, suicide is an option because there seems to be no other help that can be expected.

There are several signs and symptoms of suicide that you need to know in order to prevent them, including:

1. Talking about wanting to die or wanting to commit suicide
2. Talking about feeling empty, empty and having no reason to live
3. Making plans to commit suicide such as looking at websites about how to commit suicide, buying weapons/tools to do it, buying drugs in large quantities
4. Talking about very heavy feelings of guilt and shame
5. Talk about feeling trapped, having no way out
6. Feeling 'sick' for a long time and there is no improvement, physically/psychically
7. Feeling like a heavy burden to others
8. Using alcohol or drugs more and more often
9. Behaving anxiously and agitated
10. Withdrawing from family and friends
11. Changes in sleep patterns and eating patterns
12. Shows angry behavior or desire for revenge
13. Carrying out risky behavior such as driving fast cars and being reckless
14. Talking and thinking about death becomes more frequent
15. Extreme mood swings, from very sad to very calm and very happy
16. Giving up an important position at work, quitting college/work
17. Say goodbye to friends and family
18. Make a will
19. Writing on social media about suicide and death

Risk Factors

Everyone has a risk of committing suicide, based on gender, ethnicity, culture, educational and occupational background. Suicidal behavior is caused by various complex factors and there is no single cause. There are several risk factors that make suicidal behavior easier to occur, namely:

1. Depression, other mental disorders (schizophrenia, bipolar, substance dependence)
2. Certain disease conditions
3. Chronic pain
4. Previous history of suicidal behavior
5. Family member's history of suicide, mental disorders and substance abuse
6. Violence in the family includes verbal, physical and sexual
7. Having dangerous weapons at home
8. Just got out of prison
9. Being exposed/exposed to suicidal behavior carried out by other people such as family members, friends, film stars/celebrities who are idolized

Many people experience these risk factors but do not commit suicide. It should be noted that suicidal behavior is a sign of severe stress experienced by that person. Any suicidal thoughts and behavior should be taken seriously and seek help immediately.

Handling

If there are signs, symptoms and risk factors regarding suicidal behavior, immediate treatment is needed. Things that can be done include:

1. Carry out intensive communication and assistance to ensure that what you are worried about is not true
2. Tell him that he is not alone, there are many who are willing and willing to help
3. Provide immediate crisis response according to the level of suicide risk

a. Low: there are thoughts of suicide, no plans, don't want to do it

b. Moderate: Suicidal thoughts occur several times, few plans, don't want to

do it

c. High: frequent thoughts of suicide, clear plans, don't want to

do it

d. Severe: suicidal thoughts always appear, clear and continuous plans

always intend to do it

1. Offer help and consult a mental health professional who will assess and provide appropriate treatment.
2. Try to be proactive in offering help if suicidal thoughts arise again by leaving a telephone number
3. Remove dangerous objects that could become tools for committing suicide.

Therapy

When taken to a mental health professional, the person who is carrying out suicidal behavior will receive therapy that is appropriate to the mental condition they are experiencing.

1. Treatment/medication: Clozapine is the drug of choice to reduce the risk of suicide, other drugs that can be given are: antipsychotics, antidepressants, anti-anxiety and mood stabilizers
2. Psychotherapy: talk therapy to strengthen mental conditions and change the perception of people who commit suicide, Thought and Behavior Therapy (CBT = cognitive behavior therapy) will be very helpful.
3. Stimulation/modulation therapy with TMS ( Transcranial Magnetic Stimulation ) providing electromagnetic wave stimulation to the brain usually in the DLPFC ( dorso lateral pre frontal cortex ) area, Neurofeedback, and ECT ( electro convulsive therapy )
4. Administration of Esketamine through the nose will quickly reduce symptoms of depression and suicidal tendencies

Are You OK? ( Are you okay?)

This question is simple but can change someone's life. Living today has a lot of stressors, not to mention psychological trauma in the past and overthinking about the future. This causes everyone's life to not be going well.

“Are you OK?” show our concern for friends, family, colleagues or anyone we meet every day. Sometimes we want to ask but don't because we feel embarrassed, strange, inappropriate, excessive, etc. In fact, this question is a key question that can change a person's life.

When do we ask “Are You OK?” That is, when we see and notice these things in our colleagues:

• Changes in a person's mood, becoming more gloomy, sad, crying
• Excessive emotions, anger, irritability
• There is a change in the pattern of insufficient or excessive sleep
• Excessive anxiety, worrying about many things that weren't there before
• Difficulty doing work that was previously easy to do, loss of focus, concentration and memory
• Many are silent, withdrawn, don't want to socialize
• Lack of interest in something that was previously a hobby and pleasure
• Unnatural behavior such as talking, smiling, laughing alone, fear, etc.

If we find signs like the ones above, then do these 4 steps:

1. Ask “Are you okay?”
2. Listen without judgment
3. Encourage to seek solutions, preferred options, consult with professionals
4. Ensure that the situation is better.

Every time we show our care for someone, the world becomes more beautiful, brighter and more joyful. And for those of us who receive the question, It's OK to say YOU'RE NOT OK, it's okay if we say I'm not okay right now and start telling stories so that the burden becomes lighter.

Each of us, whoever we are, whatever our profession or position, has an important role to play in bringing about change. Let's together prevent suicide.

"Suicide does not end life for the worse, but it does end the possibility of life for the better."

"A bruised reed He will not break, a faded wick He will not quench"

Greetings SEJI-GO

(Soul Health with Lahargo)

Reference:

• Linbo Li & Hui Yang. (2023) Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behavior Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants. Psychology Research and Behavior Management 16, pages 3359-3371.
• Sarah Kim & Ju Hee Park. (2022) Does Parental Psychological Control Affect Non-Suicidal Self-Injury of Adolescents via Depression?. Family and Environment Research 60:4, pages 535-547.
• https://www.who.int/news-room/fact-sheets/detail/suicide