Often, suicide is a response to a complex set of factors and not a reaction to a single incident
A 35-year-old married woman committed suicide, in a pact along with her two children, in Bangalore. The woman had attempted to kill herself previously. There had been a longstanding marital discord between her and the husband because of financial problems and philandering by the husband. Interviews with her family revealed that she was an introvert and was without any close friends or family support. Her brother has been diagnosed with depression. Her job in the health department gave her easy access to the drugs required for suicide.
The above example gives some, if limited, insight about the variety of factors that could have contributed to the woman taking the extreme step of committing suicide. While some are situational factors, the others are personality, family, relationships, and other external environmental factors. Contrary to how suicides are often reported, it is the convergence of multiple factors than a single factor or incident that contribute to suicides.
In India, youth (15-29 years) dominate the overall suicide percentage. Some of the factors consistently identified across the studies are family conflicts, academic disappointments, relationship failures, domestic violence, and mental illness. Exposure to media, addictions and tolerance to frustration have also been identified among the causes.
Some other risk factors identified include history of suicide in the family, previous suicidal attempts by the person, mental illnesses like depression, substance abuse, hopelessness, impulsive or aggressive tendencies, history of abuse, easy access to lethal means, lack of support from friends and family and so on.
In a study conducted in 2010 by NIMHANS on 436 undergraduate students in Bangalore aged between 18-25 years, it was found that suicidal ideation was reported by 15 percent of them, 9 percent attempted suicide, and hopelessness was reported in 9 percent of them. Physical abuse was the most frequently reported type of abuse (about 30 percent) and overall abuse was more in males (general, physical, emotional and sexual). People who attempted suicides reported significantly higher history having experienced abuse.
In another ongoing study examining the prevalence of depression, suicidal risk and attempts and the sources of stress in adolescents (13-18 years), the preliminary data on 200 school going and 257 college going adolescents in Bangalore shows the following: 30 percent have moderate to severe depression, 11 percent of the college sample and 7.5 percent of the school going adolescents reported suicidal attempts. Most frequently reported sources of stress were academics (62.7 percent), family problems (25.4 percent) and problems with friends (11.8 percent).
Even when all the age groups are considered, the causal factors seem to converge around family problems, illness, failures, bankruptcy, dowry disputes, poverty and drug abuse. It is never that one single factor pushes a person to suicide but a multitude of factors interacting together. Even as experts deduce the complex factors that manifest in suicide attempts, they also point out that suicides can be prevented if society is trained to look out for signs in those vulnerable to it and if people reached out for help before committing the act. Next week, this series will discuss what you as a lay person can do to prevent suicides.
Dr M Manjula is associate professor, department of clinical psychology at NIMHANS.