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Death by suicide: the final symptom of mental illness

09 September 2022 | Story Angela Vorster | Photo Andrè Damons

Angie Vorster — Angela Vorster is a Clinical Psychologist at the School for Clinical Medicine, University of the Free State (UFS).

Opinion article by Angela Vorster, Clinical Psychologist at the School for Clinical Medicine, University of the Free State.

Twenty-three people will die from suicide today in South Africa. Another 460 South Africans will try to end their lives today. They are from different cultural groups, different income groups, attained different levels of education, speak different languages, range in age from childhood through to elderly, have different genders and sexual orientations. These people have very little in common except that their lives all ended due to the final symptom of an illness. People who experience thoughts of ending their lives describe this mental space as feeling grey. Their thoughts tend to keep returning to the futility of being alive, what a burden they are to those around them, how nothing will ever get better and that nobody can help them. They tend to experience feelings of worthlessness, self-hatred, guilt, hopelessness, immense sadness and despair. Their suffering and emotional pain are excruciating. Nothing is enjoyable anymore. There is nothing to look forward to. Everything is difficult, boring, scary or meaningless. Inwardly they are drowning. But very often they smile, do their job and pass their exams, go on dates and vacations, make plans for the weekend and check up on their loved ones. They look happy in their photos. And when someone asks them if they are okay they say yes. Because they don’t feel like they deserve to feel better. They don’t want to be a bother. They might not call a helpline or make an appointment to see a psychologist or go to their GP for anti-depressants. Because they just don’t have the energy. It’s exhausting pretending to be fine all day. The one thought that brings relief is that they can end this pain. And one day they do. And their colleagues, friends and family are left reeling with shock and disbelief. How could this have happened? How could they have missed the signs? What should they have done differently to prevent this?

The causes are as complex and varied

This is the purpose of World Suicide Prevention Day which takes place internationally each year on 10 September and through which the International Association for Suicide Prevention endeavours to increase awareness of suicidality, as well as to fight the stigma associated with suicide. Wanting to die can occur along with many other symptoms and disorders including, but not limited to, depression, post-traumatic stress disorder, bipolar disorder, psychotic disorders, personality disorders and substance dependence or abuse disorders. The causes are as complex and varied as the manner in which suicidality may present. It is dangerous to regard only certain signs and symptoms as indicative of suicide risk, because we know that suicide can be extremely unpredictable. There is no way to tell if someone is a suicide risk based purely on their behaviour. However there are certain factors which may indicate an increased risk for self-harm. These include, but are not limited to, having previously tried to end their life, having a psychiatric illness, being seriously ill or having chronic pain or the misuse of substances. Experiencing legal, relationship, financial or academic stressors may increase suicide risk, as well as having access to lethal means to end their life along with being unable to access mental health care.

So what can you do if you think someone may be at risk of self-harm? Say something. Talk to them. Tell them what you are worried about and give them the space to express how they feel without judgment or condemnation. Reach out to their support system and share your concerns with them. Encourage the suicidal person to make contact with a health care professional – this can be a psychologist, GP, psychiatrist, social worker, psychiatric nurse, counsellor or a suicide prevention help line. Other important members of our community who provide a great deal of assistance to suicidal people and their families include religious and spiritual leaders, teachers, support groups and employee assistance programmes. There are actually so many ways and places to receive health care and support; however the most significant barrier to making use of these resources is sustained by the stigma associated with suicide and mental illness. In our culture of toxic positivity where our photos are touched up, our statuses updated and our successes plastered on various social media platforms, the authentic act of acknowledging when we feel defeated, unhappy or like a failure has become a rarity. The more real, honest and vulnerable we can be about our ‘undesirable’ emotions and experiences, the more space we create for those around us to do the same. When we normalise not being okay at all times, we give ourselves and others permission to speak up when we need help. And this is our greatest weapon against suicide – authentic connection.

What suicide is not

We’ve explored what it may feel like to be suicidal, now let’s focus on what suicide is not. Suicide is not a moral failing. It is not because the person was weak or selfish, it is not because their family was dysfunctional or their faith not strong enough. Suicide is the final symptom of mental illness – and every single person is vulnerable to experiencing suicidal thoughts. Each one of us will be affected by suicide during the duration of our lives, either directly or indirectly. This is irrespective of how successful you are, how supportive your family is or how strong your religious convictions are. Dying by suicide is not a shame. It is not a failure. It is no different to a patient dying from any other disease. And just like any other illness there are symptoms we can look out for and treatments and medications that can assist in recovery.

Please think before you speak about someone who died due to suicide. I guarantee that at least one person in the conversation has suffered the pain of losing someone in this way. But you probably wouldn’t even know, because stigma silences. Stigma disconnects and alienates those who need support the most. Our words have the power to shame and silence, or to empower and encourage connection, which is lifesaving. Treat each conversation as though there may be someone present who is having suicidal thoughts or is working through the loss of someone they love due to suicide. Often we want to reach out and support families affected by suicide, but don’t because we are afraid of offending, or upsetting or because we ourselves are so uncomfortable with mental illness. But all these survivors of suicide need from you is your calm, empathetic, kind presence, a safe space to express difficult and messy emotions. Without being blamed or shunned or shamed. Support suicide survivors as though a terrible illness took the life of their loved-one. Because that is exactly what happened.

On 10 September this year I encourage you to light a candle and place it in your windowsill around 8pm wherever you are. This is in remembrance of those lost to mental illness and to show your support to those they left behind. In the words of the International Association of Suicide Prevention: “By encouraging understanding, reaching in and sharing experiences, we want to give people the confidence to take action. To prevent suicide requires us to become a beacon of light to those in pain. You can be the light.”

• If you or someone you know is at risk of self-harm please take a look at these websites and call the SADAG suicide emergency helpline.

International Association for Suicide Prevention

South African Depression and Anxiety Group

SADAG suicide emergency helpline 0800 567 567

News Archive

The launch of a unique conservation project

2011-06-06

Our Department of Animal, Wildlife and Grassland Sciences launched a very special pilot project at Woodland Hills Wildlife Estate in Bloemfontein on Friday 03 June 2011, which aims to eventually aid in the conservation and study of one of Africa’s most graceful animals.

The project aims to provide the scientific basis needed for making future decisions in the best interests of the giraffe in the Kgalagadi Transfrontier Park in the Northern Cape and involves collaring and monitoring the behaviour and movement of these animals via GPS.

Based on the public interest in the giraffe and the increased impact of the growing giraffe population on the vegetation in the area, SANParks has been considering the translocation of a number of Kgalagadi giraffe. Due to limited information regarding their adaptation success and potential impact on their new environment, thorough planning and subsequent monitoring of the species is required.

Mr Francois Deacon from our university decided to undertake a PhD study to address the existing challenges. This will be the first study of its kind, undertaken on giraffe.

He says he decided on this project because of his love for animals and conservation. “There are nine sub-species of giraffe and seven of these are already endangered. I want to involve people and make them aware of the plight of the animals and the need for conservation,” he said.

The project kicked off on Friday morning, with a group of students and curious nature-lovers tracking a herd of giraffe at Woodland Hills. The challenge laid in identifying one of the animals which could easily be collared with a GPS device, tranquilising it, and applying the device, without harming the animal.

After a young bull was identified, it was up to Dr Floris Coetzee, a veterinarian, to get close enough to the animal to tranquilise it, and to the group of students to catch it and hold it down. All this was done perfectly and the animal was fitted with its new collars. The collars were designed and made by Mr Martin Haupt, who gained extensive experience in the design of similar collars for other research studies.

Mr Deacon will spend the following two weeks personally monitoring the animal constantly, to ensure that the collars do not cause any discomfort or injury and to determine whether it should be removed or adapted.

It has taken Mr Deacon over a year to plan the collaring process and the associated study. He says the main challenges in the project are financial, since it will cost approximately R500 000 to run over five years.

Thus far he has been supported by Mr Pieter Malan of Woodland Hills, Mr Cas Kempff of Cas Kempff Consulting Engineers and Prof. Frans Swanepoel of the UFS’ Directorate of Research Development, all of whom have been benefactors of the project.
Information gathered from the pilot project will provide the data to assess how to best fit the collar onto the giraffe to ensure that the animal is comfortable and that the collar will last in the wild. Scientific data will be generated and processed for use by the Woodland Hills Wildlife Estate management.

Should the pilot project be successful, between four and eight giraffe in the Kgalagadi will be tracked using the satellite GPS collars. The GPS collars will enable the constant recording of the location of individual giraffe for up to 2 years. This will allow control and monitoring of the animals in real-time.

The main benefits of the project include, amongst others, improved decision-making, informing tourism development, education and community involvement, improved sustainability and improved cross-border collaboration between South Africa and Botswana.

Anyone who wishes to get involved with the project or get more information, should contact Me. Sonja Buhrmann at sbuhrmann@vodamail.co.za or 0827735768.

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