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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

2011 Leadership group meets for the first time

2011-08-01

Photo: Hannes Pieterse

The long application process, panel interviews and nail-biting wait finally came to an end the past week, when the cream of our first-year class of 2011 gathered in the Scaena Theatre on our Bloemfontein Campus, for their first group meeting as the selected Leadership for Change cohort.

These 150 students, from all our faculties, will over the following year be groomed to be leaders, not only at the university, but also in their respective fields and chosen careers.
The first group of students will depart for their respective universities in America and Europe on 22 September 2011, where they will spend two weeks. The second group of students will depart for universities in Japan in January 2012.

Although they have all passed a gruelling selection process, the real hard work is only starting now for these bright young students.

The programme will take place in four phases. During the preparation phase, which has now kicked off, students are prepared for the experience ahead, while being made aware of exactly what to expect from the programme.

In the study-abroad phase, students will be placed at 15 partner institutions in various countries, and will be divided into groups of six to twelve people. According to Prof. Aldo Stroebel, Director of International Academic Programmes, the groups will be diverse, in that there will be a mix of races, genders and study fields, which should guarantee dynamic interaction.

During the group’s first meeting this week, they were informed of the important goals of the Leadership for Change Programme, by Mr Rudi Buys, Dean of Student Affairs.

He imparted the gravity of their selection on the students by saying, “You may not get it yet, but I understand the reason we are all here. I understand that by looking at what you achieve after this programme, we can tell what the country could possibly achieve in the future. It is immensely moving to see the way you all carry yourselves, since I can see something special and unique in each of you.”
“You are all here, not because of which school you went to, or your race, or who your parents are, but because you all show potential to be something great.”

Prof. Stroebel reminded the group that despite the excitement that they all have about visiting universities in America, Europe and Asia, these visits should be seen as study trips.

“You may have three days to acquaint yourselves with the surroundings, but after that there will be very little sightseeing and a lot of hard work.”

They will participate in programmes designed by their respective host institutions, aimed at exposing them to different cultures, lifestyles and beliefs.

They will be accompanied by our staff, who Prof. Stroebel says will grow with the students, as they will be expected to guide the students through their tasks and assignments and interact with them on a daily basis.

Upon their return, there will be a debriefing phase, during which they will be expected to provide feedback on their experiences, as well as submit assignments which they will be assigned at their respective institutions.

The final phase is known as the impact phase, as this will see the students apply what they have learned in a positive manner and help drive the university to the future and to becoming a world-leading tertiary institution.

Media Release
1 August 2011
Issued by: Lacea Loader
Director: Strategic Communication
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: news@ufs.ac.za

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