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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

Eye tracker device a first in Africa

2013-07-31

31 July 2013

Keeping an eye on empowerment

"If we can see what you see, we can think what you think."

Eye-tracking used to be one of those fabulous science-fiction inventions, along with Superman-like bionic ability. Could you really use the movement of your eyes to read people's minds? Or drive your car? Or transfix your enemy with a laser-beam?

Well, actually, yes, you can (apart, perhaps, from the laser beam… ). An eye tracker is not something from science fiction; it actually exists, and is widely used around the world for a number of purposes.

Simply put, an eye tracker is a device for measuring eye positions and eye movement. Its most obvious use is in marketing, to find out what people are looking at (when they see an advertisement, for instance, or when they are wandering along a supermarket aisle). The eye tracker measures where people look first, what attracts their attention, and what they look at the longest. It is used extensively in developed countries to predict consumer behaviour, based on what – literally – catches the eye.

On a more serious level, psychologists, therapists and educators can also use this device for a number of applications, such as analysis and education. And – most excitingly – eye tracking can be used by disabled people to use a computer and thereby operate a number of devices and machines. Impaired or disabled people can use eye tracking to get a whole new lease on life.

In South Africa and other developing countries, however, eye tracking is not widely used. Even though off-the-shelf webcams and open-source software can be obtained extremely cheaply, they are complex to use and the quality cannot be guaranteed. Specialist high-quality eye-tracking devices have to be imported, and they are extremely expensive – or rather – they used to be. Not anymore.

The Department of Computer Science and Informatics (CSI) at the University of the Free State has succeeded in developing a high-quality eye tracker at a fraction of the cost of the imported devices. Along with the hardware, the department has also developed specialised software for a number of applications. These would be useful for graphic designers, marketers, analysts, cognitive psychologists, language specialists, ophthalmologists, radiographers, occupational and speech therapists, and people with disabilities. In the not-too-distant future, even fleet owners and drivers would be able to use this technology.

"The research team at CSI has many years of eye-tracking experience," says team leader Prof Pieter Blignaut, "both with the technical aspect as well as the practical aspect. We also provide a multi-dimensional service to clients that includes the equipment, training and support. We even provide feedback to users.

"We have a basic desktop model available that can be used for research, and can be adapted so that people can interact with a computer. It will be possible in future to design a device that would be able to operate a wheelchair. We are working on a model incorporated into a pair of glasses which will provide gaze analysis for people in their natural surroundings, for instance when driving a vehicle.

"Up till now, the imported models have been too expensive," he continues. "But with our system, the technology is now within reach for anyone who needs it. This could lead to economic expansion and job creation."

The University of the Free State is the first manufacturer of eye-tracking devices in Africa, and Blignaut hopes that the project will contribute to nation-building and empowerment.

"The biggest advantage is that we now have a local manufacturer providing a quality product with local training and support."

In an eye-tracking device, a tiny infra-red light shines on the eye and causes a reflection which is picked up by a high-resolution camera. Every eye movement causes a change in the reflection, which is then mapped. Infra-red light is not harmful to the eye and is not even noticed. Eye movement is then completely natural.

Based on eye movements, a researcher can study cognitive patterns, driver behaviour, attention spans, even thinking patterns. A disabled person could use their eye-movements to interact with a computer, with future technology (still in development) that would enable that computer to control a wheelchair or operate machinery.

The UFS recently initiated the foundation of an eye-tracking interest group for South Africa (ETSA) and sponsor a biennial-eye tracking conference. Their website can be found at www.eyetrackingsa.co.za.

“Eye tracking is an amazing tool for empowerment and development in Africa, “ says Blignaut, “but it is not used as much as it should be, because it is seen as too expensive. We are trying to bring this technology within the reach of anyone and everyone who needs it.”

Issued by: Lacea Loader
Director: Strategic Communication

Telephone: +27 (0) 51 401 2584
Cell: +27 (0) 83 645 2454
E-mail: news@ufs.ac.za
Fax: +27 (0) 51 444 6393

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