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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

UFS keeps the power on

2015-06-24

At a recent Emergency Power Indaba held on the Bloemfontein Campus, support structures at the university met to discuss the Business Continuity Intervention Plan to manage load shedding on the three campuses of the UFS.

Currently, 35 generators serving 55 of the buildings have already been installed as a back-up power supply on the three campuses of the university. According to Anton Calitz, Electrical Engineer at the UFS, the running cost to produce a kWh of electricity with a diesel generator amounts to approximately three times the cost at which the UFS buys electricity from Centlec.

Planned additional generators will attract in excess of R4 million in operating costs per year. For 2015, the UFS senior leadership approved R11 million, spread over the three campuses. Remaining requirements will be spread out over the next three years. University Estates is also looking at renewable energy sources.

On the Bloemfontein Campus, 26 generators serving forty-one buildings are in operation. On South Campus, two generators were installed at the new Education Building and at the ICT Server Room. Lecture halls, the Arena, the Administration Building, and the library will be added later in 2015. Eight generators serving 12 buildings are in operation on the Qwaqwa Campus. In 2015, the Humanities Building, Lecture Halls and the heat pump room will also be equipped with generators.

Most buildings will be supplied only with partial emergency power. In rare cases, entire buildings will be supplied because the cost of connecting is lower than re-wiring for partial demand. According to Nico Janse van Rensburg, Senior Director at University Estates, emergency power will be limited to lighting and power points only. No allowances will be made for air-conditioning.

“Most area lighting will also be connected to emergency power,” he said.

Where spare capacity is available on existing emergency power generators, requests received for additional connections will be added, where possible, within the guidelines. The following spaces will receive preference:
- Lecture halls with the lights, data projectors, and computers running
- Laboratories for practical academic work and sensitive research projects
- Academic research equipment that is sensitive to interruptions
- Buildings hosting regular events

According to Janse van Rensburg, all further needs will be investigated. Staff can forward all emergency power supply needs to Anton Calitz at calitzja@ufs.ac.za

Staff and students can also manage load shedding in the following ways:

1. Carry a small torch with you at all times, in case you are on a stairwell or other dark area when the lights go out. You can also use the flashlight app on your phone. Download it before any load shedding occurs. This can come in handy if the lights go out suddenly, and you cannot find a flashlight. Load-shedding after dark imposes even more pressure on our Campus Security staff. We can assist them with our vigilance and preparedness by carrying portable lights with us at all times and by assisting colleagues.
2. Candles pose a serious safety risk. Rather use battery- or solar-powered lights during load shedding.
3. Ensure that your vehicle always has fuel in the tank, because petrol stations cannot pump fuel during power outages.
4. Ensure that you have enough cash, because ATMs cannot operate without electricity.
5. The UFS Sasol Library has study venues available which students can use during load shedding.
6. When arranging events which are highly dependent on power supply, especially at night, organisers should consult the load-shedding schedule before determining dates and preferably also make back-up arrangements. If generators are a necessity, the financial impact should be taken into consideration.

The senior leadership also approved a list of buildings to be equipped with emergency power supplies.

More about load shedding at the UFS:
Getting out of the dark
More information, guidelines and contact information

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