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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 Communication and Brand Management receives two prestigious international awards

2015-07-07

Lelanie de Wet, Lacea Loader and Leonie Bolleurs

The Department of Communication and Brand Management at the University of the Free State (UFS) received two of the six Gold Quill Awards – that were awarded to South African companies and institutions - at the International Association of Business Communicator’s (IABC) Excellence Gala ceremony in San Francisco, US on 15 June 2015.

The awards ceremony formed part of the 2015 IABC World Conference, which took place from 14-17 June 2015. The department received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook and a Gold Quill Merit Award for the B Safe Take Action campaign.

From the 15 countries that entered, a total of 120 Gold Quill Excellence awards and 189 Gold Quill Merit awards were awarded. Other South African award winners included Barclays Africa Group Limited, Mediclinic and the Cape Peninsula University of Technology (CPUT).

This is the second year in a row that the UFS has been recognised by the IABC for its communication projects. In 2014, the department was awarded the Jake Wittmer Research Award for a Stakeholder Perception Audit conducted in February 2014. The audit was considered – by the IABC - as one of the best breakthrough strategies used by a university to measure the perceptions of its stakeholders.This made the UFS the first tertiary institution in Africa to receive the research award. The stakeholder perception audit also received an Africa Gold Quill in 2014.

"Being recognised by a global association such as the IABC for the second time, is a great honour and I am very proud of what my colleagues have achieved by entering the two campaigns. Winning the awards is a true indication of what can be done when a team of expert communicators is committed towards engaging their target audiences with campaigns that speak of quality and innovation. The fact that the UFS is one of only two tertiary education institutions in the country to receive these prestigious awards, makes it even more special," said Lacea Loader, Director: Communication and Brand Management at the UFS.

IABC World and Africa conferences 2015

The IABC is a global membership association with a network of 12 000 members in more than 80 countries, representing many of the Global Fortune 500 companies. It serves professionals in the field of business communication, bringing together the profession’s collective disciplines.

With the theme: Changing landscape: Informing the future, the 2015 world conference was attended by over 1 200 delegates from across the world. Delegates were offered an opportunity for learning, discovering, and connecting. Loader also made a presentation entitled ‘Award-winning measurement endorses sound reputation management strategy’ at the world conference.

The department will also be receiving two Africa Gold Quill Awards from the Africa chapter of the IABC for the same campaigns on 30 July 2015 in Johannesburg.

UFS #FaceOfFacebook Campaign

The university received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook. This initiative originated in the university’s commitment to its Human Project, which sets the standard for good behaviour and care.

Lelanie de Wet, Manager: Social Media and Website Content and project leader of UFS #FaceOfFacebook, said the project was born from the need to communicate with students. Thus a virtual friend, #FaceOfFacebook, was created. “Yearly auditions are being held to choose the new face representing the UFS on Facebook. Short video clips of the #FaceOfFacebook – whether it is attending events or communicating important messages - are posted on the UFS Facebook page. The successful candidate holds the title #FaceOfFacebook for 12 months.

“When I look at a campaign such as #FaceOfFacebook, from the time it took its first tentative steps in 2013, and see how it inspired staff and students alike, my heart swells with pride. Often you can see the impact you have made only in retrospect. The ripples you send into the world will inevitably create waves,” she said.

B Safe Take Action Campaign

The B Safe Take Action campaign of the university received a Gold Quill Merit award from the IABC.

The campaign was activated in September 2013. “It targeted on- and off-campus students and staff, aiming to create social ownership of personal safety, and to raise awareness of the safety measures put in place by the university,” said Leonie Bolleurs, Manager: Internal Communication and project manager of the campaign.

The campaign looked at a number of safety aspects, focusing not only on crime but also on being safe from road accidents and stress/burnout.

It is the second time this year that the BSafe campaign has been recognised for its innovative strategy. Earlier this year it received a PRISM Award (Gold) from the Public Relations Institute of Southern Africa (PRISA). The annual PRISM Awards are about recognising and celebrating great public relations campaigns.

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