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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 Centenary 2004 / 2005 October (centenary) fest Activities

2004-10-08

Friday, 08 October 2004
17:00 – 24:00
Callie Human Centre, UFS
Macufe Rock Concert
With: Rooibaardt, Karen Zoid, The Narrow, F****polisiekar, Stuurbaard Bakkebaard (from the Netherlands), DJ Bob, Ready D, Neva Me.
Cost : R50-00
Bookings : Pacofs (051-447 7772)

Sunday, 10 October 2004
16:00 – 18:00
Callie Human Centre, UFS
Macufe Three Tenors Concert
With: Phillip Kotze, Chris Coetzer and Du Preez Stolz, as well as Angela Kerrison. Free State Symphony Orchestra conducted by Chris Dowdeswell.
Cost :R60-00 (adults), R40-00 (children, scholars, students and pensioners)
Bookings : Pacofs (051-447 7772)

Tuesday, 12 October 2004
11:00 – 15:00
Centenary Complex, UFS
Inauguration of Centenary Complex
Open day with a variety of musical recitals in different rooms
Cost : Free
Enquiries : Elize Rall (051-401 3382)

15:00 – 17:00
Parking area next to the Centenary Complex, UFS
Kovsie Mosaic Day
Collage of the Century, Dance to the beat, Cultural Cartoon,
Who’s line is it anyway?
Cost : Free
Enquiries : Louis Botha (051-401 2819) or
AC Geldenhuys (084 585 3338)

Wednesday, 13 October 2004
19:00
Centenary Complex, UFS
Première of documentary film : The Life and Legacy of King Moshoeshoe
Note : By invitation only
Enquiries : Elize Rall (051-401 3382)

Thursday, 14 October 2004
18:45 – 21:00
Red Square (in front of Main Building), UFS
Centenary Honorary Doctorate Degree Graduation Ceremony
Conferred on: Me. Antjie Krog, Prof. Jakes Gerwel, Mr. Karel Schoeman, Dr. Frederick van Zyl Slabbert, Prof. Saleem Badat, Dr. Khotso Mokhele, Prof. Robert Bringle, Prof. Leo Quayle, Prof. Jack de Wet, Prof. Kerneels Nel (posthumously), Prof. Boelie Wessels and Prof. Jaap Steyn .
Cost : Free. Please RSVP if you would like to attend.
Enquiries : Elize Rall (051-401 3382)

Friday, 15 October 2004
18:30
Centenary Complex, UFS
Alumni Dinner and Centenary Award Ceremony
Approximately 140 centenary medals will be awarded in acknowledgement of exceptional contributions to the development of the University. The award ceremony is followed by the Alumni dinner in the Callie Human Centre.
Cost : R100-00/person
Enquiries : Elize Rall (051-401 3382)

15:00 (to 12:00, Saturday, 16 October 2004),
UFS campus
Reunion : Momentum Adventure and Expedition Association
Including : Setting up of the Kovsie Momentum base camp, champagne breakfast and abseiling.
Cost : R50-00/person for breakfast
Enquiries : Gerrit van der Merwe (072 4317 153) or
Niel Fraser (082 772 5642)
Website : www.uovs.ac.za/associations/momentum_hrcc.

19:00 (to 11:00 Sunday, 17 October 2004)
Reunion : Cantare Revue Group
Including : Formal dinner, budget show, bring and braai, church service.
Cost : R100-00/person for the dinner
Enquiries : Louis Botha (051-401 2819)

19:00 (to 24:00 Saturday, 16 October 2004
Reunion : House NJ van der Merwe
Including : Senior Student’s Association and concerts
Cost : R5-00/person
Enquiries : Tutu Ntlathi (051-401 4122 / 072 865 2227)

Saturday, 16 October 2004
09:00 – 10:00
Committee Room 120, Faculty of Theology
Founding of Theology Alumni Association
Enquiries: Henna Nel (051-401 2669)

10:00 – 12:00
Parking area, CR Swart Building, UFS
Alumni Campus Tour
Including : Visits to the new physical developments on campus
Cost : Free
Enquiries : Jeanette Jansen (051-401 3594)

10:00 – 12:00
Sonnedou gazellie (next to NJ van der Merwe Residence), UFS
Reunion : Ladies’ Tea
Visit our new gazellie and find out what Sonnedou is up to these days.
Cost : R25-00/person
Enquiries : Anne-Marie Delport (072 109 0507)

12:00 – 16:00
JBM Hertzog Residence (garden in front of Senior Student’s Association), UFS
Reunion : Braai
Cost : Approximately R20-00/person
Enquiries : Hattingh Bornman (084 240 5226)

12:00 Vergeet-my-nie Residence, UFS
Reunion : Braai
Bring and braai. We supply the facilities. Bring old photographs and stories. Enjoy Aunt Juls’ last visit.
Cost : Free
Enquiries : Mari Jordaan (051-444 2832/072 392 4444)

12:00 HF Verwoerd Residence Senior Student’s Association, UFS
Reunion : Spit roast
Cost : R60-00/person
Enquiries : Jan-Chris Landman (051-401 3613 / 082 664 6062)

18:30 Floreat Hall, Bloemfontein Civic Centre (Braam Fisher Building)
Irawa 60 Reunion
For all former editors, former and current main editorial staff and coworkers
Cost : R100-00/person
Enquiries : Sanri van Wyk (072 333 1011)
Elzette Boucher (072 180 6265)

19:00 – 24:00 Red Square (in front of Main Building), UFS
Informal Alumni Reunion
Spit roast and stories in a marquee
Cost : R60-00/person
Enquiries : Elize Rall (051-401 3382)

Sunday, 17 October 2004
10:00 – 11:00
Kovsie Church
Church Service

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