Insight: Suicide

Debunking suicide myths | 'Depression is an illness, not a weakness'

Suicide is a terminal disease, much like cancer. In SA, where rates are at a record high, it is crucial to debunk some myths, fallacies, misconceptions and misunderstanding this tragic form of death

10 February 2019 - 00:00 By DAVID CAPEL


Suicide is, perhaps, the most misunderstood of all sicknesses. Father Ron Rolheiser, a US-based Catholic priest whose writings on suicide provide a valuable insight into the disease, says: "It takes a person out of life against his or her will, the emotional equivalent of cancer, a stroke, or a heart attack." Suicide is an illness, not a sin. Nobody calmly decides to burden his or her loved ones with that death, any more than anyone calmly decides to die of cancer and cause pain to those they leave behind.
It's time to debunk some of the common myths and misconceptions that surround suicide. Firstly, no-one "commits" suicide. People "commit" murder, rape and armed robbery. A far more compassionate way of describing this most tragic of human acts is to say that someone "ended their own life".
Secondly, no-one "chooses" to end their own life. There is no choice involved. Suicide victims (and, indeed, that is what they are) are caught up in a vortex of hopelessness, a private despair that has its roots in their emotions and biochemistry.
Thirdly, suicide victims do not "want" to die. They see death as the only way to end their suffering. No-one trapped in this wilderness of pain can make a rational choice to end his or her life. Suicide is a desperate attempt to end unendurable pain, akin to one throwing oneself through a window because one's clothing is on fire.
In Rolheiser's words, suicide victims are "too bruised to be touched".
CONFUSED AND ANGUISHED
Another misconception about suicide is that it is an act of cowardice. On the contrary, without glamorising it or suggesting that it is any kind of reasonable solution, suicide requires a particular kind of courage and strength.
In a country where suicide has been so sharply in the spotlight over the past year or so, it is vital not only to understand the illness but to recognise the unique pain and trauma that suicide leaves in its wake.
Slain advocate Pete Mihalik, 50, who was shot dead in Green Point while dropping off his children at school in November last year, lost his wife, mother and sister to suicide. In an interview in 2016, Mihalik revealed the painful experience of losing these prominent women in his life. His wife, who suffered from depression, hanged herself in 2015 at the age of 48. His mother ended her life at the age of 38 by taking rat poison. His sister killed herself at the age of 38 by jumping from a building.
Everyone dies, of course, but it is the manner of the death of a suicide victim that leaves those close to them so particularly stunned, confused and anguished.
ALONE ON THE ROCKS
Eight years ago my girlfriend ended her own life in the dead of night, alone on the rocks at Fish Hoek beach. She was 26 and suffered from another often-fatal disease, bulimia, which she referred to as "the demon that lives within me".
In the eight years since her death I have never experienced a moment's anger towards her. Why should I? She died from a terminal disease, just like cancer. What I have experienced is an overflowing of compassion, love, understanding and a sadness and despair that know no bounds.
There have been a few inevitable "what ifs?" but I know (partly because she told me so in her final letter and partly because I know, in a place deep inside me, that, had I known what she was going to do, I would have done literally anything to try to prevent it) that there was nothing in this world I could have done to save her. She died from a terminal disease.
Rolheiser writes that "suicide is the result of a disease, a sickness, an illness, a tragic breakdown within the emotional immune system or simply a mortal biochemical illness. For most suicides, the person dies, as does the victim of any terminal illness or fatal accident, not by his or her own choice. When people die from heart attacks, strokes, cancer, and accidents, they die against their will. The same is true in suicide."
The inevitable, eternally unanswerable questions that follow the death of someone by suicide are: "What might I have done?" and "Where did I let this person down?"
We need not punish ourselves in this way. Rarely would any intervention on our part have made a difference. Indeed, most of the time, we weren't there for the very reason that the person who fell victim to this disease did not want us to be there. He or she picked the moment, the spot, and the means precisely so we wouldn't be there.
'REDEEM THEIR MEMORY'
Says Rolheiser: "Suicide seems to be a disease that picks its victim precisely in such a way so as to exclude others and their attentiveness. This is not an excuse for insensitivity, but is a healthy check against false guilt and fruitless second-guessing.
"Suicide is a result of sickness and there are some sicknesses which all the love and care in the world cannot cure.
"It is incumbent upon us, the loved ones who remain, to redeem the memory of those who die in this way so as to not let the particular manner of their deaths become a false prism through which their lives are now seen. A good person is a good person and a sad death does not change that."
Men are most at risk of suicide. As part of their 2012 Burden of Disease study (the most recent accurate suicide statistics available, according to Africa Check), SA's Medical Research Council stated that 6,133 people committed suicide that year. Of those, 5,095 were men.
TABOO SUBJECT
Tawanda Makombe, a research analyst at the South African Institute of Race Relations, says economic hardships, a lack of solutions to life problems in SA and a lack of suicide prevention programmes in schools and communities contribute to the high rate of suicide in SA.
Mental health is still a taboo subject among most South African men, which has caused many to feel that the only way out is to end their lives.
According to Garron Gsell, CEO of the Men's Foundation of SA, an NGO, this is a national crisis, and we urgently need to "address the health issues affecting South African men and raise funds for research and support programmes that enable men to live happier, healthier and longer lives".
Gsell believes mental health issues need to be destigmatised in SA.
"There are so many unanswered questions facing those left behind with the pain of not having noticed the change in behaviour until it was too late. We are making a stand for men to understand that when they are struggling there is support available . getting men - our husbands, brothers and partners - to understand that it's OK not to be OK, that friendship is there for support if you simply reach out and start these conversations."
Victims of suicide are not selfish. As Rolheiser says: "The victim has cancerous problems precisely because he or she is wounded, raw, and too bruised to have the necessary resiliency needed to deal with life."
Suicide is a terminal disease, just like cancer. It is time to debunk the myths.
'THIS TERRIBLE DISEASE'
After the suicide last year of Professor Bongani Mayosi, respected cardiologist and popular dean of the faculty of health sciences at the University of Cape Town, Professor Lizette Rabe, who started the Ithemba Foundation after her son's suicide, wrote an open letter to UCT students.
"I am so sorry that you as a student community, and especially Professor Mayosi's nearest and dearest, will also now have to grieve the loss of yet another victim of 'this terrible disease', as author Virginia Woolf wrote in her last letter to her husband before walking into the River Ouse," wrote Rabe.
"You would probably know that psychologists talk about 'compounded grief', or 'complicated grief' - grief that has been compounded by many other factors, and a death as a result of suicide certainly is 'compounded', or 'complicated' grief.
"The core of my message to you is this: Professor Mayosi, as a beloved husband, father, son, brother, or cousin, as dean of your faculty, as role model, as top researcher, as a super human being, did not make a decision to kill himself. No, he was the victim of humankind's cruellest disease.
Yet we - due to sociocultural-religious reasons, and the fact that science is also still grappling with psychiatric diseases - still cannot understand that it is a cruel disease that robbed him of his life, and with it, him from you.
"It is important to understand that the person who has lost his life did not desert you, and that you should not feel anger towards him. If anything, you should feel anger towards 'this terrible disease'. Depression is an illness, not a weakness.
"But what then is left for us to do after such a devastating loss? I think, in the name of Professor Mayosi, all of us can contribute to help raise awareness of depression as a biological disease - and realise that it can viciously claim victims, seemingly anywhere, any time.
"It is clear that we need public awareness and public education to understand that without mental health, there can be no health."

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