By Rashika Fazali

Image Credit: Free Pik

One night in July of 2009 at 17 years old, I went to the balcony and decided that I wanted to get away from my sad life and maybe go to a party for once where I could forget my troubles and this depressed state I was in the last few years. What I did next, I could never make sense of it to this day. I jumped from the balcony of a second-storey house and fell onto concrete which resulted with me being badly injured – a fractured spinal cord and an ankle. I remember being told that I might not survive or I would end up being paralysed. But I survived. I spent 3 months in total at the hospital and at home recovering from my self-inflicted injury. Did I have an intention to kill myself? No, not that time. Did I care about what happened to me if I jumped from the balcony? No. Was I depressed? A definite yes. That’s the thing with depression: when you’re going through it and have done so for a long time, you are unable to see and think anything through. You sincerely refuse to care about yourself or what would happen to you.

Here’s a bit more on my background: I come from a dysfunctional family where domestic violence was a part of my life. I grew up feeling unloved, unwanted and with no one to talk to. Imagine being woken up in the middle of the night because you heard your mum crying and pleading your dad to stop beating her up. Imagine living your life in constant fear wondering if another manic episode was to take place or not having food to eat or not being in a proper mental state because of your environment and situation. My self-inflicted injury was the result of years of mental distress. You cannot pinpoint to one cause because depression is complex. It affects people largely and differently. Globally, over 264 million people suffer from depression.

Sadly, most people don’t ask or get the help they need due to the stigmatised view of having a mental illness. Some people try their best to keep others from knowing that they have family members or friends going through depression. In fact, mental illness has such a bad name that my grandmother wanted me to tell anyone who asked that I fell from the balcony instead. There is a lot shame associated with mental illnesses as if it was a psychotic science thing. Today, we know a lot more than we did in the last few years; there are different types of mental illnesses from anxiety and mood disorders to psychotic, personality, obsessive compulsive disorder to post-traumatic stress disorders; some biological, some induced by the environment and others by situation. But unfortunately we may never truly understand what causes mental issues and illnesses because there are so many things at play. It’s appalling to even realise that we have never been taught to look after ourselves emotionally or mentally. We spend so much time exercising and dieting to become fit and healthy, but we hardly spend any time addressing real issues ongoing in our heads because what you can’t see is not real right? With physical fitness, you see results eventually, but with mental health – that’s a more intrinsic process, so we often tend to discard or we refuse to acknowledge its existence.

But what is mental health? The World Health Organisation (WHO) defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”. Unfortunately, not everyone is able to be in this state of well-being because there are so many factors that affect us at anytime, anywhere, day or night. In this fast-paced world, we are continually dealing with different emotions and situations often unwillingly surrounding ourselves with toxicity. Coping up with the stressors of everyday life is not easy, and not everyone is equipped in dealing with a variety of stressors which may come in the form of conflict, loss of a loved one, major life changes, illnesses, substance abuse or personal problems. Some go through physical, sexual and emotional abuse, and without any help, it’s even tough on them mentally. If you have no idea on how to cope with these various situations or ask for help, it will take a toll on you mentally and eventually physically because it has a way of spilling over to other areas in life. This is why it’s so important to be in a good headspace. But the truth is, most of us have no to very little understanding about mental health because we don’t learn about it in school or at home, and without coping mechanisms and the ability to reach for help, we will fall into depression gradually and when it becomes so overwhelming, we may just take the plunge to end our life.

Have you ever thought what makes a person take that plunge? Death by suicide or attempting suicide is almost never the result of one incident. It is usually a culmination of a number of incidents happening simultaneously or over a period ranging from weeks to months to even years. It starts small and if not addressed, it gradually builds this situation in your mind and later becomes a huge problem. For e.g. it can start with a parent or an elder not listening to a child. This may keep happening to the child often as he/she grows. Soon the child stops asking for attention using verbal cues and instead chooses other ways to attract attention often through substance abuse, violence, self-harm or by suddenly withdrawing themselves resulting in a drastic change in behaviour. If these issues are still not resolved due to no answer to his/her plea, he/she may resort to ending their life. The idea of ending your life is a haunting thought. If you ever think of it, please get help. You may contact any of these places for help:

• Sumithrayo (0112 696 666)
• Shaanthi Maargam (0717 639 898)
• National Mental Health Hotline (1926)
• CCC Line Counseling (1333)
• Samutthana (0112 883 847)

Often, when someone thinks of ending their life, it’s a measure taken as a last resort to a never-ending pain. It’s the domino effect of suicide.

The Merriam-Webster dictionary defines the Domino effect as “a cumulative effect produced when one event initiates a succession of similar events”. This term ‘domino effect’ was first made famous in 1954 by American President Dwight Eisenhower – a notion that led politicians to believe that the result would be an increase in communism around the world. Many areas such as economics, business and psychology utilise the domino effect to explain certain events. When it comes to mental health, we have to understand that one event, small or big leads to another small or big event one after the other. This effect can lead to devastating results. A study undertaken in Ireland in 1998 identified 3 components that lead people to die by suicide; these people were also victims of the domino effect. The 3 components were depression, the loss of a loved one and substance abuse. In a 2016 study, the authors found more components that lead adolescents to attempt suicide. One was individual factors and experiences pertaining to psycho-emotional problems where victims felt depressed, worthless, hopeless, guilt, shame, anger and hate. Family issues and lack of communication was another area that contributed to suicide attempts. Fights between parents that result in divorce and remarriage, a death of a parent or even the lack of communication between a parent and a child can increase or contribute to depression. Another contributing factor is the publicising of suicide-related events in society via different mediums such as movies. In other cases, even the suicide of a celebrity could trigger others to attempt suicide. After Bollywood actor Sushant Singh Rajput ended his life in July, there were numerous incidents of young people dying by suicide. Hearing the demise of their beloved actor may have triggered them to end their life.

Currently, every 40 seconds someone dies from suicide. It is the second leading cause of death among 15-29-year-olds. Over 800,000 people die from suicide every year. 57% die from suicide more from war and homicide combined and 79% of them occur in low- and middle-income countries with 90% of them being adolescents. South-East Asia had the highest suicide rate in the world in 2016 with 13.4% per 100,000 population. From South-East Asia, Sri Lanka had the second highest crude suicide rate of 14.6% per 100,000 population. That year, 3035 people in Sri Lanka died by suicide with 77.3% of them being males. In 2019, out of 3135 suicides, males accounted to 79.3%. These are shocking figures, but what are we doing to improve mental health and reduce the number of suicides yearly? Are we spending enough time, energy and money in creating awareness about the importance of mental wellbeing?

If there are any lessons we have learnt from the above data and information, they are:

• To destigmatized mental illness. Many people want to get help, but the idea of being referred to mental health professionals and then being ‘seen’ going to a ‘psychiatrist’ or ‘psychologist’ creates so much distress. Over the years, mental illness has been strongly linked to the notion that people who have mental illnesses are crazy or neurotic. This has been seen in a negative light. Even Sri Lankan movies have contributed to this picture.
• To promote mental health. Instead of media reports and suicide portrayals in television and movies which lead to an increase in suicides, these mediums can use their platform to create awareness on mental wellbeing using positive reinforcements.
• To enable and increase effective communication between parents, guardians and their children. Why is it that we bring our children into this world and then refuse to talk or listen to them? Effective communication in any area can only do good, enabling clearer messages and constructive feedback.

• To teach mental health in schools. Just like most things in life, a talk on mental health should start at its earliest, so that when they become adults, they know how to deal with mental health issues and illness.
• To have an abundance of access to mental health tools, information, coping mechanisms, institutions and professionals at all times.

However, as someone who has gone through years of depression and has also attempted suicide, if you are struggling with mental health issues, please ask for help! You are never alone in this fight. We all want to be loved, cared and understood. It is human nature after all. Please contact any of these places for support:

• Sumithrayo (0112 696 666)
• Shaanthi Maargam (0717 639 898)
• National Mental Health Hotline (1926)
• CCC Line Counseling (1333)
• Samutthana (0112 883 847)

And trust me, you can get through it!

(Editors Note: This article was written exclusively for bakamoono.lk and at the time of publication had not appeared in this form in any other publication)