Eulalee Thompson SINCE THE popularisation of Freud's theory, the medical community has come a long way in understandanding suicide. For instance, Dr. Earl Wright, psychiatrist and director of the Health Ministry's mental health services, says that about 90 per cent of suicide cases are due to mental disorders including clinical depression, schizophrenia, drug and alcohol abuse.
Various studies, he also pointed out, indicate that most individuals who commit suicide have been found to have abnormal levels of serotonin, a neurotransmitter linked to sleep pattern. These abnormal levels, Dr. Wright said, is in keeping with a psychiatric disorder.
"The average individual, (experiencing life's normal stressful events) will not commit suicide; so suicide is not a response to stressful situation but a response of a psychiatric diagnosis," he said.
It is also believed that there are those who commit "rational suicide". In this group are individuals with terminal illnesses, for example, those who after weighing the pros and cons of their existence opt for euthanasia.
Suicide is now listed by the World Health Organisation (WHO) as a major public health problem. The age-standardised suicide rate for 1996 was 15.1 per 100,000. The rate for males was 24 per 100,000 and for females 6.8 per 100,000. Trends vary worldwide from an almost 62 per cent increase in Mexico to a 17 per cent decrease in China.
More cases of suicide are being reported to the authorities in Jamaica but this country's rate is still among the lowest in the world.
Do socio-economic environments impact the suicide rate? The World Health Report 2001, in its survey of countries notes "that socioeconomic change (in any direction) is often suggested as a factor contributing to an increase in suicide rates ...but
increases in suicide rates have also been observed in periods of socio-economic stability, while stable suicide rates have been seen during periods of major socio-economic changes."
The same report notes that an increase in unemployment rates is usually but not always accompanied by a decrease in suicide rates of the general population (for example, in Finland) but by an increase in the suicide rates of elderly and retired
people (for example, in Switzerland).
Dr. Wright said that demographically, young and elderly people are more likely to commit suicide. The young adult male (in his early 20s) is at an increased risk for this act.
"It is not unusual because young adults suffer impulse control disorder, substance abuse is more prevalent in this group and they haven't yet learnt enough about coping skills. They sometimes self-treat their depression by abusing alcohol or drugs," he said.
Other people are in the more-at-risk group those who are single,
widowed, divorced or separated; those under economic or occupational stress; those who suffer humiliation (by parents and significant others), especially among males and adolescents. Humiliated people, Dr. Wright said, begin to feel that life is not worthwhile or they feel that they cannot again face the environment of abuse.
Freud, the well-known psychotherapist, argued that human personality and behaviour were motivated by instincts some inborn impulses. In his psychoanalytic theory, he pointed to several instincts including sexual, life and the death instincts. He believed that human beings had an unconscious wish to die and that indications of this unconscious wish are seen in acts of aggression, wars, masochism and suicide.
Country Suicide rate
(per 100,000)
Hungary 32.0
France 19.0
U.S.A. 11.0
Trinidad and Tobago 11.0
Jamaica 3.1
Suicide can be prevented
DR. EARL WRIGHT says that it cannot be over-emphasised that since clinical depression - the major cause of suicide can be successfully treated, then acts of suicide can be prevented.
Depressed patients are treated with anti-depressant drugs and this is sometimes combined with talk
therapy. There is a wide variety of anti-depressant drugs and these are not habit forming. He said that more medical practitioners are being sensitised to screen for psychopathologies in patients who visit them for other conditions.
SIGNS TO LOOK FOR
An individual with a previous episode of attempted suicide will more likely attempt it again
Those with impulsive and violent traits are more likely to commit suicide
Some mental disorders have genetic aetiology so strong family history is a possible indicator
People who are old and living alone, isolated, withdrawn from family and social support systems
People under stress
Those who have developed sleeping problems, poor work ethics and unkempt dress
Social withdrawal
Giving away of personal possessions and saying goodbye
PROTECTIVE FACTORS AGAINST SUICIDE
Strong social support
Married
Religious affiliation and church
Women with children usually think twice about suicide
People with good coping skills who
are self-aware and able to manage their emotions
Those who engage in stress management activities, including
exercise
