Suicidal tendencies we should all watch out for

Q. “I have lately noticed a growing trend where more men than women are taking their own lives in Kenya, what could be fuelling this?”

Your observation about suicide rates in Kenya is absolutely correct. There are more men dying from suicide than there are women. That said, and here is the real paradox, there are more women who think about and attempt suicide than their male counterparts.

It was once claimed that this paradox was because men were more efficient in “doing this job” but time and research have shown suicide to be a very complex matter, if only because more people die from suicide than from road accidents!

A number of facts about suicide might be of some interest to you.

More than one million people die by suicide every year. One person dies from suicide every 40 seconds. Global suicide rates have increased by 60 per cent over the past 45 years. This, therefore, is not a problem that is about to go away and is not a problem the world can ignore.

Without saying what may be the reasons for the following observations, let us state that South Korea has the lowest suicide rates in the world. On the other end of the scale, Lithuania, Russia and Guyana seem to have the highest rates of suicide.

On this list of death from suicide, Uganda is rated 11th. In spite of your observation on increasing suicide rates in Kenya, we are ranked 140 in the world with a suicide rate of 5.6 persons per 100,000.

The Caribbean Islands of Jamaica, Granada and Barbados seem to be the safest places with regard to suicide.

The above statistics do not tell us anything about why different rates exist in different parts of the world. Any pseudo expert who tells you about this or the other being “the real cause” must be treated as one must treat an armchair scientist.

The next thing you might want to know is what causes suicide, or perhaps more accurately what factors are associated with suicide.

There is no doubt that the majority of those people who kill themselves suffer from one form of mental illness or another. Indeed, some experts believe that the fact that one kills himself is more than adequate reason to diagnose a mental illness.

Severe depression is the most likely cause of suicide, in particular in persons who also abuse drugs and or alcohol.

In other words, a combination of depression and alcohol abuse is a serious reason for concern by the family.

People who have made previous attempts, as well as persons with a family history, are also at increased risk.

The situation gets more complex because of a past personal history of violence, in particular, sexual violence which increases suicide risk.

Persons with physical illness and chronic pain particularly in the elderly can be an added risk for suicide.

Importantly, many people who go on to kill themselves will have hinted about their intentions. Some tell doctors, spouses, priests and increasingly social media.

Your question has not been answered by all these facts and so it might be useful for us to state the following.

There is a difference between the concept of self-harm and suicide. In both cases, the person harms themselves but in the former case — self-harm or deliberate self-harm — the causes, consequences and treatment are significantly different, from those who complete by death.

Self-harm

Late last year, we saw a 17-year-old girl who had made an attempt at suicide by swallowing tablets given earlier to her mother for high blood pressure.

After taking the tablets, she went to the sitting room and dramatically fell on the floor and told her parents what she had done. In a panic, she was rushed to the hospital, observed overnight and no harm came to her. Her boyfriend brought her some flowers, they kissed and made up and that was the end of that episode of self-harm intended to get attention.

In an adjacent ward, a 65-year-old man with a history of heart disease and diabetes was recovering from a gunshot wound to his chest inflicted in an attempt at suicide. He had intended to kill himself and hence the self-harming behaviour. Only an expert can correctly make a distinction between the self-harming behaviour of these two people. In all such cases ask the expert.