I’m reposting this article in observance of World Mental Health Day 2020. I wrote this when I was still with PJI.

Depression is almost always a sign. About 25 percent of patients with depression have thought of committing suicide. And 10 to 15 percent of them have committed suicide, most of the time unsuccessful.

Depression is a mental illness involving deep, unshakable sadness and diminished interest in nearly all activities. It also means temporary sadness and loneliness common to most of us from time to time. Almost everyone gets depressed at one point. But in contrast to “normal” sadness, severe depression can dramatically impair a person’s ability to function in social situations and at work. People with severe depression often have feelings of despair, hopelessness, and worthlessness, as well as thoughts of committing suicide.

So says Dr. Genuina Ranoy, the psychiatric consultant of the Children’s Welfare Specialist Group of the Department of Social Welfare and Development.

Local study

There are no national data on suicide and depression in the Philippines. But Ranoy cites a study at the Medical City from 1996 to 2000, where at least 150 suicide cases have been recorded.

Of these cases, 117 or 78 percent are women while 33 are men.

The most common mode of suicide for women is wrist-slashing and drug overdose. It’s the same mode of suicide from men.

But generally, men use the more lethal form: using a gun to shoot themselves, intentionally causing vehicular accidents, and jumping from heights.

The study observed that the common reason for women to commit suicide is a problem with the opposite sex. For men, it is often a financial difficulty.

Ranoy said that suicide can also be determined genetically. “If you have a first-degree member of your family who has committed suicide, there is a greater increase for you to commit suicide, too,” she said.

“Lalo na kung mother or father mo, especially when you were physically involved, or you saw how your mother kills herself or your father kills himself. Mas magiging acceptable for you and suicide,” she pointed out.

If the coping skills needed to handle stresses do not develop during childhood, this increases a person’s vulnerability to commit suicide.

SIGNS

Suicide knows no class barriers. “Whether you come from a well-to-do family or a poor one, you can develop the same depression and commit suicide,” she pointed out.

She said patients who are severely depressed don’t commit suicide because they don’t have the initiative to do it.

“It should be noted that when patients recover from severe depression, it is the time that they commit suicide. This is called paradoxical suicide,” Ranoy said.

Described as strings of down emotions, depression is seen in people who are unable to sleep or have the tendency to oversleep; unable to eat or could overeat in the process.

“Almost every day parating down ang feeling. They don’t have the energy. The usual activity that they take delight in previously is no longer enjoyable,” said Ranoy, managing editor of the Philippine Journal of Psychiatry (at the time of the interview).

She disclosed that a big percentage of patients with suicidal behavior also have homicidal tendencies.

“Persons with homicidal behavior think of hurting or killing somebody else, not just themselves. It is more acceptable for them to kill other people than to kill themselves. People should take not only suicidal precaution but also homicidal precaution,” Ranoy said.

She said some medicines for chronic illnesses could also trigger depression. Medication for hypertension, diabetes, neoplasia, steroid, and anti-cancer drugs, for example, may cause depression.

INTENTION

The attempt to kill oneself depends on the intention of the person to commit the act.

“There are suicides wherein the intention of killing themselves is low. They are called borderline personality disorders. They try to commit suicide at the slightest feeling of depression or frustration in their lives. They attempt to kill themselves just to gain attention. This suicide act is also described as suicide gesture or threat,” Ranoy explained.

The mode of suicide, on the other hand, determines the intent of a person to commit suicide.

“Drug overdose or intake of corrosive materials, that’s a high intent of suicide. They want to die because corrosive materials that include Clorox and muriatic acid, once you have taken them, the chance for you to heal is low,” she said

A suicide letter left by the patient also shows the high intention of the person to die.

“It is more acceptable for the person who will commit suicide to leave a letter with the knowledge that their family knows why they did it,” Ranoy said.

Some persons are extremely happy before taking their own lives.

“This is because they have already accepted the fact that they are going to die and don’t want anybody to know this.”

Then some explicitly state the intention.

“There are others who will call a friend or relative before they do the act. However, the intent of killing themselves is low compared to the other one who stays in the room and doesn’t want to be bothered by anyone.”

PAIN

People around or close to the person who commits suicide experience third-degree pain.

“Guilt is always there…I should have done this to prevent this kind of condition. Although most of the time it’s not their fault, they could have done something,” Ranoy said.

SUPPORT SYSTEM

Patients with depression undergo drug therapy. Through psychotherapy, psychiatrists also help patients look for the causes of depression.

A support system plays a major role in preventing suicides. “Those that are vulnerable to suicide and depression are those who do not have any support system. They are single, divorced, or don’t have an active relationship with anyone so they are the most vulnerable,” Ranoy noted.

A support system could also come from friends and colleagues in the workplace. Some government hospitals are offering therapy for poor patients suffering from depression.

Experts said the best way to prevent depression is to live a stress-free life by having a balanced lifestyle and by learning how to breathe or relax.