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Life is a beautiful and precious gift of God. A new life comes in the world with the parcel and package of happiness, hopes, challenges and unlimited optimisms, but thinks for a minute of a situation where all these hope and happiness appears to be meaningless. A condition in which a person is enfolded in depression and anxiety and chooses to end his most prestigious possession i.e. life. We all are surrounded by a large number of beautiful things but everyone perceives it differently. In life it is normal to face success and failure because everything happens for a reason. We have to accept that the sun will rise after the dark night.
Laaiba, a 15 years old girl, was brought to the emergency department in unconscious state with the history of ingesting pills. On exploring further, health care member came to know that she had ingested 7 tablets of OTC drug after the frustrating argument with her father about her boyfriend. After the conflict in the evening, her mother found her unconscious on the ground. She was rushed to the hospital but, fortunately or unfortunately her life was saved.
She belongs to a middle class family and recently she passed her intermediate with only passing grades. She was depressed and was emotionally stressed out due to the major life changes like admission in university, financial crises and family relationship problems. There was no one to support her and make her comfortable by catharsis. To get rid of those entire curses she decided to commit suicide as this was her last recourse to finish her miseries.
A recent study stated that, suicidal behavior might be regarded as a long process usually stretches over many years, from suicidal ideation to planning and culmination in suicidal attempt (Levinson et al., 2007). Suicidal ideations are basically the thoughts which come in a person mind due to some problems and worthlessness of life and prioritize the death as a good option and those who act on those thoughts commit suicide. About one million people die by suicide each year globally and majority of them belong to developed countries (Khan et al., 2008). Suicide is the third leading cause of death in USA. In the past the suicide rate was 5% between the ages 15 to 24, but now it is raised to 14%. The suicidal attempt rate is higher in females while the death from the suicide is higher in males (Stuart, 2009). In Asian countries like Hong Kong, Taiwan and Singapore the suicidal rate is low below the age of 10, while its rate increases between the age 10 to 14 years like the western countries and there is a dramatic increase for the rate between the 15 to 24 years of age. In Islam suicide is unpardonable sin and in Pakistani constitution it is considered as a criminal act. According to khan, (2005) in Pakistan, the DSH cases would be 30000 and 60000 yearly. There is no approved data on suicide in Pakistan in the annual national mortality statistics and none is reported to the World Health Organization (2000).
The causes for suicidal behavior are immense which captivate these poor and innocent creatures in great trouble and sometime even seize their lives. Suicides are infrequently voluntary. In teenagers the suicidal ideations are related to multiple internal and external factors such as depression and stressful life events, parent child conflict, lack of parental support, family history of suicidal behavior, psychopathology, negative life events, child sex abuse, same gender orientation, hopelessness, risky behavior that is drug and alcohol abuse, aggressive impulsive behavior, pessimism, conduct behavior, panic disorder, firearms availability, body image dissatisfaction, suicide contagion and biological risk factors. Depression has been acknowledged as a foremost risk factor for suicidal ideation, suicide attempts, and successful suicide (AACAP, 2001). In the participants with the moderate to severe depressive symptoms, the intensity of depressed effects was the most momentous prognosticator of the existence of suicidal ideation and the wish of killing oneself both in boys and girls (Chabrol, Rodgers & Rousseau, 2007). There is a strong association between the pressure to excel in school and the suicidal behavior among the teen agers (Toero et al, 2001). Growth, development and the behavior of the child is totally dependent on the child rearing style of parents. There authoritarian parenting style, higher maternal overprotectiveness, less parental warmth, negative family environment and child rearing practices leads to the low self-esteem and depression which ultimately leads to the suicidal ideation and attempts. Lai and McBride-Chang stated that lack of parental care and understanding, a non-harmonious family, and conflicts with parents were all related to suicidal ideation in Hong Kong adolescents. Stressful interpersonal interaction initiates the majority of youngster suicide in seconds. Genetic factor and family history of suicidal behavior and parental psychopathology also increases the risks of suicide among the teen agers. Most of the adolescents who committed suicide had major psychiatric problems like depressive and substance abuse disorders. Major depression has been the most prevalent condition. Suicidal intent is also associated with psychopathology and stress from mental disorder (Koutek, Kocourkova, Hladikova & Hrdlicka, 2009). Access to the lethal method like the firearm availability especially the guns in homes is the foremost hazards for suicide. It has been found that the successful and unsuccessful attempt of suicide is higher in gay, lesbian and bisexual youngster built upon the strain and isolation related to their sexual orientation stigma and parental rejection. Besides all these, exposure to the selective serotonin reuptake inhibitors also increase the risks of completed or attempted suicide (Barbui, Esposito & Cipriani, 2009). An abnormality in the neurotropic system also adds towards the suicidal tendency (Kohli, Young, & Conwell, 2010).
There is no rose without thorn, so there must be some negative aspects of suicidal ideation as well as suicidal attempts. It has a devastating effect on his/her individual and family life but has an impact on the society as well. It takes parents from children, children from their families, and valuable people from the society. Suicide hurts family to such a level that their wounds never heal. They always blame themselves and curious that why they were not given the chance to help that person. Suicide is an egocentric action that ceases the relations of reliance in family. Their family has the feeling of hurt, resentment, depression, guilt and the most important facing the stigma of suicidal act of family member. Suicide is contagious and spread by the process of idea and imitation. Friendship with suicidal others may increase the risk of suicidal ideation and suicide attempts (Bernburg, Thorlindsson & Sigfusdottir, 2008).
While coming on to the solution, it is not easy to recognize the people suicidal ideation, and to help those who did the attempt. We donââ‚¬â„¢t have the magic stick to change their mind in very little time; actually it requires a lot of efforts, time and the collaboration of different institutions. As a member of the society we have to assess their sufferings and to help them in accessibility to different social groups who would help them in different continuum. Suicides are preventable and are worth preventing. Suicidal ideation can be the predictor of suicidal acts. It is important to know about the risk factors for suicidal ideation as it increases the risks for suicidal attempts and ultimately completed suicide (Brent, 1995). Prevention of depression is one of the methods that are helpful to reduce the suicidal behavior. Suicide rate has been decreased by training the primary health care professional in the detection and management of depression (Khan et al, 2008).
In conclusion, with a burning candle, I took the oath to provide culturally sensitive care. So, being a part of the health care provider, I will not violate the cultural health practices.
Can we break our culture of silence to help them and accept them as human being deserved? Can we embrace them to be the part of us and this world? Can we help them to make a winning period; they need to have sense of identity and to teach them not to go the way the life takes you, take the life the way you want to go. In the end I would like to quote: ââ‚¬Å“God didnââ‚¬â„¢t promise days without pain, laughter without sorrow or sun without rain But God did promise the strength the day, comfort for the tears and light for a way.ââ‚¬Â Unknown.
Suicidal behavior might be regarded as a process of
varied length that usually stretches over many years,
fromsuicide ideation (thoughts about the worthlessness
of life and death wishes) to concrete planning
ending in actual suicide attempts (1, 2). The study of
such a process in the general population is important,
for the prediction of potentially preventable
deaths, and for the relief and monitoring of the high
distress level expressed by this behavior.
Information on suicide attempts in the