It is often said that having good mental health helps to lead a relatively happy and healthy life. Mental health is often neglected by us and it reflects in our daily life, relationships and physical health. It includes emotional, psychological and social well-being. A level of fear and anxiety by COVID-19 has instilled in all of us. It has isolated us physically and mentally. Almost all the people around the world have feelings of depression as we miss our friends, family and loved ones. These feelings are just an impression into what it is like to be living with anxiety, depression or other mental health challenges. These issues were a daily battle before COVID-19 and they will continue to be afterward, or they may be worsened by the pandemic. Some of the mental health issues are caused by the lack of investment in mental health promotion, prevention and care before the pandemic.
The impact of COVID-19 pandemic on suicide scale of people has increased tremendously. When we come across any incident related to suicide, the first thought comes to our mind is why someone would take their own life. It is sometimes even difficult to imagine that someone has committed a suicide. It might be due to some emotions or stresses in a person’s life and there are many reasons behind taking such step. Examples could be, depression which leads a person to commit suicide. Schizophrenia is another type of illness that affects ability to think, feel and behave clearly. Borderline personality disorder or illness in which a person has suicidal or self-mutilation tendencies. Bipolar disorder which leads a person into dramatic mood swings. There could be some other reasons as well such as traumatic stress, substance related disorder, hopelessness, suffering from illness, isolation, etc.
The magnitude of COVID-19 disaster cannot be compared to any other earlier epidemics. The last pandemic was H1N1 virus in 2009. Centers for Disease Control and Prevention estimated that 151,700-575,400 people worldwide died from H1N1 virus infection during the first year the virus circulated. The Flu was related to increase in suicide rates. Similarly, Ebola outbreak in West Africa in 2013 resulted in various neuropsychological and psycho-affective alterations faced by the disease survivors. A decrease in social interaction, fear of being a burden to the family, anxiety, and psychological affliction during such situations likely increase suicides. Isolation and fear of the disease are also common during the current COVID-19 pandemic.
The COVID-19 cases have increased immensely crossing the 17 million mark around the globe as of this publication. The only possible solution with us till date is maintaining social distancing due to the non-availability of efficient antiviral drugs. It has also compelled the governments globally to declare lockdown, which is the only option left with them. Self-isolation and the fear of handling the stressful situation are the major reasons behind COVID-19 suicides. Social isolation brings restless situation for many people around the world. However, the victims of suicide are mostly those who have existing mental health issues such as isolation or depression. Such people are vulnerable as they have extreme suicidal thoughts. Numerous instances indicate that pandemic has discerning psychological and social effects. The first suicide case was reported in India was on 12th Feb 2020, a 50-year-old man assumed his normal viral infection as COVID-19. The suicide cases are not only limited to common people but medical professionals as well: Dr. Lorna Breen, a Manhattan (New York City) emergency doctor, killed herself due to immense pressure of handling COVID-19 affected patients. Recently, Sushant Singh Rajpoot, Indian actor committed suicide which heaved depression into focus again.
The economic emergency has created unemployment, poverty and suicide risks which in turn, increased the suicide rates. With the increase in unemployment, lockdown will cause more deaths resulting in suicides. Individuals working for businesses such as travel companies, schools and colleges closure, event cancellations are impacted directly, with the temporary or permanent job loss. The pandemic has almost brought to a halt the economy of United States and other countries across the globe. The restaurant industry, auto industry and the stock market have incurred enormous losses. Laying off employees across the globe are taking place in waves. People are producing less, spending less, and consuming less. As if now, nobody is aware about how long the full magnitudes of this decline would be. The uncertainty of self-quarantine tenure will bring unbalanced routine and panic among people, making them feel hopeless about future.
According to HelpAge India Report, the COVID-19 lockdown has affected the livelihood of 65 percent of elders in India and they are either jobless or facing a loss of income. The report also shows that 42 percent of elders are recorded deteriorating health conditions during the lockdown. Attempted suicides by the elderly have drastically increased due to financial constraints and isolation. Elderly people are most vulnerable victims of suicide. The research investigations show that social isolation and loneliness leads to depression and anxiety disorder. For example, the Quebec Health Survey showed that living alone and having no friends were associated with both suicidal ideation and suicide attempts. It is of major concern that the most important public health approach for the COVID-19 pandemic is social distancing from a suicide prevention perspective.
Suicide is the worst thing to happen for any individual. It generally does not have one single cause. Certain factors like untreated depression and self-isolation can lead to higher risk of suicide, thus, having a trusted group of friends can help to protect. There are situations, conditions and other factors that put some people at a greater risk of becoming suicidal. Suicidal warning signs should be taken seriously. There are some signs that are obvious, such as talking about suicide and dying, but others are much more subtle and can be easily missed. The early warning signs that a person may be in danger includes past suicide attempts, family history of suicides, looking for a way to kill oneself, acting differently, talking about being a burden to others or showing extreme mood swings. There are some less obvious warning signs as well such as unusual changes in behavior, sleeplessness, accessing lethal means (stockpiling pills), emotionally isolated, etc. Having such risk factors does not mean that suicide is imminent, however, if our near and dear has one or more of these symptoms, we need to be careful. With greater awareness of the less subtle signs of suicidal thoughts, it is easier to know when to get help or provide help to others.
The financial uncertainty caused by the COVID-19 pandemic made us realize that one thing which matters the most is employment; it matters for the economic livelihood and our mental and emotional health. Also, the elderly and senior citizens are forgotten when they require help the most. There is a need for an action plan for senior citizens by the government, supported by the community and the family members. Psychologists and psychiatrists claim that the current time is a challenge, especially for those suffering from mental health issues. People with a history of depression need special attention. If you suspect someone is suicidal, talk to them about their problems and say you care about them. Talking to the person privately, listening without judgment, and being compassionate would help. The possible solutions to overcome and reduce suicide rates could be easy access to clinical interventions, restricted access to highly lethal means of suicide, effective care to such patients, family and community support and handling problems in a peaceful and calm way. Providing a dedicated national hotline number and assisting them in all possible means whenever there is a need for a trusted doctor or a professional counselor. Everybody must be aware of all warning signs of suicide, and should be cognizant of someone they care about seems “off” or “different”. Facing new realities of working from home, unemployment and living in isolation without other family members, friends and colleagues, it is important that we look after our mental as well as our physical health.
-Kunal Gupta (One of the Prize Winners of Article Writing Competition 2020 in the 25-44 Years Age Group)
National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177120/
Picture Credits: Andree Vodolazhskyi / pharmaceutical-technology.com