Statistics from the World Health Organisation rate Uganda among the countries with the highest suicide rates in the world. Yet, suicide is a topic that is still often avoided or kept quiet in our society because of the unfortunate stigma it carries.

Psychiatrists now connect suicides with most mental disorders such as schizophrenia, psychosis and depression among others.
In fact according to Rachel Nabirinde, a clinical psychologist, untreated depression is the number one cause of suicide.

Hildah Aseu, a 48-year-old mother of five attempted suicide ten times during her adolescent years. She remembers those as the darkest times of her life and is grateful and amazed that she survived.

Aseu was born in a polygamous family and unfortunately her mother died when she had just turned 12 years old. Her father immediately stopped paying her school fees and she became the housemaid looking after her extended family.

“The first time I attempted suicide was when my stepmother beat me savagely claiming I was feigning sickness to get out of doing chores. When my father came, instead of taking me to the clinic for treatment, he denied me supper and locked me out of the house. I spent the night in the kitchen. I felt abandoned and bitter.

In the morning, I sneaked into the house and found chloroquine tablets and swallowed a substantial amount. I was rushed to a nearby health centre and given first aid,” Aseu relates.

Isolation
The harsh treatment and punishments continued, causing Aseu to feel abandoned and worthless. She reveals she tried different ways of ending her life but none were successful.

“The last time I tried to throw myself in a pit latrine. My legs went in but my bottom and hips failed to pass through the opening.
It was while I was stuck that I decided to stop trying to end my life. I realised the best way to pay my tormenters back was to prove I was better than who they wanted me to believe I was. That my life was worthwhile,” Aseu recounts.

She left home, got a job as a waitress and started going to church, reading the Bible and praying whenever she felt overwhelmed by sadness. She got close to the reverend at her church who kept counselling her and encouraging her to remain strong in her faith.

Moving on
Having saved money from her job, she enrolled for a tailoring course and successfully went on to start her own tailoring business. The mother of five is now happily married and a strong pillar of her community. She provides counselling for young girls going through emotional distress.

Nabirinde notes that for many people with poor mental health such as those experiencing stress or depression, or suffering from a mental illness, suicide seems like the only way out. “The idea of committing suicide comes with thinking about it almost every day. This leads a person to form a plan on how to end their life.

Unfortunately, some will be successful and fortunately there are those that will not be, she says adding that research has found that 10 to 40 suicide attempts are nonfatal. Nonfatal suicide attempts can be seen as a cry for help, meaning the person may be seeking emotional support from the people around them.

Signs
Suicidal thoughts are usually secretive, and this might mean loved ones may not realise what is going on until it is too late. Many people that commit suicide struggle with their thoughts internally and suicide for them is an external release of what they felt inside.

The good news according to Nabirinde is depression which is often related to suicide is treatable. “Depression occurs because of an imbalance of chemicals in the brain. It is an illness. And it is highly treatable. You are not depressed when you feel sad for a day or two; you are depressed when you experience a prolonged period of sadness that interferes with your ability to function.”

Nabirinde says you should seek help immediately assistance if you feel sad for two or more weeks, are unable to concentrate, are sleeping too much or too little, eating too much or too little, losing interest in activities that you previously enjoyed, crying frequently and withdrawing from others, among others.

Risk factors
Prof Eugene Kinyanda of Makerere University Department of Psychiatry, identifies some of the factors associated with suicide as loneliness, problems with making/maintaining friends, unemployment, poverty and feelings of shame. Others include chronic pain, hostile childhood experiences and socio-political, economic and cultural forces.

Several research studies have shown that successful suicide attempts are greatest in patients with schizophrenia, major depression, bipolar disorder, alcoholism and other substance abuse, personality disorders, post traumatic disorders, eating disorders.

Although these are all mental illnesses, suicide is not only common among people suffering from these illnesses. Suicide can also affect anyone with poor mental health or experiencing feelings of hopelessness.

Prevention
Rachel Nabirinde, a clinical psychologist, urges people to take care of their mental health by adopting strategies that help them cope well with bad times and the good times.

Some of the things one can do to keep suicidal thought at bay include writing down a list of positive things in one’s life; distracting oneself by doing something one enjoys such as listening to music, reading a book, watching a film, getting sufficient sleep, calling a friend or family member and going to a safe place such as a place of worship among others.

She strongly advises anyone having suicidal thoughts to go for psychotherapy. Many people do not think of going to a medical doctor when they are depressed, but it is an important step because there could be a physical problem beside the chemical imbalance that is causing the depression. There are many psychological interventions that have been studied to help people with suicidal thoughts.
“One might just need talking therapy such as counselling.

having an open space to talk about what is going on can make a major difference. There are also more directed therapies one can partake in such as Cognitive Behavioural Therapy, Interpersonal Therapy or Group therapies,” the psychologist advises. Nabirinde further advises seeking social and family support. Studies show that social support is associated with a decreased likelihood of suicide.
“Stay in contact with those that love and value you.

Also, family and friends should take it upon themselves find out the mental and emotional state of their loved ones,” she adds.

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