Suicide and Mental Illness Myths in the Philippines

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I started this blog so I could spread the word that the Philippines has The Compassionate Friends , a grief support group for families that have lost a child or a sibling. Aside from its primary mission to assist families toward the positive resolution of grief following the death of a child of any age, it also provides information to help others be supportive. The second mission proved useful to a blogger whose friend’s sibling died of sucide. (NOTE:In my entry, Suicide:How do you say it?, ““Died of suicide” or ““died by suicide” are accurate, emotionally neutral ways to explain the death.)

What a compassionate friend she is! She took time to send me an e-mail asking my advice on how to deal with her close friend’s loss. I just told her this:

The best thing to do is just listen to her without any judgement at all. In short, just be a friend, Be there, If she wants to talk, let her talk. Listen. If you feel like crying, just cry with her. Hold her hand. Hug her. There are no words that can comfort really. Mention the loved one’s name and anecdotes if you have memories…we love to listen to stories of our loved one.

I also offered her some tips when dealing with bereaved family member or friend. True enough, just talking helped her friend and even the friend’s mother. Suicide is the most difficult topic to talk about. I know of a few suicide survivors (bereaved family members) who refuse to even say the “S” word. A trusted friend is what the suicide survivor needs in their early grief, one who is non-judgmental and compassionate. Talking helps relieve the pain.

The suicide survivor usually feels isolated and guilty for not having prevented the death one way or another. Guilt combined with incomprehension is what I think makes suicide different from any other death. It’s very hard to make any sense of it. All the Whys? and What ifs? that you can think of remain with them for such a long time. But the question remains, what causes death by suicide? Could it have been prevented?

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I don’t have statistics or studies to prove that it can be prevented because there are many factors that might have caused the death (see above image). Let me just tackle one myth which is suicide ideation as a result of mental illness. These are my observations from informal discussion on the topic of mental illness and suicide.

1. There is a stigma on people who have mental illness. Heck , even some Human Resources officers frown upon job applicants and employees taking some sort of anti-depressants or mood disorder drugs. Often, these people are labelled “mentally unstable”. The fact that they are taking medicines show they are helping themselves and are less likely to be “unstable”. What is scary are the undiagnosed mentally ill persons like Charles Roberts,that milkman who killed Amish girls in a school house.

2. Oftentimes, the death was a result of a chemical imbalance that controlled the person; it was not a rational choice. Often a victim of bipolar disorder, also called manic depression, this type of depression results to drastic mood swings. They often get confused and very afraid for years before they finally give in and end their life. With the right medication and enough holisitic therapy, the mental depression can be minimized. Sometimes the medication may not even work for the patient and it’s a matter of regular visits to the psychiatrist to determine the right dose and type of medication.

3. Despair is a sin, the old folks say. Feeling gloomy, and desperate can be easily cured if one has strong spiritual faith. I don’t think so. It might help but remember, a chemically imbalanced brain isn’t wired well. “You will get over it . Don’t lose faith. Keep praying.” are often the words given to the desperate person. But God asks us to help ourselves and seek medical help.

Shame often prevents a person from seeking medical help because of this stigma towards mental illness. And even if they ask for help, the gravity of their problem is minimized as mere despair. Oh yes, I know of one death by suicide from a friend because of this reason alone.

Suicide survivors, like this blogger’s friend, will most likely struggle for many years, to find reasons why her sibling would even consider death by suicide. Were there other available options? What if one of these other options had been considered? All these questions make the grieving process last even longer. However long the process, this search for meaning, safe sharing with others and time, helps diminish the suffering. The sad fact remains that there is so much stigma surrounding death by suicide which is very regrettable. Maybe someday, a suicide survivor will discover it’s safe to share their stories with friends , families and other survivors.

Save a life. Read more on General information about suicide and suicide prevention

For Suicide Prevention Hotline in the Philippines,

The Philippines’ FIRST depression and suicide prevention hotline is now open.

Hopeline PH’s 24/7 hotlines: 0917-558-4673 (Globe)

0918-873-4673 (Smart)

02-88044673 (PLDT)

2919 (toll-free for Globe and TM)

NATIONAL MENTAL HEALTH CRISIS HOTLINE

Suicide prevention is everybody’s business #WorldMentalHealthDay

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Last year, I wrote about “Social Media and Suicide.” The World Health Organization (WHO) states that close to 800,000 people kill themselves every year, which is one person every 40 seconds. Suicide among young people is increasing, and social media is pointed out as the cause due to documented research.

Research findings published in the medical journal JAMA on July 2019 found that “adolescents are of particular concern.“ Increase in screen time have been found to be associated with increases in depressive symptoms. More evidence also points out to social media use. The 2012 study on “Social Media and Suicide: A Public Health Perspective” (David D. Luxton, PhD, Jennifer D. June, BA, and Jonathan M. Fairall, BS) cited the role social media might have in suicide-related behavior. The rise of pro-suicide, social media sites may pose a new risk to vulnerable people who might not have been exposed to these potential hazards. Media also plays an influence on suicidal behavior and suicide methods used. Cyberbullying and cyber harassment are prevalent problems. An increase in publicized cases of suicide in 2011 involved social media.

Another paper came out, “Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among US Adolescents After 2010 and Links to Increased New Media Screen Time” (Jean M. Twenge, Thomas E. Joiner, Megan L. Rogers, Gabrielle N. Martin), in 2017. The study discovered that adolescents who devoted more time online were more likely to report mental health issues. Psychiatrist Dr. Dinah Nadera said “that sense of lack of social connectedness is very, very prevalent…. They’re connected, but they couldn’t seem to have a trusted person.”

The relationship between social media use and depression remains a controversial topic. A study in 2018 by San Francisco-based social innovation group called HopeLab did not find a correlation between use and self-reported depressive symptoms. Despite the lack of conclusive studies, I couldn’t stress enough that our digital well-being matters. It is best to disconnect when called for and create healthy habits for our family.

Suicide prevention is everybody’s business. Educate our community that suicide is a preventable public health problem in the Philippines. Suicide should no longer be considered a taboo topic, and that through raising awareness and educating the public, we could SAVE lives.

To prevent suicides, the whole community from the school, family, church, government, netizens and media are involved. WHO said responsible reporting of suicide in the media to decrease suicide rates. Responsible reporting include: avoiding detailed descriptions of suicidal acts, avoiding sensationalism and glamorization, using responsible language, minimizing the prominence of suicide reports, avoiding oversimplifications, educating the public about suicide and treatments, and providing information on where to seek help.  Every person, as a part of that community, need to take responsibility.

The Lancet published research on “What Works in Youth Suicide Prevention?” and the review identified many studies testing a broad range of interventions across multiple settings, which could reduce the frequency of self-harm and suicidal ideation, “although it is likely the size of these studies that is driving the effects.”

The question is are Facebook, Twitter and Google, the most popular platforms doing enough to prevent suicide?

Facebook announced during World Suicide Day on Sept. 10, 2019 that it is taking steps to fight the youth suicide epidemic, including sharing data about how its users talk about suicide and self-harm and hiring a safety policy manager focusing on health and well-being. Some changes in policy is Facebook’s decision to “no longer allow graphic cutting images.” Even Instagram which they own would also make “it harder to search for this type of content and [keep] it from being recommended in Explore.” Whether you’re worried about someone you know or you’re struggling on your own, Facebook provided a Suicide Prevention Page (http://facebook.com/safety/wellbeing/suicideprevention).

In Google’s Suicide Prevention page (https://support.google.com/youtube/answer/2802245?hl=en), content that promotes self-harm or is intended to shock or disgust users is not allowed on YouTube. Google allows users to post content discussing their experiences with depression, self-harm, or other mental health issues. Instagram also has a page on those who spot content about suicide or self-injury (https://help.instagram.com/388741744585878 ). Twitter’s approach to self-harm and suicide threats is explained in their “About self-harm and suicide” (https://help.twitter.com/en/safety-and-security/self-harm-and-suicide). After Twitter assesses a report of self-harm or suicide, they will “contact the reported user and let him or her know that someone who cares about them identified that they might be at risk.” Twitter would also provide the reported user with available online and hotline resources and encourage them to seek help.

One couldn’t just rely on social media platforms to moderate the content. Let’s take time to understand the social media platforms and potential warning signs or indicators for self-harm or suicide.

First published at the Sunday Business & IT, Manila Times on October 6, 2019.

The Natasha Goulbourn Foundation: Bringing depression to light

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““Mental illness is nothing to be ashamed of, but stigma and bias shame us all.” Bill Clinton

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Did you know that the Philippines has the highest incidence of depression in Southeast Asia? In 2004, there were over 4.5 million cases of depression reported in the Philippines.

Jeanne Goulbourn shares her wisdom on depression.

““Depression is a condition that knows no social class; it could strike anyone regardless of intelligence, educational attainment and financial standing.”

This wisdom she has learned in the midst of pain brought about by the sudden and untimely demise of her well-loved daughter, Natasha, who suffered from depression. As she grieved over her daughter’s passing, Jeanne said she asked God what losing her daughter meant, and prayed for a sign. The sight of over 100 dolphins convinced her she had a higher calling to help people with depression.

“I prayed that if I see five dolphins, Natasha might be in hell. If I see 10 dolphins, could she be in purgatory? But God, if you show me a lot of dolphins, more than 10, I know my daughter is with you. We saw about 108 in Puerto Galera,” she recalled, saying the sight was so rare it even brought the boatman to tears.

Like Jeanne, we know our grief will always be a part of our life and we eventually find ways to resolve it. She and a group of friends from various sectors formed the Natasha Goulbourn Foundation (NGF) five years after the death of Natasha. Its primary advocacy is to promote awareness on depression.

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Not many know what depression is. I have written about suicide prevention and mental health before just to raise awareness. I don’t claim to be an expert on mental health. It’s just that in the course of my grief work at the Compassionate Friends Philippines, I’ve come across a few observations of these mental health issues.

1. Shame often prevents a person from seeking medical help because of this stigma towards mental illness. And even if they ask for help, the gravity of their problem is minimized as mere despair. Oh yes, I know of one death by suicide from a friend because of this reason alone.

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How would I know if someone I care about was contemplating suicide?

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Suicide is very much in the news these days. A forensic expert who conducted an autopsy on Trina Etrong, wife of Ted Failon said that the contact wound on her temple indicates suicide. (Edit on April 22– A second autopsy points to suicide)

I ‘d like to point out that the Compassionate Friends refer to the death as ““died by suicide” or ““died of suicide” to replace the commonly used ““committed suicide” or ““completed suicide.” The phrases “Died of suicide” or “died by suicide” are accurate, emotionally- neutral ways to explain the death.

Suicide, no doubt, is the most misunderstood of all deaths and leaves behind a residue of questions, guilt, anger, second-guessing, and anxiety which, at least initially, is almost impossible to digest. Even though we know better, we’re still haunted by the feeling that suicide is the ultimate act of despair, a deed that somehow puts one outside the family of humanity, the mercy of God, and (in the past) the church’s burial grounds.

Let’s not be judgmental on people who died by suicide.

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