Exclusive: A Psychiatrist's View On Mental Health And Suicidal Behaviour

According to the statistics by WHO, 7.5 per cent of the Indian population suffers from mental health issues. That is, out of the 135 crores population, more than 10 crores people suffer from one form or another of mental illness. Studies have pointed out that, by the year 2020, 20 per cent of the Indian population will be suffering from some form of mental health problem.

In light of the recent apparent suicide of Bollywood actor Sushant Singh Rajput, the importance of mental health awareness in the country is in prominence. Dolefully, reports show that every 3 seconds - a suicide attempt is recorded in India [1][2].

On speaking to Boldsky, Dr Sebind Kumar, Consultant Psychiatrist and Assistant Professor at Govt. Medical College Thrissur, weighed in on the impact of mental health on the overall well-being of an individual and the linkage between mental illness and suicidal behaviour. Dr Sebind Kumar also works part-time in NGOs, where he focuses on reaching out and helping the society.

Q: How often do you treat patients with suicidal behaviour?

A: Daily and the most common cause for the suicidal tendency in individuals is due to depression, which has the prevalence of 1 in 5 and is twice more common in women than men. Also, individuals between the age of 30-35 are increasingly prone to this behaviour.

Dr Kumar went on to point out that, an individual goes through three stages, hopelessness (a feeling or state of despair), helplessness (unable to act without help) and worthlessness (state of being unimportant and useless). These factors or stages have a direct impact on his/her mental health (brain) and they could indicate depression. An individual reaching this stage views suicide as their ultimate outlet, which becomes the 'answer' to their struggle.

Psychologists term this as adjustment disorder - a group of symptoms, such as stress, feeling sad or hopelessness that take over an individual in the event of a stressful situation in life.

Q: How do all these (stress) affect the mental health of an individual?

A: Speaking in detail, stress and tension can cause the serotonin levels in one's body to decline, and an imbalance in serotonin levels can influence your mood in a way that it leads to depression. However, not everyone with stress will have low serotonin levels, and not everyone with stress will go on to develop depression.

Mental Illness Or Stress: What Leads A Person To Suicide?

Q: How do you treat individuals with mental health problems?

A: First of all, the method of treatment varies from person to person, as each person is unique. For us to begin the treatment, it is necessary to be aware of the details of the individual such as his/her family background, education, personality etc. as these play a major role in diagnosis as well as treatment.

The primary aim of treatment is to correct the serotonin levels, which requires the intervention of medicines.

Before beginning the treatment, the doctor examines and analyses every (necessary) aspect of the person because - for a psychologically minded person, the treatment will differ from that of a person who is not. Psychological-mindedness is an individual's capacity for self-examination, introspection, self-reflection and personal insight.

So, for such an individual with the ability to assimilate and understand, psychotherapy will work better whereas for an uneducated or an individual with intellectual disability counselling will not yield the optimum result.

Q: How do you analyse and determine the suitable treatment option?

A: As I had mentioned before, it is determinant on the patient's overall background and before-mentioned aspects. Apart from that, some individuals can develop mental problems such as stress and depression (mainly depression) as an inherited risk. For these people, the condition is biological and would require medicine more than therapy.

Then, you understand and assimilate the majority of the situation by talking to the individual. As psychologists, we understand the individual through their mannerisms and other related factors, which help us understand them and chose the best treatment option.

It is through clinical diagnosis a psychologist examines the patient because no laboratory tests, CT scan or MRI can produce the exact data. Mental illness cannot be examined and understood as one would understand the symptoms of tuberculosis or cancer.

Q: Are the examinations and analyses accurate?

A: It is medically erroneous to say that clinical diagnosis or clinical observation is a 100 per cent correct. With the science of psychological analysis still being limited, there is no precise assimilation. It is the culmination of analysing and examining hundreds and thousands of different people.

The exact and precise impact of genetic differences and the impact they have on one's brain circuit has not yet been studied. That is, the changes (emotions & feelings) that occur in an individual are live - that is, it is happening currently and changes every second, where the science has met the limitation of studying the changes as it happens live.

Although a CT scan or an MRI can produce a close representation, it cannot be termed exact.

Q: Do you think there are specific reasons that cause a person to develop suicidal thoughts or behaviour?

A: It is impossible to assert that an individual developed suicidal behaviour due to a specific reason or a single reason. For example, if for one individual, it was due to a specific reason - for the other, it can be due to more than one or many altogether.

An individual develops depressive symptoms between the age of 30 to 40, again this is a grasp from clinical observation. Upon examining 100 patients, the aggregate 80 per cent is the psychological understanding. The complexities of the human brain and emotions are what pose as the minor constraints here.