GUYANA has recorded unprecedented rates of suicide over recent years. With a prevalence of teenage self-destruction that is shattering families from one end of the country to the other, there is an urgent imperative in addressing this scourge in our nation through counselling and/or relevant interventions.    

Morbidity associated with depression is difficult to quantify, but the lethality of depression takes the measurable form of completed suicide, a primary cause of death in many developing countries.

Depression is a potentially life-threatening mood disorder that affects most people at one time or the other in their lives. Depressed patients are more likely to develop type 2 diabetes and cardiovascular disease. Research has shown that, not counting the effect of secondary disease states, over the next 20 years, unipolar depression is projected to be the second leading cause of disability worldwide, and the leading cause of disability in high-income nations, including the United States.

The current economic cost of depressive illness is exacting a toll on nations hugely both economically and financially. In addition to considerable pain and suffering, which interferes with individual functioning, depression affects those who care about the ill person, sometimes destroying family relationships or work dynamics between the patient and others. Therefore, the human cost in suffering cannot be overestimated.

In Guyana, depression is neither generally viewed nor treated as a disease; and people with depression do not realize that they have a treatable illness, and do not seek treatment, so only a few of those individuals receive treatment consistent with current international practice guidelines; and certainly, most of these people have resources, not to mention caring and supportive persons in their lives.

The reality is that, of patients who had suicidal ideation, and of those who have actually made attempts at suicide, few are recognised to be ill. What is worse, those persons who attempt suicide in Guyana are treated as criminals, instead of as people who are really ill and in need of help, because the powers that be do not provide the requisite care, or even perceive the need for such care.

Persistent ignorance about, and misperceptions regarding, depression, by the public and even some health providers, as a personal weakness or failing that can be willed or wished away, lead to painful stigmatization and avoidance of the diagnosis by many persons who are affected by the disease.

The cause of depression is multifactoral, but family history of depression is common among persons with the disorder.
In addition to depression, other etiologies, such as alcohol/substance abuse (especially of opiates and cocaine), impulsiveness, and certain familial factors are highly associated with risk of suicide. These factors include a history of mental problems or substance abuse, suicide in the immediate family, family violence of any type, separation or divorce, and other depressive emotional issues.

Other risk factors include prior suicide attempt(s); presence of a firearm in the home; incarceration; and exposure to the suicidal behaviour of family members, peers, celebrities, or even highly publicized fictional characters; along with peer pressure; bullyism in and out of schools or other institutions; and sibling rivalry, among many other factors.

It is also established that the initiation of treatment for depression with psychotherapeutic agents can temporarily increase the incidence of suicidal ideation, and therefore the likelihood of suicide attempts.

The incidence of depression in health-care workers is comparable to that in the general population, though the rate of completion of suicide is higher.

In a society where societal, community, and even family structures have broken down, leaving someone feeling alone, lonely and abandoned, with no one to turn to for help, guidance, or even companionship — such as old and helpless parents neglected or abandoned by their children; or little children whose perception is that their parents do not care about them, whether real or imagined — there is every likelihood of an increase in depression, leading to a suicidal state and even to committal of the ultimate act of self–destruction – suicide.

“If only…” are the saddest words at grave sites during funerals, so each of us should ensure that we never have cause to repeat those words over a burial site of a loved one.

Pay heed to mood swings; listen, get involved in your children’s lives, so that they feel free to confide in you about any and every issue; be a friend to the friendless, and a guide to the directionless; be less judgmental of your fellow human being, and reach out with friendship and care to others less fortunate. In doing these things, you may very well help save a life.