What makes a person want to commit suicide?

If a person has an anxiety condition mixed in with depression, the situation is even worse. In addition to the depths of despair, he or she is in constant worry about many things, so much so that one can’t sleep.

Last week, suicide made headlines with the deaths of designer Kate Spade and celebrity chef Anthony Bourdain. That two successful and seemingly balanced individuals would take their own lives was a shock — and it brought attention to the rising number of cases here, especially among the youth. Suicide does not discriminate, affecting teens, young adults to persons in their 50s or 60s.

Latest estimates from the World Health Organization (WHO) approximate that around one person dies from suicide every 40 seconds. This does not count the many more who attempt, and do not succeed, in taking their own life. There appears to be an epidemic of suicides, caused by mental health conditions that are often misunderstood.

Following news that someone attempted suicide, we hear reports that he or she suffered from a mental health condition such as depression. Depression is the leading cause of ill health and disability worldwide. According to the latest estimates from WHO, more than 300 million people are now living with depression, an increase of more than 18 percent between 2005 and 2015.

What is depression really like and where does it come from? For many, the concept of a depressed person is one who might look unkempt, morose, anti-social or almost catatonic. But with increasing concern, we notice “regular-looking” and even “successful” people reported to suffer from depression. Many observe: “He had good grades/a good job, a loving family, every comfort a person needs, why would he want to die?” What makes a person feel so terrible, that he would take his own life?

Let’s first understand the root of this sickness. There are a host of possible reasons one might get depressed. Just like heart disease or asthma, depression can be inheritable. In addition, certain neurotransmitters or chemicals such as dopamine or serotonin, found in in the brain, if out of balance, may contribute to the disease.

There are a series of other factors that might also predispose one to mental health conditions. These might include: lack of social or family support or sense of connection, major life events like trauma, natural disasters, life transitions both professionally or personally, such as job loss, separation or death in the family. These life events on their own may not always cause depression, but a pattern of unhealthy thinking and coping can lead one to be vulnerable to mental health problems.

A person who is vulnerable to depression due to genetics, as well as some predisposing conditions mentioned above, often encounters a life challenge that triggers the illness. But this is not always the case. It can happen that symptoms slowly develop over time with daily life stressors and the imbalance of neurotransmitters or chemicals.

A person who is depressed can feel a depth of despair comparable to grief. I’ve heard people say: “I’ve been sad, but I’ve never wanted to die!” Perhaps you’ve felt sad, but a major depressive disorder is different. Try to imagine a time you lost someone dear to you, or that you suffered a devastating heartbreak or failure. Now multiply that pain by 10 or 20 and remove the sense of hope that things will be better tomorrow. That’s how grave the sadness of a person suffering from depression might feel, on most days. It becomes emotionally, mentally and physically exhausting to live like that. And that’s just one of the symptoms. In many cases depression and anxiety can hit a person at one time.

If a person has an anxiety condition mixed in with depression, the situation is even worse. In addition to the depths of despair, he or she is in constant worry about many things, so much so that one can’t sleep. Losing sleep can make one even more vulnerable to the mental health condition getting exacerbated.

A person with depression may wake up from restless sleep, feeling exhausted, sad, or hopeless. He or she recognizes that there is something wrong with him or her. People close to them start to notice and yet can’t seem to understand what is happening. Well-meaning family or friends might say: “Wala ka naman problema, ba’t ang lungkot lungkot mo? (You don’t have a problem, why are you so sad?) Other people have it worse!” Or they might say: “Snap out of it!”

Not knowing that patients with depression have tried telling themselves exactly the same thing, every day, and have failed. They cannot seem to “snap out of it.” Worse, they can’t explain why that is so, and therefore, they start to feel alienated.

Patients suffering from mental health conditions want to feel better; but many cannot do it on their own. It is a daily struggle. So, on top of feeling intense sadness, one feels alone and incapable, too. Often they look around at their family and friends and think: “Pabigat siguro ako (I’m a burden).” And this is when existential questions arise. Thoughts of death and putting an end to the suffering begin to surface.

These thoughts might seem “dramatic” and unfounded, but are actually symptoms of depression. In the same way a person with pneumonia suffers from fevers and difficulty breathing, a person with depression gets these thoughts of isolation, feelings of incapability and debilitating sadness and exhaustion.

These are all symptoms of an illness. They are not efforts to be “dramatic” or signs of weak character. The sooner we realize this, the sooner persons with depression can be open about seeking help, instead of trying to hide their condition with fears that they’ll be judged.

Many times, in the counseling room, I hear clients say: “I don’t want people to know I have depression, they will say I’m weak, being dramatic, lazy or lacking faith.” I have clients who hear mass and pray the rosary every day. And yet they continue to suffer. Clearly, it is not a question of lack of spiritual life. Rather, it is an illness of the body and mind, that needs care and often medication.

It doesn’t mean that just because your relative has a mental health condition, you might get it, too. It doesn’t mean that if you encounter a big life change, you are in danger of getting depressed. In the same way, one can find ways to prevent heart disease, one can exert measures to stay mentally healthy.

Just like physical health, mental health can be strengthened by restful sleep, exercise, a good diet, a good support system of friends and family. The pursuit of healthy hobbies and interests also help. All these contribute to feeling good and release healthy hormones into our body. In addition, medication and psychotherapy can help heal and prevent the onset or recurrence of these conditions.

When life’s stressors seem to affect you more intensely that you start to lose sleep, feel isolated and start getting anxious, do a healthy lifestyle check: are you exercising, getting enough rest, practicing self-care and seeking social support? You might also want to seek help from a counselor right away. This can prevent a worsening of symptoms so it doesn’t develop into a condition.

For those living with persons with mental health conditions, acceptance, understanding and sensitivity are necessary. Judgement, criticism and sensationalizing don’t help. When someone succumbs to pneumonia and dengue, we don’t say it was because they were selfish or being dramatic. In the same way, let’s stop ourselves from belittling and trivializing mental health conditions and the patients who suffer from them. Instead, seek to know more about what they’re going through and how you can help.

If you or a loved one is suffering from depression or you suspect is at risk for suicide, you can call Crisis Line by In Touch at +63 2 893 7603; +63 917 800 1123; +63 922 893 8944.

The author is a licensed psychologist, career coach, workshop facilitator, and speaker. You may follow her on Instagram @malou_psychologist_coach or email malou.delcastillo@thecareerroadmap.net.