Suicide and Poisoning

Overview

Suicide, taking your own life, is a tragic reaction to stressful life situations — and all the more tragic because suicide can be prevented. Whether you’re considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else’s. It may seem like there’s no way to solve your problems and that suicide is the only way to end the pain. But you can take steps to stay safe — and start enjoying your life again.

Situation in Bangladesh

Suicide in Bangladesh is a common cause of unnatural death and a long term social issue. Of all the people reported dead due to suicide worldwide every year, 2.06% are Bangladeshi. According to a report by the World Health Organization, 8,879 people committed suicide in Bangladesh in 2017 (http://www.worldlifeexpectancy.com/bangladesh-suicide). According to a report by Shaheed Suhrawardy Medical College Hospital, Dhaka, published in 2010, around 6,500,000 people of Bangladesh are prone to suicide. The rate is 128.08 people per 100,000 commit suicide in Bangladesh every year. The six-member team led by Dr AHM Feroz and Dr SM Nurul Islam of the medical college conducted the survey at Mominpur union of Chuadanga district from January to April 2010. According to a report by The Daily Star, from 2002 to 2009, 73,389 people committed suicide in Bangladesh. Of these 73,389 people, 31,857 people hanged themselves and 41,532 swallowed poison to commit suicide. Bangladesh Manabadhikar Bastabayan Sangstha, a human rights group of Bangladesh shows that from January 2011 to August 2011, 258 people committed suicide, and of them, 158 were women and the remainder were men (https://www.thedailystar.net/news-detail-232009).

According to a research conducted by Md. Mohsin Ali Shah, Srijony Ahmed and S.M. Yasir Arafat, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University the findings suggest that about one million people die each year by suicide over the world with a global mortality rate of 16 per 100,000 and 39.6 per 100,000 in Bangladesh. Although suicide can happen at any stage of life, it is the second most frequent and in some countries it is the leading cause of death among people aged 15–24 years. Developing countries account for about 73% of the global suicides and, on the continents level, Asia accounts for about 60% of global suicides. Bangladesh, being a densely populated developing country in Southeast Asia, has achieved health-related Millennium Developmental Goals (MDG) but suicide is still under-addressed. There is no surveillance for suicide and nationwide study on suicide is yet to be conducted. Moreover, suicide is considered as a criminal offence and religious factors and social factors as well as legal consequences hinder the suicide disclosures. People prefer to hide suicide news, as it is a criminal offence and aftermath of legal hazards is miserable for the family members. There is also dearth of research and paucity of literatures on suicide of this huge population. Suicide happens because of multifactorial involvement such as genetic, psychological, social, and cultural risk factors; those can interact in different perspectives such as diathesis-stress model and gene-environment interaction. Psychiatric morbidities play an important role in suicide as previous research mentioned that about 90% of suicide victims were found to have at least one psychiatric disorder and depression was the most mentionable one. It recommended that establishment of national suicide surveillance is now a time demanded step.

Symptoms

Suicide warning signs or suicidal thoughts include:

  • Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
  • Getting the means to take your own life, such as buying a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Having mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increasing use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Doing risky or self-destructive things, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order when there’s no other logical explanation for doing this
  • Saying goodbye to people as if they won’t be seen again
  • Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Warning signs aren’t always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.

Prevention

To help keep yourself from feeling suicidal:

  • Get the treatment you need. If you don’t treat the underlying cause, your suicidal thoughts are likely to return. You may feel embarrassed to seek treatment for mental health problems, but getting the right treatment for depression, substance misuse or another underlying problem will make you feel better about life — and help keep you safe.
  • Establish your support network. It may be hard to talk about suicidal feelings, and your friends and family may not fully understand why you feel the way you do. Reach out anyway, and make sure the people who care about you know what’s going on and are there when you need them. You may also want to get help from your place of worship, support groups or other community resources. Feeling connected and supported can help reduce suicide risk.
  • Remember, suicidal feelings are temporary. If you feel hopeless or that life’s not worth living anymore, remember that treatment can help you regain your perspective — and life will get better. Take one step at a time and don’t act impulsively.

In case of poisoning

As we can see earlier, poisoning is one of the mostly used suicidal method. Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. Many substances — such as drugs and carbon monoxide — are poisonous only in higher concentrations or dosages. And others — such as cleaners — are dangerous only if ingested.

When to suspect poisoning

Poisoning signs and symptoms can mimic other conditions, such as seizure, alcohol intoxication, stroke and insulin reaction. Signs and symptoms of poisoning may include:

  • Burns or redness around the mouth and lips
  • Breath that smells like chemicals, such as gasoline or paint thinner
  • Vomiting
  • Difficulty breathing
  • Drowsiness
  • Confusion or other altered mental status

If you suspect poisoning, be alert for clues such as empty pill bottles or packages, scattered pills, and burns, stains and odors on the person or nearby objects.

What to do for help

Call 999 or URAL emergency number 01969906555 or use URAL EMS app to get emergency ambulance. Make sure to take the victim to Dhaka medical college hospital, BSMMU, Shaheed Suhrawardy Hospital or any other government hospital. Do not take him/her to any Private or corporate hospital or clinic as they may reject suicidal case. Here is what you can do while waiting for help:

  • Swallowed poison: Remove anything remaining in the person’s mouth. If the suspected poison is a household cleaner or other chemical, read the container’s label and follow instructions for accidental poisoning.
  • Inhaled poison: Get the person into fresh air as soon as possible.
  • If the person vomits, turn his or her head to the side to prevent choking.
  • Begin CPR if the person shows no signs of life, such as moving, breathing or coughing.
  • Have somebody gather pill bottles, packages or containers with labels, and any other information about the poison to send along with the ambulance team.

Caution

Don’t give syrup of ipecac or do anything to induce vomiting. Expert groups, including the American Association of Poison Control Centers and the American Academy of Pediatrics, no longer endorse using ipecac in children or adults who have taken pills or other potentially poisonous substances. No good evidence proves its effectiveness, and it often can do more harm than good. If you still have old bottles of syrup of ipecac in your home, throw them away.

 

-URAL Research Desk