I have advanced a fundamental hypothesis on suicide

Dear Editor,

I would like to address several issues raised by The Caribbean Voice (TCV) regarding my recent letter in late August on suicide in Guyana.

TCV states as follows: “The Caribbean Voice wonders why Ms Baliram is casting doubt on the 2015 suicide rate for Guyana, which shows a reduction from 44.2 to 30.6 per 1000,000 [sic] inhabitants, and not all or any previous rates.”

I have always been sceptical about the WHO statistics on suicide, particularly for Guyana where misclassification, underreporting, poor data collection methods /procedures, and corruption are serious problems skewing the data. Moreover, my scepticism has intensified since there is a robust increase in the suicide rate in 2012 for males, females and both sexes followed by a sharp decline in 2015 in spite of the fact that the primary triggers arising out of the social, economic and political turmoil remain virtually unaddressed and that interventions of any kind remain sparse. Such an increase in the 2012 data is only possible: (a) if something unusual had pushed almost twice the number of Guyanese into suicide, or (b) if the data is of poor quality. The latter is highly plausible since there was nothing unusual in 2012. Obviously, the 2012 data obscures the consistent increase in the suicide rate and gives the false impression of a decline. Given this narrative, I do not see how in good conscience anyone can speak of a real reduction in suicide in this country.

TCV states as follows: “According to Ms Baliram, a significant reduction in suicide can come about by addressing the abnormally high levels of stress arising out of the catastrophic social, economic and political conditions... The limited characterization by Ms Baliram runs counter to the complete picture.”

I am highly confident that I have advanced a fundamental hypothesis on suicide in this country. But it was unfairly criticized by TCV. I am convinced that unbearable stress drives the bulk of this problem which causes Guyana’s suicide rate to stand above the global average. Even though TCV talks about copycatting and other secondary issues arising from stress (depression, anxiety, hopelessness, suicidal thoughts, dysfunctional relationships, and divorce, etc) in impacting suicide, it obviously fails to see this connection.

TCV needs to know that stress in itself is a risk factor for suicide. Additionally, it is the key player driving this problem in this country because it is chronic, high and unbearable. Moreover, stress has the ability to rewire the brain through alterations in its chemistry and cellular structures (dubbed here as the hijacked brain) and diminish the ability to cope with life situations.

TCV also unreasonably complained that my explanation was limited. It needs to know that as a research scientist, my job is to zero in on the crux of the problem and this is precisely what I have done. I am not sure why it is unable to map the details to the key points I have outlined. In fact, I have created a model explaining suicide in this country with stress as the key player and I hope to share this with the Guyanese people in the near future.

TCV states that suicide in this country comes about because Guyanese are “Prone to copycatting, a practice referred to as the Werther Effect. Suicide ideation is the result of depression and/or anxiety triggered by helplessness, hopelessness, powerlessness, and loneliness. These triggers are catalyzed by low levels of selfacceptance and/or feelings of inadequacy/low self-esteem, as a result of abusive

and dysfunctional relationships; lack of empathetic communication, teenage affairs and pregnancy; rape and incest; an inability to deal with problems (lack of coping skills) and/or unbearable pain, psychosis, bipolar disorder and some other mental illnesses.”

TCV needs to know that copycatting is not a primary trigger driving suicide, rather it is a maladaptive response. Also, copycatting is high among individuals with personality characteristics like impulsiveness, aggressiveness or antisocial tendencies, and that stress potentiates copycatting behaviours in these individuals. To abrogate copycatting, at least the primary triggers inducing stress need to be eliminated or decreased.

The variables listed by TCV are all related to stress and that they are directly or indirectly tied to the calamitous conditions in this country.

Importantly, stress is known to trigger relapses and individuals rescued through interventions can relapse into suicidal thoughts, particularly in Guyana where stress is intolerable. Moreover, stress also causes a relapse of substance abuse which is another risk factor for suicide. Almost all the variables listed by TCV are products of a hijacked brain stimulated by stress or through some kind of inherent pathology.

Stress also increases suicide vulnerability in individuals with poor coping skills. Clearly, the suicide rate will fall if stress is attenuated.

Editor, a practical example can help connect the dots to illustrate how stress emanating from Guyana’s rough economy influences suicide. For example, the proprietor of Stretch-D Dollar store was recently the victim of fatal suicidal behaviour after his business went bankrupt in a bad economy. Such a stressor has got to trigger unbearable stress which breaches psychological well-being and elicits or exacerbates depression, anxiety, hopelessness, etc, and pushes the proprietor into a series of problems which entail divorcing and killing his wife and ultimately suicide. In another example, we have all witnessed that dysfunctional politics in this country have snuffed out diversity from the workforce and this, unfortunately, unleashes intolerable stress and ultimately pushes Guyanese into suicide. I am not sure why TCV is unable to connect the dots. I remained baffled. Given this narrative, I am convinced that calamitous conditions in this country largely spur such human tragedy and as such aggressive actions need to be taken to bring down the high unemployment rate, the high crime rate, curb widespread discrimination, end cruelty and end dysfunctional politics, among a wide spectrum of other things.

In closing, I need to be clear that I am very much in tune with the highly valued and much-needed work done by the NGOs. They deserve praise. But definitely, more needs to be done. To this end, emphasis needs to be placed on reducing or eliminating the primary triggers in conjunction with broad therapeutic approaches aimed to reach every citizen. While my letters to the editors remain insightful, it is also my wish to be on the ground fighting this problem. And I remain hopeful that Guyanese will win this battle against such a human tragedy when egos are set aside, new ideas and insights are allowed to flourish and constructive criticisms are welcomed with open arms.

I wish to thank TCV for its criticisms which stimulated the contents of this letter. And although this letter cannot address every aspect of the suicide dynamic, I have nevertheless put forward a highly relevant hypothesis. Moreover, it needs to be realized that stress arising from the calamitous social, economic and political conditions influence brain functions in multiple ways accounting for most of the suicide in this country.

Yours faithfully, Annie Baliram

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