Back from the brink

Though our ma­cho cul­ture can make it dif­fi­cult for men to dis­cuss their men­tal health, it’s es­sen­tial they speak up

Irish Examiner - Feelgood - - Parenting - MAN FRI­DAY DR PHIL KIERAN

ASHORT time ago I found my­self run­ning along Sun­day’s Well in Cork, at four in the morn­ing, just as dawn was break­ing over the city. I was tak­ing part in the Dark­ness into Light event for Pi­eta House. It was an in­spir­ing ex­pe­ri­ence.

Two and a half weeks ear­lier, I was at home with my fam­ily and I got a text ask­ing had I heard any­thing from a friend of mine over the past day or two? Nine min­utes later, I re­ceived a phone call to say that he had been found dead. That dis­tress­ing call led to other calls and trips and chats with friends I hadn’t seen in too long.

This is the sec­ond col­league I have known well to have taken their own life in the decade since I grad­u­ated.

Un­for­tu­nately, I’m sure for a num­ber of you read­ing this, the story I have out­lined is a fa­mil­iar one. In the af­ter­math of sui­cide I am al­ways struck by the sad­ness in those left be­hind and their de­sire to go back and tell the per­son who died that they are loved, that things can get bet­ter and it’s OK to talk about this.

How big a prob­lem is sui­cide?

There were 425 deaths in Ire­land re­ported as sui­cide in 2015. This is three times more peo­ple than were killed in road ac­ci­dents in the same year. The of­fi­cial num­ber of deaths by sui­cide are be­lieved to be an un­der­es­ti­ma­tion as it is thought that a num­ber of deaths due to fall­ing, drown­ing or single ve­hi­cle car crashes are likely sui­cides. And, al­though a di­ag­no­sis of de­pres­sion is twice as com­mon in women as in men, men are five times more likely to die by sui­cide.

This dis­crep­ancy sug­gests that the higher level of sui­cide in men may be a re­flec­tion of un­der-re­port­ing of de­pres­sion in this group. This could be due to so­cial stigma, or the fact that, par­tic­u­larly in young men, peer sup­port can tend to avoid talk­ing about emo­tional prob­lems.

This can lead to a lot of men not get­ting the help they need. We also know that an­other rea­son more men die of sui­cide is be­cause of the choice of method. Men tend to use more vi­o­lent means to com­mit sui­cide there­fore have less at­tempted sui­cides but more com­pleted sui­cides.

Can any­thing be done?

You may no­tice at cer­tain places around the coun­try there are signs with a phone num­ber to ring if you are feel­ing sui­ci­dal. These are of­ten at rail­way lines, road fly­overs and near rivers or the sea. The Sa­mar­i­tans put these up in lo­ca­tions that have had high in­ci­dence of sui­cide. There was a study done in Bri­tain in 2005 which showed that these signs can be very suc­cess­ful, re­duc­ing sui­cides in the lo­ca­tions stud­ied from 10 to three per year. This re­duc­tion proves that there are ef­fec­tive ways to re­duce sui­cide and to save lives.

There can be a fa­tal­ism as­so­ci­ated with sui­cide, that this is a hid­den prob­lem, that noth­ing can be done about it be­fore its too late and, for those who find them­selves con­tem­plat­ing sui­cide, that it is the only op­tion that makes

sense. How­ever talk­ing to some­one, be it a coun­selor, friend or your GP could save your life.

De­pres­sion mind­set

De­pres­sion can take away your abil­ity to see through the dif­fi­culty in which you are cur­rently mired. It can make you be­lieve that there is no way you will ever feel bet­ter of­ten be­cause it makes you feel that this de­spair is due to un­change­able fac­tors in your life, none of which is in your con­trol.

It can make you be­lieve that no one cares and that in fact some peo­ple in your life will be bet­ter off when you are gone. This is not the case. This is how de­pres­sion warps your think­ing and it can be helped.

How­ever, you can feel bet­ter even if the ob­sta­cles in your life re­main the same. They can be­come man­age­able if your de­pres­sion, just like pneu­mo­nia, is treated.

Over­stretched ser­vice

So far this year I have had two acutely sui­ci­dal pa­tients in my surgery and talk­ing to my friends in gen­eral prac­tice this isn’t above av­er­age. These pa­tients need a few things im­me­di­ately.

Firstly, they need time. Time to dis­cuss what is go­ing on with them. Se­condly, they need on­go­ing sup­port and plan­ning to help them re­cover. Un­for­tu­nately, due to time pres­sures I of­ten have to sit them in a dif­fer­ent room in the surgery and keep check­ing in while at­tend­ing to my other pa­tients.

The sys­tem is too stretched at the mo­ment to be able to give these peo­ple enough time un­til ei­ther lunchtime or the end of the surgery. Dur­ing this time I was fran­ti­cally ring­ing the psy­chi­a­try ser­vices and other sup­port groups to try and ar­range fol­low up, and in both cases I was left with no op­tion but to bring the pa­tient to the emer­gency depart­ment.

What scares me is the fact that it can be quite dif­fi­cult for my pa­tients to get a same-day ap­point­ment with me. How many might ring and de­cide not to come in when they hear this?

I usu­ally try to sign off with some­thing light­hearted but this isn’t the topic for that. If you need help please talk to some­one. Sui­cide is per­ma­nent, de­pres­sion doesn’t have to be.

Sa­mar­i­tans: www.sa­mar­i­tans.org, freep­hone: 116 123

Pi­eta House: www.pi­eta.ie, freep­hone 1800 247 247 (Text HELP to 51444)

Pic­ture: iS­tock

DARK TIMES: De­pres­sion can be de­bil­i­tat­ing, leav­ing a per­son feel­ing hope­less about the fu­ture, how­ever, like an ill­ness, it can be treated.

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