• How to detect depression, mental health cases –Psychiatrist, sociologist
By Oluseye Ojo
These days, the media space is awash with sombre news headlines relating to suicide cases. Each day, you are greeted with such screaming headlines as: ‘79 Nigerians commit suicide in 2022’, ‘Soldier kills self in Ogun barracks’, ‘Lagos police probes banker’s death’, ‘Police rescue man from committing suicide in Lagos’, and so on.
Dr. Oludayo Tade
The story is the same from South West to South East, from South South to North Central, and North West to North East. It is the same everywhere you go.
Unending suicide cases
One of the recent suicide cases involved a 32-year old female employee of a bank in Ikorodu, Lagos, one Amarachi Ugochukwu, who reportedly took her own life in January, this year. She allegedly consumed an insecticide inside the restroom of the bank.
In the same vein, a soldier in the Nigerian Army, identified as Boyi ThankGod, attached to the 35 Artillery Brigade, Alamala, in Abeokuta, the Ogun State capital, purportedly shot himself in the head, and died instantly.
Dr. Afolabi
Operatives of the Rapid Response Squad (RRS) of the Lagos State Police Command, prevented a man from killing himself in Iyana-Iba area of Lagos. The RRS made the disclosure on its Facebook wall recently. The squad stated that its team was on a routine patrol when their attention was drawn to the man who wanted to commit suicide by jumping in front of speeding vehicles on LASU-Iyana Iba Expressway.
A former Battalion Commanding Officer, who reportedly at a time, led the fight against Boko Haram in the North East, Major U.J Undianyede, allegedly committed suicide recently.
It was also in the news that a 45-year-old Lagos accountant, Folake Abiola, committed suicide at her residence in the Lekki area of Lagos a few months ago. As gathered, she drank some insecticide and died.
A case of a 40-year-old woman, Lilian Omokhuale, a mother of two, was also reported for committing suicide. She reportedly drank a dangerous poison, Sniper in Edo State after she was purportedly defrauded to the tune of over N300million. A recent study carried out on the suicide rate in Nigeria, showed that 79 persons committed suicide in Nigeria in 2022, comprising 70 males and nine females within the period and as reported in the media. But the report did not capture cases of those who killed themselves and were not reported in the media.
Sociologist/criminologist speak on suicide cases
A criminologist and sociologist at the University of Ibadan, Dr. Oludayo Tade, shared his perspective on the spate of suicides in Nigeria. He said: “In societies with responsive and responsible leadership, the increasing rate of suicide is all that is needed to put things right. But, here in Nigeria, the major concern of those at the helm of affairs is whatever threatens their hegemonic control of the national commonwealth. While suicide is not peculiar to Nigeria, the dimensions of suicide in Nigeria and the characterisation of those who have attempted or actually died of this reflect the mood of the country.
“A society experiencing sudden changes in its social structure will alter the lives of her citizenry, who may find it difficult to adjust to the new social reality. Put in other words, the country is hard and we live in a season of anomy and what follows is anomic suicide.”
“Of course, people now come to the public to voluntarily kill themselves. Since suicide is mostly of social origin, understanding this and remedying it socially may be a timely intervention.
“Only a society with morals can exercise control over the needs and aspirations of her members. In this season of crises such as evident in the current economic recession, unemployment, loss of jobs, unpaid salaries, business collapse, botched relationship, poor or weak bonding, hunger and so on, Nigeria lacks the moral power to regulate the needs and aspirations of her people who are experiencing unprecedented changes in their needs and values. This is why suicide is on the increase during this anomic season.
“The underlying deductions extractable from the narratives of those who left suicide notes or those rescued on their way out of mother earth, as well as the observations of those around them, attest to the anomic state of things.
How suicide began
The history of kingdoms and their rulers is replete with suicide as voluntary action or imposed or induced. Kingdoms were ruled by warriors due to their functionality, a need for defence against external aggression.
According to Dr. Oludayo Tade, with such responsibility to protect their people, a conquered kingdom becomes a slave to the conqueror, while the head of the ruler of the defeated kingdom is cut off as a means to humiliate and shame a supposed powerful entity. Voluntary killing does not end there; its unintended consequences are borne by the significant others who have to live with the stigma of having a suicide instinct in their family blood.
For instance, people may prevent association or marriage between their children and family of a debtor who committed suicide unlike a warrior who sacrificed his life for his people to live. This, however, happened in relatively homogenous communities where the collective conscience subsisted.
“Fast-forward to contemporary forms and dimensions of suicide. Different approaches have been adopted to achieve termination of their lives: from jumping into well or river, hanging self to the ceiling, poisoning, stabbing, electrocution and gunning. Suicide cases reported are also planned and well executed. Some people want to die covertly and spring surprises to attract sympathy or overtly, such as those who went to the scene of suicide with their driver and young children.
“At the University of Ibadan, an undergraduate lady reportedly drank ‘Hypo’ because of a botched relationship. That phenomenon is now called “Hypo-love”. Why should we bother that people attempted to and resorted to taking their own lives? Why should such trouble us? They point our attention to reasons underlying their decision; mostly the narratives of those who committed suicide and left notes
“No human being can be happy unless his/her needs are sufficiently met, including being accepted as a member of a group. In other words, if the needs fall short of expectations, human beings will only painfully function and respond to social reality. Human needs are insatiable and we compete on a social stage where all men are born equal, but some are more equal than others.
“How will people with normative responsibilities not give up when governments owe salaries of eight months? How shall people not give up when they have borrowed to get involved in MMM and the handlers decided to halt money circulation? Why will people not die in a country where the reality being experienced by the ruled is different from that which is experienced by the rulers?”
Mental health cases on the rise
A medical doctor, Oyeyemi Afolabi, who specialises in the psychiatry aspect of health and works University College Hospital (UCH), Ibadan, noted that mental health cases generally are on the rise these days, and not only suicide.
“If you listened to a report at the end of last year by the Federal Neuro Psychiatry Hospital, their data showed that there was 100 per cent increase in admission rate. So, for there to be an increase, it should tell us that there is a problem. So, I quite agree that from the report that we see, it is on the rise.
“We should also bear in mind that for every one case of suicide that is duly reported, there are tens and probably hundreds of cases that are being swept under the carpet. But generally, for every case of suicide, we can attribute almost 90 per cent of the cause to be associated with depression, and that is the truth.”
Causes of depression
Afolabi stated that other factors have also come to play, which are interwoven with depression. He added: “Some of them are things that cause depression, especially economic problem in the country. Some people are finding it difficult to cope financially in the home to discharge their responsibilities. At the end of the day, it culminates into mental health challenges, most often, depression. So, that doesn’t rule out the fact that there are many other causes.
“At times, some of the causes could also be what we called psychotic disorders, like you have people probably hearing strange voices telling them to jump from high buildings or to dangerous places.
“In the last one month, I have seen about two or three cases of people that heard the strange voices. One jumped from a high building, and the other jumped from another of such. The two of them ended up having fractures in their legs bones, which means that it could have also been a head injury that would have led to death. Such cases are not depression but psychosis.
“Also, I also believe that more cases like that happened that were not reported. So, it is also an important and common attributable cause to depression. Of course, we have other mental health conditions, such as anxiety, substance abuse, substance intoxication, and doing what they did not plan to do. An intoxicated person is not even in the right frame of sense.
A case was reported to me of a man under intoxication, who was using his bare hands to remove electrical wire at home. The man did not know what he was doing. He could have been electrocuted and died. So, we have such different causes coming to the fore these days.
“Sometimes, it is not depression, it is not any mental health disorder. It is just overwhelming social and psychological stress. Everybody has an elastic limit. Sometimes, people get to their elastic limit due to marital pressures and the inability to cope with the demands of life.
This is why you can have somebody who does not have mental health problems, something tragic, would just happen and, in the spur of the moment, just takes something dangerous. So, these are different possible causes of suicide. But I will still say that depression forms all those causes.
“When we have a case of suicide, depression is the first cause everybody is thinking of and looking at. This is important because it is a treatable cause. This calls for early detection and early suspicion.”
Symptoms of suicide
On the common symptoms of depression, Dr. Oyeyemi Afolabi, mentioned persistent sad mood as one of the factors. He said: “This is when a person is persistently unhappy, even in the face of things that should make them happy or joyful.”
The psychiatrist also said low energy could lead to suicide. He explained that the people, whose energy level dropped and have become so reduced that things that they were energetic enough to carry out, such as house chores, going to work, walking some distances , teaching and whatever work they are doing, become a job that they are unable to do. They will be saying something like ‘I cannot do it. ‘
“Three, people do lose interest in what they used to enjoy doing. If you see somebody who loves social media, loves watching movies, and all of a sudden, the interest is not just there. They don’t feel like doing those things again. They need attention.
“On top of that, we have sleep disturbance, appetite disturbance, thought of suicide and so on.
So, these are common symptoms that if we have people going through them or any of them, it is good to always call the attention to it. If you know somebody who is active on social media, and suddenly he or she goes silent. We need to find out what is going on.
“Some people also drop hints or posts on social media such as ‘whatever happens, this should be attended to promptly. These are things that we can spot.
“Importantly, almost everybody who ends up committing suicide has dropped the hint. The problem sometimes is that the hint might not be direct, and people may not be able to understand the message. In this social media era, it is one of the ways people drop the hint, especially the young ones.
“Sometimes, people start arranging things as if they are preparing for their end. Sometimes, you will see people distributing their property with no reason. Somebody who has never written a will saying he wants to write a will. I am not saying something is wrong with writing a will… Those hints are a form of cry for help
What to do
Dr. Oyeyemi Afolabi, in suggesting the way forward from the quagmire, noted: “What do we do? Spot it early and report to the appropriate hospital. You need to call for help when your ability to be in full control of yourself is lost.” Afolabi noted that the government could introduce advocacy to orientate people and then better the economy of the country. “The government should pay more attention to mental health.
In most of our government facilities, especially now, the primary health care facilities, which is the grassroots that is closer to the people, the government has been able to achieve success in maternal mental health, in the sense that people get there now in terms of childbirth and immunisation. Those ones are working. It is working at PHC level, even HIV care.
“So, the kind of emphasis that we have placed on that, if we can also place it on mental health, such that people can get to PHCs and have mental health assessments.
“Apart from doctors, there are mental health trained nurses, and people that we can also train to full up the gap. This is to ensure that cases that can be handled at that level would be handled.
“We are the ones to take primary responsibility for our health. Nobody is immune to mental health condition, whether you are a doctor or a psychiatrist yourself.”