22 April, 2021

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A Study On Suicide & Socially & Legally Possible Recommendations For Suicide Prevention In Sri Lanka

By W.A.G.R. Jayalath and E.R.H.T. Gunawardana –

Although the suicide rate has dropped in recent years, the incidence of suicide attempts is still high. However, the issue of suicide has always been a topic of news. It is possible to see news of suicide almost every day. This is well experienced in Sri Lanka. The purpose of this research was to study the legal and social provisions for suicide, and to make suggestions for suicide reduction. It also conducted a small comparative study in this regard with several other countries. In conducting this study, websites, daily news, expert opinions and reputable statistics were used as sources. It is emphasized that the mental state of the people should be developed and the gaps related to suicide in the law should be taken into consideration. It was also concluded that in Sri Lanka, suicide laws need to be developed and social attitudes towards suicide need to be changed and social development taken place.

Introduction

Suicide is one of the biggest problems in the world, and according to the WHO, nearly 800,000 people commit suicide each year. It can be expressed as one person every 40 seconds.[1] Of these, South Asia occupied a significant position and Sri Lanka showed significant growth in some years. In 1995, Sri Lanka had the highest number of suicides and, it was 47 per 100,000. There can be many reasons for this. However, subsequent gradual suicide deaths have decreased in Sri Lanka. But the number of suicide attempts is high. According to 2016 sources, 79% of suicides occur in low and middle-income countries and 1.4% of the world’s deaths were suicides.[2]

This is an issue that affects not just one area, one group of people, but the whole society. This research aimed to find recommendations to reduce suicides, especially since it is essential to safeguard the future of the country. Because suicide often reduces the country’s labor force. Sometimes people who have the ability to do something new and valuable to the country and the world are lost to the world because of a decision they make instantly. Therefore, this topic is extremely valuable and deserves everyone’s attention.

This paper is mainly divided into 6 sub-topics. The first part focuses on what suicide is and the opinions on the subject. The second part focuses on suicide in Sri Lanka, the third part deals with the world’s suicide statistics based on Sri Lanka, and under the fourth sub-topic is devoted to a study of the current laws on suicide in Sri Lanka, India, Singapore. The next part is devoted to the findings of this research and the final part discusses the socially and legally possible recommendations for mitigating the problem of suicide. The issue of suicide, which has become a major problem in the world, is one of the most serious problems for a developing country like Sri Lanka due to the collapse of the aforementioned workforce.

What is suicide?

Suicide is described as the deliberate act of causing one’s own death. Substance abuse, mental illnesses, and physical disorders are also risk factors. Some suicides are impulsive acts resulting from stress (including such financial or academic problems), relationship issues, or harassment/bullying.[3] Those that have attempted suicide before are at a greater risk of doing so again. Those that have attempted suicide before are at a greater risk of doing so again.[4] Limiting access to suicidal approaches such as weapons, medications, and poisons; treating mental illness and substance abuse; vigilant media reporting on suicide; and improving financial climate are all effective suicide prevention strategies. Despite the fact that crisis hotlines are common, they have not been thoroughly researched. The most common method of suicide varies by country and is partly determined by the availability of effective methods. Suicide techniques include hanging, pesticide poisoning, and the use of weapons.[5] Suicides claimed the lives of 828,000 people worldwide in 2015, up from 712,000 in 1990. Suicide had become the tenth main cause of death.[6]

Suicide accounts for around 1.5 percent of all deaths worldwide.  This equates to around 12 per 100,000 people in a given year.  Completed suicide rates are usually higher in males than in females, ranging from 1.5 times in developing countries to 3.5 times in developed countries. Suicide is most common in people over the age of 70, although in some countries, people between the ages of 15 and 30 are at the greatest risk. In 2015, Europe had the highest suicide rates of any country. a Per year, there’s an estimated 10 to 20 million non-fatal suicide attempts. Suicide attempts that do not result in death can result in injuries and long-term disabilities. Attempts are more common among young people and women in the Western world.

Religion, dignity, and the meaning of life have all had an effect on people’s attitudes toward suicide. Because of their belief in the sanctity of life, Abrahamic sects have historically viewed suicide as a sin against God. Mostly during samurai period in Japan, seppuku, a type of suicide, was revered as a way of making amends for failure or as a form of protest.[7]Sati, a British Raj-outlawed tradition, expected the Indian widow to commit suicide on her husband’s funeral fire, either voluntarily or under the influence of her family and community.

Suicide and attempted suicide were once illegal in most Western nations, but this is no longer the case. In certain nations, it is also a criminal offense. Suicide has been used as a method of protest on occasional occasions in the twentieth and twenty-first centuries, and suicide bombings have been used as military or terrorist strategies. Suicide is regarded negatively almost everywhere in the world, and it is always viewed as a huge tragedy for families, friends, and other local supporters.

Suicide in Sri Lanka

In Sri Lanka, suicide is a major public health issue. Sri Lanka has long been a tolerant society that supports such types of suicide, such as altruistic suicide. Suicides typically evoke concern for the deceased, so a permissive attitude toward suicide is often noted.

Suicide culture is often encouraged by some media reports that elevate the suicide to a heroic status. Lack of coping skills among vulnerable people and failure of friends and family to recognize their suffering are seen as major causes of the recent rise in suicide rates.

Easy access to lethal pesticides and medicines leads to high suicide rates by making lethal substances available for self-poisoning in times of distress. Undiagnosed and undertreated mental disorders, as well as alcohol and illegal drug-related deaths, are major contributory factors that need immediate attention. Other major factors warranting a socio-political debate include poverty, unemployment, migration of caregivers of disadvantaged people, discontent among youth, and isolation among the elderly.

Suicide rates in Sri Lanka rose sharply from the 1950s to 1995, rising by up to eightfold. Evidence suggests that 26% of people who committed suicide have made suicidal attempts in the past, with depression and alcohol use disorders being the most prevalent psychological disorders. Inhaling poisonous pesticides was the most popular form of suicide at the time. This rose to 47 per 100,000 in 1995, making Sri Lanka the nation with the world’s second highest suicide rate at the time. Suicide rates in Sri Lanka fell by half over the next decade, starting in 1995.[8]

According to a study presented at a conference in September 2011 by Dr. Neil Fernando, the head of the National Institute of Mental Health, nearly 4,000 people in Sri Lanka commit suicide each year.  The vast majority of victims were between the ages of 15 and 44, as per the data. As per the Registrar General’s office, the suicide rate in Sri Lanka was 9 per 100,000 people years ago of independence (1948). It climbed to 19 per 100,000 in the 1970s, and 33 per 100,000 by the mid-1980s. According to the most recent figures, Sri Lanka has a suicide rate of 15 per 100,000 people.[9]

Statistics on suicide

Suicide affects people of all countries, races, religions, genders, and social groups all over the world. According to estimates, the countries with the highest suicide rates are extremely diverse.

The eastern European country of Lithuania (31.9 suicides per 100k), the eastern European country of Russia (31 suicides per 100k), the South American country of Guyana (29.2 suicides per 100k), and the Asian country of South Korea are among the top five in the year (26.9 suicides per 100k). Belarus (26.2 suicides per 100k) and Suriname and Kazakhstan, both at about 22 suicides per 100k, are among the other eastern European countries with high suicide rates.[10]

Belgium, on the other hand, is the only western European country with a particularly high suicide rate, ranking eleventh with 20.7 suicides per 100,000 people. It’s worth noting, however, that Belgium has some of the world’s most liberal rules on doctor-assisted suicide, which is likely to play a role in the country’s statistics. Bhutan, which is known for calculating Gross National Happiness, a metric that measures a country’s population’s collective happiness and well-being, has a relatively high suicide rate of 11.4 per 100,000 people.

Surprisingly, many of the world’s most troubled countries have relatively low suicide rates. There are 4.7 suicides per 100,000 people in Afghanistan, three in Iraq, and just 1.9 in Syria. It’s unclear if the suicide figures for these countries represent suicides caused by mental health issues and terminal illnesses (which are the most common causes for suicide around the world) or suicides caused by other factors. The Bahamas, Jamaica, Grenada, Barbados, and Antigua and Barbuda have some of the world’s lowest suicide rates. Suicide is uncommon in these countries, with suicide rates of 0.8 and 0.5 per 100,000, respectively, in Barbados and Antigua and Barbuda.

Legal frameworks and history on suicide

When we consider about Sri Lanka, suicide is mentioned in article 299 of the Sri Lankan Penal Code[11].

“If any person commits suicide. whoever abets the commission of such suicide shall be punished with death.”[12]

It states that the death penalty is imposed on anyone who aids and abets the suicide of a person. Although the penal code takes steps to control aiding and abetting suicide, it does not provide for the prevention of suicide. Suicide rates in Sri Lanka have been on the decline in recent years. This has arisen from a variety of legislative reforms as well as a reform in the penal provision to counter the high suicide rate. In view of this, a presidential committee was formed in 1997 to suggest the decriminalization of suicide attempts. ‘Besides decriminalization of the attempted suicide law, the committee also recommended an increase in medical services (including those for the management of serious mental illness) and discouraged widespread media reporting of the prevalence of suicide incidents.’[13] In May 1998, the Parliament implemented an act to repeal the country’s strict laws on taking one’s own life.[14] It also severely restricted the distribution of suicide-inducing drugs, especially pesticides. ‘In a study named Suicide in Sri Lanka: Past, Present and future transformations by WHO, Forum for suicide and cultural research along with National Science Foundation it was found that the fall in the suicide rate was the result of sales restrictions placed on the most toxic pesticides, and not the result of falling levels of suicide attempts per se.’[15] Even so, research shows that the number of suicide attempts in Sri Lanka has risen during the same time span. In 1997, the Presidential Committee of Sri Lanka was one of the first countries in Asia to devise and introduce a national suicide prevention policy. The action plan aimed to–

* Reduce easy access to lethal methods;

* Promote research on reducing the lethality of pesticides in use;

* Educate the public on less harmful use of pesticides;

* Create a culture which discourages suicides;

* Ensure survival after poisoning; and

* Remove legal barriers to the correct handling of those at risk.’[16]

According to Indian Law, article 309 of the Indian penal code deals with suicide;

“Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both.]”[17]

Also, Indian Penal Code has set aside article 305 for abetment of suicide of a child or insane people.

“If any person under eighteen years of age, any insane person, any delirious person, any idiot, or any person in a state of intoxication, commits suicide, whoever abets the commission of such suicide, shall be punished with death or 1 [imprisonment for life], or imprisonment for a term not exceeding ten years, and shall also be liable to fine.”[18]

Finally, Article 306 of Indian Penal Code deals with the abetment of suicide.

“If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.”[19]

Although India has enacted various laws to reduce suicide and prevent aiding and abetting suicide, according to statistics provided by the WHO in 2016, India still has higher suicide rates than Sri Lanka. However, in 2014, it is announced that “the Law Commission of India, in its 210th report, had recommended that Section 309 (attempt to commit suicide) of IPC needs to be effaced from the statute book…Keeping in view the responses from the states/UTs, it has been decided to delete Section 309 of IPC from the statute book.”[20]

And when we consider about laws of Singapore on suicide, article 309 of the Singapore Penal Code deals with suicide.

“Whoever attempts to commit suicide, and does any act towards the commission of such offence, shall be punished with imprisonment for a term which may extend to one year, or with fine, or with both.”[21]

The law was seldom applied. Article 306 of the Indian Penal Code as well as the Singapore Penal code deals with the abetment of suicide;

“If any person commits suicide, whoever abets the commission of such suicide shall be punished with imprisonment for a term which may extend to 10 years, and shall also be liable to fine.”[22]

And article 305 also pertains to the aiding and abetting of suicide, but only if the suicide victim is under the age of 18, drunk, or mentally ill.

“If any person under 18 years of age, any insane person, any delirious person, any idiot, or any person in a state of intoxication, commits suicide, whoever abets the commission of such suicide shall be punished with death or imprisonment for life, or with imprisonment for a term not exceeding 10 years, and shall also be liable to fine.”[23]

The Penal Code Reform Committee called for the attempted suicide legislation to be repealed on September 9, 2018. The bill was formally changed on May 6, 2019 to decriminalize suicide. So, Suicide is decriminalized in Singapore. However, Singapore has a much lower suicide rate that Sri Lanka in 2016.

Findings

Article 299 of the Sri Lankan penal code provides for legal action against persons who support suicide.  But for people who are trying to commit suicide, there is no comprehensive way to get rid of it. Despite the introduction of a telephone number and the formation of various organizations, it has not yet become a responsible mechanism. The issue of suicide often comes to the fore when something special happens. That situation is extremely temporary. But there are a notorious number of suicides across the country. Moreover, in most cases of suicide, once it is proven to be a suicide and the cause is found, it does not go beyond that.  Or they may be distracted by others. As we can see, the reason is the ideology in the society.  Eastern countries like Sri Lanka look down on someone who has attempted suicide.  This is especially the case in rural areas.  Without helping him or her get out of this situation, he or she will be further degraded.  After that we realized while doing research that they fall more and more mentally. And a person who goes to a psychiatrist or a counselor is still looked down upon by society. And a person who goes to a psychiatrist or a counselor is still looked down upon by society. Another factor is that although the suicide rate in Sri Lanka was lower in 2016 than in 1995, the number of suicide attempts is still high.

‘In rural Sri Lanka, we identified four subgroups within the population who are statistically more likely to attempt suicide: 1) farmers; 2) daily wage labourers; 3) female headed households; and 4) foreign migrant households.’[24]

Recommendations

From a legal point of view, not only the person who encouraged a person to commit suicide, but also the person who caused his or her suicide should be investigated and legal action should be taken to determine if it is justified. For example, if, after being insulted by a person for no apparent reason, the insulted person decides to commit suicide, the insulter must formulate a legal framework for liability. And survivors of suicide attempts need to develop a program that focuses on what they are doing until his or her mental health improves beyond that. They also need to find out the cause of the condition and take remedial action.

As recommendations that can be made on the social and educational side, this condition is most often caused by a deterioration in mental health. So, the development of mental health should start with his family when he was young. It is a socially important thing to do in a family. Then the existing mental health development program in the school should be developed and systematized.  Although it is included in the syllabus to some extent, it is often not given prominence. Not only sex education but also psychological education should be provided to prevent the occurrence of things that should not happen in the society. They also want to learn about the seriousness of suicide from an early age. Opinions in society must change. Society needs to change so that psychological counseling takes an important place.  The value of psychological counseling should be taught from an early age. Just as some schools have psychologists, a psychologist should be attached to every school and workplace. ‘Two public health campaigns to be conducted by the Ministry of Health, in collaboration with relevant stakeholders: first, focusing on mental health awareness and second, raising awareness of the effects of alcohol addiction.’[25]

In addition, ‘School and community settings should deliver a relationship and conflict resolution skills training programs, …increase its provision of scholarships/grants to children from poor families, …deliver an adult education program on basic budgeting skills in society. Schools should also priorities budgeting skills development, Provision of vocational training should be increased to promote self-employment opportunities with small grants to facilitate this.’[26]

Conclusion

Suicide is one of the worst problems in the world. It harms the workforce and the future of countries like Sri Lanka. Compared to the past in Sri Lanka, there has been a marked decrease in the number of suicides, but there has been no decrease in the number of suicide attempts. There are various social, psychological and other reasons for this. Social and legal development is needed to minimize it. The low point of view of mental illness and suicide in society needs to be changed. Our conclusion is that in order to do that, we need to start with the family and then with the school and the community.


[1] ‘Suicide data’ (World Health Organization) < http://www.who.int/teams/mental-health-and-substance-use/suicide-data > accessed on 23 March 2021.

[2] ‘Suicide data’ (World Health Organization) < http://www.who.int/teams/mental-health-and-substance-use/suicide-data > accessed on 23 March 2021.

[3] ‘Suicide’ (World Health Organization, 02 September 2019) < https://www.who.int/en/news-room/fact-sheets/detail/suicide > accessed 23 March 2021.

[4] ‘Suicide’ (World Health Organization, 02 September 2019) < https://www.who.int/en/news-room/fact-sheets/detail/suicide > accessed 23 March 2021.

[5] ‘Suicide’ (World Health Organization, 02 September 2019) < https://www.who.int/en/news-room/fact-sheets/detail/suicide > accessed 23 March 2021.

[6] ‘Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013’ < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340604/ >

[7] Evan Andrews, ‘What is Seppuku?’ (History.com, 11 January 2016) < http://www.history.com/news/what-is-seppuku#:~:text=Often%20called%20%E2%80%9Chara-kiri%E2%80%9D,to%20ensure%20a%20fatal%20wound.> accessed 25 March 2021.

[8] ‘Suicide Prevention in Sri Lanka: Recommendations for Action’ < https://slma.lk/wp-content/uploads/2020/10/Suicide-Prevention-in-Sri-Lanka-Recommendations-for-Action-final.pdf > accessed on 24 March 2021.

[9] ‘Suicide Prevention in Sri Lanka: Recommendations for Action’ < https://slma.lk/wp-content/uploads/2020/10/Suicide-Prevention-in-Sri-Lanka-Recommendations-for-Action-final.pdf > accessed on 24 March 2021.

[10] ‘Suicide rate by country 2021’ (World Population Review) < https://worldpopulationreview.com/country-rankings/suicide-rate-by-country > accessed 24 March 2021.

[11] Penal Code (Ordinance No.2 of 1883)

[12] Penal Code (Ordinance No.2 of 1883) s.299

[13] Sneha Sanyal, ‘Attempt to suicide: comparative study of Indian Laws vis-à-vis Singaporean Laws and Sri Lankan Laws’ (The Criminal Blog, 2020) <https://www.google.com/amp/s/criminallawstudiesnluj.wordpress.com/2019/10/30/attempt-to-suicide-a-comparative-study-of-indian-laws-vis-a-vis-singaporean-and-sri-lankan-laws/amp/> accessed 26 March 2021.

[14] Deborah L. Kahn & David Lester, ‘Efforts to Decriminalize Suicide in Ghana, India and Singapore’ (Suicidology Online, 09 December 2013) < Efforts to Decriminalize Suicide in Ghana, India and Singapore (suicidology-online.com) > accessed on 26 March 2021.

[15] Sneha Sanyal, ‘Attempt to suicide: comparative study of Indian Laws vis-à-vis Singaporean Laws and Sri Lankan Laws’ (The Criminal Blog, 2020) <https://www.google.com/amp/s/criminallawstudiesnluj.wordpress.com/2019/10/30/attempt-to-suicide-a-comparative-study-of-indian-laws-vis-a-vis-singaporean-and-sri-lankan-laws/amp/> accessed 26 March 2021.

[16] ‘Suicide in Sri Lanka: Past, Present and Future Transformations’ <https://suicideandculture.files.wordpress.com/2013/03/suicide-in-sri-lanka-proceedings_final1.pdf > accessed 25 March 2021.

[17] Indian Penal Code (Act No. 45 of 1860) s. 309

[18] Indian Penal Code (Act No. 45 of 1860) s. 305

[19] Indian Penal Code (Act No. 45 of 1860) s. 306

[20] Bharti Jain, ‘Govt decriminalizes attempted suicide: ‘What about fasting activists?’ (Times of India, 11 December 2014) < https://m.timesofindia.com/india/Govt-decriminalizes-attempted-suicide-What-about-fasting-activists/articleshow/45464644.cms > accessed 26 March 2021.

[21] Singapore Penal Code (Ordinance NO. 4 of 1871) s. 309

[22] Singapore Penal Code (Ordinance NO. 4 of 1871) s. 306

[23] Singapore Penal Code (Ordinance NO. 4 of 1871) s. 305

[24] ‘preventing suicide in Sri Lanka: Supporting vulnerable populations.’ (University of Bristol) <https://www.bristol.ac.uk/policybristol/policy-briefings/preventing-suicide-sri-lanka/ > accessed 27 March 2021.

[25] ‘preventing suicide in Sri Lanka: Supporting vulnerable populations.’ (University of Bristol) <https://www.bristol.ac.uk/policybristol/policy-briefings/preventing-suicide-sri-lanka/ > accessed 27 March 2021.

[26] ‘preventing suicide in Sri Lanka: Supporting vulnerable populations.’ (University of Bristol) <https://www.bristol.ac.uk/policybristol/policy-briefings/preventing-suicide-sri-lanka/ > accessed 27 March 2021.

*Authors are third Year LLB (Bachelor of Law) Undergraduates at Sir John Kotelawala Defense University

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Latest comments

  • 1
    1

    WHO data of 800000 suicides has been repeated for the past 10 years or so. No reduction or increase. New substantiated data on world suicide rates not available. So this is being quoted by all who report on suicide. Since suicide is no longer a crime it is better to avoid using the word “committed” which stigmatizes suicide. “Died by suicide” would be better? To devise effective preventive methods it is very important that policy makers record and throw out data on attempted suicides. This data is currently unavailable in Sri Lanka. The manner in which the mainstream and web media report suicide is horrendous.

  • 4
    0

    A timely article , most needed.
    This is my own personal opinion.
    Suicides have many causes in Sri Lanka, especially connected to our culture of lacking empathy and not knowledge or education , highly educated & lesser educated people among the society are aware and well informed today with the access of knowledge in their palms from city, urban to villages, it’s the culture connected with beliefs of indoctrinations ,.dogmas and prejudice that supersedes even education and promotes to contribute to judge & condemn rather than embrace humanity.
    Sri Lanka The social media is not used to spread to the well-being of human mental health social harmony , rather to destroy it mostly, you can not permit freedom at the cost of injury to humananity by those who refuse to be responsible Citizens.
    CT pls don’t edit , becoz of my critism of irresponsiblity and abuse of social media.
    It has to be highlighted

  • 4
    0

    1)Suicide is one of the leading public health issue contributing to mortality rates.2) Suicide is preventable but will need public awareness, education, empathy, mental health services in addition to others 3) Even today there are many myth such as people who attempt will not verbalize or warn, people who say will not attempt, people who are suicidal are always suicidal and so on which are absolutely NOT true 4) Many such who attempt, suffer from mental health issues such as depression,bipolar, substance / alcohol dependence, eating disorders , personality issues (borderline) and schizophrenia which are treatable 5) People who suffer from severe pain, terminal medical and health issues too eventually lose hope 6) Any law which criminalize or penalize a person for suicide is primitive and dosent give any hope to a person who is desperately seeking help/hope. 7) Many who attempt leave scuttle warning signs (verbal, non verbal, signs of hopelessness) which can be picked by others who are aware of these warning signs.8) We as professionls consider suicide as a desperate call for help and when denied ends in loss of a life.9) Suicide has nothing to do with individual personalty , that is to say weak personalty vs strong personality 10) suicide is not same as impulsive /risk taking behavior, attention seeking, making gestures for secondary gains or other disruptive behaviors.

  • 0
    0

    @Chiv,
    You deserve praise for your knowledge and being well informed.

    But we have a huge problem with our Culture , believe me, it is a problem with all people , not one particular group, I do not want to mention them by names , as soon as I do that, CT moderator gets sensitive and edits my whole pains taking of may be more than a hour of preparing comment without sparing even part of it.

    So instead I am encrypting my message whereever it’s necessary..

    I know people whose family members have certain form of addictions, it can relate to anything anti – Social, self destructive , but will not accept reality .

    Anything a person engages is seen as anti- Social, self destructive, which includes all sorts of addictions are connected to the imbalance of the brain chemicals, mental health is an illness, people today even embrace Cancer as they do with diabetes, Blood pressure, etc.

    But when it comes to mental health, no way, most of them refuse to acknowledge it viewing it on scientific terms.

    It has to do with the devil or someone’s evil charm.

    So it’s a hard thing, even if most people watch the TV programmes and other medias by reputed doctors , they will still not accept it as an illness.

  • 0
    0

    @Chiv .
    There is another absurd fear among some people that antidep medications have severe side effects , is there any medication that has no side effects? Or is Regular consumption of Alchohal , drugs and other substance a better alternative ? In my opinion people who drink frequently and large quantities are not normal in their mental health and need mental health evaluation if they care .

    There is huge difference with social drinking and this.

    And thee other unfounded theory is that antidepressants shrinks the brain , a total nonsense, I can be sure any doctor will tell you the same, as to what I state.

    It is not antidepressants that shrink your brain, it is now scientifically proved that by not taking medication , the depression is what shrinks your brain.

    You can get more information online about how untreated depression shrinks the brain.

  • 2
    0

    Bro Netizen, I got your message. The fact is majority mental health issues can be effectively helped. There are few which are chronic and tend to gradually decline,(like dementia and schizophrenia ) yet we have treatment available to markedly improve their quality of life, productivity and rehab. Depression as such has impact not just on our mental health, but physical health(uncontrolled diabetes, hypertension, lack of activity, poor diet), family life, social life, educational/occupational productivity too. It is a precursor for many such chronic medical issues as cardiac and neurological problems. Vice versa following heart attack , stroke many such affected patient can develop depression/anxiety . Same with alcohol/substance use, many patients with depression and bipolr can endup self medicating/abusing. It is pretty much chicken and egg story. Bottom line is Good Health means both Physical and Mental it is not possible to maintain one without other.

    • 0
      0

      @Chiv,
      Yes I do agree with most of what you say, as for Schizophrenia, though I believe it’s a more severe form of mental illness, Dr.Navin of Navy hospital is an expert , , I personly witnessed a patient whi habe been going for healing of devil possession, which only made the illness worse , was completely treated by Dr.Navin and but the person back on life and now settled overseas happily married and settled, not many are willing to do that, it is also a new evloved suspicion connecting dementia with untreated depression, it is confirmed that if you do not treat depression it will lead to shrinking of the brain and this could be a possible cause for demantia.
      ====================
      But it’s very hard to convince Sri Lankans.
      They prefer to take the patients and beat the devil out or to death.
      Tragic..People of irrationality .

  • 0
    0

    LN, To keep it simple, I tell my patients, when there is a neurological issues as minor as headaches to even the thought of having a stroke, people immediately rush to a doctor. But when it comes to mental health issues, though the origin is at the same organ, there are many hurdles in seeking help. Starting from stigma, denial, myth, poor insight, apathy, social attitude , lack of care/access and lack of awareness are few among many. Unfortunately in this day and age , where robots are performing certain surgery, 3 D organ harvesting /transplanting, DNA mapping and genetic engineering Mental Health is left far behind where people still identify it as seen in movies, violent ECT, restrained patients to bed, locked cells and sanatoriums.(many of which are not at all in use now)

    • 0
      0

      @Chiv.
      Lol , you sure did a good job putting it in a nutshell.
      It’s mostly denial of reality followed with Stigma and of cause the self- Righteous never stops judging and condemning and like you said lack of aaccess.
      As for awareness our doctors have done a lot, Dr.Ghaneshan offers advice in Tamil and English.,It’s on YouTube.
      People will rather waste time looking for gossip and myths rather than enlightening themselves
      Future most of the degrees and other higher educations will become redundant may be even high school, internet will do it , in fact it has done a lot , who needs maths now ? Just ask Alexa or Siri and you haven’t answers future AI will be a friend of the human rather than anti human most beliefs promote it as .
      With Science there is always hope and faith in God is very good as long as it’s spiritual and one uses his or her intellect and understand God gave us that just do so with our freewill .

      • 1
        0

        @Chiv.
        Sorry .meant to type you have the answer .oh horrible self correction. Some typos above too but tired of correcting. Am.Sure you will read it right.
        Cheers , .it was indeed a productive interact.
        Thank you

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