ON THE BLINK Healthywoman Magazine Kenya Saturday, 31st May 2014




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Suicide may be considered a taboo subject in the Kenyan society, but that hasn’t deterred those afflicted by depression from taking their own lives.
We shed light on this mental health issue
September 10 is World Suicide Prevention Day – a date set aside to create awareness on one of the most misunderstood subject in our society. Data from the Department of Psychiatry at the University of Nairobi and the Africa Mental Health Foundation (AMHF) shows that in 2012, there were 310 suicide cases reported in Kenya, up from 72 cases in 2010. The data, published in April 2013, focused on cases of suicide in low-income areas and the youth in Kenya.
Even though these statistics are not conclusive – primarily due to the low rate of reported cases, there’s consensus among concerned professionals that the numbers are on a gradual rise.
To understand what would lead one to intentionally take their own life, HealthyWomanconsulted with concerned mental health professionals. We also held an intimate chat with a woman who has literally ‘lived’ through it.

DEMYSTIFYING SUICIDE
Dr Catherine Mutisya is a psychiatrist at the Nairobi Parenting Clinic, the Deputy Medical Superintendent at the Mathari Hospital, and a Senior Assistant Director of Medical Services. She has dealt with cases of suicide across the country.
“The common thing with suicidal people is a feeling of helplessness,” explains Dr Mutisya. “Ninety per cent of suicide cases are because of depression, while 10 per cent are because of drug abuse, frustrations of life, and other mental health diseases. Those with a long history of suicidal thoughts have long term mental health or substance abuse problems, while those who suddenly think of suicide are often frustrated.”
Suicide rates are higher in hospitals than they are in the general public – chronically and mentally ill people are more likely to take their own lives. For example, Mathari Hospital’s rate of suicide is 40 per cent higher than that of the general population, while that of Kenyatta National Hospital is 10 per cent higher. “There are certain factors, such as increased poverty and violence, which might be the predisposing factors behind the current increase in suicide rates,” Dr Mutisya hypothesises.

SUICIDE SENSITISATION
“There are two peaks – or high risk periods – of suicide. One is for adolescents and young adults and the other for elderly people. In Kenya, the peak for adolescents is higher,” she reveals. Similarly, women are more likely to attempt suicide – mainly because they are caregivers and feel they are not allowed to be unwell. Undoubtedly, community often shuns a woman who has mental health issues or drug dependency.
Often, a suicidal person will give some signs that loved ones might not pick up on or might dismiss. For this reason, The International Association for Suicide Prevention (IASP) advocates for prevention by teaching parents, medics and community leaders to recognise the signs. “There are cases of people giving out all of their household items or talking about a time when they will no longer be there. They may also change their behaviour drastically and act as though they do not care about life. It is important that you take them seriously,” says Dr Mutisya.
Most people believe that talking about suicide will make a suicidal person more likely to kill himself or herself. This is not true. “I always encourage medics and parents to ask, ‘Have you thought of killing yourself?’ especially if someone is exhibiting signs of depression or is constantly at the hospital complaining of illness yet there are no physical symptoms. Asking these questions allows the person to talk and share some of their fears,” Dr Mutisya advises.

REAL LIFE
Jane* is a 46 year old mother, who struggles with depression and alcohol abuse. She recently went through intensive rehabilitation and is in recovery. She has requested anonymity.
Jane’s problems began when she started drinking as a teenager.
“I was always told that depression was ‘an attitude’ so I grew up learning how to hide my condition,” she says. “I wanted to be cool and to dull all the pain and sadness I always felt. At first, it worked. But after sometime, I would feel worse than before. With time, I was drinking all the time, even during school hours.”
In Form two, she was expelled from school and sought help from church. Instead of helping her, the experience there made her feel less understood. She felt that she had failed everyone.  “This was the first time in my life that I felt useless. One day my pastor prayed for me, but he also lectured me. The next Sunday, I noticed that everyone was talking about me and none of my friends wanted to sit next to me. That night, I stole pills from the medicine cabinet, went by a river next to our farm and washed them down with alcohol. This was my first suicide attempt.”
The next morning, Jane woke up in a pool of vomit. “I was a bit numb and didn’t know what to think or feel. I felt like a failure. I wondered how I could fail at something as simple as killing myself! I went home to a thorough scolding from my mother, who called me a prostitute, asking where I had slept. This only made me feel worse. I resolved to try it again and immediately started thinking of where I could get a rope – I even wrote a suicide note.”
Fortunately, Jane did not succeed as her mother watched her keenly, ensuring that she did not leave the compound unaccompanied. “I stayed in this jail-like state for a few months, before my aunt convinced my mother to let me move to Nairobi. My aunt understood that I had a problem; she was the first person who believed that I was not being moody. I just could not stop feeling sad. She home-schooled me so I could sit my KCSE exams, after which I got a secretarial job at a church. Everyone thought it was a miracle!” says Jane.
However, Jane was still struggling with depression. She had only found a better way to hide it.  Addictive tendencies were beginning to manifest – she would mix alcohol and tea in a flask or fake an illness for a chance to pop medication and get high. She struggled through each day, worried that she would disappoint her aunt. Eventually, she got married to the youth pastor at the church where she worked. “I felt like a terrible person. Whenever I felt suicidal, I read the Bible and tried to pray the thoughts away. I really wanted to maintain the ‘good image’. When I got pregnant, I thought I had solved everything. I tried to be happy, but I still had bouts of depression. Nothing changed – it was a constant struggle.”
Jane secretly drank throughout her pregnancy. “I felt worse than I had at any point of my life. All I knew was that women who drunk were considered ill mannered. I didn’t know that there were other people with the same problem. More so, depression was considered a white man’s problem. I was afraid that I was bringing a child into the world to torture them. It’s difficult to understand this space if you haven’t been in it, but I honestly felt that it would be better for my child and I to die.”
Eventually, Jane stopped trying to disguise her condition. She would lie in bed all day, unable to eat or shower. Her church group began praying for her, in the belief that she was possessed. As her husband was unable to care for her, she moved out of her matrimonial home and moved back in with her aunt. “I owe a lot to my aunt. There were times where my only resolve to live would be because of her. These were very trying times. When I look at my son now, I can’t believe how much I risked his life.”
Jane and her husband have since split up. She still lives with her aunt and her son visits her often. She continues to struggle with bouts of depression. She has tried to kill herself three more times. She doesn’t like to discuss the methods she used, fearing she may give others some ideas. “There is no instant fix to my condition. I try to live each day at a time, I see a doctor often and I have recently joined group therapy,” she says.

GETTING HELP
Jane’s final words are to others with a condition like hers: “It’s important for them to know that they are loved, even if they feel otherwise, or as if the world would be better off without them. I wanted to talk to someone so many times and not feel judged. That is why I’m grateful for those who have stuck by me, because I didn’t choose to be like this,” says Jane.

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