By Wasim Kakroo
The Covid-19 pandemic has had an extraordinary influence on the worldwide landscape since Feb 2020. The illness began in Wuhan, China, at the end of 2019 and evolved into a public health danger in less than two months, posing unique problems to all nations. The impact extends far beyond medical problems. Such large-scale outbreaks will probably have far-reaching emotional and economic consequences that outlive the infection itself. In order to control the spread of sickness, travel has been prohibited, international and national borders have been locked, economies have been reduced and jobs have been lost, and billions have been isolated in their own homes across the world, though some countries have started to open their economies back. Social connection and regular routines, two key cornerstones of human civilization, have been significantly disrupted, resulting in significant psychological consequences. Social isolation and hygiene remain the most effective approaches to battle the virus in the light of inadequacy of the supply and use of vaccines among the larger population. As a result, different countries have imposed lockdowns, causing social structures to be disrupted. Increased psychological issues, exacerbation of pre-existing psychiatric disorders, fear of infection, uncertainty, loneliness, unemployment, stress, and mass panic have all contributed to one of the most alarming causes of death: suicides. Suicidality risk factors converge with the pandemic’s effects, resulting in a twofold vulnerability. The United Nations has made suicide prevention a priority as part of mental health initiatives (U.N.). Suicides will not inevitably increase as a result of pandemics like COVID-19, but a variety of socioeconomic and psychological variables may contribute to a sustained and chronic increase in the risk of suicide.
Let us look at the problem of suicide from a bio-psycho-social perspective because contemplating upon the relationship between COVID-19 and Suicidality from a bio-psycho-social perspective has the probability to improve our understanding of individual suicidal behaviour and it may also help us in devising suicide prevention strategies both at an individual as well as population level.
1. Biological links:
Suicidal ideation, attempts, and committed suicide are all linked to inflammatory changes in the brain and blood, according to current research. Researchers have been evaluating the use of inflammatory biomarkers in suicide risk assessment due to the strength of the evidence, with some promising results. Seropositivity for respiratory coronaviruses has also been associated to an increased risk of suicide. Though the exact processes underlying this link are unknown, it is assumed to be related to the virus’s neurotropic potential and propensity to cause a protracted central and peripheral inflammatory response, both of which may increase suicidal vulnerability. Treatments that reduce inflammatory alterations may have favourable effects on suicidal behaviour and should be investigated further.
2. Sociological pathways
The association between the emerging coronavirus epidemic and suicidal behaviour may be influenced by multiple, overlapping societal routes. Firstly, the worry of getting the infection and transferring it to family members may lead to altruistic suicidal thoughts (India.com News Desk, 2020); these concerns may be especially evident among high-risk sub-populations such as police officers and health-care workers. Next, pandemic containment measures such as lockdown and social distancing norms may foster feelings of isolation and entrapment, as well as a lack of general social direction, potentially leading to anomic suicidal behaviour; suicides among migrant workers (News18 India, 2020), attributed to a combination of unemployment, feelings of isolation due to separation from family, and apprehension about future may be its example. Simultaneously, lengthy containment tactics such as lockdown may cause individuals lacking appropriate social integration to feel isolated from others, leading to egoistic suicides. Finally, extended societal constraints that limit individual freedom might lead to fatalistic attitudes and pessimism about the future, especially among populations already subjected to such constraints. One example is the reports of detained people committing suicide after being placed on lockdown, apparently motivated by pessimism and despair as a result of the rigorous containment procedures.
3. Personality and Psycho-scoial factors:
Research has highlighted the proximal role of fear about contracting COVID-19 as a potential driver of suicide. But the question is why is fear of contracting COVID-19 been considered so important a factor behind somebody’s suicide?
The answer could be found in personality traits like intolerance to uncertainty, which is a key component of anxiety disorders. This concept refers to dispositional dread, which is characterised by a strong fear of the unknown, resulting in anxiety and emotional issues. Economic difficulty, unemployment, poverty, and the resulting sufferings produced by the pandemic are all key psychosocial issues that may be at play here. Furthermore, being confined to one’s home increases one’s access to weapons and pesticides, which raises the likelihood of a person acting on suicidal intentions. One of the most successful approaches for preventing suicide has been means restriction-preventing such people from having means and access to attempt suicide. However, when people are confined to their homes, this is quite difficult to implement.
Finally, the media’s involvement in inciting suicidal behavior should not be overlooked. In the context of the pandemic, irresponsible and sensationalised reporting of suicides might not only drive suicidal behaviour, but it can also deepen fear, compound stigma, and increase suicide risk. COVID-19-related suicides should be reported with caution by media experts, as it is an important population-level suicide prevention strategy.
To summarise, I as a practicing clinical psychologist believe that understanding suicide behaviour in the context of the pandemic requires a bio-psycho-social approach. Interventions for COVID-related suicidality should follow this understanding and can be both population-based (e.g., media level reporting strategies or mass media education campaigns) or individual-focused (e.g., searching for anti-inflammatory medications, psychiatric evaluation and putting the person who has suicidal ideations on medicines and enrolling him or her for psychotherapeutic interventions to address psycho-social predispositions and precipitators of suicide).
Author is Clinical Psychologist at IMHANS Srinagar. He has done M.phil in clinical psychology from Government Medical College Srinagar
For any professional assistance, the author can be reached at 8825067196
TALE OF TWO PANDEMICS: COVID-19 AND SUICIDES
