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Feeling alone even when surrounded by others is common among people who are at risk of suicide. With a reported suicide rate of 23.5 per 100,000 people in South Africa, there is an urgent need for us all to talk more openly about mental health.

According to a statement issued by Netcare Akeso, the youth are disproportionately affected, “with suicide being the fourth leading cause of death among 15 to 24-year-olds in our population,” the statement noted.

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Netcare Akeso’s Crisis Line Manager, Megan Gonsalves, says, “Behind every statistic is a person, as well as their family and community; suicide is not an isolated problem, even though for the person with suicidal thoughts it may feel extremely alienating.”

She pointed out that the link between suicide and mental health conditions such as depression, bipolar mood disorder, and, sometimes, substance use disorders is well established. “Unfortunately, in some homes or workplaces, these topics remain uncomfortable and are often considered off-limits,” she points out.

She added that to protect the people we value, we need to create supportive environments in our homes, offices, and communities, places where open conversations about mental health are normal and where we feel comfortable bringing up these subjects when someone really needs support. “In this way, suicide can be prevented with appropriate treatment, before it is too late,” she added.

According to Gonsalves, for a person who feels there is no other way out, it can seem impossible to imagine that life and their state of mind will ever improve. But with professional mental healthcare, that hope can gradually become a reality.

“There are many aspects to treatment, including medication, therapy, learning coping skills, and building connections to help support individuals during their most difficult times. Often, people look back on this journey and are astounded at the strength and resilience they are capable of with professional support to manage mental health disorders,” she says.

“If your doctor prescribes medication, it can sometimes feel overwhelming. Although there may be a period of adjustment, medication can help stabilise your mood and reduce the symptoms you’ve been experiencing so you can start feeling more like yourself again.”

She emphasises that medication adherence is crucial to treatment; otherwise, the risk of suicide may rise again. “This means taking your medication exactly as prescribed, never skipping doses, and never stopping any medication without first consulting your doctor.

“Keep in mind that it may take a few weeks before you start feeling better on the new medication, and at first, there might be some ‘trial and error’ to find the right combination to help you manage your condition. Our bodies’ needs can change over time, during major stress or lifestyle shifts, so regular checkups are helpful for reevaluating your medication with your doctor, if necessary,” Gonsalves says.

“Struggling with thoughts of harming yourself or suicide can feel very lonely. It might seem like no one understands or that there is no other way forward for you. But if you are struggling, this is not the end of the road. There is a different way through your experiences, one that leads to recovery, growth, and rediscovering life’s joys. Remember, there are many resources and suicide helplines available to support you.”

Understanding new medication

According to the statement, if you are prescribed medication for depression, anxiety, bipolar disorder, or any other mental health diagnosis, it is important to understand the following fundamentals.

Seven questions to ask your prescribing doctor:

  1. What is the name of the medication, and are generics available?
  2. Why do I need to take it?
  3. How many pills do I need to take, at what dosage, and how often?
  4. When should I take it (e.g. ‘daily, in the morning’) and under what conditions (e.g. ‘on an empty stomach’)?
  5. When should I expect it to start working?
  6. How long will the effects of the medication last?
  7. Are there any side effects I should be aware of?

For support at any time of day or night, contact Netcare Akeso’s 24-hour crisis line on 0861 435 787 or the South African Anxiety and Depression Group (SADAG) 24-hour suicide crisis helpline on 0800 567 567.

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