When we hear about suicide, the first question that often arises is "Why did this happen?" The truth is, there is rarely one answer. Suicide is not the result of one bad day or one unfortunate event. Much like a heart attack, it is the outcome of many risk factors — psychological, biological, and social — converging over time.

Reducing it to a single cause oversimplifies a profoundly complex human experience.

Suicide Is About Pain, Not Death

At its heart, suicide is not about wanting to die. It is about wanting relief from unbearable suffering — sometimes visible, but often hidden within the mind.

Research in psychology and suicidology (Shneidman, 1993; Joiner, 2005) describes this as "psychache" — intense mental pain arising from unmet psychological needs, guilt, or loss of belonging.

Emotions like helplessness and hopelessness are among the most reliable predictors of suicidal thinking (Beck et al., 1974). In such distress, the mind experiences "cognitive constriction" — a narrowing of thought and imagination (Ellis & Rutherford, 2008). It becomes difficult to see alternatives, hope, or reasons to keep going.

For some, this pain builds over months or years. For others, it strikes suddenly — a crisis that appears impulsive but was silently brewing beneath the surface. Either way, suicide is not inevitable. With care, intervention, and time, recovery is possible.

It's Never Just One "Trigger"

When we hear of a suicide, we often focus on the final event — a breakup, job loss, or academic failure. But that's like blaming a heart attack on the last heavy meal. The true causes usually lie deeper — in years of cumulative strain, untreated mental illness, or social isolation.

A meta-analysis by Turecki and Brent (2016) found that suicide arises from the interaction of biological predispositions, mental illness, and psychosocial stressors. The visible trigger is often just the final straw; underneath lie layers of vulnerability — depression, trauma, impulsivity, loneliness, substance use, and poor coping mechanisms.

When we stop at "why now," we miss the deeper "why at all."

Mental Illness and Suicide: A Strong but Complex Link

In Western countries, studies estimate that up to 90% of suicides occur in the context of a mental illness — most commonly depression, bipolar disorder, or substance use (Cavanagh et al., 2003). In India and across much of Asia, this number is lower — around 40–50%, according to the World Health Organization (WHO, 2019) and the Indian Council of Medical Research (ICMR, 2021).

This doesn't mean the rest are unrelated to mental health. Rather, it reflects how impulsivity, stress, and cultural factors shape how distress manifests and is understood.

Many Indians experiencing depression present with physical symptoms such as fatigue, headaches, or gastrointestinal issues rather than sadness — a phenomenon known as somatization. Research by Patel et al. (1998) and Raguram et al. (2001) found that a majority of Indian client with depression reported only physical complaints, leading to frequent underdiagnosis.

This cultural bias in diagnostic systems built primarily on Western models means many people never receive the help they need. It underscores the importance of developing culturally sensitive mental health assessments and interventions that recognize the Indian context.

The Two Paths: Long Struggle and Sudden Crisis

When we examine suicide closely, most cases fall into two broad trajectories:

1. The Long Struggle

Here, suicide occurs after prolonged mental illness — often untreated or undertreated depression, bipolar disorder, or substance dependence. WHO estimates that untreated depression increases suicide risk by up to 20 times.

2. The Sudden Crisis

Other times, suicide happens impulsively, triggered by anger, shame, or loss. Studies show that impulsivity and access to lethal means are key factors in these cases (Deisenhammer et al., 2009). If that moment can be interrupted — through emotional support or restricting access to means — lives can be saved.

Even without a clinical diagnosis, risk factors like poor impulse control, low frustration tolerance, lack of social support, or substance use can heighten vulnerability.

That's why suicide prevention must combine long-term mental health care with short-term crisis response — including helplines, community outreach, and media awareness.

The Modern World: Rising Risks in a Changing Society

Modern life brings its own pressures. Faster lifestyles, economic uncertainty, and constant digital comparison contribute to stress and disconnection.

A 2023 Lancet study on global suicide trends noted that social isolation, sleep disruption, and online exposure to self-harm content are emerging predictors among young people. In India, NCRB data (2023) show suicide rates rising most sharply among students and daily-wage workers — two groups deeply affected by academic and financial insecurity.

Technology is both a tool and a trap. While it allows access to therapy and information, it can also amplify loneliness and shame. Social media often curates a world of perfection that makes people feel unseen or inadequate.

Recently, researchers (Pavarini et al., 2024) have also explored the rise of AI companionship, noting that while it may comfort people temporarily, it cannot replace real human connection and, in some cases, may reinforce isolation.

These factors don't cause suicide directly. But just as pollution increases the risk of heart disease, social and cultural stressors increase vulnerability to mental illness and despair.

Recognizing the Warning Signs

Suicide rarely occurs without warning. Learning to recognize signs can save lives.

Common indicators include:

• Withdrawal from social contact or usual activities
• Talking about being a burden or feeling trapped
• Giving away possessions or saying goodbye
• Expressing hopelessness or sudden calm after turmoil
• Risky behaviors — reckless driving, unsafe sex, substance abuse
• Neglecting appearance or hygiene
• Changes in sleep, appetite, or mood
• Loss of interest in future plans

Research by Rudd et al. (2006) highlights that direct talk about suicide or feelings of entrapment are among the most critical warning signs that require immediate attention.

How to Respond

If someone you know seems at risk:

• Don't minimize their pain or assume it's "for attention."
• Gently ask, "I've noticed you seem really down lately — are you okay?"
• Listen patiently. Avoid rushing to "solve" things — your presence matters more than advice.
• Acknowledge their pain: "I can see this feels really hard for you."
• Encourage them to seek help — from a counselor, helpline, or trusted friend.
• If danger feels imminent, stay with them and call emergency services or a helpline immediately.

Research shows that empathetic listening and early intervention reduce suicide risk significantly (Stanley & Brown, 2012). Sometimes, one caring conversation can change everything.

Healing Together: Families, Workplaces, and Communities

A suicide affects more than one person — it affects entire circles of family, friends, and communities. Grief, guilt, and unanswered questions can linger for years.

That's why suicide prevention must be seen as a shared social responsibility, not just a medical task.

• Families can create emotionally open homes where talking about feelings isn't taboo.
• Schools and colleges can train teachers and professors to recognize distress and refer students early.
• Workplaces can establish wellness programs to prevent burnout, bullying, and isolation.

Evidence from community-based interventions (World Health Organization, 2021; Vijayakumar et al., 2017) shows that multi-sector approaches involving schools, health systems, and media reduce suicide rates by up to 20–30%.

Just as CPR became a public skill that saves lives during cardiac emergencies, suicide prevention literacy must become a shared societal skill.

Building a Society That Protects Life

To build a suicide-safe society, we must:

• Treat mental illness with the same seriousness as physical illness.
• Ensure therapy and medication are accessible without stigma.
• Strengthen community bonds — belonging protects against despair.
• Advocate for stress-reducing policies and mental health funding.
• Promote culturally relevant diagnostic systems that reflect India's lived realities.

A Final Word: Hope Is Always Within Reach

Suicide is not selfishness. It is not weakness. It is the result of deep pain that feels impossible to bear — but it is also preventable.

Every act of listening, every open conversation, every moment of empathy matters. Just as no one should die of a treatable heart condition, no one should die of emotional anguish.

If you are feeling hopeless or overwhelmed, please remember: you are not alone. Support is available 24/7 through Never Alone. Reach out — there is help, and there is hope.