Breaking a taboo: time to care for your mental health

I got the job to write the blog post of this month and was wondering about what I could bring to the table in times of a global pandemic. For me it is quite difficult to pretend that this life is “the new normal life”, while so many people are getting sick and even dying due to this new pandemic. And when I say “sick”, I do not only mean a viral contamination, but also a mental exhaustion. Due to the lockdown, we got stuck into our houses, not allowed to meet friends, family and beloved ones. Many people are working from home until now, trying to balance domestic and professional duties. We needed and still need to wear facemasks, not to hug elderly persons, to avoid close social contact and to keep at least 1.5 meters from others. Definitely these are not easy measures we are used to, and for sure this is affecting our mental health. However, unfortunately, we must be ready to face a second wave of the pandemic, and a new lockdown knocking our doors. Yes, I know, that is pretty sad and scary, but a reality.

A few months ago I read an article that says that health professionals are concerned about the mental health of the population during lockdown. People with pre-existing mental disorders can be directly affected by the lockdown, and one of the main concerns of health authorities is the increase in suicide rates. This concern is associated with some studies that have shown an increase in suicide cases when previous diseases spread, such as the influenza pandemic in the USA between 1918-19, and the epidemic of severe acute respiratory syndrome (SARS) in Hong Kong in 2003 [1]. These historical cases, together with our lifestyle – extremely busy and virtually connected – activated the alert signal of doctors and psychologists regarding our mental health. That is why I have decided to write about something non-related to my PhD topic, but briefly about something terribly necessary.

As you might remember, I am Brazilian, and in Brazil the whole month of September is dedicated to the suicide prevention. This campaign is known as Yellow September and occurs since 2014. It has the objective to paint, illuminate and stamp the color yellow everywhere (Fig 1), guaranteeing more visibility to the cause. Also, every September 10^th since 2003 we commemorate the World Suicide Prevention Day, which is promoted by the International Association for Suicide Prevention (IASP), in collaboration with the World Health Organization (WHO).

Figure 1: Brazilians landmarks illuminated by yellow light during the September Yellow campaign. From left to right: Christ Redeemer (Rio de Janeiro), National Congress (Brasília), and Lacerda Lift (Salvador). [2, 3]

Data from 2016 shows that every year around 800,000 suicides happen globally. This means that a suicide occurs every 40 seconds [4]. The global suicide rate in 2016 was 10.5 for every 100,000 deaths, while the Brazilian one was 6.1 for every 100,000 deaths. Among the reasons, suicide was the second main cause of deaths among young people, from 15 to 29 years old (Fig 2). Even though 79% of the cases happen in low and middle income countries [5], suicide is a health public issue and may not be ignored by the authorities around the world.

Figure 2: Leading causes of death, ages 15-29 years. [4]

Prevention

There are many reasons why a person commits suicide, such as depression, anxiety and income level. However, with respect to pandemic times, adverse effects caused by the pandemic might be intensified by fear, self-isolation, and physical distancing [1]. High levels of stress can also lead to feelings of hopelessness and despair [6]. According to a recently published scientific paper [1], there are some preventative measures to mitigate suicide risks during COVID-19 pandemic. As can be seen in Figure 3, public health responses may not only focus on mentally troubled people, but also on the whole population who needs extra support during this difficult period. On one side, people with mental disorders or have suicidal experiences, must have adequate mental health services that can be carried online. On the other side, general public, who are facing financial stressors, domestic violence and an increasing alcohol consumption, should have governmental intervention for catering individual support. It’s worth remembering that family and friends support are crucial to alleviate these situations.

Figure 3: Public health responses to mitigating suicide risk associated with the COVID-19 pandemic. [1]

Trivialization and taboo

Trivializing mental health has a direct negative effect on people who are dealing with suicidal thoughts. This attitude can inhibit people from looking for help and worsen the crisis. Mental health illness is a serious public health issue but fortunately, there are treatments to deal with that. First and foremost: never being judgmental is essential for the early prevention.

In some countries the suicide theme is still a taboo and have not been openly discussed. To date, only a few countries have included suicide prevention among their health priorities, and only 38 countries report having a national strategy for managing this [5].

What you can do

If you need help, do not hesitate to look for professional help who can guide you with the right treatment. Do not have shame on share and communicate honestly about your feelings with the other who can help you. Remember: depression, anxiety, stress, and mental exhaustion have treatment. Reach out for help!

If you know someone who needs help, let the person know you care for them. Listen to the person and be compassionate with him/her. Together, find professional help and Make sure that you will be on her/his side despite any challenges.

Above all, stay safe and take care of your mental health! Makes life worth living! 🙂