Rising suicide rates: Key factors and effective coping mechanism

This is the first article in a five-part series on the issue of rising trend of suicide cases in Malaysia, where we speak to clinical psychologists to find out the reasons behind it and ways to cope. If you are feeling distressed, depressed or suicidal, help is available – speak to someone from Befrienders at 0376272929.

SHAH ALAM – The increase in suicide cases is a global issue, with various countries, including Malaysia, facing similar challenges.

Recently, Deputy Prime Minister Datuk Seri Ahmad Zahid Hamidi pointed out there is a rising trend in suicide cases in Malaysia, from 609 cases in 2019 to 621 in 2020, 1,142 in 2021, 981 in 2022, and 1,087 last year,

The Pillars clinical psychologist Daniel Tan said that the rise in cases could be due to many complex factors, including economic and financial stressors which include economic downturns, retrenchment and high cost of living.

He added that it could also be due to cultural and societal factors which include negative stigma and taboo as well as lack of adequate mental health services which could contribute to the increase in suicide rates.

“Additionally, with social media being more prevalent these days, the constant exposure and comparisons to curated lives and achievements on social media from people they follow can lead to feelings of inadequacy, low self-esteem, and worthlessness, especially amongst younger generations who are more exposed to these sorts of settings," he added.

Daniel further outlined that more vulnerable individuals would be more easily influenced and affected negatively, which may lead to self-defeating thoughts.

He addressed that social media was merely a medium of delivery and could potentially serve as a tool to further allow people to share about their feelings and difficulties.

"Normalising that aspect of expression whilst communicating mindfully will be the key to fostering an environment that is both supportive and impactful,” he said.

To combat these issues, Tan recommends building a support network of family, friends, and support groups to reduce feelings of isolation.

Practising self-care through regular exercise, a healthy diet, adequate sleep and mindfulness practices, he said, could also improve overall mental well-being.

Developing healthy coping mechanisms, such as journaling or creative expression, and limiting time spent on social media were also mentioned to help manage stress and negative emotions as more doable options before seeking professional help from therapists, psychiatrists, or counsellors, which is crucial for getting additional support and treatment needed.

“The most important thing is for individuals to have a person, place, activity, or environment in which they feel 'safe' where they can be away from distressing situations or thoughts and just take some time to rest and recover,” he said.

He also said that feeling hopeless, worthless and overwhelmed by stress was a normal response from patients, stemming from academic or work pressure, social isolation, bullying, and unresolved trauma.

Along with that, he highlighted that a key consistent factor in overcoming depression was storing hope and believing that things would improve.

On having suicidal thoughts, usually being closely linked to depression, Tan said that depression battlers constantly struggled with a lack of willpower, energy, and a pervasive sense of heaviness.

"Therefore, it is crucial for them to maintain the belief that they can overcome their condition," Tan said in endorsing overcoming depression.

He acknowledged that maintaining the belief could be challenging, especially when feelings of hopelessness were prevalent.

"This is where a strong support system becomes vital," he said.

He highlighted friends, family, and support groups as individuals who could provide understanding, companionship, and encouragement, all of which were important and needed to help individuals push through and overcome depression.

He said that commonly, individuals who had close relationships might feel motivated to get better for the sake of their loved ones.

He also highlighted the importance of having personal goals.

"The desire to improve one's quality of life can be a powerful motivator," he said.

Despite all that, he stressed that the main motivation for overcoming depression varies across individuals.

Tan said coming out of depression was a complex condition where each case of depression required a deep understanding as to what exactly could be contributing to the situation.

"Depression can manifest in different forms, from more acute episodes due to an event or recent trigger to more chronic, where it is due to months and years of more internal conflict.

"As long as they have a reason and belief in that reason (of coming out of their depression), it can serve as a strong motivator," he said.

Daniel further highlighted the importance of getting the right treatment and support as the intensity of depressive feelings could fluctuate, accordingly which could effectively reduce the symptoms of depression.

He emphasised the need to be introspective in fluctuating depression, which functioned just like normal human emotions, and not entirely give in to the belief that having the condition meant that it was a ‘dead end.’

"Oftentimes, depression is largely a symptom of a deeper, more intricate root problem and understanding that is the key to overcoming the condition," he said while dismissing the stigma towards depression and addressing the essence of understanding the root cause of depression to fix it.

He specifically suggested being introspective by reflecting on one's thoughts, feelings and behaviours that allowed oneself to identify triggers, patterns, and underlying issues contributing to one's depressive symptoms. "Understanding your emotional landscape can help gain insights into yourself and hence lead you to acknowledge how you are feeling whilst finding solutions to overcome it," he said.

He also recommended seeking support by reaching out to friends, family, or support groups that could provide a sense of belonging and understanding where sharing experiences with others could help reduce feelings of isolation and offer practical assistance.

Daniel highlighted the importance of being compassionate and kind to oneself despite it all, where acknowledging one's struggles without judgement allowed the space to not sink into feelings of hopelessness and individuals to push through their concurrent challenges.

"Set goals that are realistic," he suggested as one of the ways to overcome depression or depressive episodes better and quicker, where setting small, achievable goals could create a sense of purpose and accomplishment, which was vital for someone battling depression to allow life to be meaningful once again. "Breaking larger tasks into manageable steps helps prevent feelings of overwhelm and boosts motivation," he added.

The last step would be to seek professional help when everything became overbearing, he said.

"At times, you may feel overwhelmed and lost about what to do and those feelings can be paralysing.

"Hence, seeking professional help is an option that allows someone to walk with you through your journey of overcoming your depressive symptoms.

"Therapy can help you explore the root causes of your depression, develop coping strategies, and learn new ways to manage your thoughts and feelings," he said highlighting the importance of attending therapy sessions.

Daniel also addressed the issue of suicide linked to depression.

"Suicide is a sensitive and complex topic, especially when discussing it in the context of depression," he said.

He said that it would be important to understand that suicide was not the primary goal for individuals battling depression where it would often be seen as a last resort and a desperate attempt to escape overwhelming emotional or physical pain.

"Many who contemplate suicide do so not because they want to die, but because they wish to end their suffering," he said.

He addressed the normalisation of assisted suicide in certain countries where it was presented as a means to alleviate suffering for individuals with serious, incurable medical conditions, such as a nervous system disease (ALS), multiple sclerosis, or severe chronic pain, where all other options had been exhausted.

"In these cases, some view it as a more humane option," he said.

Upon this, he said when mental illness, such as depression, was involved, the boundaries would become more complicated.

"While assisted suicide might be seen as a choice for individuals battling depression, it is important to recognise that within that context, suicide is more often a response to extreme distress and a feeling of hopelessness," he said.

"Therefore, spreading mental health awareness and encouraging individuals to seek help and expose themselves to other options is essential.

"It is important to approach the topic with sensitivity and a deep understanding of the underlying issues, emphasising that there are ways to manage and alleviate their suffering other than suicide, which can provide hope and potentially save more lives," the psychologist said.

Previously, former Prime Minister Tun Dr Mahathir Mohamad had also pointed out that concerning trends such as the unprecedented increase of suicide cases among Malaysians, especially the Malay due to economic strain.

"Malays normally do not commit suicide, but when you find you can't even feed your own children, then of course you may commit suicide," he had said, highlighting the severity of economic hardship faced by some segments of society.

Dr Mahathir also raised alarm over instances of extreme behaviour of cases where people killing their family and themselves due to financial pressure.

These acts, he said, was the distress and desperation faced by individuals grappling with economic challenges.