Suicide & Stigma: Sikkim's multifaceted social issue that remains unresolved - II
Sikkim stands at the second position in the rate of suicides with 33.1 according to the NCRB 2019 data
The National Crime Records Bureau 2018 report has shown that Sikkim stands second in the rate of suicides among the states/UTs in India. Between 2015-19, the rate has dropped from 37.5% to 33.1% yet the consistency in the rate is still much cause for alarm.
In 2016, Sikkim had the highest rate of suicide at 40.5%, in 2017 it was 32.9% and in 2018 it stood at 30.2%. There has been a slight increase between 2018-19 even though the efforts of the state’s mental health professionals have been imperative to curtailing further increase.
Certain demographics within this data still remain fairly the same. The most vulnerable age group was 18-35 and women. The reports don’t however show how many LGBTQ+ folx or other marginalized communities were within the purview of the information collected.
More and more young people have been using their social media platforms to advocate for better healthcare and encouraging their peers to seek help or talk about their problems with either mental health professionals or groups that work for specific communities that might not avail the same grace as the majority of India’s population.
Young people in Sikkim have mixed feelings about visiting a psychiatrist/therapist/counsellor for help. Some agree that it helped them and some were disillusioned by the entire process, leading them to seek more holistic ways of treating their illness.
S* a medical student from Sikkim, recalls sitting with her friends on a lunch break when she suffered from her first anxiety attack. “I didn’t know it was an anxiety attack. I never thought I would have any issue like this because I was always normal, or at least I thought so. I was taken to the CRH Manipal Emergency Room (ER) because I was hyperventilating and having muscle spasms. When the doctors arrived and began questioning me, I was so surprised by how rude they were that I began crying. I was terrified”.
The doctors in the ER, she says, traumatized her with their persistent questioning. “He asked me if I was in an abusive relationship (after clearing the room) or if I was pregnant and about my sexual life.”
She says that she was asked for a urine sample but it was only later that she found out that they had asked her friends, who had accompanied her, to get a pregnancy kit and tested her without her knowledge. “Apparently they thought I was lying when I told them I wasn’t pregnant - I was offended when I found out because I didn’t want to discuss my sex life with them neither were any of those things related to my problem. From that minute on, the trust between doctor and patient was broken”.
She was met with a psychiatrist after that, who informed her that she needed to seek help from the psychiatry department, where she was prescribed medicine. “When they asked me if anything was wrong, I said I was okay because I really didn’t know what was happening. I took the medicine yet the attacks continued and the side effects - drowsiness and such - made it difficult for me to catch up with my studies so I thought I should approach another doctor.”
“All the second doctor asked me was if I was fine and then prescribed more medicine. There was zero counselling and he just said, “just take the pills and you’ll be fine.” She feels that this was a wasted effort because despite being a senior, well-reputed doctor, he had dismissed her case easily.
So she too took to researching about her symptoms on her own. “Since I am also in the medical field, I knew the root was something deeper. I took a leave from my college after I started the prescribed medicine but it didn’t work. The attacks occurred for two whole years and my health began deteriorating. In my research, I found that treatment from both a psychologist (who doesn’t prescribe medicine) and a psychiatrist (who prescribes medicine for physical symptoms) should go hand in hand, but the doctors I’d met before had never informed me of this.
“I began to meditate and currently, the attacks are usually minimal to none. Because I was a medical student, it was easy for me to go and approach another medical professional for a solution but not a lot of others would have the courage to do the same, not even the patients I treat”.
Jarina Lepcha, a junior engineer at Roads and Bridges, National Highway (NH) Department is open about her experiences with seeking mental healthcare and talking about her experiences.
She was 20 when she first realized she wanted help, which led her to visit two doctors in the capital.
“The first doctor was nice but I was rude to him. I wanted someone to listen but he asked me questions that I didn’t want to answer still I did. I became mad at him and said things I shouldn’t have”.
After realizing her mistake, she decided to visit another, an older doctor and this time she had promised herself that she would behave. “At the beginning of the session, he asked me if I had sex. I answered but this question made me want to never see him again because even though he asked a simple question, that was not what was on my mind”.
Dejected, she regretted lashing out at her former doctor so she made up her mind to somehow help herself without external aid.
“I stopped hanging out in my old lifestyle. I saw skateboarding as something I liked. I did that and found a family in Skatekonnect. I was doing art therapy for myself and continued to do so because I love drawing. I sang and danced, reflected on myself and started to see my weakness and do something for it.
“But I still felt hollow and got anxiety attacks”. She recounts how she talked about these issues with her parents, who were supportive and in her words, “allowed me to feel my pain”.
“And suddenly, I don't know how I became well, back to my old self but with new lessons, memories. Parts of me I hadn't explored came into existence. I felt a huge burden leave me, then I realized how silly I was. Happiness is not permanent nor is sadness. I just had to embrace and learn from both. Before, I had thousands of thoughts popping in my head and got headaches and felt hopeless. I felt emotionally numb”.
In the course of the self-therapy she gave herself, she researched depression and anxiety and the solution to them. “I tried so many which I could practice but the one I didn't read about, I didn't think I would do, came true.”
Going just a little further from Sikkim’s borders, a young person D* from Siliguri, recounts her first experience with psychiatric help. After a referral from her first psychologist in the city to another psychiatrist, who prescribed her medication and despite taking them for a month, she found that it didn’t help.
“Then I met a family friend who performed various therapeutic exercises and I slowly began to respond. To control the mind, one has to know the mind. Yoga, meditation and art therapy helped me more than anything. Unless you have a medical history of mental illness I don’t suggest anyone visit a psychiatrist. It didn’t help me at all. The medication would make me more anxious and drowsy throughout the day.
“I’ve been sad for a while but in 2019, for the first time I came out openly and asked for help and it wasn’t easy. The psychiatrist I met had a straight face, no empathy whatsoever and he didn’t even care about my problems. He just took out a paper and wrote down what I should take to get more sick”, she says.
Yet, there are a few who believe that seeking consistent medical care would help. R* from Sikkim went for two sessions to a therapist/counsellor but quit after two weeks. “The meds definitely helped but I also can’t keep taking them forever. I stopped seeing the therapist and counsellor after 2 weeks which I shouldn’t have. I’m sure it'd have helped”.
On being asked if he would like to restart therapy, he says he would like to. “I don’t think it'll get any better without it”.
In these anecdotes, it is clear to see that young people are often subjected to harsh judgement and intrusive questioning that traumatizes them from the get-go. It’s also pertinent to note that those who have been through this are mostly women. It should not be surprising to anyone that sexism is prevalent everywhere, even within a healing space. Despite all the women empowerment programmes, sensitization campaigns and discussions on social media, it all falls short when women’s lived experiences that say otherwise.
Is psychiatry just another way to dismiss women’s problems or are the medical professionals choosing to be ignorant? Even though there are groups in Sikkim that cater to women’s mental health separately, there is still no place for the LGBTQ+ community.
Those who suffer from stress and suicidal thoughts while questioning their sexual/gender identity or after coming out to their friends and family still find no respite as there isn’t a channel for them to communicate their emotions in a healthy, bias-free environment.
Sikkim needs more awareness on not just the issues of old but look forward to the future generation which will have an exponentially different set of struggles they face. From climate change to sexuality to living mostly online, the scope of mental health research is still largely untouched.
Mental health professionals need to not only find a quick cure but truly understand that the Millennial and Gen Z generations have different needs than the ones before.
“One must imagine Sisyphus happy”, Camus had concluded in his famous essay. But Sisyphus was a mythological character, a metaphor to a person’s relentless struggle against life’s absurdities - there are real people, flesh and bone, who are going through real problems of inequity, unemployment, relationship - platonic, friendly, familial - problems and try as the people can, it is difficult to imagine them happy when news of their untimely demise arrives on phone screens - and all people do after is like, share and scroll on, another life lost in the pixels.
*Asked to remain anonymous
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