 Welcome back this is Y254 and we call this the health Wednesday. So if you're just joining us our discussion today is on a fight against suicide. Remember you can send your insights and comments through our Twitter handle that is at Ngena underscore Lizzie and at Y254 channel and be part of this discussion. So as I told you earlier I have a guest with me and her name is Emma Karetu who is a cancelling psychologist. So Emma, welcome. Thank you. Yes so let me just go straight and ask my first question. What leads people to commit suicide? What really triggers them to end their lives? Okay there are quite a number of issues. Yes. Make someone to go that direction. First we have mental health. Yeah. Mental health, we have several but I'll just mention a few that are very common. Like bipolar is a mental illness. Okay. Somebody has high moments and when they're feeling high they think they can be a president. They think so highly of them. Yeah. Okay. But then the flip side of that is when they are depressed mood. Yeah. So when they get a depressed mood they can end up committing suicide. The other one is stress. There's a lot of stress in society right now. Yes. There is so much stress that if not handled well it ends up to depression. Yes. And once stress moves to severe depression somebody becomes suicidal. Yeah. So some people who commit suicide they saw that it's their wish. It becomes a disease at some level. Okay. That is why they find themselves committing suicide. Oh so there is a level where this bipolar, this stress, this depression becomes now it's not just that it goes to being a disease and something else. Yeah. Okay bipolar is a mental illness. We have schizophrenia which is also a mental illness where somebody gets hallucinations delusions so their brain chemicals are not balanced. Yeah. But when it comes to depression which is also another mental illness this one starts slowly. It starts with stress. Maybe somebody has issues in their marriage. Yeah. Maybe for young people they have issues with school fees. Yeah. They're coming from dysfunctional families. There's a lot of peer pressure in what you want to achieve in life. There's also the element of drug and substance abuse. So if these ones are not managed when it's still very, very, we call it, we have mild, moderate and severe. Yeah. When it is at mild or moderate we can help through cancelling. But now when it gets to the next level which is severe depression it now becomes a disease and becomes a mental illness. Okay. Yeah. So by the time they're committing suicide, yeah, their level of cognitive reasoning, yeah, thinking, it just directs them to committing suicide. So well, yeah. So when someone gets to that point and they can commit suicide are there warning signs that people can see and tell, yeah, are there those things that you can tell that this one is about to do it? This one is not at a good place. Yes. Okay. If you know your family members, some now in a family setup, if you know your siblings very well. Yeah. And you know, for example, Elisabeth is a very outgoing girl, she likes hanging out. Yeah. There are those symptoms that you will see and you can easily pick because some of the symptoms include isolation. Somebody just starts isolating themselves. They lose interest in activities they have to like enjoying. Like let's go out. No, I don't want to go. They lock themselves in their rooms. Some of them lose appetite. So in its initial stages it's more or less like depression as in when it's when it's starting. Yeah. You just see when the moods have changed. There's a lot of hopelessness, some sleep patterns, some people sleep too much or rather don't sleep at all. You can notice weight loss. Yes. So if you see symptoms in a span of two weeks, I mean, after two weeks, that's a red flag. So it's our responsibility to be checking. Is there something wrong with Emma? Is there something wrong? So it's something that those symptoms you can pick. But unfortunately we're living in a very busy life here, such that it is not easy for people to pick. When somebody has actually actualized, is when somebody actually had seen, had started changing. But because of our business, we rarely pick it up. But yes, those symptoms are there. You can easily pick and hopelessness. And somebody will start even talking about, I'm thinking of taking away my life. There's nothing that is making sense anymore. So when somebody starts talking like that, it's our responsibility to pick it up and say, Hey, this is a red flag. Yeah, and exactly now on that point. With my friends back, maybe with my friends as we interact and maybe someone comes and tells me, You know what? I want to commit suicide. So what should I tell them? What do I do? Number one, you start and probe. Oh, and just a minute just before you you go further into it. So what do I tell them? And how do I know if this is this person is just seeking for pity or sympathy? Or what is this? This is the way someone can come and tell me I want to commit suicide just in a way to seek sympathy. Not like this. How do I know the difference between someone who is serious? You know, it's just joking. And how do I deal with it? By listening. Okay. Listening is a very critical element here because when you listen to what is going on, like maybe looking at your age, I think maybe you could be in that era of dating, you can listen to that person. And you can pick and you see, I always tell people something may look like very trivial to me, but one other person, it is very critical. So it is always easier to like just brush somebody off. You are joking. But then you need to really take your time and listen to them. And even because there are somebody, the people who are close to you, you'll have noticed. You'll have noticed or maybe okay, maybe it's somebody you've not seen in a long time, then they come and approach you and they say, but Elizabeth, I think I'm done. So number one, you listen to them. Just hear the story. Ask questions that are leading, open-ended questions. What is it about? When did you start feeling this way? And when the moment they start talking, you can actually judge. Don't take anything for granted because maybe to a relationship you can brush it off, but for them, they're very heartbroken. And they're taking it very personally. So you start talking to them. And if you feel like you don't have the capacity to work with them, you lead them to professionals. You have so many counselors. There's a group I saw there that they called Befriend us Kenya. We checked their website. When somebody is having suicidal thoughts, dealing with grief, dealing with whatever issue, drugs, addictions, they're able to work with you. So you pick it up very fast, let the professionals know and even involve the family. Sometimes you take it for granted, then you realize what some... I have a friend who committed suicide. She called me on a Wednesday, and then I told her, have you seen a doctor? She said, yeah, I've gone to Nairobi West Hospital. I've seen a psychiatrist. I'm on medication. So because I knew she was on medication, I knew she was at a good place. So I told her, I'll see you on Sunday. But unfortunately, the medication she was given was not the right medication. So by the time I was being called on Sunday, she had actually hanged herself in her house. So let's not take anything for granted. But it is our African culture, rather, in society. Ah, you want to kill yourself? Go ahead. It's because of lack of awareness. There's also another group of people where maybe there's someone I'm worried about. I have a friend who, you see, it's not everyone who is upfront who come and tell me this is what I'm going through. No, there's someone I'm worried about their mental health. So are there questions that I can ask that, you know, can make them open up to me a bit, maybe, or are there questions I can ask in such a way that I can know the course of their problem, or even help when they're not ready to talk? Okay, it normally also goes with personality. It also goes with the level of trust that that person you're calling your friend has towards you. So as soon as you've noticed there are some changes in the way they are behaving, the way they are doing stuff. And in counseling, there are people who block. In as much as you're trying to reach out to them, they block. But when you approach somebody with care and with concern that you're really concerned about them and you're genuine because there are those qualities of that you require as a friend to be able to work with them. So somebody can easily tell whether you're genuine, whether you're approachable, whether you end even your body language. So there are so many factors. First, your body language, maintain eye contact. Most of us, by the time we, by the time somebody's asking us a question, we are very quick, we already have the answer. But we're not even processed. We least, we listen to answer and to respond not to understand. Yes, we don't process. So there are those questions you can ask us. So how have you been? You have to break the ice. So have you been? It's been a while. I've not been seeing you, or ever you hang out, or you know, or maybe you've heard something about them. You just a wise way of doing it and also looking at the words that you use. Because when you use words like you, it's a condemning word. But when you say, I feel like you, you are going through something. Do you feel like you don't talk about it? Well, and also on that, is it safe to ask them, can you hurt yourself? Like, are you, are you planning to hurt yourself? Amma, can you really hurt yourself? Can you ask that question? That's a direct question. Well, maybe after, after you've gone through the details, is it, is it convenient to ask the question? Because, well, it could be direct, but sometimes I think it's important to just be upfront and, you know, ask what you're thinking. Yeah, no, what normally have, it's usually about the, the person, not you. Because it could be you having your thoughts, or rather pushing your perceptions on them. So you ask those questions that will help them, facilitate, actually it's just facilitating. So yeah, so you're asking questions like, I feel like there's something going on in your life. And then they'll tell you, then you say, do you want to talk about it? So it's you driving, you know, asking them questions that will provoke them to speak about it. Okay. For how long has this been going on? But don't ever say like I feel. And then, because if they're already at that position of being suicidal, they will tell you whether I've been feeling so hopeless. So when somebody is talking about hopelessness, you can easily pick hopelessness leads to suicidal thoughts. And they'll tell you, I've been having suicidal thoughts. I've been thinking things are not going on well in campus. You're having issues in our family. So they'll open up. Yeah. So apart from just telling them to go to a council and talking to them, is there any other way we can help these people and guide them? Are there other things? Support system. Support system is very, very critical. Like now in a family setup, I know of young people who are going through so much, but their parents are not aware. Yeah. Or even in a church setup, whatever religion, I'm sure there are those support systems that are there. Support groups. Like now, like now I go to International Christian Center. And none of the things that you're trying to do as a church is to come up with support systems for different issues like now loss and grief. So many people are losing their love once through death. People are losing their jobs. People are going through divorce. People are going through separation. Children are going through drugs and substance abuse. But when you come up with a support group, they realize how I'm not the only one going through this. Even Elizabeth is on the same boat. But when they think I'm the only one going through this, they are more prone to suicidal thoughts and attempt. So those support groups are very, very critical. And also just being checking on each other. Like in a family setup, always check on, because I'm seeing a trend of we wake up so early at five. Are you guys ready? Are your books in their bags? In the capitalist society? Yes. The bus is outside. We're always on the move. Always on the move. But do you take time as a family and just sit down and check? And don't ask about books. No. We are always asking our children, have you done your homework? Have you finished your homework? Even when they hear about a family meeting, they think it's a chance to be scolded. Yes. So we have to make it a lifestyle and very, very intentional. That every day God help me. I'll check with my daughter. You can even tell, you know, you can tell somebody's physical appearance. Like today, mommy, you look moody if it's a girl or hey, what's up, John? You know, when you are concerned with what is going on in their life, you can actually prevent. Because by the time they are getting to those last stages of becoming suicidal, it takes a while. It's not something that happens overnight. It can take a year. It can take two years. Some are, depending also on their personality and what the issue is. Some people are so, their personality, they are not able to handle. They are delicate. They are very, very delicate. Yeah. And what about if you have a friend or a family member who has made their attempt on suicide? How do you deal with that? How do you deal with that? Because I'm sure you're constantly afraid they might do it again. They might repeat it. Yeah. Or it might, maybe they might have encouraged someone else in the social setting or in the family. How does, how do you go about that? They need to go through cancelling, number one. Because sometimes you want to help, yes, as family members. But it's the professional angle. Because there's a way a psychologist or a psychiatrist will bring it across here. So number one is to ensure that they seek, they seek help from a professional. Number two, one of the things that are... Sorry Emma, you've said about seeking help. Now we are talking about just the victim. Even because I imagine the whole stigma comes with, you know, assuming it's apparent, wow, my son attempted suicide. Now in the village it's going to be that family of them. Yeah, yeah. So how, what, so as you talk on that, also touch on the stigma, well with the family and friends. Okay, yeah. So like now for the family, they are called like caregivers. Because they are the ones who will like, they are the ones the society is watching, yeah, this family has this issue. So the best thing is just when, there's also family therapy that now will bring the victim on board plus the family members. And in that setup they are taught how to cope, the coping techniques here on how to not allow because I always tell people you are in charge of the internal, the internal, you are in charge of your internal issues here. But anything external, you are not under control. Yeah. People will always talk. Whether you've done something good or something bad, people will always talk. So when you're able to have that defense mechanism here of I don't care what people say, I know the truth and I know our son or our daughter has overcome and we're going to work with them. So it's more of empowering them, yeah, to look at things positively. Because even if you are not a victim and you're having an issue in your life, that thing of what people are thinking, people are saying, it can really bring you down. But once you have coping skills and say you know what I don't care what people say, it's about me. But the moment you start looking at what are people saying, what are people thinking, you're prone to go down very, very fast. Yeah. So yeah, there's family support. There's also support groups that are there that can be, that are there for caregivers. Because it can be very strenuous, yeah, taking care of a or having had a suicidal attempt in the family. And also to prevent it. Most people commit suicide maybe using, they're called what's best sides. These Poisoners, Rat and Riot, those things, yeah, some people even the knives. So you keep away, even a gun, yeah, so you keep away things that can easily make them, that are easily accessible for them. So if it is maybe drugs, you make sure that you don't have any, and I'm telling this to both the family members and even the, if you've attempted suicide before and you know the method that you used, you keep those things far away. If it is a rope, you know, yeah. So still on that, I have been meaning to ask, because earlier through there's something I was watching and someone was saying she was, she had attempted suicide before. So she was saying before you actually go to buying those medicine, buying the the pills or the medicine before you go for the rope, before you go for the gun. This is something you have planned and you even have backup plans. You have planned, you have revisited, even if it failed you know what you'll do after that. So my question is, can suicide be impulsive? Okay, for suicide, as I said earlier on, it's by the time you're getting to being suicidal, it has taken time. So at no point can someone just come and say I want to kill myself and then just do it? No, unless there are some very few cases, yeah, that the suicidal cases are genetic. Okay. So what you normally do like now in therapy, we draw your genogram, in layman it is a family tree. There are families that have predisposition to, to suicide. So if you, if you draw a genogram up to the third generation, you're able to tell uncle, so and so committed suicide, auntie, so and so committed suicide. So that actually the message is awareness. Are you aware of your family tree? And it's not only suicide, even alcohol, there are families that have predisposition to alcohol. So if you know you're coming from a family that is predisposition to alcohol, how do you handle your family? Because automatically you become an addict. It's going to be a big effect. So when you're aware, but the issue of now actualizing, it takes time because when those symptoms of depression, they are about nine. So suicidal thoughts is the last one, which is the ninth one. So by the time you're seeing somebody isolating themselves, losing their appetite, losing interest in activities they used to enjoy doing, having a sense of hopelessness, you know, having a sense of they don't want to go out, don't want to see the sun. By the time you're picking those symptoms, you're able to curb it. You're able to stop it in good time. But by the time they're getting to symptom number nine of suicidal thoughts, having even planning to do it, that is the extreme part. So but when you pick it earlier, or even when they're already here, now you start taking, because by the time it's getting here, it's your brain chemicals are not balanced. So you're even doing it not that you want to do it, but you may be able to buy the sun. That is why they're given antidepressants to balance the brain chemicals. Then you're given, you're given what do you call it, you go for therapy, you go for counseling, because there's always an underlying factor. You have to address the issue that is causing, directing you to committing suicide. Otherwise if you don't direct it, you'll still come back. So if it's an issue with school fees, if it's an issue with marital problem, you have to resolve it. And then now you start coming back to normal. Okay, well that's very knowledgeable. And now as we conclude the discussion, because time is not on our side, people keep posting, there are people who keep posting suicide messages on social media. Like you find someone has dropped a whole paragraph on how they want to end their life. So how do we as a society deal with that and how do we help them? You see even on social media you'll find there's a very different crowd. Some are willing to tell you just go ahead, kill yourself, you see you're insignificant in the world furthermore. And what can we tell them? They are encouraging things that you can tell them, because I also understand that also these social media pages, they have help planes where you can just post. But you can repost or you can report them to those specific pages. So also are there things we can write in the comment section? Are there things we can write to encourage them? Yeah, whether you can write, of course definitely. You can even tell them whether your life is so valuable, you know encouraging them because at that point they're feeling so hopeless, they're feeling so worthless, they're feeling like you know I don't belong. So you can just encourage them by telling them that their lives are very valuable, whatever issue you're going through. I'm sure it can be resolved, then you can say side charts. Of course I'm sure by the time you're doing that, it is of course there are those people that you don't know, but you want to reach out to. So you write to them the importance of their lives, you write to them that you can seek help, whatever it is, there's nothing that cannot be resolved. And then of course the consequences, like for example if it is a parent, if you want to commit to side your kids are being left behind, if it is a student, the circle, the family set up or the circle that you're in, so you start by encouraging them, but the critical is for asking them to seek help because sometimes when you're telling them about the people they're leaving behind and all that, then they're ready like they're sick. And I want to tell people out there, please, please, depression is sickness because people tend to think it's what a Jew is, but somebody is unwell and they need help. So let us as a society go out there, go out of our way and help people that are in need of help, refer them to professionals, just to work with them, encourage them, find out some of the issues you can even do it as a peer. As a peer, it doesn't have to go the professional way, it could even be something like maybe a broken relationship and that is one of the skills that we use, you call it self-disclosure. You tell them even me I've gone through that, then they realize, oh come but it's something I can deal with and they need support system, they need somebody to talk to. Okay, well thank you so much Emma for that discussion. I wish we had more time, trust me, I have multiple questions. I wanted to know and people back at home to know about depression. So thank you so much for staying with us throughout the discussion. Unfortunately, we have to go, time is not on our side, but in case you missed anything or you'd want to follow through the whole discussion again, you can follow this discussion on our YouTube page that is on Y254 channel. There you'll find this and much, much more. So that's it from us and you can keep it Y254 for more amazing programs and youthful vibes. Until next Wednesday, bye bye. Bye. Thank you.