“The real war is not life itself but from your mind. Win your mind and you will win in life”
…… Roger Lee
The battlefield to win or loose in this life is to a great extent our very own dear minds. When this mind now turns against itself, as it often does in all suicidal ideations and behaviours, the one place that help is most likely to come would have to be from the oustide. Friday, September 10th is this year’s suicide prevention day. The theme for 2021 is ‘creating hope through action’. The operational word ‘action’ probably suggests this ‘outside help’.
The normal human mind has infinite assets from within to not only heal from all form of adversities but also move on loving itself. When some of these sophisticated, complex, mysterious and interdependent brain systems fail, the mind succumbs, and tells itself to kill itself. This is perhaps the greatest mystery of life itself from a source so essential to it but yet much more mysterious (the mind).
The mind is the source of all impulses, but it rarely acts to end itself on such impulses. Killing oneself is rather usually a slow grinding process of nihilistic self loathing, endless ruminitions of worthlessness, extreme hopelessness, and fatal helplessness that push one into the abyss of cognitive anarchy. Though sometimes, clear voices from the mind would simply suggest to the conscious mind to end itself. The verdict is therefore that of the supremacy of the mind (even when it is sick) over the body (mostly when it is optimaly healthy) as is the case in most completed suicides.
The practice of medicine may therefore need to, through it’s agents (the doctors), undertake a thorough and critical self reflection on how it apportions it’s resources and energy into what happens within our minds.
While the world is almost exclusively focused on completed, and to an extent attempted suicides, those whose mind desires to die but still a part of it (the same mind) isn’t prepared (remarkably for cultural/spiritual reasons in our society) to end it live the most miserable lives on this planet. And the fact that these are subjects doctors routinely miss in their fancy consulting rooms is the greatest argument for this collective professional self reflection.
Simple routine inquiries about a patient’s mood may not only prevent deaths from suicides but will also greatly improve the quality of lives that will otherwise crumble and loose the battle of life under the weight of depression, anxiety disorders, bereavement, psychotic spells, drugs and alcohol burden, and various forms of psychosocial and interpersonal difficulties.
Doctors must discipline themselves to routinely ask and look for mental symptoms in all their patients. That won’t make us ‘mad’ but better doctors instead who live true to their hippocratic oath and save lives. The blood of some categories of patients who eventually complete their suicides may actually be on the hands of certain doctors who (either out of their ignorance) couldn’t or simply won’t (for other reasons) identify and stop them!
It is also immeasurably crucial for every individual to learn to identify and communicate some of these symptoms to their doctors. Telling your doctor that you feel ‘worthless’ or like ‘life isn’t worth living anymore’ and ‘it has totally lost it’s meaning’ or feel ‘hopless’ and sad doesn’t mean one is loosing their mind. It certainly isn’t a verdict on the quality of your spirituality either. It is rather the only way to help your mind work for and not agaisnt you!
Dr Nuruddeen Muhammad, MBBS, MWACP, FMCPsych, was former Minister of Interior