Suicidal ideation is a medical emergency: Types of indirect deaths (Part 1)

Café Coffee Day founder VG Siddhartha, who has been missing since Monday night, had reportedly written a letter to CCD staff, in which he mentioned about his financial struggles and his failed business model. In the letter, the coffee baron indicated that he was facing huge financial burden and was under tremendous pressure from one of his private equity partners. As reported in the Times of India, in the letter, he writes: “I am very very sorry to let down all the people who had put their trust in me. I have failed as an entrepreneur. I fought for a long time, but today I gave up as I could not take any more pressure from one of the private equity partners forcing me to buy back shares, a transaction I had completed six months ago by borrowing a large sum of money from a friend. Tremendous pressure from other lenders led to me succumbing to the situation… My intention was never to cheat or mislead anybody, I have failed as an entrepreneur. This is my sincere submission, I hope someday you will understand, forgive and pardon me…”

Several factors increase the risk of suicide, for example, living alone, unemployment, a recent sense of failure, childhood abuse and adverse childhood experiences, psychiatric disorders, medical illnesses, prior history of suicidal attempts or family history of attempted suicide. Suicidal ideation is also a risk factor for suicide.

Suicidal ideation is thinking about, considering, or planning suicide. Simply put, suicidal ideation means suicidal thoughts. Hence, identification of suicidal ideation is important for prevention.

There are two dimensions of attempt motivations: Internal motivation such as hopelessness, extreme emotional pain, a need to escape, and other distressing emotional or cognitive states. The other is communication motivation, such as a desire to communicate with, influence, or seek help from others. Understanding the motivation of the individual for suicide attempts also help prevents a suicide (Annu Rev Clin Psychol. 2016;12:307-30).

Sri Ramcharitmanas has described 14 traits, which if present, makes a person like dead even if he or she is alive. These traits were communicated by Angad to Ravana, when he went to Lanka as Rama’s emissary to Ravana with a message asking Ravana to return Sita.

सदा रोगबस संतत क्रोधी।

बिष्नु बिमुख श्रुति संत बिरोधी॥

तनु पोषक निंदक अघ खानी ।

जीवत सव सम चौदह प्रानी॥2॥

भावार्थ:- नित्य का रोगी, निरंतर क्रोधयुक्त रहने वाला, भगवान्‌ विष्णु से विमुख, वेद और संतों का विरोधी, अपना ही शरीर पोषण करने वाला, पराई निंदा करने वाला और पाप की खान (महान्‌ पापी)- ये चौदह प्राणी जीते ही मुरदे के समान हैं॥2॥

These 14 traits or the types of indirect death (tum mere liye mar gaye) are: Vama Margi (Kaul or the one who follows the path of tantra); Kamuk (full of Vasanas]; Krapan (Maha Kanjoos); Vimud (Murkha); Dradra ( poor); Ajasi ( Badnami); old (no intellect left); ever sick (Santata Krodhi ) always angry); Vishnu Vimukh (abuses Vishnu); Shrutu and Sant Virodhi (opposes Vedas); Tanu Poshak (Swartha) and adh Khani (the one who earns by sins)



जौं अस करौं तदपि न बड़ाई।

मुएहि बधें नहिं कछु मनुसाई॥

कौल कामबस कृपिन बिमूढ़ा।

अति दरिद्र अजसी अति बूढ़ा॥1॥

भावार्थ:- यदि ऐसा करूँ, तो भी इसमें कोई बड़ाई नहीं है। मरे हुए को मारने में कुछ भी पुरुषत्व (बहादुरीनहीं है। वाममार्गी, कामी, कंजूस, अत्यंत मूढ़, अति दरिद्र,बदनाम, बहुत बूढ़ा,॥1॥

If the letter to CCD staff is correct, it sounds like a person who is at the end of his tether and would clutch at straws to solve a problem or to remedy the situation, but was not able to find any.

A person who is facing genuine financial difficulties or other such events needs help and not rejection. If no support is forthcoming and the person sees no way out, he or she may commit suicide. Timely support can prevent a crisis from becoming a tragedy.

Suicidal ideation is a medical emergency. All depressed patients must be specifically enquired about suicidal ideations.

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