Suicide has emerged as a major public health concern in India, with a significant number of cases linked to mental health problems. Conditions such as depression, schizophrenia, bipolar disorder, anxiety disorders, and substance use disorders have been found to have increased suicide rates. There are various factors that contribute to suicidal behaviour.
Persons with mental disorders often experience dysfunction in brain functioning due to an imbalance of neurotransmitters, which affects cognition, emotions, and behaviour. Neurotransmitters such as serotonin, dopamine, and norepinephrine are associated with depression, impulsivity, and suicidal behaviour. Increased levels of stress hormones, particularly cortisol, resulting from chronic stress can impair emotional regulation and increase feelings of hopelessness and despair, thereby elevating the risk of suicide. Substance abuse further increases this risk by altering neurotransmitter systems, including serotonin, dopamine, and gamma-aminobutyric acid (GABA). Long-term use of alcohol and drugs can impair cognitive functioning, reduce problem-solving abilities, and intensify feelings of hopelessness. During intoxication, individuals may act impulsively without fully considering the consequences of their actions, while withdrawal states often worsen emotional distress and suicidal thoughts.
Various physical health conditions can contribute to the development of mental health problems and increase the risk of suicide. Chronic illnesses such as cancer, diabetes, cardiovascular diseases, neurological disorders, chronic pain, and disability can lead to persistent stress, functional impairment, and reduced quality of life. Sleep disturbances, fatigue, hormonal imbalances, and physical limitations may further worsen emotional well-being. The burden of managing a long-term illness, along with feelings of dependence, hopelessness, and loss of autonomy, can increase psychological distress and contribute to suicidal thoughts and behaviours.
Individuals experiencing suicidal ideation often manifest feelings of hopelessness, helplessness, worthlessness, guilt, and low self-esteem. A poor quality of life, lack of purpose, and uncertainty about the future can contribute to persistent negative thinking patterns. Difficulties in coping with stress, emotional distress, and everyday challenges may further increase feelings of despair, leading individuals to view suicide as a way to escape their suffering.
Family environment plays a crucial role in shaping an individual’s mental well-being. Individuals with mental illness face criticism for being unable to work or contribute financially, and some experience neglect, abuse, or discrimination within the family. Marital conflicts, relationship problems, and social rejection can intensify feelings of isolation and emotional pain.
Social isolation, stigma, and discrimination associated with mental illness remain major contributors to suicide risk. Individuals may withdraw from social relationships due to fear of judgment or rejection. Limited access to mental health services, lack of community support, poverty, and inadequate social welfare systems can further worsen psychological distress.
Another significant factor contributing to suicide risk is the limited availability and accessibility of mental health services. Delayed diagnosis, inadequate treatment, and the large treatment gap for mental disorders in India, estimated at around 85 per cent, often leave individuals struggling with untreated symptoms and psychological distress.
Taken together, these factors suggest that suicide is rarely the result of a single event or illness. More often, it reflects the cumulative burden of biological vulnerabilities, mental health conditions, physical disease, social pressures and economic insecurity.
Pramod Gupta is a psychiatrist and director, Central India Institute of Mental Health And Neuro Sciences, Dewada, Chhattisgarh
This column is part of the article “What suicide statistics conceal”, published in July 1-15 print edition of Down To Earth