PART 1:

DEPRESSION- AN ABYSS OF DARKNESS!

In the wake of recent upsurge of suicides in youngsters of our society, especially medical students, I feel
there is a dire need to write on a core unaddressed issue badly taking a toll on our youth nowadays only
because they have no awareness about the problem. In the first of this inter-connected series of articles,
let’s know the basics about depression.

There have been quite a number of opinions by our worthy fellows warning their friends like:

"Don't commit suicide just because you're depressed or sad, many people have been in worse situations
than yours".

While that's a handy advice, unfortunately not realistic enough!

What you are missing is knowledge of the disease called Depression.

Let me start by a simple tagline:

Depression CAN kill!

Now to enlighten you a little, it is a mental illness daunting and challenging even for the psychologists
and psychiatrists to understand the complexity of, or to treat fully. That's why it's not even treated
properly and there is no single universal treatment except for a set of sequential treatments by trial and
error.

While feeling low, bad mood, sadness is normal, Depression isn't!!

What you need to instill in your minds is the fact that it is as solid and real an illness as say Diabetes or
HTN!

People who have been through even a phase of depression are familiar with how dark and vicious a
spiral of self-consumption it is.

(jaisay koi cheez deemak ki tarah andar he andar aap ko kha rahi ho).

The worst part is that the person who is actually experiencing it is NOT in a state to control these
feelings of despair or utter melancholy he is drowning in!
That person loses interest in whatever gave him joy, e.g., he might even do ablution/wuzu but is unable
to pray, sit down to recite the Quran but is unable to.

He might oversleep or not sleep at all.

He might be so fond of going out with friends but now wouldn't put a step out and shun all contacts. He
feels emotionally detached from loved ones but cannot help it.

Actual people who suffer from the mental illness describe it as having "constant voice in my head, like an
enemy, making a non-stop monologue of negativity...the evil voice urging me to end my life"

But what does help out is seeking Treatment, modalities like Cognitive-Behavioral Therapy and sets of
medications, opening about it to a professional counselor (psychologist, psychiatrist)

Believe me, it's not like we take it to be generally, "Jao ja k Nimaz parho, sara depression nikal jaye ga."

If you go on forcing and pushing a person telling them to be near God and blaming their state for their
not being religious- performing prayers or going to masjid, believe me ure NoT helping that person at all
but forcing him to blame himself even more and feel worse in the state of self-hate he is already in.

If you want to help a person undergoing depression, first learn how to approach him. First equip
yourself clearly with an understanding of the disease.

Look at the cause of depression and try addressing it. The causes can be genetic, improper functioning
brain cells, negative social influences, drug and substance abuse, chronic domestic issues, toxic
relationships financial tensions etc.

There are Mental Health Support groups you can contact to help your friends out. Do some research.

(Unfortunately they may be non-existent in Pakistan. But you can join such groups on social media)

Convince and accompany him properly to seek treatment.

It's not that simple as it looks to u. keep checking on how they are doing. Be patient with them. Be kind.
Be receptive and tactful.

Don’t be judgmental and avoid rambling or lecturing unnecessarily Pleeasee!!

Try to win their trust. Please help and reach out to them in the right way if you really want to create a
difference in someone's life!
PART 2: Is Suicide my Only Liberation?

“We are not asking the right questions and so we aren’t getting the right answers!”

Our opening argument: Suicide is Haram. Period!

No alternate justification above the strong condemnation of this act in Islam.

So we attribute it to cowardice on part of someone who couldn’t man up to fight for himself!

Well let’s try looking at it from various angles and see where the problem is stemming from at the root
level.

One explanation of why mostly youngsters resort to suicide as pointed out in many discussions on this
doctors’ forum is because of the drama and attention it gets them, for e.g., the tenth graders who have
just started familiarizing with romance, falling in love, all that emotional turbulence and adrenaline
rushes we get with pubertal physiological changes. Stories of unrequited love, failing an audition for a
certain career like modelling, a film actor, TV anchor etc, explosive jazbaat in domestic fights with a
parent etc.

Big names of literature and media personalities who committed suicides at the peak of their careers,
fame, and luxurious lives make it sound highly tempting, heroic and weirdly sensational for people
idolizing and crazily copying these celebrities.

Suicide is glorified and celebrated as such.

BUT this is only one reason why young adults get suicidal, which according to international stats makes
up only 5 % of the problem.

THIS gives us a reason to look elsewhere for the root cause of the problem, which brings us to second
cause- drugs, substance abuse and in the West, alcoholism. The former is infiltrating deep in our society
and both cloud one’s ability of judgment and reason, making them act uninhibited culminating in rash
suicidal attempts.

Mental illnesses, like Depression and Bipolar Disorder, are another BIG cause why people commit
suicide.
Genetic predisposition, financial burdens, broken families, victims of torture like rape, or bullying or
images of self-distortion, having a perception of bad self-image like being obese or too skinny, too dark
or being an albino etc all fall in this category.

Again other reasons lead people to suicide.

There is something called Existential Crisis where a person generally of a higher intelligence than normal
and an overachiever in life has this constant catharsis of one’s self and the meaning of life which
ultimately brings him to a conclusion that life and all this materialism is useless, so he ends his life.

Again this is a mental wiring gone haphazard, although unlike being depressed, the person in this case
may actually be quite an achiever, only he thinks he is a misfit in society.

In students enrolled for medical courses committing suicides, depression and protracted mental stress is
much higher as compared to similar age group students of other courses. We think, they being gifted
and comparatively more intelligent than the rest of the students, why should they have depression. But
this is exactly where our logic deceives us. A JAMA journal article states the stats to be as high as 27 %
and actual suicidal consideration of 11 % which is why many big universities have course/ module
changes over time and regular mental check-in sessions with the struggling under grads.

Apart from this, they suffer from sense of De-individualization which is basically a sense of loss of that
glory they used to enjoy being position holders in schools where they stood out among other students,
when they enter med schools where they are contended by students as smart or even smarter.

Next comes the pressurization and victimization by the sadist type of professors who derive enjoyment
by inflicting mental stress upon students. Repeated Failure in exams is a big blow to a student which
directly challenges a student’s self-image. e.g., he thinks he studies as hard as the rest and attempts the
paper as told, but still he fails which puts him in constant anxiety and depression.

Above all, it is denial of a problem that ends in a tragedy.

Just because someone was laughing the other day with u, or was a student leader does NOT indicate
they are normal inside or living a conflict free life.

As long as we don’t search for the right answers, we will never be able to stop anyone from committing
suicide and we will keep losing the best of us, mind it!
Final Part: Is Suicide my ONLY Liberation?

In the final part of this series, let’s try addressing depression by finding solutions to overcome it and see
alongside how we can help prevent suicide.

First and foremost:

As previously pointed, it is important to understand that while depression and other mental illnesses are
BEYOND one's control and one is NOT responsible for this state, nonetheless MAKING an EFFORT to
overcome it is still under one's control!

IF you don’t feel right in the head, meaning your thoughts are troubling you or you have an unexplained
ill-feeling for long, PLEASE seek professional help!

The earlier, the better!

As the ability to revert to normality is directly linked to the severity and duration of the illness.

A person does NOT lose his intellectual ability while being in the state, but yes, rational thinking suffers
which is why he/she is NOT able to cope with the hollowness and despair it brings along, resulting in
drug dependence or suicide as the presumed way out.

Here is a list of tips I have compiled from different sources and reckon highly effective:

1. Have faith in Allah that bad times don’t last forever and suicide isn’t the answer to the problem. It is
an act strictly condemned in every religion, so don’t even go near it.

2. You are not flawed or weak, but right now temporarily unable to cope with the magnitude of the
problem. Your trusted loved ones, professional counselors, psychologists, psychiatrists may make you
see solutions and ways out to your problem that your affected thinking ability cannot at the moment. So
reaching out to seek help is good.

3. Your suicide will bring upon great misery to your parents, friends and loved ones. Would u like to
cause such pain to them for ever?
4. Self-pity makes you weak. Don’t overthink about how lonely and helpless you are. There are always
people around to reach out to and seek help. TRY to contact them!

5. Avoid being alone and seek professional help to quit drug and substance abuse. This clears up your
thinking ability and irrational behavior while under influence of the drugs.

6. Avoid being in easy access to weapons and poisons etc so as to prevent self-harm in an impulse of
emotion.

7. Behavioral strategies like Cognitive Behavioral Therapy, a mode of treatment for depression is highly
effective in many ways supplemented by medications to help break the vicious circle of first not being
able to perform well in life and then feeling bad about not performing well, that constant low energy,
aversion to life etc.

So First Believe that depression is highly treatable but it takes a little time to uplift u back!

8. Extremely important to combat depression on ur own.

Kisi bhi soorat mein haar nahi maan'ni, datt kar muqabla karain.

Remember when you're depressed, classically there is an inner voice feeding u negative things about
yourself self, urging u to isolate yourself, hide from people, give up on something. What you need to
LEARN to practice is conquering this voice thinking it to be the Enemy inside. Defeat it. Don’t follow it, it
misleads. Practice to go against it: Boycott it! No doubt it’s going to be really hard but you gotta do it
alright.

( jaisay jab aap chotay thay tu apni ammi ki warning k bilkul ulta jatay thay wohi kaam kar ke jis se aap
ko mana kia jata tha!)

If you start believing in that stupid voice, u will treat yourself as helpless "mazloom, lachaar, qabil-e-tars
insan", and this will distort your self-reliance and self- image.
Suicide is NOT your Liberation. It is Not the ONLY answer to your problems. It doesn’t glorify you or
make you eternal. U just can’t QUIT on LIFE and the opportunities it brings along in the future and miss
out on all the goodness and fun, because you met a failure or temporarily lost something, anything...

U can and will win one day soon!

If you are badly wounded today, you will be healed tomorrow.

Just tell yourself that you won’t hurt yourself today and repeat the same tomorrow till u get a solid
footing to set yourself at.

Imagine:

This is just not the right time for you to shine, as the Sun of your Life is covered in dark clouds blocking
all light from u but for how long can it stay like that!!

There will be thunder and rain awhile, after which your Sun will conquer its glory back and shine even
harder than before.

U only have to stay put while it thunders and rains believing the Sun will be back soon!

Best for all!

By

Dr. Javeria Hayat Khan

17301-6161720-4

309/E-3, Street 11, phase 1, Hayatabad Peshawar

0333-9240959