Enab Baladi–Louay Rhebani.

Suicide has become a specter looming over several regions in Syria. Some people who are overwhelmed with feelings of frustration and helplessness have become susceptible to suicidal ideation. The news about men and women taking their lives intentionally in various parts of Syria is no longer new or unique.

Suicides have risen markedly following the economic crisis that hit the country, which is seen as a common factor in all areas of control on the Syrian map, including those controlled by the Syrian regime, the opposition, and the Autonomous Administration of North and East Syria (NES). 

Suicides are estimated to occur in all these areas, but what pushes a person to end his life is influenced by a complex set of factors.

The director of the Syrian Response Coordination Group (SRCG), Muhammad Hallaj, told Enab Baladi that around 19 suicide cases were documented in opposition areas in northwestern Syria in 2020, while four cases were reported this year, the last of which was in two camps in Idlib governorate.

Choosing their end

On 8 March, a young man in his thirties committed suicide after he was displaced from the city of Kafr Nabudah, west of Hama, to the Kafr Nabudah Martyrs Camp, a part of Tell Elkarame Camps north of Idlib. He shot himself in the head, according to Enab Baladi’s correspondent in the region. 

Within the 24 hours of the same incident, another young man, in the Andalous Camp Gathering in the town of Zardana, north of Idlib, committed suicide using “toxic gases.”

Local sources close to the young man who took his own life said that he killed himself due to poverty and distress.

Hallaj talked to Enab Baladi about the causes of suicide in northwestern Syria as represented in the deteriorating economic situation, widespread poverty, and unemployment, in addition to domestic violence, the absence of family care, and societal pressures.

Furthermore, people suffering from mental illnesses also tend to commit suicide, according to Hallaj. 

On 3 March, a young man named Hussein Shamas, aged 18, committed suicide in Damascus controlled by al-Assad, leaving behind a message expressing his weakness and boredom of life, demanding his relatives and friends stay strong. 

His friends described him as a creative and talented person, blaming the country’s economic and social conditions for Hussein’s suicide.

On 26 February, local networks in the city of Qamishli reported that a young girl, aged 17, shot herself with a military pistol at home.

She wrote a message before she died, saying, “I decided to kill myself because life is not beautiful.”

Stages, causes, triggers of suicide

The decision to commit suicide is not made suddenly. Rather, many thoughts and ideas build in a person’s head that prompt him to take his own life.

The road to suicide: from experiencing suicidal thoughts to killing oneself 

In an interview with Enab Baladi, the psychiatrist Ismail al-Zallaq enumerated the stages that a person who intends to commit suicide goes through. The person first thinks of death, then of tools that help him end his life, and finally commits suicide. 

Al-Zallaq explained that many people experience thoughts of suicide at some point in their lives. In other words, suicidal thoughts are not permanent. However, there are many alternative solutions and ways to cope with suicidal thoughts and feelings and overcome pain. He highlighted that what is viewed in movies and television series and what is spread among people talks about suicidal thoughts dominating a person’s whole life is “a complete myth.”

Several different risk factors lead to suicidal acts

In general, several risk factors increase the possibility of suicide. They might be direct causes such as psychological disorders, or they may be related to the circumstances that an individual passes through, such as economic and social conditions, according to al-Zallaq.

He believes that due to the lack of social support, a vulnerable individual may consider suicide, plan, and then start developing these plans.

In addition, the life of displacement—which has become a reality for millions of Syrian people and which is accompanied by a deteriorating human socio-economic status— contributes more to the increase in suicidal thoughts among people who are already considering suicide.

In turn, the psychiatrist Mamoun Moubayed said in an interview with Enab Baladi, “Suicide is a complex issue and has medical, psychosocial, social, legal, religious and economic dimensions,” explaining that suicide is divided between the desire for death by suicide and the capability for suicide.

The desire to die by suicide occurs when a person is wallowing in pessimism and despair and does not find a way out of his suffering. The desire may be fueled by the absence of a society to support this person and the lack of a helping hand.

As for the capability for suicide, “it arises and grows from the intensity of pain to the point of not feeling it,” Moubayed said.

He gave an example of people subjected to arrest, torture, and possibly sexual harassment. They have “flashbacks.” Their past trauma memories feel as if they are occurring in the current moment, becoming an endless nightmare.

The rise in youth suicide: Why?

Economic and life burdens do not solely stifle breadwinners these days; they also affect children who do not know the meaning of a stable life, especially those born during wartime and who experience it every day.

Psychiatrist Ismail al-Zallaq believes that young people may commit suicide due to the difficult conditions prevailing in Syria. They might be in charge of providing for their families’ needs, or they have to pay their living expenses. Thus, they may suffer from unemployment, loss of income, and the absence of social support. Ultimately, they may have a great deal of responsibility from a very young age and feel utterly helpless and at a loss, leading to suicidal thoughts. 

Al-Zallaq continued, “Those who have a family cannot decide to end their life easily because they have to think first of their family and what will happen to them after their death.”

He added, “one of the important factors that contribute to suicidal behavior is the absence of a partner, meaning, the absence of social support.”

 For his part, the psychiatrist Mamoun Moubayed said that these young men “have lost hope over their future aspirations and cannot see beyond the acute reality.” He points out that hopelessness is one of the chief risk factors for suicide. Losing hope prompts a person to end his life as a way to escape from what he suffers.

Those who escape life’s suffering resort to direct and indirect methods. The indirect methods are represented in abusing drugs to silence their stressed mind, while the direct method is by ending their life, according to Moubayed.

 Below poverty line

With 90 percent of the Syrian population living under the poverty line, Syria tops the list of the world’s poorest countries, according to Akjemal Magtymova, the World Health Organization (WHO) representative in Syria.

The United Nations World Food Program (WFP) spokeswoman Elizabeth Byers warned of an unprecedented food crisis in Syria, triggered by the outbreak of the coronavirus (COVID-19) pandemic.

The UN official said that nine million and 300 thousand people in Syria lack adequate food and explained that the number of people lacking basic foodstuffs increased by one million and 400 thousand during the first six months of 2020.

These warnings came at a time when 2,300 Syrian Pounds (SYP) were equal to 1 US dollar, which is nearly twice as high as it is today.

Suicide: one person dies every 40 seconds globally

The WHO said, in September 2019, that one person dies every 40 seconds from suicide and that “the number of people who die of suicide every year is higher than those killed in wars.”

The WHO pointed out that the most commonly used methods for suicide worldwide are hanging, self-poisoning, and firearms.The WHO urged governments to put in place suicide prevention plans to help people cope with stress and reduce their access to the means of suicide.

Suicide is the first leading cause of death

 Suicide, following road injury, is the second leading cause of death among people aged 15 to 29, according to the WHO.

Suicide ranks as the second leading cause of death for girls aged between 15-19 years, whereas maternal health complication is the top cause of death.

The organization added in its report that suicide is the third death tool for male adolescents after road traffic injuries and violence.

Immediate response can save those considering suicide

People who contemplate suicide believe that suicide might be a solution to their life challenges, to alleviate their physical and emotional pains, or escape their worsening living condition. 

Psychiatrist, Ismail al-Zallaq, likened the suicidal person to “a man who puts his nose at the wall, so he only sees the small spot opposite his eyes in the wall, which represents solutions; however, if he moves away and backs down, he will see a larger area of the wall, meaning, more solutions.” 

Those who experience moments of depression and despair just have to get through them and regain their psychological well-being slowly by reengaging with the social environment and practicing activities that are enjoyable for them.

Ismail al-Zallaq confirmed to Enab Baladi that the psychological response to suicide is critical, explaining that it includes identifying cases that first consider suicide and then dealing with them.

He indicated that the response has two levels: the first is the immediate response to the suicide plan by providing support and assistance. Besides, the social environment should be supportive and understanding to secure psychological calm for the person who develops suicidal thoughts.

In addition, families, friends, and spouses can play an essential role in preventing suicide. If someone is feeling suicidal, it is safer to take several actions to ultimately reduce access to lethal means of self-harm from the household. They can also protect them from self-harm by providing emotional support and advice, according to al-Zallaq.

The second level lies in the research on the ground and background behind suicidal thoughts, whether economic or psychological pressures, according to al-Zallaq.

Al-Zallaq indicated that the supportive psychological methods seek to strengthen social cohesion and social structure, establish awareness activities in mental health, and promote self-enhancement and positive thinking. 

He said, “Psychological services can be provided to a person if he suffers from mental disorders, such as depression and psychosis (schizophrenia), or he can be referred to various support centers, providing psychological services and medication.”

Al-Zallaq added that “psychological support aims to clarify the link between the circumstances that a person lives in with suicidal thought.” He also pointed to the importance of introducing people to the phenomenon of suicide and its prevention methods and the need to inform people of how to deal with suicidal individuals, “which is one of the basics of psychiatry.”

He indicated that a person who reaches a higher level of depressive mood, frustration, and despair, can have a psychological disorder. He can be perceived as a depressive patient who needs to be treated psychologically or pharmacologically.

He pointed out that the media can play a major role in reducing suicidal behavior by providing psychological awareness and promoting mental health.

However, Mamoun Moubayed said, “Thinking about suicide does not mean that you are mentally ill.”

He confirmed that psychological support provides an opportunity for a person to reveal what is going on deep down, and thus helping him to relieve his pain.”

Moubayed added that isolation and loneliness are key risk factors for suicide, explaining the necessity of the humanitarian organizations’ role in providing social assistance in this aspect.