Some deaths leave behind silence, and others create a silence so deep that families spend the rest of their lives trying to understand it. Suicide belongs to the second category. It is not only the end of a life; it is also the beginning of unanswered questions. Why did we not see it? Could we have done more? Was there a word left unsaid, a gesture withheld, a pain overlooked?
For centuries, suicide has stood at the uneasy intersection of morality, religion, law, medicine and human sorrow. Societies have condemned it, romanticised it, hidden it, criminalised it, explained it away, and too often whispered about it after the event. Yet the one thing suicide most urgently requires is the one response we have historically denied it: compassion.
The unseen anguish behind suicides
As a psychiatrist, I have learned that suicidal despair is rarely a sudden event in the simple sense. It may appear sudden to the outside world because the sufferer has continued to smile, work, study, attend family gatherings and answer routine questions with routine replies. But beneath that surface, there may have been weeks, months or even years of private anguish. The tragedy is that many people do not die because nobody loved them. They die because their suffering became unspeakable, and because they felt unable to imagine a future in which that suffering could be shared, treated or transformed.
The World Health Organisation estimates that more than 720,000 people die by suicide every year. It is among the leading causes of death in young people globally. In India, the National Crime Records Bureau recorded 170,924 suicides in 2022. Behind these figures are not abstractions, but sons and daughters, students and farmers, young professionals and elderly parents, people of promise, people of fatigue, people who may have appeared outwardly competent while inwardly collapsing.
Dismantling the stigma
India has a particularly difficult relationship with suicide because we are still, in many ways, a shame-based society. We speak easily of success, duty, family honour, sacrifice and resilience; we speak far less easily of despair, depression, emotional exhaustion and mental illness. A student who fails an examination, a young person facing romantic disappointment, a farmer caught in debt, a woman trapped in domestic distress, an elderly person living with loneliness, or a professional humiliated by failure may all experience pain not merely as private suffering but as public disgrace.
This is where culture can become cruel without intending to be. In many Indian families, mental distress is still concealed for fear of gossip. Depression is dismissed as weakness, laziness, overthinking, lack of prayer, lack of discipline or lack of gratitude. A person who seeks psychiatric help may still be labelled as unstable. Families that would rush to treat diabetes, hypertension or cancer may hesitate when the illness is of the mind. The result is not strength, but secrecy. And secrecy is often the dark room in which despair grows.
We must begin by saying clearly that suicide is not an act of cowardice. Nor is it a simple act of selfishness. Such language may satisfy the anger or bewilderment of survivors, but it does not explain the psychological state of the person who has died. Many suicidal individuals are not thinking with the ordinary logic of a healthy mind. Their thoughts have narrowed. Their sense of time has collapsed into the pain of the present moment. They may sincerely believe, however tragically and mistakenly, that their absence will reduce the burden on others.
This narrowing of the mind is one of the most dangerous features of suicidal despair. Psychologists sometimes describe it as a form of tunnel vision. The person does not see the full landscape of life. He or she sees only the immediate pain, the perceived failure, the unbearable shame, the unpayable debt, the broken relationship, the humiliation, the loneliness. What is temporary begins to feel permanent. What is treatable begins to feel fatal. What is survivable begins to feel impossible.
Understanding depression
Depression remains one of the most important conditions associated with suicide, though suicide cannot be reduced to depression alone. It may also be linked to alcohol or drug misuse, severe anxiety, trauma, chronic pain, social isolation, financial distress, family conflict, domestic violence, academic pressure and untreated psychiatric illness. But depression is especially dangerous because it changes not only mood, but perception. It drains colour from the world. It distorts memory. It persuades the sufferer that the past has been wasted, the present is unbearable, and the future is closed.
The symptoms are not always dramatic. Depression may appear as withdrawal, irritability, loss of interest, poor sleep, unexplained fatigue, loss of appetite, excessive guilt, reduced concentration, or a quiet abandonment of ordinary pleasures. In India, where emotional distress is often expressed through bodily complaints, depression may also appear as headaches, body aches, digestive symptoms or vague physical exhaustion. Too many people move from clinic to clinic without anyone asking the simplest and most necessary question: " How are you feeling within yourself?
Debunking sucide myths
One of the most dangerous myths is that people who speak about suicide will not act on it. This is false. A person who says “I cannot go on” or “my family would be better off without me” may be offering a warning, not seeking attention in the trivial sense. Attention is precisely what is needed. To listen carefully at such a moment is not to encourage suicide; it is to interrupt isolation. Silence is not safety. Compassionate conversation can be lifesaving.
Another myth is that suicide happens only among the poor or only among those with obvious mental illness. Recent public tragedies involving students, actors, professionals and people who seemed successful remind us that achievement does not immunise anyone against despair. Social media has made this more complicated. We now live in a culture where people display happiness while concealing humiliation, loneliness, debt, addiction, failure or emotional collapse. A smiling photograph is not a psychiatric assessment. Public confidence may coexist with private desolation.
Community intervention
The law, too, has shaped our collective response. For many years, attempted suicide in India carried the shadow of criminalisation, a colonial inheritance that treated a person in extreme distress as an offender. The Mental Healthcare Act, 2017, marked a humane shift by recognising that a person who attempts suicide should be presumed to be under severe stress and should receive care, treatment and rehabilitation. But law on paper and practice on the ground are not always the same. Police involvement, stigma, family fear and inadequate mental health services can still convert a moment of crisis into a second punishment.
A civilised society should never punish a person for reaching the edge of despair. It should ask what brought the person there, and what kind of care might bring him or her back. Suicide prevention is not only the responsibility of psychiatrists. It is a responsibility shared by families, schools, colleges, workplaces, hospitals, religious communities, the media and the state.
Schools and colleges must take emotional distress seriously rather than treating young people merely as examination machines. India’s competitive educational culture has produced extraordinary talent, but it has also produced fear, comparison, parental pressure and a dangerous equation of marks with human worth. No examination result should be allowed to acquire the meaning of a final judgment on a life.
Workplaces, too, need moral reform. In many professional settings, exhaustion is mistaken for commitment and emotional distress is hidden because employees fear being seen as weak. A humane workplace is not one that merely celebrates productivity; it recognises that human beings are not machines. Managers must be trained to notice burnout, humiliation, bullying, isolation and sudden changes in behaviour. A culture that speaks endlessly about performance but never about vulnerability is not efficient. It is dangerous.
Families have perhaps the most intimate role. Love is not enough if it cannot listen. Many parents love their children deeply but speak to them only in the language of expectation. Many spouses share a home but not an inner life. Many elderly people live among relatives and yet experience profound loneliness. We need to recover the art of asking gentle questions and waiting long enough for honest answers. “Are you all right?” must not be a ritual greeting. It must sometimes become a serious invitation.
Religious communities can also help, provided they replace condemnation with tenderness. Faith at its best does not shame the broken; it accompanies them. It reminds people that suffering is not a moral failure and that despair is not the whole truth of a human being. But when religion treats suicide only as sin, it may deepen the suffering of families and silence those who need help. The proper response of faith to despair is not judgment, but mercy.
Role of media
The media has a delicate responsibility. Sensational reporting can harm. Careless language can wound families and influence vulnerable readers. Responsible journalism should avoid lurid detail, respect privacy, provide context, and emphasise that help is possible. Suicide should be reported not as spectacle, but as a public-health concern and a human tragedy.
The path forward
What then must India do? We need better access to affordable mental health care. We need counselling services in schools, colleges and workplaces. We need family doctors trained to recognise depression and suicide risk. We need crisis helplines that are functional, widely publicised and adequately staffed. We need police and emergency personnel trained to respond with care rather than suspicion. We need public campaigns that make it as acceptable to seek help for depression as it is to seek help for heart disease.
But beyond policy, we need a change in moral imagination. We must learn to see the suicidal person not as weak, sinful, selfish or shameful, but as someone in unbearable distress. This does not romanticise suicide. On the contrary, it helps prevent it. Only when stigma is removed can suffering speak early enough to be met by care.
Every suicide leaves a wound in the world. Families are left not only with grief but with a particular kind of grief sharpened by questioning. Friends search old conversations for clues. Parents replay ordinary mornings. Spouses remember small silences. Communities move on, but those closest to the death often live with an ache that has no easy name.
Yet suicide is not inevitable. Many people who once felt unable to continue have later lived meaningful, loving and useful lives because someone listened, because treatment was found. After all, time passed. After all, the mind healed. After all, the future reopened. This is the truth we must hold before every person in despair: the present moment is not the whole of life.
To speak about suicide is not to invite it. It is to bring it out of the darkness where stigma has kept it for too long. India must learn to speak about suicide with honesty, intelligence and compassion. We must teach our children that failure is not final, our families that silence is not strength, our institutions that pressure has consequences, and our society that mental suffering deserves care, not shame.
Some cries are never heard because they are never spoken aloud. Our task is to become the kind of society in which such cries need not remain silent.
The author is a retired British Emeritus consultant psychiatrist from London, now based in Kochi .
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
