'I have learned that suicide is preventable'

There are many lessons Suresh Unni has learned from the death of his brother Santosh (called Dosh by his family and friends) in Chicago over a decade ago. You can have a loving family, and caring friends, and yet be prone to end your life, he says.

When Dosh killed himself, Unni, whose father is a physician and mother a housewife, started studying psychiatry. He is currently conducting research on suicide among Indians in America. He also says that many Indian families in America and in India do not want to admit that family members have killed themselves.

Unni works with Dr Aruna Jha, one of the founders of the Asian American Suicide Prevention Initiative in Chicago. Jha is also involved with several organisations in India that are fighting suicide trends.

Like Jha, Unni is convinced that young Asians in America are at increased risk of depression, drug abuse and suicide. He tells Arthur J Pais that suicide is preventable and asking for help is a sign of strength

Tell us about your research.

I am seeking Indian American siblings who have lost a brother/sister to suicide, who was between the age-group of 18-30 years at the time of their death, and would be interested in taking part in confidential interviews about their experience. This research is going to be used to help construct suicide prevention programmes and help healthcare providers know what issues and themes to be aware of when working with someone or coming across someone who may be suicidal. Participants would only need to be 18 years or older and have lived in the United States for at least 10 years.

Do your relatives in India know that Dosh killed himself?

They do. We had a discussion at home and my parents decided that by letting people know what had happened, we could create some awareness about suicide. In fact, our family holds an annual event in northwest Indiana where Dosh grew up. It is a cookout and basketball tournament and is called Doshfest. Many family friends attend the event and make donations to AASPI.

What is the most important thing you want to tell people with suicidal thoughts?

There is a lot of help available from many sources. Even in India, there are people and organisations that are reaching out to people who are suicidal.

You have said that though Dosh was very depressed before his death, you still see him as a fun-loving person.

(Chuckles) He was easygoing and funny and I remember he was also a ladies man who once made his girlfriend hide in the basement when our parents returned home unexpectedly.

My parents had gone out for the evening so Dosh decided to invite a girl over when they were gone. He was in high school at the time. My parents did not allow girls to come over to the house, whether they were at home or not. So when my parents came home earlier than they had planned, Dosh's girlfriend was still at our house.

In a panic, Dosh asked her to hide in the basement so my parents would not see her. Then, after some time, he planned to ask her to sneak out the door so my parents wouldn't see.When my parents came home, my father asked Santosh to play ping-pong in our basement, which is where she was hiding. Nervously, Dosh played ping-pong with my dad for over 30 minutes while she was hiding in the closet. After the game was finished and my dad went back upstairs, Dosh asked his girlfriend to quickly leave out of the garage to get away without being seen, but as she was trying to escape, my mother saw her running down our driveway and Dosh was caught!

What started going wrong with Dosh?

In March 1996, one of Dosh's best friends was killed in a car accident. We were all traumatised but Dosh had a very difficult time expressing his sadness. He presented himself as very stoic, almost being afraid to show others he was sad. Dosh went with his friend's brother to Boston to take some classes.

One night, Dosh went out to a bar and was physically assaulted by white racists. I think this event further contributed to Dosh's depression. Dosh came home and attended Indiana University in Bloomington, in the fall of 1996.

Dosh was seeing a psychiatrist…

True but he had stopped taking medications before his death; we came to know this when it was too late. I believe he also needed to be spending a good amount of time with a therapist.

Why do you give so much of importance to therapy?

The most important single factor in therapy is the therapist-client connection. Because I believe asking for help is a sign of strength and not weakness.

What are the most valuable lessons and insights you have learned from this tragedy and your own work?

Although there are many common elements in the stories of people who have experienced intense depression, each individual case has its own unique set of circumstances that must be understood for successful intervention. Only then can depressed individuals identify with someone who can understand their suffering. This counteracts the intense feelings of isolation experienced by someone who is very depressed. Another important lesson I have learned is that suicide is preventable and that talking about suicide actually decreases the likelihood of suicide occurring.

Did you always believe in talking to depressed people about suicide?

No. I used to be under the impression that talking about suicide with [a depressed person] may contribute to the person seeing suicide as an option. However, a depressed individual, who has made some statement about not wanting to cope with his/her pain any longer has already thought about suicide and most likely will feel relieved that someone has identified the sadness they are experiencing. I have also learned that the only way to battle cultural/social stigma is through education and awareness.

Tell us more about creating awareness.

Because social stigma about depression and suicide has persisted in the Asian cultures over a long period of time and because of the high level of pain and suffering that result from depression and suicide in both individuals and communities, it is necessary to make aggressive efforts that mobilise people to fight against this ignorance. There are individuals and families who may avoid taking their own lives and start talking about their pain and suffering if only there was someone there to shine a light on their darkness and let them know it is okay to talk about it.

Looking back, how did you begin dealing with Dosh's suicide?

I believe I was put on a path to discover what may have contributed to his suicide and what his story could do to help others who are contemplating suicide as well as how it could inform the public as a whole on the need to pay more attention to this issue.

Were you afraid at any time that you could be drawn to suicide too?

As I was doing my own research, I learned about 'suicide contagion,' the common occurrence for other suicides to occur not only in the family where the suicide has occurred, but also within the community where the suicide occurred. After Dosh's suicide, although I was very concerned with how my family would cope, I was not particularly afraid of anyone in my family killing themselves as well.

Why was that?

My parents have always had a strong marriage and were very supportive of each other as well as my older brother and myself after the suicide. My older brother was always a very motivated person who excelled in meeting life's challenges head-on.

However, because I went through a bout of depression and was not very emotionally or mentally stable at the time, I was most concerned with my own ability to live through this time. Therefore, it was especially important for me to stay in counseling after Dosh's death.

What is the best advice you can give siblings of those who kill themselves?

My advice is, realise that seeking professional help to cope with this kind of a tragedy is a sign of strength and not weakness. I would also advise the sibling to take his/her time in coping with the grief and that although it does take time for healing to occur, what you do within that time to heal is also important. I benefited immensely from spending time with my family and friends, journaling, exercising, and seeking professional help.

Where did most of your own healing come from?

It occurred during my prayers to God as well as my time spent in meditation over the years. Surely, it was not an easy process and one has to work hard at it.

What kind of a religious upbringing have you had?

I have always been drawn to spirituality and have always had a belief in a higher power throughout my life. Whether it was the influence of going to a Catholic school for most of my life or my own exploration of various Eastern philosophies within the Hindu and Buddhist traditions, I often found myself pondering questions about the grander scheme of things, including the meaning of my life. After Dosh's suicide, this became even more of a mystery.

What is the best coping lesson you have learned in recent years?

I believe that the only way to cope with human suffering is to look deeply into the meaning of our suffering. That, perhaps, is the most important coping skill that has gotten me through Dosh's suicide and kept me moving forward: the questioning and searching of finding my own true purpose of being here. Talking about Dosh's life and death gives me a sense of that I may be fulfilling my own purpose for being here.

You have also said humility is important...

I have found that if I am able and willing to humble myself and ask for my Higher Power's wisdom and direction, I will always be given the strength to carry on.

(You can write to aaspichicago@gmail.com or to Suresh Unni at seshu98@hotmail.com)