Fighting to stay alive - Woman battling suicidal thoughts for nearly 20 years

Marianne Black* gets up every day, takes her 12-year-old son to school and heads to work, where she does her job efficiently and has the respect of all her colleagues.

She also has what many would consider a supportive family and a strong network. But she has gone to death's doorway more times than she'd like to count. At 36, having battled depression since she was 19, she still sometimes thinks about ending it all.

"Mi just feel like mi don't deserve fi be here. A nuff time mi think bout how me woulda do it and play out the scenario dem inna mi head," she admitted. She said her first suicide attempt came at age 23, shortly after she graduated from university.

"I went through a tough time. Mi finally finish school but I wasn't proud. Landed a good job right after and still I felt so sad. That's when I knew something was really wrong," she recalled. Black said she tried everything to feel better including weed and alcohol, but nothing could stop the sadness. One day she decided to end it all.

"I just took all the medication at once. I woke up in the hospital and all when I saw mommy a cry, I still wish I died," she said. She continued trying to live, but even as she built a career and had her son, her pain would return. Her last serious attempt was in 2015 when her son was two. Since then she has been clinging to him, her only anchor.

"Since I had my son, I decided that I have to try harder. It worked but then I got overwhelmed with problems from the father and I tried again when he was two. I felt guilty and decided that I have to live. I will have my moments but I never stop taking my medication and I always go to therapy. I have to be here for him if not for me. Every day is a struggle to not think about or do it because sometimes I don't even know what trigger it. I just try," she said.

September is Suicide Prevention Month, and recently the suspected suicides of 26-year-old Tyra Spaulding, a former Miss Universe Jamaica contestant, and Shamar Brown, a 24-year-old painter from Bamboo, St Ann, have reignited questions about how the country treats mental health and suicide.

One of the loudest voices on the issue is Professor Wendel Abel, consultant psychiatrist. He explained that suicide and suicidal behaviour cover a wide variety of areas.

"It starts with suicide ideation, where you may have ideas, thoughts of hurting yourself, and it may progress to active plans to execute or attempt suicide. The reality is that, unfortunately, there are lots of people who are walking around very distressed, and that distress may be triggered by trauma in many instances," he said.

He warned against dismissing the root causes, including childhood trauma.

"When you're in the emergency room working, the vast majority of people who present with suicidal attempt give a history of childhood trauma. But you must remember, childhood trauma leads to poor self concept, it can lead to severe depression and suicidal behaviour," Abel said. "Suicidal thoughts are not a choice. They are symptoms of an underlying condition."

DRIVEN BY HOPELESSNESS

He explained that someone who is suicidal is driven by a sense of hopelessness and has no desire to live. But Abel emphasised that depression is a treatable condition.

"It's not about encouraging them to be 'normal'. It's treating whatever problems they're having. In many cases, it's linked to depression. But in all instances, apart from treating with medication, therapy is going to play an important role," he said. He challenged the wider society not to be judgemental or critical.

"Always listen to people. We encourage people who may be emotionally distressed to express their feelings, to find a family member or friend, somebody that they can trust to talk to. Don't be afraid to seek professional help, because this is a major problem in this country. Because of the stigma, shame associated with mental illness, a lot of people are afraid to seek professional help," Abel said.

He also asked the Church to examine itself because many people associate mental illness with demon possession.

"Of course, I don't want to undermine the role of prayer, because yes, prayer and other techniques like mindfulness may play a role to help us to deal with our emotional distress and pain. But sometimes it takes a little bit more than prayer. Too many people go to their grave praying because they won't seek professional help."

*Name changed at her request to protect identity.