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SPECIAL REPORT Oat.) Lii I :3 of41 1411[ il ) BURDEN Five times more men than women die by suicide in South Africa. One of the main reasons: we just don't talk about it. Let's try ErMIXIIIIIAMPIIP JULIAN TURNER ISA 54YEAROLD BANK MANAGER WITH TWO SONS, X TURNER WAS POPULAR AT SCHOOL AND SUCCESSFUL in both sports and academics. He continued his success into adult life, securing a position at a top financial institution after university, meeting and marrying his beautiful wife and having a happy family. By all accounts, he had it all. But in private, life was a struggle. Turner battled with depression all his life, although he only identified it in his 20s. "My father suffered from an anxiety disorder and my mother from amood disorder. Put this concoction together and you can imagine what my life was like," he says. His moods were characterised by extreme highs and devastating lows. "I would strive for the things that made me happy, but the happiness was momentary and would always be followed by lows, like the waves of the sea. I constantly felt stressed and extremely anxious about things and always thought the worst At work I always thought other people were better than me. I had very low selfesteem and a persecution.complex. My life was filled with darkness and hopelessness for many years." Turner's wife was the one who picked up that he was depressed and encouraged him to see a professional for a diagnosis and treatment. "But I never went because I didn't trust anyone," he says. Turner hit rock bottom when he was 51. "I was.completely burned out. The signs were there but I ignored them. In February 2014 the wheels finally fell oft I said goodbye to my family in the morning for what was to be the last time. I went to work as usual. Then I left midmorning to.commit suicide. I drove from Johannesburg to Kransldoof in KwaZuluNatal, where I jumped 80 metres off the cliff edge to what I thought would be a certain death. Miraculously I survived without major injury and during my rehabilitation for a crushed nerve in my left leg and mental observation, I was eventually diagnosed with bipolar disorder." On the right medication, Turner's life changed. "I felt more stable, more consistent in my behaviour and happier than I had been in years. I no longer experience the extreme highs and lows. The dark side of life disappeared and the thoughts of suicide have been eradicated." He admits his medical condition will always need management "Without my medication I would die. I know the pitfalls of depression and the dark hole one can fall into because I have been there. I know the triggers of my depression, and I'm able to manage them carefully. Daily medication is nonnegotiable; sticking to a regular sleep pattern is absolutely critical, as is surrounding myself with positive people, and having spirituality in my life. I also find that helping others who suffer from depression keeps me on the right track." ACCORDING TO RESEARCH, THE MOST PROMINENT triggers for suicide are: interpersonal, marital, family, or financial problems; stress; academic pressure; and depression. "Stress and mood disorders are among the greatest maladies of our time and often go undetected," says Professor Lourens Schlebusch, an international expert on stress and suicide and the author of Suicidal Behaviour in South Africa and Mind Shift: Stress Management and Your Health. In 98% of suicides there is a diagnosis of at least one mental disorder, most often a mood disorder. Psychological autopsies show that about half of victims suffered from depression, and that's true across all ethnic groups in South Africa, says Schlebusch. "Chronic and acute stress are critical.comorbid causal considerations in suicidal behaviour," says Schlebusch. He also emphasises the role of socioeconomic pressures, high crime and violence rates as suicide triggers. HIV is also having an effect on suicide rates. Suicide rates here are "inordinately high", says Schlebusch. Men are five times more likely to 'succeed' at suicide than women for a number of reasons, including choosing more brutal methods, like shooting and hanging, rather than the more hitandmiss approach of overdose. Another reason is that men often do not talk about feeling depressed, and don't seek help. "Traditionally, we have not supported men in their attempts to become emotional or vulnerable... This attitude often.compounds a depressed man's condition, so that he gets depressed about being depressed, or ashamed about feeling ashamed. Because of the stigma attached to depression, men often allow their pain to burrow deeper and further from view," says Terence Real in his book/ Don't Want To Talk About It: Overcoming the Secret Legacy of Male Depression. "Men who either do not recognise that they are depressed or know it and don't get help risk the illness becoming so severe that it totally impacts their lives or they become Men & Suicide SUICIDE ACCOUNTS FOR AROUND 10% OF ALL NONNATURAL DEATHS IN SA, ACCORDING TO THE MRC NATIONAL INJURY MORTALITY SURVEILLANCE (NI MSS). 8 000 South Africans die by suicide a year that's 667 deaths a month, or 1 every hour. BOTH IN THEIR TWENTIES. TO LOOK AT HIM, YOU'D NEVER GUESS HE ONCE LEFT HIS OFFICE IN THE MORNING, DROVE FIVE HOURS TO THE COAST, AND JUMPED OFF AN 80METRE CLIFF. X X X 5 TIMES as many men die by suicide than women. 2534 The age group with the highest rates of male suicide. 800 000 people a year die by suicide worldwide. (Suicide was the second leading cause of death among 1529 year olds, worldwide, in 2015.) 20 suicide attempts take place for every suicide recorded as successful. 30.3% The lifetime prevalence for a mental health condition. 40 SECONDS Someone, somewhere in the world, dies by suicide every 40 seconds. (The World Health Organisation estimates that by 2020, 1.5 million people will die every year from suicide: That's one death every 20 seconds.) DEPRESSION will be the leading cause of disability by 2030, according to the WHO. Suicide is recognised by WHO as a global health priority. 10% of people will become depressed at some point in their lifetime, according to the South African Stress and Health Study. H OTOG RA H G E TT Y/G NaNia 'k \ f 4i k A A \ ?t\ i k .,. 13301 "Because of the stigma attached to depression, men allow their pain to burrow deeper." "It doesn't take away from your masculinity to say Everehing is no okay." suicidal," says Johannesburgbased psychiatrist Dr Frans Korb. "Stigma works against men taking a step forward to get help," says Korb. "Severe depression is not something you can 'snap out' of and it's certainly not going to go away by itself." DEPRESSION DOESN'T DISCRIMINATE. IT AFFECTS astronauts (Buzz Aldrin), authors (Stephen King),.comedians (Stephen Fry, Trevor Noah, David Letterman), captains of industry (JD Rockefeller), elite sportsmen (Frank Bruno, Dan Vickerman), screen stars (Owen Wilson, Heath Ledger), musicians (Bon Jovi, Michael Hutchence), world leaders (Winston Churchill, Abraham Lincoln, John Adams) and men across all socioeconomic strata and ethnicities. But there is one thing that men have in.common that prevents them accessing help and that is their very nature. Their masculinity. "Pride prevents men getting help. The fact that men can't be seen to be weak. It's a fallacy that men cannot be allowed to show emotion. Acknowledging that you have this illness and being prepared to seek professional help is the first big step to take. Once you have done this the pieces will fall into place. Imagine a world where your life changes for the better forever. It can happen. It happened to me," Turner says. "I think this is a problem not only for men to solve but the whole of society. The basis of acceptance lies in understanding all aspects of mental illness. For instance, that mental illness is a medical condition like any other physical illness and should be treated as such. It has its origins in genetics, biology, chemicals and as well as psychological aspects," says Korb. "Men are brought up with the perception that they always have to be strong, the provider, and the protector as well as the fighter," says Korb. "It doesn't take away from your masculinity, or your strength to man up and say, Everything is not okay. I feel depressed. I need help. And if we did this, fewer men would die." "Although I wish I'd spoken up earlier, and had the opportunity to understand the illness sooner, I realise that my journey was meant to happen. It was important for me to travel to the gorge that day to jump off as it opened up new doors for me. I have true happiness for the first time in my life. I treasure life now and my family. Work is more enjoyable than it has ever been," says Turner. "I only hope my experience can help others be more open and save them the decades of pain I went through." "Having been through my personal experience, know that there is hope. However, you cannot taclde this illness alone. The first critical point is to admit that you have an illness. It is not anything to be ashamed of. With the right medication and lifestyle adjustments you can live a successful, happy life. But it does start with you knowing that there are many people out there who care," says Turner. EEEB Take the Test DECIDE HOW MUCH OF THE TIME THESE STATEMENTS DESCRIBE HOW YOU'VE BEEN FEELING DURING THE PAST TWO WEEKS. TICK THE APPROPRIATE COLUMN AND TOTAL UP AT THE END sse e X X X I feel downhearted and blue Morning is when I feel the best have crying spells, or feel like it have trouble sleeping at night eat as much as I used to still enjoy sex notice that I am losing weight have trouble with constipation My heart beats faster than usual I get tired for no reason My mind is as clear as it used to be find it easy to do the things I used to am restless and can't keep still feel hopeful about the future am more irritable than usual find it easy to make decisions feel that I am useful and needed My life is pretty full I still enjoy the things I used to do I feel that others would be better off if I were dead SCORING RESULTS: Add the values of all the boxes you ticked. If you have a score between 50 and 80, you could be depressed. Contact the South African Depression and Anxiety Group (sadag.org) or see your GP or mental health professional. Bring these test results to your appointment.