Suicide: Navigating the Line Between Choice and Mental Illness

Sometimes, a question hits you so hard that it leaves you paralyzed, stuck in a spiral of your thoughts. This happened to me recently while reading Albert Camus's "The Myth of Sisyphus." Camus talks about life’s meaning and presents suicide as a key philosophical question. This led me to wonder:

"Is suicide a voluntary action, or is it driven by factors beyond our control?"

I reflected on this for a while but couldn’t settle on a clear answer. I found myself stuck in a mental loop, so I did what I often do when I feel stuck—I reached out to others to get their perspectives.

Perspectives: Voluntary or Involuntary Action?

Involuntary Action

I started by speaking with a friend who works as a doctor in a rehab center, treating people who struggle with addiction and suicidal thoughts daily. His perspective was quite clear:

When someone is suffering from severe depression or other mental health issues, they often lose control over their thoughts. The brain, affected by the illness, can push them to do things they wouldn’t normally do, without them fully realizing it.

This reflects the medical model of mental health, where conditions like depression or psychosis are viewed as illnesses that can cloud judgment and self-control. People experiencing such disorders often feel overwhelmed, and their ability to think rationally becomes compromised. In such cases, suicide might not be a choice made out of clear intent, but rather a desperate act when someone is unable to think clearly due to their mental state.

Several of my friends echoed similar thoughts. Their views focused on the idea that:

• Helplessness: People may feel like they have no other options left.
• Loss of Thought Control: Overwhelming thoughts lead to actions that don’t feel fully voluntary.
• Mental Instability: Severe mental health issues can take away someone’s ability to think rationally.

The consensus was that, in cases of extreme mental distress, the person’s judgment is so impaired that suicide becomes less of a conscious decision and more of an involuntary outcome of their emotional and mental struggles.

Voluntary Action

I also spoke with a clinical psychologist who has been working in therapy for many years. Her view was more about personal agency:

Mental health issues influence us, but people still have control over their actions. The decision to act is conscious, even if the situation makes it harder to think clearly.

From her perspective, even in extreme cases, there’s still a level of awareness and choice involved. She argued that no matter how clouded our thoughts are, we still possess the ability to make decisions. While mental health might complicate this process, the individual ultimately makes the final choice.

I also spoke with some religious individuals, and their reasoning was similar but based on Islamic teachings. They argued that because suicide is haram (forbidden) in Islam, it must be a voluntary action. For them, the person is aware of the religious consequences but chooses to commit the act, making it a conscious, voluntary decision despite their mental or emotional challenges.

Both perspectives raised new questions in my head, and now the question shifted from "Is it a voluntary action or not?" to "Why do we think it's a voluntary or involuntary action"

Why Do We See It As Voluntary?

Language’s Influence

Language plays a big role in shaping how we perceive actions. In Urdu, the word for suicide is "khud-kushi," which translates to "self-killing." The word "khud" (self) is frequently used in daily conversations, implying personal responsibility:

• "Main nay yeh khud kiya" → "I did this myself."
• "Yeh kaam khud karo" → "Do this yourself."

The repeated use of "khud" (self) in relation to responsibility might subconsciously lead us to believe that suicide is a fully voluntary action. It makes it seem like the person deliberately and consciously chose to take their own life, without considering the potential mental health struggles that might have influenced their decision.

Religious Teachings

Religion also influences how we view suicide. In Islam, suicide is prohibited, as stated clearly in the Quran:

"And do not kill yourselves [or one another]. Indeed, Allah is to you ever Merciful." — Qur'an 4:29

"Whoever kills a soul unless for a soul or for corruption [done] in the land—it is as if he had slain mankind entirely." — Qur'an 5:32

The belief in Islam is that life is sacred, and it belongs to Allah. As such, taking one’s own life is seen as a violation of that divine trust. Suicide, in this sense, is a deliberate act of going against Allah’s will. This belief often makes people think of suicide as a voluntary action, where the person is consciously deciding to defy what is forbidden in the religion.

This can create a sense of stigma around suicide, making it difficult to sympathize with those who commit it. The idea that suicide is a conscious sin overshadows the possible mental struggles that may have contributed to the person’s choice.

Why Do We See It As Involuntary?

Mental Health Awareness

Mental health awareness has risen dramatically in recent years, especially with the increasing influence of social media. While this awareness has led to important conversations, it has also introduced some confusion about the nature of mental illness.

For instance, many people confuse sadness with clinical depression. Sadness is a normal, short-lived emotional reaction to life's challenges, while clinical depression is a far more serious and long-lasting condition. Depression affects not just mood but also cognitive functioning and decision-making abilities. Individuals with depression may feel overwhelming despair that distorts their ability to see hope, leading them to contemplate or attempt suicide.

Moreover, as there are no definitive measures to identify mental health issues, even the psychiatric (especially in our region) are under pressure to prescribe the medication as soon as they can most of the time without even a proper diagnosis.

This misunderstanding can sometimes lead to oversimplifying mental health struggles, framing all suicides as the result of temporary emotions rather than recognizing the deeper psychological and neurobiological factors at play.

Cognitive Distortions and Neurochemical Imbalances

To better understand the involuntary aspect of suicide, we need to dive deeper into how mental health conditions affect the brain. Cognitive distortions, for example, are irrational thought patterns that people with conditions like depression or anxiety often experience. These distortions might make someone believe things like “I’m a burden to everyone” or “There’s no way out,” even when these thoughts aren’t based in reality. These distorted thoughts can feel overwhelming and leave someone with a false sense of hopelessness.

From a neurobiological perspective, severe mental health conditions often involve neurochemical imbalances. For example, individuals with major depression might have lower levels of serotonin, a neurotransmitter that regulates mood. These imbalances affect decision-making regions of the brain, such as the prefrontal cortex, which is responsible for impulse control and rational thinking. When these areas are impaired, a person may no longer have full control over their actions.

In some cases, like schizophrenia, individuals experience hallucinations or delusions, which can drastically alter their perception of reality. When someone is not fully aware of what is real or what is happening to them, their actions—including suicide—may not be voluntary in the typical sense. They may be responding to voices or irrational beliefs that they can’t control.

Impaired Judgment and Emotional Distress

For those suffering from extreme emotional distress, such as intense grief or severe trauma, their ability to make rational decisions can be greatly impaired. In these situations, people often experience what’s known as tunnel vision, where they feel trapped in their pain and unable to see alternatives. Suicide may seem like the only way to escape unbearable suffering, even though, under less distressing circumstances, they would likely make different choices.

These factors combined illustrate why suicide cannot always be considered a fully voluntary act. While there may be a moment when a person makes a decision, that decision can be heavily influenced by cognitive distortions, chemical imbalances, and impaired judgment. These factors cloud the ability to think clearly and act rationally, which leads us to understand that the question of whether suicide is voluntary or involuntary is far more complex than it appears on the surface.

A Complex Picture: Voluntary and Involuntary Factors

Suicide can’t be neatly categorized as either voluntary or involuntary. Psychologist Thomas Joiner’s Interpersonal-Psychological Theory of Suicidal Behavior suggests that suicide often occurs due to a combination of factors:

• Perceived Burdensomeness: The individual feels like a burden to others.
• Thwarted Belongingness: A sense of isolation or not fitting in.
• Acquired Capability: Over time, repeated exposure to pain or trauma can lower a person’s fear of death, making it easier for them to act on suicidal thoughts.

This theory shows that while the final act might seem like a choice, it’s often influenced by emotional pain and suffering. It’s not a simple, conscious decision; it’s a reaction to overwhelming psychological distress.

Examples of Voluntary and Involuntary Suicide

Voluntary Suicide

History is full of examples where people have voluntarily taken their own lives for a cause:

• Political Protest: Thích Quảng Đức, a Vietnamese monk, famously set himself on fire in protest against the persecution of Buddhists. His act of self-immolation was a clear, conscious decision to die for his cause.
• Seppuku in Japan: In Japanese samurai culture, seppuku was a ritual suicide performed to preserve honor. It was a voluntary decision, done with full awareness and often seen as a noble act.

Involuntary Suicide

On the other hand, some suicides might be less voluntary:

• Mental Health Disorders: Conditions like schizophrenia can cause hallucinations and delusions, leading people to act without full control over their thoughts or actions.
• Impaired Judgment: Extreme emotional distress, such as grief or depression, can cloud a person’s judgment, making suicide feel like the only option when it isn’t.

Ethical and Religious Considerations

Is suicide haram? I am no scholar or mufti to state something as halal or haram but from what I studied, according to Islamic teachings, suicide is forbidden, as clearly stated in the Quran. Yet, there’s a deeper question about how we respond to those who have committed suicide.

For example, lying is also haram, but we don’t quickly declare that every liar is bound for hell. Similarly, when a crime is committed, a judge listens to the full story, considers the context, and sometimes shows leniency based on the circumstances. If a person steals food to feed their starving family, the judge might reduce their punishment because of the desperate situation.

Why don’t we expect the same level of understanding from Allah, who knows everything? Mental health struggles, emotional pain, and many unseen factors might have contributed to a person’s decision. We should be careful not to pass quick judgments on their fate, as only Allah knows the full story.

Moving Forward with Compassion

When discussing suicide, it’s important to approach it with compassion, acknowledging both the mental health factors and personal responsibility involved. Here’s how we can move forward:

• Promote Mental Health Education: We need more accurate information to help people understand the difference between normal emotions and mental health disorders.
• Encourage Seeking Professional Help: Mental health professionals can guide people to the right diagnosis and treatment, helping avoid self-diagnosis and misinformation.
• Open Dialogue: Reducing the stigma around suicide and mental health can make it easier for people to seek help before it’s too late.
• Balance Religious Teachings with Compassion: While recognizing that suicide is haram, we should approach it with empathy, understanding that only Allah can fully judge someone’s actions.

Conclusion

Is suicide a voluntary action or a disease? The truth is, it’s a deeply complex question that defies a simple, binary answer. As we've explored, both voluntary and involuntary elements often play a role. Mental health challenges can significantly reduce an individual’s ability to make clear, rational choices, while emotional distress can cloud judgment, leading people to feel trapped in their pain. At the same time, there are instances where individuals may consciously choose to end their lives for reasons they feel strongly about, making the issue even more nuanced.

Suicide is not a decision that exists in isolation; it’s shaped by layers of personal experience, mental health struggles, cognitive distortions, social influences, and, in many cases, cultural or religious beliefs. Understanding this complexity requires us to move beyond simplistic labels and adopt a more compassionate approach to the subject.

Religious teachings may frame suicide as haram, but they also remind us that only Allah knows the full context of someone’s life and struggles. Mental health professionals remind us that many who take their own lives are acting under the weight of mental illness, not free will. It’s important to recognize both views, not as opposing forces, but as two sides of a larger, intricate discussion.

In the end, what matters most is not whether we view suicide as voluntary or involuntary, but how we respond to those who are suffering. Promoting mental health education, encouraging professional help, and maintaining open, empathetic dialogue can save lives. We must approach these conversations with humility and compassion, remembering that we may never fully understand someone else’s pain or the reasons behind their actions.

So, while we may never have a complete answer to whether suicide is voluntary or involuntary, what we do have is the ability to offer support, empathy, and understanding to those who need it most.

Thank you for taking the time to read my thoughts. I hope this sparks a conversation and encourages you to explore these complex issues further.

Note: I don’t claim to be an expert on these matters. I’m a software engineer and a psychology student with an interest in philosophy, theology, and Islam, just expressing my thoughts. Feel free to disagree with me, and I encourage constructive criticism, as differences in opinion often lead to deeper understanding and new perspectives.