The 17-year-old girl switched off the fan in her room, and listened for sounds outside. It was past midnight, and her parents were asleep. Her brother was probably watching a movie or playing a video game on the “Insti Internet” at the hostel. Or perhaps he was studying for his upcoming, third-year examinations at Indian Institute of Technology Madras (IITM). She was expected to follow in his footsteps. She had even begun to think of IITM as “Insti”, as if she were already part of its student body. It did not seem likely any longer. She had never known such low confidence in her life.

She climbed up on her bed, looked at the fan, and looped her dupatta between two of its blades. She then knotted the ends, making a contraption that looked like the cloth swings aerial yoga practitioners used. She then leaned all her weight on the loop. She lifted her legs off the bed. The fan swung slightly, but did not fall. It would bear her weight, she thought.

If the fan had fallen off, she had an explanation ready for her parents. She would tell them she had been trying to study the capacitor as part of an assignment for her physics class.

The systematic approach that had made her one of her school’s star students and a shoo-in for the Indian Institutes of Technology would now make her suicide foolproof. She had run a test and knew it would work. She pulled the dupatta off, switched the fan back on, and sat down to write a third and final draft of a farewell note for her family.

She began with the date: March 20, 2020.

***

In India, the suicide rate reached a record high in 2021, at 12 per 100,000 people. Over the last ten years, India has gone from forty-third to forty-first in the list of countries with most incidents of suicide. The National Crime Records Bureau’s (NCRB) Accidental Deaths and Suicides in India Report 2021 found that the number of student suicides has increased by 70 per cent in this period—from 7,696 cases in 2011 to 13,089 in 2021.  The numbers have been steadily going up since 2015, drastically in 2020 and 2021. Most alarmingly, independent studies have found that suicides are vastly under-reported—the actual numbers could be far higher.

According to estimates by the World Health Organization (WHO), updated in August 2023 and based on data collected up to 2019, suicide is the fourth leading cause of death among young adults. Overall, WHO said more than 700,000 people across age groups killed themselves as per the latest available statistics, and about 20 times as many attempted to. The average global suicide rate is 11.6 per 100,000 people. This means there is a suicide every 45 seconds, and an attempt every two and a half seconds.

Not only is the suicide rate higher in India, but a 2016 study by the Global Burden of Disease (GBD) reported an additional 802,684 suicide deaths compared with the NCRB statistics for the 2005-15 period—a discrepancy of nearly 40 per cent. Separate statistics on under-reporting are not available for the 15-19 age group, but the study inferred that this was the age group in which suicide was most under-reported. In 2016, adolescent males accounted for about 16 per cent of total suicide deaths, and adolescent females for about 32 per cent.

While student suicides are often politicised, with caste, class, language, and examination syllabuses blamed, it is in the rare case that a clear cause can be determined. The NCRB report does list causes—“family problems” (3,233 cases), “love affairs” (1,495 cases), “illness” (1,408 cases), “failure in examination” (864 cases).

When students take their own lives, everyone is quick to blame examinations and pressure. Kota, the Mecca of coaching centres for the IIT-JEE entrance exam, went from zero suicides in 2020 to a record 23 in 2021. Experts theorised that this might have been caused by the resumption of in-person classes after a hiatus during the pandemic. The Kota district administration proposed a solution—spring-loaded fans “to provide mental support and security to the students”, and “anti-suicide nets” on balconies.

However, mental health professionals say there are typically multiple causative factors for suicidal behaviour and ideation.

Dr. John Vijay Sagar Kommu, Professor and Head of Department of Child and Adolescent Psychiatry at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, said studies such as the NCRB calculated a percentage to arrive at numbers for possible causes, and this does not mean that there was a single cause in each case. He said causation could be broadly classified into predisposing factors and precipitating factors. The former would include exposure to interpersonal violence in the family, problems with peers, a history of anxiety, depression or other mental health problems—genetic or otherwise—or extreme sensitivity to negative experiences or comments, or even what is called ‘life skill deficit’, which is below-normal capability in coping with stress or handling interpersonal relationships. Depression, if untreated, could become chronic. Precipitating factors could be the experience of loss—the death of a grandparent, the separation of parents or estrangement from one parent, academic failure, or the end of a romantic relationship. It is the interplay of these two sets of factors that determines whether a person has suicidal ideation.

"We need to highlight that not everyone who has attempted, or even completed, suicide has a diagnosed mental illness," Dr. Kommu said. "There could be environmental factors, such as bullying in school or even cyber bullying. These are called adverse childhood experiences. Sometimes, we see adolescents facing severe physical, emotional or even sexual abuse in their own homes. These experiences are very traumatic."

Suicides themselves make up a fraction of the cases of severe depression and trauma in this age group. Dr. Kommu quoted the National Mental Health Survey, conducted in 2016, which found that depression in adolescents was 3.5 per cent. This means they have reached the diagnostic threshold of depression. But not everyone who has mild symptoms or is even severely depressed might have reached this threshold, in which case they would remain unidentified. He pointed out that we must also keep in mind that not everyone who is depressed seeks help.

“If the formal diagnosis has arrived at a number of 3.5 per cent, we estimate that the actual prevalence is 12-15 times,” he said. “This would mean up to 52.5 per cent of adolescents could be depressed. That is 52,500 out of every 100, 000.”

Jayalakshmi N., counselling psychologist, quoted pioneering American psychologist Stanley Hall, who she says is considered 'the father of adolescence' as describing this period as one of 'storm and stress'—the storm being decreased self-control and the stress, increased sensitivity.

As all those of us who have passed through adolescence know it is a period of intense turmoil. One’s changing body coincides with changes in friends’ circles with the shuffling of schools between Class 10 and Class 11, followed by the move to college. It also entails making decisions of enormous consequence that will have an impact on the rest of one’s life, particularly in India, where one’s stream of education in Class 12 determines one’s options for advanced degrees forever more.

She also pointed out that the parents of adolescent children have typically been married for a certain number of years and have begun to lose interest sexually and emotionally in each other. Fights become common, and teenaged children often witness, hear, or are aware of such discord, which can take a toll on their sense of security and comfort.

***

The 17-year-old who found herself drafting a suicide note with her Class 12 board exams around the corner and her IIT-JEE entrance exam to follow a few months after, had never thought academic distress would kill her. And yet it could have, if the crisis had come just one day earlier.

Gayatri, now 20, has an air of fastidiousness. Her desk is nearly arranged, the books she needs for the evening in one corner, notebooks in another, highlighters of various colours among the stationery arranged between them. The books she uses regularly are on a shelf right above her table, and the others on a stand by her perfectly-made bed. Her room smells vaguely of soap and petrichor from the plants by the window. Through the one-and-a-half hours of our interaction, her phone remained on vibrate mode. One can see her being a model student—not a hair out of place, shoes always polished, clothes ironed with the right creases, hands that can write for seven hours without being sullied by so much as an ink stain. One can see her doing a dry run before attempting suicide.

The word teachers like to use is “thorough”. A child who is thorough with her revisions. Thorough with the portions. Thorough with a plan of action.

Sitting in the same room, under the same fan, she narrated the sequence of events that led to her episode of depression. A “star student” was simply expected to score more than 495 on 500 in the school-leaving exams, she said. As for IIT aspirants, there was little chance of being placed in the stream of one’s choice in the institute of one’s choice unless one was ranked in the All India top 300. And in the pursuit of this rank, students registered at various IIT tuition centres, which dished out weekly exams and asked students who under-performed to leave so that their success percentage would not be unfavourably affected.

I thought, If I don’t make the cut, I’ll be a failure. My hands were shaking and cold. I cried myself to sleep.

Although I myself had no intention of studying engineering, I was a science student in Class 12 and my cohort comprised mostly IIT-aspirants. I remember the rites of passage—between Class 10 and Class 11, one had to enroll in the IIT coaching classes. There were five gods, who coached maths, physics and chemistry between them. One typically needed an introduction to get in. And staying in was contingent on performance in the class exams the gods set. The gods charged tens of thousands in fees, at a time when the Class 12 fee in an exclusive school was Rs. 10,000. About 100 students were crowded into a stuffy classroom with no power backup for fans, let alone air-conditioning, for between three and four hours after an eight-hour day in school, three to four days a week.

The old gods still operate, with some new ones. The fees have gone up astronomically. In some cases, the classrooms are air-conditioned and so perhaps there are fewer fainting fits, but the intense pressure remains the same, as does the weekly schedule of quizzes.

Gayatri had never done badly in a quiz until March 2020. But in the second week of that month, a migraine affected her ability to concentrate. She scored 18 out of 30, apparently an ignominious figure.

“My Sir didn’t say anything. He just looked at me with a face like this”—she lowered her head and raised her eyes, and the expression was something between anger and contempt. “Maybe he thought I wasn’t studying. Suddenly, for the first time, I stopped thinking, ‘What if I get a rank below 500?’ For the first time, I thought what if I just don’t get in? The thought was just horrible. It had never occurred to me that I would not get in. But scoring 18 out of 30 was like failing. I’ve never known failure. And I thought, ‘If I don’t make the cut, I’ll be a failure.’ My hands were shaking and cold. I cried myself to sleep. I had fever next morning. I just couldn’t study. That whole week, I did badly in all quizzes. I felt this was over. I was breaking down.”

And that was when she decided to test the weight of the fan. She would spare herself the horror of a rank below 500 and her family the humiliation of a daughter who had failed to get into IIT. Once she wrote the final version of her suicide note, she made a list of personal effects to destroy, files and emails and photographs and chats to delete. She would give herself the weekend to do it, copy her farewell note out on a piece of paper and then loop the dupatta around the fan one final time.

But then, something changed on March 22.

The lockdown was announced. What was initially expected to be a fortnight—a week for the tuition centres—turned into months. The classes moved online, even as everyone tried to figure out what would happen next. The board exams were staggered. Everyone expected the JEE to be postponed, and although it wasn’t, Gayatri found herself relaxing at the thought. She was able to study again.

In the meantime, everyone in her family was home 24/7 for an extended period, which she doesn’t remember ever having happened before. Her brother had to leave his hostel and move back into the house. The family came closer. Although she didn’t mention her plans for suicide, she confided in her parents and brother about the effect a week’s below-par performance in quizzes had had on her self-esteem. They reassured her that it was only because she was unwell, and she found her confidence again.

The entrance exams were eventually held on schedule, but Gayatri was prepared. She scored the rank she needed to get into the stream and institute of her choice, and is in her third year now.

“The pandemic saved my life,” she said.

***

If students who thrive within the academic system need a pandemic to save their lives, what about those who don’t? Aditya, now 19, dropped out of school in Class 9. He had grown up in Bangalore, and went to five schools over the years before his parents agreed that he truly could no longer take it.

School ran from 9 am to 3 pm. There was just enough time to get home and eat before tuition class began. Then, there was school and tuition class homework to finish. Four days of the week, he had extracurricular activities to get to—the lot of most students, and the last usually considered destressing by parents.

“In all this, where is the time for my brain to fucking relax for one second?” he said.

There was exam pressure. The notion that everyone had the same capacity for standardised education. Everyone else was “lazy”. Schools were run as a business—underpaid teachers, overcharged parents, fraught staff, desperate students, boring textbooks. No one wanted to be there, and yet everyone was. It was a vicious cycle where parents wanted their money’s worth, fatigued teachers took out their frustrations on students, and children going through a crucial developmental stage were impacted, sometimes for life.

I was miserable in school,” he said. “I was clinically suicidal.

“This is something that has affected me on such a personal level. I lost like a good five years of my life because of it,” Aditya said, “after getting out of the system.”

He had never fit in. He had a medical issue which tempted other children to gang up against him and bully him. He never took it lying down. He fought back.

“It’s okay, kids are going to be kids. They’re going to fuck with each other. I used to get into fights—they were normal, children fights. No one ever got seriously hurt or injured, apart from me,” he said.

And when he didn’t fight, he swore. Even now, his sentences are punctuated by expletives.

“I don’t have a problem with swearing. It’s part of the fucking language. What’s taboo about it? It’s a fucking word. It’s not a slur. No one’s identity is going to get damaged because I said the word ‘fuck’.”

But he was seen as a ‘problem child’. Academics didn’t interest him. As he laid out his problems, in an incisive manner and with effortless articulation, I wondered how the school had failed to see what his current employers did—that it made no sense for a child as bright as Aditya to be struggling; that the student was not a problem, the system was. Aditya had an answer for that too: “They don’t see you as an individual, but as part of a body of students. I was one of the neglected ones, and I’ve known people who have been in that same situation.”

They tried to discipline him, with caning on the palms—physically painful, the public humiliation emotionally damaging—and calls to the principal’s office.

“I was miserable in school,” he said. “I was clinically suicidal.”

He knows others who went through similar ordeals, but who are still stuck in the system.

“’Because they are too scared to tell their parents, ‘Look, hey, I’m not doing this.’ Even the first time I said it, nothing happened. I fucking fought for it, fought for it, for years.  I kept saying, ‘No, I’m not doing this. This is going to kill me. If you have any sense, you’ll take me out of this.’ If someone feels like this about a system that is supposed to be so impactful and influential in your life, then that’s not a good system.”

But the system was never at fault, the student was. Unless a teacher noticed the incongruity between intelligence and performance, and intervened from the goodness of his heart. With salaries that often require a teacher to work a second job after hours to make ends meet—the simplest being tuition classes—they are rarely incentivised to take the trouble.

Aditya’s problems at his first school culminated in expulsion when he was 12 years old.

***

Policymakers have seen fit to ensure that a period already rife with tension, with an inevitable conflict with parents coinciding with need for approval from a peer group that comprises other confused children, is anxiety-provoking for both adolescents and their parents, Jayalakshmi said. This is the period when a student has to make crucial decisions about higher education that will affect and limit his or her career. They are forced into competition with their fellows, a situation that can affect bonding and encourage bullying and belittling. 

Dr. Mohan Raj S., consultant psychiatrist and director of Tharu Clinic, notes that depression can occur at any age, and studies show that the highest number of people go through it in the 20-40 age group. However, several factors come together to make adolescence a time when depression, and sometimes suicidal ideation, may manifest.

“A 10-year-old dependent child has to become a 20-year-old independent adult in this period,” he said. “That process can be tough.”

As the children begin to look more grown-up, parents’ expectations of them in terms of taking responsibility—helping with chores around the house, running errands, handling money judiciously, even cleaning up after oneself—are higher. Yet, they expect to be obeyed.

Jayalakshmi pointed out that the prefrontal cortex of the brain, which allows one to feel and display empathy, is still developing in a teenager. The incongruity between body and brain furthers the misunderstanding between child and parent.

“Adolescence is often called the second individuation, the first being when the mother weans the child off the breast milk and the child realises its body is different from the mother’s,” she said. “Often, this second individuation becomes the cause for the rift between parents and the children.”

The ultra-realism of violence in video games and in cinema has the effect of making violence on the self and others more palatable.

For parents, too, it is a confusing time. A child who has always been close or dependent, suddenly shifts his or her need for approval and attachment to a peer group.

“It’s unsettling for the parent, because in this identity-forming and identity-developing stage, they may want to shut the parent out and not just metaphorically, but literally, want to shut the door of their rooms and be by themselves,” Jayalakshmi said.

Dr. Mohan Raj pointed out that underlying medical conditions such as Attention Deficit/Hyperactivity Disorder (ADHD) and dyslexia may trigger depression.

“Parents just say the child is naughty and don’t bring him in for a consult, so they never realise he has ADHD,” said Dr. Mohan Raj. “When he becomes a teenager, they say he’s disobedient or not listening. Their academic performance will be poor because of ADHD. And there is another condition called dyslexia, where you are intelligent, but you have a problem with reading and writing. And all our exams involve writing. So, you’re getting less marks, and the parent says you’re not studying. But the child has put in enough effort. There is help available. There is remedial training for dyslexia and medicines for ADHD. But the parents never realise they are the ones at fault. When the student’s academic performance is poor, the self-esteem goes down. And at this time, the parents and teachers are constantly criticising him, saying he’s lazy. So many times, we see students who come here with depression from the lowered self-esteem, and then we recognise that they actually have ADHD or dyslexia.”

For this particular generation, the ultra-realism of violence in video games and in cinema has the effect of making violence on the self and others more palatable. Self-harm is becoming increasingly common, he said.

Social media is another factor. A client told Dr. Mohan Raj that she felt under enormous stress when her birthday was around the corner. How many people would put out a public display of affection to wish her? One’s social worth in one’s peer group may be played out on Instagram. And these are aspects of a child’s life that a parent might never see.

What, then, can parents do to bridge the gap?

There are warning signs of depression, particularly of suicide, to which parents must be attuned, Dr. Mohan Raj said.

“For one, say the child is always talking about suicide. There is a misconception that if they say it, they won’t do it. You need to take the child to a psychiatrist and see what’s going on. Or if a child has become withdrawn, or is not enjoying the usual stuff, if the interest level in things they liked has gone down, that is a sign. Another warning sign is sometimes adolescents give away prized possessions. They will suddenly tell their classmate, ‘Hey, you always liked this pen, no? I’m gifting it to you.’ Or, ‘Oh, you like this bracelet? I’m going to give it to you.’ It’s like saying goodbye. That’s a very, very big warning sign. Or, if a child becomes suddenly philosophical, asking things like: What is life all about? Why should we be there? What if one person is not here? The world will not change…Why am I living? That is a sign.

The other challenge is that the resources also are limited in our country. Dedicated child and adolescent mental health services are very limited across the country and mostly they are located in the metro cities.

“But then, there are parents who don’t want to believe their child is depressed. I have a patient… I know the family well. The girl kept asking them to bring her to me. They said she was just being lazy, she didn’t want to study or do her homework. I could see she was very depressed, even suicidal—she had self-harmed. I told the mother she is depressed, and the mother’s reaction was, ‘Oh, so she managed to trick you also?’  You bring her to a psychiatrist who examines her and tells you she’s depressed, and you don’t want to believe it. You say she’s cheated me. So I ask, ‘What more can I do to make you believe?’ and the mother promptly asked, ‘Is there a blood test for depression’?”

A parent going into denial could be a ‘big, big tragedy’, he said.

The dependence of minor children on parents for seeking therapy makes the situation particularly problematic in this case.

Their only recourse is to a helpline, which is a temporary fix.

The Department of Psychosocial Support in Disaster Management at NIMHANS started a helpline during the first wave of the Covid-19 pandemic, to deal with the stress caused by uncertainty for parents and adolescents. For one, there was illness and death from the pandemic itself, including loss of close family members. Second, with schools and colleges closed and no clarity on whether the board exams would be held that year, it was a period of acute anxiety for students.

But while the pandemic was a trigger for the helpline to begin, Dr. Kommu pointed out that depression existed long before the pandemic itself. And especially for those who don’t show severe symptoms, seeking help could be very delayed. Often, depressed teenagers never go through a psychological evaluation or receive a diagnosis.

“The other challenge is that the resources also are limited in our country,” he said. “Most mental health services are tailored towards adults’ issues, but dedicated child and adolescent mental health services are very limited across the country and mostly they are located in the metro cities.”

With a population of 1.486 billion according to projections by the United Nations, of which a fifth are in the 10-19 age group (according to the National Health Mission), this is a huge burden.

Helplines were only meant to provide brief psychological support in a crisis situation, Dr. Kommu said. They are not an alternative for regular mental health care. After frontline intervention, there has to be follow-up care. When parents are either unsupportive or inaccessible, as in the case of students living in ‘cram schools’ and preparing for competitive examinations, the situation is dire.

***

Aparna, 49, is the mother of an 18-year-old. “Just like an adolescent goes through an adolescent stage, for a parent also, there is birth, the adolescent stage, and all of that,” she said. “As parents also, we are growing. We don’t know. With changing times, with kids growing up the way they are today, and we grew up the way we did that time, there is so much of a difference, and even we are kind of figuring out what the hell to do. And in this figuring out, which is a very scary part and it is an unsure, unknown part, the easiest thing or the safest route is to go with what has already been done, which is school, you know? Whatever happens, it’s not about you getting that first rank, second rank ... somehow you finish school. In our, the parents’, perspective also, oh, I’ve done my job, at least this is over, tenth is over, twelfth is over, so those kind of things become a milestone. We are human beings, we do tend to survive in circumstances which we are given, in whichever way we feel is comfortable.”

But were parents doing what was best for the child, she wondered. Could we actually see what needed to be done in a harmonious way, could one set aside all one’s own anxieties and troubles and conditioning and see what was best for the child, which would also give the parent a sense of calm and peace?

Aditya felt the line of thought to which Aparna referred had very nearly killed him. He should have dropped out in Class 5, he said, and he only got to do it four years after. He was clinically depressed by then, and it would take him nearly half a decade to recover.

“You think this is right because your parents think this is right because their parents thought this was right. Even when I wanted to drop out, my parents were like, ‘You drop out, and what then?’ We’ll figure out what then. Because there is never not an option. People like to put up imaginary walls in front of things. I’m not going to spontaneously combust if I drop out of school. But they’re always thinking about four years in the future, so much that they don’t notice what is happening now. From Class 6-7, they’re thinking about college. I’m like, what’s the fucking point? What am I even doing? What am I living for? What am I working for? I’m not enjoying a fucking second. I’m miserable in high school, I’m miserable in college, I’m miserable in my job, and then I’m dead. What’s the point?”

After his expulsion from a school which describes itself as a ‘learning space’ that is committed to a ‘holistic’ approach, he went to an international school. He believes the school was trying its best to get him out from Day One, because “a big fancy international school does not want someone with an expulsion record on their rolls”. Although he was not the only student swearing, he was summoned to the principal’s office repeatedly for ‘using bad words’. When another student’s iPad got stolen, he was accused of it and called to the principal’s office, with no evidence.

“This was not fucking schoolyard nonsense. They’re charging you with a crime. But I was supposedly a delinquent or whatever, and that is all the proof they had. Because no one else had been expelled.”

He felt constantly singled out. He was taken to the principal’s office for not doing his homework once. When he answered questions, the teachers told him off, only to accept the same answer from other classmates, he said. Eventually, he was expelled for getting into a fight.

He went to another international school after, which he described as “a fancy campus and expensive education, but the same fucking problems”.

Being an international school, it had a counsellor for students.

“I really opened up to her and I told her all my problems,” Aditya said. “And I remember exactly what she told me. She told me I have to man up’.”

He left that school of his volition, and went to one last school. This one described itself as favouring ‘alternative education’.

“That was actually a nice place,” he said. “But by then, I was at the end of my tether. I had no capacity for this anymore. It was a really nice place—a small, homely building, nice teacher. But by that time, I was already so fucked that I could not take anything. In my current state, if I’d gone there, I think I’d have really liked it.”

He simply began to bunk class. Finally, his parents agreed to his leaving school.

It’s a system that cannot be fixed. It has to be burnt down and rebuilt.

So, the next few years, he went to the odd class—art, music, writing. He finally matriculated this year, at 19, through the National Institute of Open Schooling. His main motivation, he said, was being able to produce a sheet of paper when he wanted to get a visa to travel without the authorities thinking he was trying to immigrate illegally.

“I had a job before I wrote that shit,” he said. “I’m doing other things. I’m fine. Dropping out didn’t give me heart failure. I’d have offed myself if I’d stayed on in that system. I was fucking suicidal. I was diagnosed. We went to a therapist, in fact I went to three-four of them. But that didn’t really help me. I’m sure it helps a lot of people. But for me, the only thing that helped was time.”

The system, he said, was a mess.

The disproportionate importance given to academic performance from Class 7 came as a rude shock to students. Over the course of a single summer, school changed from a place one went to hang out with friends to a place that would prepare one for life. Eight subjects with eight separate papers, and mock competitive exams from Class 9 in preparation for the college entrance exams. Those who do not belong can rarely drop out. Not only was a matriculation certificate a requirement for higher education, there was also an unfair and overwhelming reliance on qualifications as the indications of a person’s competence.

“It’s a system that cannot be fixed,” he said. “It has to be fucking burnt down and rebuilt.” His problems at school were compounded by a difficult environment at home.

“’There were severe problems at home, and I got pulled into it. I was like, you guys want to fight, you fucking fight. Don’t drag me into it. I just want to do my own thing. All this, combined with what was happening at school, took a major toll on my mental health.”

The toll can be long-term. In Aditya’s case, it affected his memory for several years. He told me he wasn’t able to give me exact timelines and dates, figure out when something happened or for how long, because he didn’t remember. The numbers he was giving me were an estimate.

Dr. Kommu said the usual duration of an episode of depression is 4-6 months. However, if undiagnosed and untreated, it could last years and even become chronic. Worse, the longer depression lasts, the more difficult it is to treat and uproot. This could lead to functional impairment, not just in academics and at work, but also in interpersonal relationships.

***

All three mental health professionals whom I interviewed mentioned the experience of loss as an important causative factor for depression. And several of the telltale signs of depression are dismissed as ‘attention-seeking behaviour’ by uninformed parents.

Dr. Mohan Raj classifies suicide into three types—suicidal attempt due to severe depression, impulsive attempt, and manipulative attempt. In the first case, he said, the person would invariably complete suicide. Describing such attempts as ‘genuine’, he said such people plan their suicides carefully, doing their research, ensuring they are safe from discovery, that no help is available at the time, and that they cannot be saved. The impulsive attempt is the decision of a moment, and whether the person dies or not depends on what modalities are available and how lethal they are. Someone who lives in the top floors of a high-rise or who has access to high doses of dangerous medication or who is home alone for long periods of time is at increased risk. The manipulative attempt is usually used as a threat, typically in cases of one-sided ‘love’, and is not really relevant in cases of true depression.

He also mentioned another kind, para-suicide, which does not involve death but does involve self-harm.

I did remember an acquaintance having posted a series of videos on social media, in which she and her daughter discussed the latter’s self-harming. They are based in the United States, and I met them on an annual trip to India, two years after the incident.

When she had self-harmed, Naina was 13 and her mother had spoken in the video about how she had been depressed in school. She was an empath, the mother said, and had been upset at something a friend was going through. They had not been to a therapist at the time, although the student did speak to a counsellor assigned by her school. There was no diagnosis.

“It was a lot of things,” Naina, now 15, told me as her mother looked on. “But most of all, it was Coco.”

Coco was the family’s Labrador, 15 years old when they had to let him go. Naina’s mother Gina had told me how as a 2-year-old, he had once snuggled up to her and sniffed her belly. Even before she had taken a pregnancy test, she had suspected she was carrying a child because of Coco’s sudden interest in her midriff. Through the pregnancy, he had become increasingly protective of Gina. He was indulgent of Naina once the child was born, allowing her to pull his tail and try to ride on him. The two had been inseparable for the next thirteen years.

“When he went, I thought, ‘I’ve never known life without him, and don’t like it’. And the pain was so much, so much. And I just wanted to be distracted from the pain in here”—and Naina pointed at her chest—“so I thought let it hurt somewhere else. ”

At this, there was a sudden noise from Gina, perhaps an intake of breath.

“You never told me this, bebu,” she said, and then looked at me. “She never told me this.”

“I thought you knew,” Naina said.

Dr. Mohan Raj said self-harm was not always an indicator for suicide. Typically, it is indicative of borderline personality disorder (BPD). “They may slash their wrists, but there is no intention to die. They just want to inflict pain. The emotional pain is so much that the physical pain distracts. Most of them say they [give themselves] physical pain so that the emotional pain gets numbed. But it is not always BPD. Sometimes, it could be histrionic, sometimes it could be attention-seeking, and sometimes it could be to numb the pain triggered by a particular occurrence”—in this case, the death of the only sibling Naina had ever known.

However, the experience of loss does not necessarily have to do with an actual death. It could be estrangement, from one or both parents, or loss of a parent’s presence in one’s life because of a divorce. It could be a loss of self-esteem from poor academic performance. Or, it could be the loss of a peer group.

Prachi, a student of Class 9 at an exclusive school in Bombay, began to get into ugly fights with her parents soon after they denied her permission to go on what the school called a ‘trip’. It was a tour of Europe, priced at Rs. 4 lakhs, exclusive of taxes.

“The entire family can go on holiday on such a budget,” her father told me, when I interviewed her parents over the phone in Prachi’s absence.

“We put her in that school because we had a chance. It’s not easy to get into,” her mother said. “But my boss’ kids were studying there, and she put in a word, and we got her and her brother in.”

The early years were quite special, the couple said. Their children’s classmates were typically celebrity kids, with sports and film stars for parents. They were invited to birthday parties with bouncers to keep the media away. It was a rather charmed life for the parents, too, with invitations to pre-release film screenings, tickets to cricket matches, memberships to various clubs and golf games with the who’s who of the city and country on offer.

The couple is by no means poor, although salaried incomes can barely compare with the remuneration of a film actor or cricketer.

“Technically, it’s not like we can’t afford it,” Prachi’s father said. “But it is simply wasteful. There’s only so much you can do for your kid to “fit in”. The way I see it, this was also an opportunity for her to stand up and say, ‘Look, I’m different from you in some ways. I don’t have to be a part of everything for us to be friends.’ But when we tried explaining this to her, she said some really…I don’t know…”

“Hurtful things,’ her mother said. “Things like, ‘You guys don’t make enough money’ or…”

“‘You’re not good enough at your work, and I’m paying the price’,” her father said. “It was a real tantrum.”

When I spoke to Prachi, with her parents’ permission but without their listening in on the conversation, she said, “I resent them, because they’re actually using me to network. They make friends with all the important people, but they won’t let me go on holiday with my friends. You think the other kids in school can’t see it? Every one of my friends went. Only the ayahs’ and watchmen’s kids, and the regular losers, didn’t go.”

The tradition of furthering career or societal opportunities for oneself and one’s offspring by choosing the right schools—which could facilitate entry into the right universities later—is a successfully tested modus operandi across the world. In some cases, it could lead to charmed careers; in others, to royal titles. And yet others, to alienation, depression and familial discord.

What do parents do when faced with an angry teen bludgeoning them with accusations?

Jayalakshmi pointed out that this was a good time for the parent to find a balance between showing empathy and setting rules. For instance, a teenaged child may come home and fling his belongings about. Instead of telling him off, a mother could ask why.

One of her clients told her the answer to that question had brought about a paradigm shift in the way she saw things. The client’s son had answered, “For eight hours in school, they make me sit without moving unless I ask permission, I feel free when I come home, and so I throw everything about.” This was an opportunity to find a mean between nurture and structure. At this point, Jayalakshmi said, the parent could tell the child it was fine, he could throw things about and relax, but perhaps after a couple of hours, he should tidy up after himself. Instead, parents tend to err by either being too rigid—hitting a child for disobedience, which is abuse and particularly scarring at this critical developmental stage—or being too permissive, which was tantamount to neglect.

The presence and availability of parents is crucial through teenage, she stressed. If a parent could “‘show up as a predictable, safe, available and consistent adult”, it becomes easier for the adolescent to confide in that parent about things he or she is going through in school, from exam anxiety to bullying.

“‘But in most households,” she said, “it coincides with a time when the parents are hitting a midlife crisis or the mother is going through menopause or someone has lost a job, or the grandparents whom the child is close to are falling sick, or maybe the child has lost a grandparent.”

The current generation of adolescents is also one where the mother is typically a high-flyer in her own career.

I think you can never do the right thing. There is no right thing. You can only do what you think is right.

Saraswati, a singer by profession, told me artists are relatively lucky because the6y can largely work from home or on their own terms and don’t have the pressure of targets and performance assessment.

“There is so much pressure on women to do it all,” she said. “You want to have it all, also. It’s easy for me, I was able to be hands-on and also have a career. But a lot of the mothers in school, they have servants dropping off the child and picking them up. I remember, once, when my son was in first or second standard, he told me about a child whom they would all make fun of because he was stinking. The child was called to the principal’s office one day. Then, the mother was called. I found out later what had happened. The child was soiling his underwear and hiding them in his school bag. The maid didn’t bother checking or washing. He had a week’s worth of unwashed underwear in his bag. And the kids were all making fun of him, and then the teacher noticed. The mother had no clue. Now, imagine the sort of teenage this child will have? The mother will only get busier, right? And if she takes time off also, she will be judged for throwing her career away.”

Saraswati was not exempt from being judged. She chose to turn down lucrative foreign tours and concert performances abroad until her son was eight years old. Her daughter was eleven. She didn’t think it was right to go away for a whole summer when the child couldn’t even understand why the mother was absent, she said, but there are times now when she wonders whether she has made them too dependent on her.

“’Either way, I think you can never do the right thing. There is no right thing. You can only do what you think is right.”

Aparna, too, felt the pressure on the mothers of adolescents was enormous.

“Here, you have mothers who are really very delicate and vulnerable beings. I can’t even begin to explain what that vulnerability does to a woman. It’s very under-spoken, it’s very unsaid, it’s laughed off. But for me, as a mother, the most important thing is acceptance of the child by the society which means he is safe, she is safe. An outlier or a child who is not as accepted, the mother doesn’t really feel safe. So she wants to make the child fit in. She starts looking for the influential peer group which is walking around. This is basically animal instinct, hunting for a ’hood, finding a safe pack. And you have these packs of mothers, too—packs of women with CEO mentalities looking into every aspect of the child and the child’s connection with other children and their parents and the parents’ influence on whatever, and also ready to be judged.”

Unlike a day job, with acknowledgement and accountability and a physical transaction of money, the mother’s job is one without parameters. One could not function naturally in this setting, Aparna said. There was a constant fight between which aspects of what the child was saying one had to take and which aspects one had to overrule, and then come to a conclusion.

And then there are families where there is no mother.

Ashutosh is a single father, with sons aged 12 and 15. He has had sole custody of them since his divorce six years ago. They have no contact with their mother. About a year ago, his older son’s grades began to drop. A friend suggested counselling.

“I’m working, working, working,” Ashutosh said. “I try my best to spend quality time with the kids, but quantity time is just impossible. In a typical set up, you have the dad—in some cases, maybe the mother—bringing in the money, and the other parent taking a step back in career to look after the kids. But here, it’s just me. They’re not neglected, obviously. My parents live with me, and they’re always around. My brother is in the floor above, and his wife is always with the boys. Their son is 13, so the three of them have grown up together. My sister got married only last year, and she lives nearby too. So, they kind of have a composite mother. But the fact is that I honestly don’t have the time for my kids. And I worry about how it will affect them.”

All psychologists and psychiatrists speak about the importance of parents being available. “There are parents who don’t give time,” Dr. Mohan Raj said. “It starts right from childhood. Children want to tell them all the trivia about what happened in school, and I tell parents, please listen to them when they come in. And some parents will say, ‘No, I’m busy. I just came back.’ And I ask, ‘What do you do when you come back from office?’ The mother says, ‘I make something in the kitchen.’ I said, ‘Make the child sit in the kitchen and talk to them while you’re doing whatever you have to.’ So what happens is when children start talking, they say no, no, I’m busy, don’t tell me. So, kids lose that [impulse] after some time. While what the child wants to share might seem trivial to the parents, it is significant for the child, and for that excitement to be dampened by a parent’s lack of receptiveness is a tough blow.

“So what happens is, when they say no time, no time, no time children gradually withdraw. In adolescence, suddenly parents will have antennas and then they’ll see the child on the phone and ask, ‘Who called you? Is it a boy or a girl?’ And the adolescent will be thinking, all these years when I wanted to talk these people didn’t have time, now why should I talk? So once communication is cut, it’s cut. Having a confiding relationship is a major protective factor. Parents have to nurture a confiding relationship.”

Naturally, that is easier said than done. Aparna pointed out that school timings are built around the industrial process, to coincide with parents’ work timings. Everyone comes home irritable and exhausted.

When his older son was diagnosed, Ashutosh took a sabbatical from work. The boy wouldn’t open up to him.

The counsellor who first diagnosed the 15-year-old boy suggested the two of them attend both separate and joint counselling, to try and bridge the gap.

“‘I don’t know if he’s talking to his therapist in his solo sessions. He’s absolutely silent when I’m there,” Ashutosh said. “I have obviously had to go back to work. But then, we’re still attending sessions, and I’m hoping we can get a breakthrough. Because…I mean…I can’t imagine if…you know…”

An adolescent goes through what experts call a phase of five-pronged development—cognitive, emotional, social, biological, spiritual—and needs support, ideally from the parent. It is a time when one longs for independence, but is also pained about moving away from one’s parents. They could shine and excel in various fields if they do get that support.

Parents do need to be educated about this, Jayalakshmi said. "I really think instead of looking at young adults and teenagers as some sort of incomplete thing, developing into complete adults,  as caterpillars who are eventually going to become butterflies, we have to respect the adolescent phase as something that is complete in itself, that has its place in the human trajectory, with its own purpose, and not simply as a transition. If parents were to look at young adults as these beautiful creatures, so sensitive and so vulnerable, and engage with them, we see how loving they are, how much they wish to support their peers and what fresh ideas they have and how much they care for the world, how much they love their parents. They are really wondrous creatures."

However, not every parent is receptive to being told how to parent. Which is why the need of the hour is to put a comprehensive system in place.

I asked Dr. Kommu what was wrong with our current approach, and what he would put in place. He told me the calls the helplines have received, often from remote geographical locations, have shown just how crucial the setting up of mental health infrastructure across the country is. There is a misconception that depression is the luxury of a certain socioeconomic class, a first-world problem. However, it is one of the biggest battles young people from every stratum of society are fighting.

Talking over the phone to someone going through an acute episode of depression for a few minutes would not prevent its recurrence, he said. While the government has introduced certain initiatives which are welcome, such as the National Health Mission’s Rashtriya Kishor Swasthya Karyakram or the Ministry of Education’s Manodarpan, our overall approach tends to be piecemeal, with no programme or policy in place to address mental health in general, particularly common problems like depression, anxiety disorder, and also risk behaviours such as suicidal ideation or substance abuse.

Dr. Kommu said the intervention needs to begin in school, with the introduction of mental health screening along with the physical health screening that is already conducted in most schools.

“This is especially important for adolescents, to identify the predisposing and precipitating factors, and to identify adolescents who may be at risk for depression or even self-harm or substance abuse. That way, we can identify those who may require more in-depth intervention within the school setting itself, and refer them to mental health professionals.”

Then, he said, there had to be a universal life-skills education programme in schools, starting from Class 7 or Class 8. Through this, we could create mental health awareness among pre-teens and adolescents. It is also important to run public awareness campaigns and sensitisation campaigns for the general public, targeting the parents of adolescents. Teachers must be trained and educated in mental health issues in adolescents, so that they could help identify teenagers with problems, rather than label them ‘problem students’. As for the institutes which are popularly known as ‘cram schools’ as well as centres of higher education, universities and colleges, there must be in-house trained counsellors who could provide continued psychological support, and empowered to liaise with the institution as well as the parents or caregivers of the students.

“We must understand that these conditions are common and effective interventions are available and they help the young person,” Dr. Kommu said, “and if we identify some of these factors, we can at least prevent suicide to some extent—I’m not saying 100 per cent—but we can make some impact.”

***

She was a brilliant student, described as a ‘top performer’ by her school teachers. In a grand ceremony attended by her parents, from which her mother would share videos on social media, she was made cultural secretary of her school.

In the wee hours of September 19, 2023, Meera Vijay Antony took her own life. She was found by her father soon after, but could not be revived. She left behind a suicide note, from which the police have only released one line: ‘Love you all, miss you all.’ She had reportedly written that she would miss her friends, teachers, and family, and that she knew they would be heartbroken.

They were.

The next day, actor-musician Vijay Antony posted a note in Tamil on social media, saying:

My dear people,

My daughter Meera is a very affectionate, courageous girl.

Now, she has gone to a place better than this world with its caste, religion, class, jealousy, pain, poverty, and malice.

She does talk to me.

I, too, have died with her.

I have begun to set aside time for her.

All the good deeds I will carry out in her name will be flagged off by her.

Yours

Vijay Antony

On October 9, her mother Fatima shared a post:

If I’d known u will live only for 16 yrs, I would have just kept u very close to me, not even shown you to the sun and moon, am drowning and dying with ur thoughts, can’t live without you, come back to babba and amma. Laara keeps waiting for u, love u Thangam.

I thought of Gayatri assessing the weight of the fan. I thought of Aditya telling me over lunch that he was clinically suicidal. Of Naina cutting into her thighs. Of Prachi feeling left out when inside jokes from her class trip were shared, when photographs from Prague or Paris showed up as DPs. Any of them could have chosen to leave it all behind.