Depression and Suicidal Ideation: A Worrying Trend

Depression and suicidal ideation are familiar phenomena in the country today. Among the factors that a person has suicidal thoughts and depression is mental health disorders. This situation affects those who have a low level of mental health. This is because mental health disorders will cause a person to be unable to think reasonably and rationally and fail to control their emotions. There is a correlation between a high level of depression and the tendency to suicidal ideation. Identifying the factors and characteristics of a person facing this issue will be able to help them as early as possible for treatment and early intervention from professionals. Policymakers must implement intervention and social support programs more often with smaller and focused groups apart from general and large-scale activities to ensure that the program reaches the target group and the community and successfully creates a healthier environment. Some suggestions have been made to be beneficial and reduce suicide statistics. Collection of research data using previous research such as books, articles, journals, working papers and theses. Signs of depression experienced by an individual need to be because it affects their health, such as suicidal ideation


Introduction
Mental health is the mainstay of ensuring the well-being of a person. Individuals with good mental health can play a role in society, actively developing and constructing a country, religion and race. Mental health can be defined as the individual's ability to maintain harmonious relationships with others, to be able to engage in community activities and the ability to contribute to the community in Malaysia. Currently, the community is still in the process of rebuilding a new life after the Covid-19 pandemic, which is still not over. There are still individuals who cannot reason, find it difficult to fall asleep, are quick-tempered, and act beyond rationality after going through the challenges of the Covid-19 pandemic. This ultimately affects some individuals' emotions and causes them to start thinking about ending life in their own hands (Johari & Fadzil, 2021). The situation was widely reported on social media throughout the pandemic process in 2020 until now.
In Malaysia, statistics from the morbidity and national health survey conducted by the National Institutes of Health (2019) reported that 472,420 residents experienced symptoms of depression after diagnosis. It was found that 19,574 of the population were teenagers between the ages of 15 and 19. This finding is a sign of the need for seriousness in addressing the growing issue of depression among the Malaysian population. Mental health issues are so less focused than physical health that some people underestimate this, even though suicides are increasing due to low levels of mental health (Rahman & Nor, 2021) Depression is a condition in which an individual has a disorder that involves changes in thoughts, emotions, feelings and behaviours that make daily life difficult and have adverse effects if left untreated and even affect the individual and society  and it is found that there is an association between depression and suicidal ideas among those with low levels of mental health, in addition, it was found that extreme depression causes an increase in suicides (Jasmi & Hassan, 2021).
The symptoms of depression are prolonged sadness, loss of interest, easy feeling tired, easy to feel guilty, uselessness, lack of concentration, ease of anxiety and restlessness. Some patients experience problems such as loss of appetite, sleep disturbances, headaches, and body aches which ultimately lead to suicide attempts (Mohd et al., 2020;Wahid et al., 2022) While the idea of suicide or self-harm without suicidal intent is an attempt to self-harm but not fatal, it is still deliberately intended to cause harm, including the behaviour of burning, cutting, swallowing an excess dose of medication, and taking drugs or harmful substances (Hawton et al., 2002). It is also associated with depression, anxiety, substance abuse and suicide.
Some studies state that those who have suicidal intent or ideas have a positive relationship with the early symptoms of mental health disorders . Even individuals who feel that there is no longer any meaning and purpose in life have the possibility of suicide. This has annoyed especially in today's very challenging society, especially in education, career, family, etc.
A study by Khairul et al (2018) found that the rate of involvement of adolescents in selfharm behaviour without suicidal or non-suicidal self-injury (NSSI) is seen as increasingly frequent and alarming. It also has a harmful and detrimental effect on these youths.

Problem Background
This study was done to see how depression has significantly impacted the intention to commit suicide and that it causes safety issues. Depression also affects many social groups, such as adolescents, early adulthood, youth and the elderly. Some studies say depression is a global issue that is gaining more attention because it creates a declining feeling (mood) in a person and affects daily life to the point of impacting the way of thinking, behaviour and personality, as well as the actions taken (Wan & Hidayah, 2020) Depressive disorders in Malaysia have been found to be the most common mental health disorder experienced by the country's population (Latif et al., 2021). In fact, a 2015 national morbidity survey by the Ministry of Health Malaysia found that those aged 16 and above had a mental disorder, 29.2 per cent. In addition, according to Toghyani et al (2018), depression is among the global health issues that are polemic, and it is estimated that over 300 million individuals have depression issues worldwide, and this figure will continue to rise.
The National Health and Morbidity Survey 2017 (NHMS) Statistical Report states that there has been an increase in suicides in the adolescent age group, and it has increased since 2012 (Ministry of Health Malaysia, 2017). The report also revealed that 13-to 17-year-olds have mental health problems. English terms or terms, self-harm without suicidal intent is referred to as non-suicidal self-injury (NSSI). It also commonly uses the terms self-injury, self-harm, deliberate self-harm, parasuicide and self-mutilation (Klonsky, 2011). These terms are self-harming behaviours but have no suicidal intent.
There are findings that those with suicidal intent have a positive relationship with the early symptoms of mental health disorders . Even individuals who feel that there is no longer any meaning and purpose in life have the possibility of suicide. This has annoyed me, especially in today's very challenging society, especially in education, career, family, etc.
A study by Khairul et al (2018) found that the rate of involvement of adolescents in selfharm behaviour without suicidal or non-suicidal self-injury (NSSI) is seen as increasingly frequent and alarming. It also has a sour and detrimental effect on these youths

Problem Statement
Data from the Royal Malaysian Police (PDRM) showed that suicides in 2019 amounted to 609, while in 2020, there were 631 cases from January to May. While for 2021, 468 cases have been reported (Astro Awani Online, 2021). Meanwhile, the annual report issued by the Ministry of Health (MOH) in 2020 recorded 465 cases of suicide attempts between January and June 2020. The COVID-19 pandemic has also had negative implications for the world community, including in Malaysia, to disruptions in human mental health.
This alarming statistic also shows that 16 out of 100,000 people, or in other words, every 40 seconds, people commit suicide every day (WHO, 2017). This raises a sign of anxiety that this suicidal idea needs to be fought as early as possible, especially when the individual has been identified as having depression. In addition, depression, if not overcome and treated, will cause lingering problems such as self-harm and suicide. When there is a mental health disorder, a person cannot think sensibly, which can cause them to act out of control and pose a very high risk.
Mental health, such as depression, will directly impact a person's daily life and future. Treating and preventing from early childhood and adolescence is an action that should not be ignored as it can help the individual's development improve (Peng & Letters, 2021). This is because children and adolescents also contribute to depression statistics in Malaysia. Ariffin et al (2022) in his study affirmed that the symptoms of individuals with depression are different based on age, environment and maturity factors. It can be seen from the cognitive, behavioural and affective points of view of an individual towards his environment. This will cause the individual to experience various feelings such as frustration, stress, and worry about being sad, which can also cause harm if left untreated, leading to more serious mental health. Signs of depression should be seen more seriously as this can prevent a person from taking action of self-harm and can instead channel professional help to counselling services or psychiatrists so that the disease can be cured and not destitute resulting in suicidal ideas and thoughts (Rashid et al., 2021) Yahya & Sham (2020) asserts that if depression is underestimated and left to linger, it can cause harm to the quality of life, including self-harm and suicide. This can cause deep feelings of sadness and trigger various textures such as sadness and despair, disrupting the individual's activities with the community and the loss of enthusiasm to move on.
During the pandemic, individuals with mental health disorders will become more affected and risk-threatened. This view was presented by Li et al (2020), who found that the condition harmed mental. Somatic symptoms such as shortness of breath, chest pain, chest palpitations, and so on are signs of depression that do not show abnormalities while receiving treatment at the medical centre.

Literature Review
Mental health is an essential component of human life and is equally important to physical health. Preserving mental health is integral to protecting the mental health of children, adolescents and youth. This is because it will help with better development among those in the future. The Mental Health Policy 2012 (Malaysia, 2012) has defined mental health as the ability of individuals, groups and environments to interact with each other to promote optimal subjective well-being and the use of cognitive, affective and relational capabilities towards the achievement of individual and group goals.
Depression is a type of disorder that falls under the group of neuroses. A mental illness can cause a person's feelings and emotions to decline. This can affect daily life in terms of thinking, feelings, behaviours and well-being if it is not addressed effectively, thus leading to dangerous acts such as self-harm or suicidal ideas (Latif et al., 2021). This, of course, will give an unstable situation and upset family members, even the community, mainly because we do not know what we think or feel by those who may be close to us. Rashid et al (2021) in a study of 363 teens who attended school, stated that most of them had depression problems, leading to suicide attempts. Bradvik (2018) also agreed with this finding when in his study, he also found that the level of mental health greatly influences an individual's life. This is because, according to him, mental health disorders are the leading cause that drives an individual to commit suicide.
Mental health impacts the individual's daily life and future direction. It can affect a person's way of thinking, behaviour, feelings and emotions. A person with mental health issues can affect his ability to make good decisions, solve problems, and associate and interact with others (Peng & Letters, 2021). This causes a person to take irrational actions due to the state and way of thinking affected by the depression.
Suicide-related studies have also found various terms used in the issue. Among them are suicide, suicidal behaviour, suicidal ideas, self-harm and non-suicidal self-harm. They all have their differences (Yasin & Zaib, 2021). Therefore, it is not surprising that the various terms used to refer to this act are increasingly trending and alarming.
According to Kamin, Ame Husna; Incredibly (2015), suicidal ideas are divided into two main parts, and the first being suicide is an option, the second a suicide or a suicidal idea due to several factors such as despair, failure, doubt and the basis of responsibility. This causes suicidal thoughts to often occur due to a strong desire to die; however, there is also a concern about pursuing intentions. The idea of suicide, on the other hand, is a person's desire to commit suicide and can be summed up as a person's thoughts and feelings to commit suicide without the intention to die.
A study by Novel Lyndon et al (2020), found that some causal factors influence seniors with suicidal ideas. Such as society and culture, social support, belief in religion, economic influence, socio-economic status, and depression due to changes in their social environment.
In the philosophy of science and civilization seminar 2021, Jasmi & Hassan (2021) stated that among the factors that cause a person to commit suicide is due to depression. In addition to mental disorders, illness or injury, trauma and life crisis, financial losses, and drug use problems also affect suicidal ideas. Meanwhile, a study by Wan & Hidayah (2020) found that among the factors of depression is the difficulty of forgetting the black events that occur and have long-term effects on the brain.

Symptoms of Depression
Using the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorder Associaton (2013); Ismail et al (2018) listed the main symptoms of depressive disorder. Among the symptoms are: 1. Prolonged feelings of sadness, hopelessness, and a sense of loneliness for no particular reason 2. Lost interest in something previously liked 3. Loss of appetite 4. Difficulty sleeping or oversleeping 5. Deterioration in terms of psychomotor such as movement, slows down 6. Easy to feel guilty and irrational It's hard to focus 7. It's hard to focus 8. Attempts to harm yourself or others 9. Easy to handle tiredness despite not doing any job.

Methodology
This study used library research that talked about suicidal ideas with depression in Malaysia. At the same time, the collection of study data used past studies such as 15 previous study articles taken between 2016-2022 through searches at Google Scholar, Research Gate, Scopus, Science Direct, Elsevier, SAGE Journal and other authorized and relevant sources related to study titles on the internet to add appropriate knowledge and information to the study. It used keywords such as 'depression and suicidal ideation', 'depression and suicidal ideas' and 'mental health.

Depression Highlights Against Suicidal Ideas
This year is the second year the COVID-19 pandemic has hit the world. The pandemic has left nearly half a million Malaysians with depression and implications for individuals' mental health . The WHO reports depression can cause out-of-control actions such as early killing, and even a WHO report found more than 800,000 individuals who commit suicide each year or about one life per second die from mental illness.
The findings found by  state that depression is hazardous and causes disability that can contribute to aggressive, uncontrollable and more frightening actions that affect suicide. In addition, this study also found that problems with friends and family cause suicidal ideas among Malaysians, mental health, financial crisis, anxiety to face punishment, chronic physical illness, lack of support, and sexual orientation have influenced suicide attempts among teenagers.
During the Covid-19 pandemic, many individuals were affected by changes in their daily routines. In fact, the reactions shown, such as anxiety, anger, fear, worry, stress, sadness, growl, confusion and various other responses, have led to mental health problems which in turn lead to suicidal acts and ideas if all these reactions are not well controlled (Qiu et al., 2020). This is easy to understand given that the spread of the disease is rare on a large scale and brings unthinkable reactions. Sari (2018), in his study of adolescents in the City of Makassar, found that when high levels of depression eat, the tendency to commit suicide also increased. It is also found that having mental health issues such as depression will cause a person to plan to commit suicide repeatedly. This study is also supported by a previous study in which Klonsky, Alexis & Boaz (2016) asserted that suicidal behaviours and ideas are caused by mental disorders that are so severe that they cannot reason.
Some family members do not support their fellow members who have mental health issues such as depression and consider them to be outside the average human norm, which ultimately occurs suicidal tendencies and ideas in them (Shoesmith et al., 2018). Without family support, those with mental health issues such as depression will feel alone and have no chance and support to recover.

Findings and Discussion
Mental health, such as depression, has a prominent role in suicidal ideas and has been proven through past studies found. According to Shaffer et al (2019), a person is inclined to have suicidal thoughts due to at least one delirium and usually has a depressive disorder. It turns out that depression cannot be considered a common mental illness if left untreated.
For the elderly, five factors cause suicidal ideas among them, namely community and cultural factors, social support, belief in religion, economic influence and socio-economic status as well as depression due to changes in their social environment (Novel Lyndon et al., 2020). Seniors usually experience changes in their lives in old age and often feel a burden to those around them between issues that play on their minds and end up causing depression.
A person with depression also sometimes shows or expresses a suicidal desire through their feelings, such as joking, and this should be noted by those of us who hear it, as it is one of the signs of depression or emptiness as a way of getting attention (Hayati & Rini, 2011).
In addition, a study conducted by Kusumayanti, Swesdarma and Nurhenti (2020) found that the vast majority of adolescents suffer from depression which has led to attempted suicide ideas. This is because adolescence is a transitional phase, and it is necessary to adapt from childhood to adulthood and need to adapt to emotions and behaviours. The risk of suicide among students and adolescents is also increasingly troubling when it is found that as early as 13 years of age are confirmed to have suicidal tendencies and ideas (Rashid et al., 2021). This finding makes the notion of suicide not only applicable to adults.
While gays and lesbians are also among the individuals who often threaten to commit suicide due to environmental factors, internal self-conflict pushes them to be moody and eventually have suicidal ideas. This was discovered through a study conducted by (Jamal et al., 2019). This may be due to their sexual orientation, which is not accepted by society as well as conflict in themselves, causing these people to suffer from depression This study also found that more women made suicide attempts more than once than men. This was amplified by gender differences that showed a significant influence between the two age groups pioneered by women concerning suicidal ideas and making suicide plans over 12 months compared to men (Zubrick et al., 2016). A study by Silva et al (2020) on teenage girls aged 10 to 19 found that mental health affects them more because they are always concerned about physical appearance, body image dissatisfaction and exposure to sexual behaviour.
The findings from a study conducted by Khairul et al. (2018) identified that two factors influence suicidal ideas, namely the internal factors of an individual and psychological factors, i.e. cognitive distortion and self-esteem, play an essential role in influencing self-harm behaviour in an individual WHO (2017) states that emotional disorders are mental disorders that correlate with suicidal desire behaviour. Moreover, those who are in unstable emotions cause them to suffer from mental disorders and psychiatric and psychological disorders associated with grief (Norshahira et al., 2021).
Suicides and suicidal ideas are also seen to be increasing due to Covid-19 that has hit Malaysia and the world. This is because protracted emotional instability causes mental illnesses such as depression, anxiety and stress . The main thing to focus on is eliminating stigma and removing underestimating attitudes and negative perceptions of mental health problems such as depression. This is because when a person has depression but is not handled well and left prolonged, it will lead to more chronic emotional disorders that drive them to suicidal tendencies. The study by Salman et al (2022) further reinforces that the effects of depression will go a person to have suicidal ideas and attempts.

Conclusion
Mental health is a fundamental issue after the rest of the world faces the Covid-19 pandemic. Based on the review of depression, it has led a person to attempt and have suicidal ideas. As members of society, parents, and counsellors, the increase in suicides is of great concern to us. It is a shared responsibility that we can be concerned and aware of the initial symptoms that a person with mental health issues has to facilitate the distribution of professional assistance so that the disease can be treated and not to the point of resulting in suicidal ideas and thoughts. To build a loving Malaysian family, the role of all community members in dealing with this issue is vital so that all assistance and services can be used and reach those at risk of mental health problems. The study also suggests that awareness can be increased about the need to seek counselling and professional services to help alleviate the crisis experienced by those with suicidal ideas.