Depression is the leading cause of mental and physical disability worldwide. Around 300 million people are currently living with depression, an increase of more than 18% between 2005 and 2015. [1] Major Depressive Disorder (MDD) represents the classic condition in the group of depressive disorders, involving episodes of clear cut changes in affect, cognition and neurovegetative conditions and interepisode remission, occurring most of the day, every day for at least 2 weeks’ duration [2], affecting a person’s ability to function at work and at home. One of the symptoms of MDD is suicidal ideation. Many people die because of suicide every year and the number are large in teens and college students, risk factors for which include depression and other mental disorders and substance use. Most common technique used is the use of fire-arms in both sexes, males however are more successful.

Depression is the leading cause of mental and physical disability worldwide. Around 300 million people are currently living with depression, an increase of more than 18% between 2005 and 2015. [1] Major Depressive Disorder (MDD) represents the classic condition in the group of depressive disorders, involving episodes of clear cut changes in affect, cognition and neurovegetative conditions and interepisode remission, occurring most of the day, every day for at least 2 weeks’ duration [2], affecting a person’s ability to function at work and at home. One of the symptoms of MDD is suicidal ideation. Many people die because of suicide every year and the number are large in teens and college students, risk factors for which include depression and other mental disorders and substance use. Most common technique used is the use of fire-arms in both sexes, males however are more successful.

Pakistan's exact suicide rate is not known as many cases are not reported and remain undisclosed by the families. Recently, 5 suicide cases have been reported in Pakistan from Oct 2018 to Feb 2019. All of them were undergraduate students. A final year engineering student in Faisalabad committed suicide after a teacher repeatedly failed him in a course. A young female fine arts student committed suicide by jumping from the building of a private university in Lahore. A medical student of Bolan University of Medical & Health Sciences, Quetta, committed suicide reportedly due to mental stress and depression after he failed his exams. A third-year medical student shot himself in his hostel room at the Liaquat University of Medical and Health Sciences (LUMHS) in Sindhs’ Jamshoro district. A final year medical student of the Khyber Medical College allegedly committed suicide due to unknown reasons.

Lack of awareness, perception that only a person with psychotic features needs a psychiatrist, strict parenting, stressful college environment, fear of being mocked and lack of adherence to the treatment in those who’ve been recognized are some of the common reasons that this devastating disorder is still increasing the death toll due to suicide in this part of the world.

Weekly visits of a psychiatrist along with a psychologist, and a counselor should be appointed in all the institutes to prevent such incidents. A regular drug screen to look for substance use should be made mandatory. A lecture series on mental health should be introduced in which participation of teachers, students and parents should be made compulsory.

Pakistan is known to be a country with massive family support. Someone suffering from depression somehow manages to fake a normal living. Effective treatment is available through behavioral therapies and antidepressant medications, or a combination of both. These treatment options are available here, however the real obstacles are lack of insight, lack of awareness and consideration of these topics as taboo.

We declare no competing interest.