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AUDIE CORNISH, HOST:

The suicide of a young Egyptian activist two months ago set off alarm bells among Cairo's activists. The young woman had fought for democracy only to see four years of protests culminate in yet another military-aligned government that jails dissenters. Activists and mental health professionals are urging others not to follow her example.

NPR's Leila Fadel reports from Cairo.

LEILA FADEL, BYLINE: In mid-November, Zainab El Mahdi, just 23, hanged herself in her home. The young woman's death sent shockwaves through the activist community and people mourned her on social media. They quoted her as saying, there is no justice - we're lying to ourselves just to live.

A musician mourning Mahdi's death put his pain into this haunting melody.

(SOUNDBITE OF SONG, "REQUIEM FOR ZAINAB MAHDI")

AHMAD AMAR: (Playing piano).

L. FADEL: Many activists saw shades of themselves in her struggle. They were jubilant at ousting a dictator in 2011, but now find repression and economic stagnation as bad as any time in their lives, if not worse. Mohamed Kuhsess (ph) was Mahdi's friend and fellow activist.

MOHAMED KUHSESS: (Through interpreter). She found out that instead of democracy taking a step forward, it was going backward.

L. FADEL: Mahdi's path in many ways represented the fear and uncertainty of Egypt's recent years. She was a revolutionary who marched in Tahrir Square in 2011. She was a member of the now banned Muslim Brotherhood, but split with them after the uprising because she didn't think they upheld revolutionary ideals. She campaigned for justice and freedom of expression and she worked to bring attention to the thousands of people who've been jailed in Egypt for voicing dissent. But nothing changed, and at some point she gave up.

Again, Kuhsess.

KUHSESS: (Through interpreter). The dream of the revolution was not achieved and youth are frustrated, and that takes different shapes. Ending your life is one of the hardest, most severe ways to express that frustration.

L. FADEL: Mahdi made her fatal decision in a society where suicide is so taboo that one speaks about it and families hide the cause of death. Other public suicides followed hers. A 48-year-old driver hanged himself from a billboard in Cairo over economic woes and family problems, a relative said. Another man later hanged himself from the side of his apartment building. And those are just the most public examples. More often, Egyptians take their lives in anonymity, in a country where social stigma prevents frank public discussion of mental illness.

Sally Toma is a psychiatrist who treats trauma. She is also an activist.

SALLY TOMA: It's a vicious cycle of trauma, violence, anxiety and depression, you know, and no one is getting help. And some just leave the vicious cycle by suicide. They just exit. That's the idea, it's like pressing an exit button out of this.

L. FADEL: Anecdotally, Toma says suicide appears to be on the rise in Egypt based on her own cases. She's identified at least 10 suicides in the last two months and many other attempts. But the country doesn't even document suicide cases and there is little access to mental health care. It's clear though that Egyptians are suffering as their government lurched from Islamist to now a former Army officer and strongman.

TOMA: They've been promised every day things are going to get better. They're not getting better. We got an Islamist, he didn't make it better. Now we've got a military man and it's not getting better, so there are reasons. Every time they want to hope, you know, hope is taken away.

L. FADEL: Khalil Fadel is a psychiatrist in Cairo and he says the public displays of hopelessness are a cry for help.

K. FADEL: When you are hanged from a billboard, you are telling people that you are screwed up by the society and by the government, and you're fed up. You are telling them by your body, by your hanged body.

L. FADEL: After Zainab El Mahdi's startling death, a prominent activist organization, the April 6 Movement, pleaded with others not to commit suicide. Despite the hopelessness, it said, you must not forget that your life is the most precious.

Leila Fadel, NPR News, Cairo. Transcript provided by NPR, Copyright NPR.

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