SUICIDE AND SELF HARM

What is Suicidal Behavior?

The umbrella term suicidal behavior can be defined as the preoccupation or act that is focused on causing one's own death voluntarily. Suicidal behavior can encompass a combination of three different aspects. Suicidal ideation occurs when someone experiences thoughts of suicide or wanting to take their own own life. Actual suicidal behavior occurs when someone who is either considering suicide or preparing for it does harmful actions to themselves. A suicide attempt or gesture occurs when someone does an act that is focused on causing their own death but is unsuccessful in doing so.

What Causes Suicidal Behavior in Teens?

Teenagers are under a lot of stress from development as major changes occur with their bodies, thoughts, and feelings that leave them in a vulnerable place where suicide can seem like a viable option. Influences on a teenager's problem solving and decision making abilities (such as strong feelings of stress, confusion, fear, uncertainty, or the pressure to succeed) can drive them to suicide as well. Sometimes normal developmental changes compounded with other events can make suicide seem like a solution or the only solution. This can happen when a teenager is facing changes in their family, changes in their friendships, difficulties in school, or grief and other losses. The chemical imbalances that cause mental illnesses can also lead teenagers to suicide.

What Are the Risk Factors of Suicide?

There are a lot of risk factors for suicide, and they usually occur in conjunction with each other. Some of the risk factors of suicide are:

having one or more diagnosable mental or substance abuse disorders
impulsive behaviors
undesirable life events or recent losses
- death, divorce, etc
family history of mental or substance abuse disorders
family history of suicide
family violence
- physical, sexual, verbal, or emotional abuse
prior suicide attempt
firearm in the home
incarceration
exposure to suicidal behavior of others
- family, peers, the news, fiction stories

What Are the Warning Signs of Suicide?

The warning signs of suicide can display themselves in a variety of ways ranging from more obvious to more subtle. The warning signs can appear differently on each person struggling with suicidal feelings, thoughts, or behaviors. The warnings signs of suicide are:

changes in eating and sleep habits
loss of interest in usual activities
withdrawal from friends and family members
acting out behaviors and running away
alcohol and drug use
neglect of personal appearance
unnecessary risk taking
preoccupation with death and dying
increased physical complaints typically associated with emotional stress
- stomachaches, headaches, fatigue
loss of interest in school or schoolwork
loss of pleasure or interest in social activites
feelings of nervousness, agitation, or irritability
feelings of boredom
feelings of wanting to die
lack of response to praise
indication of plans or effort toward plants to commit suicide
- verbalizing "I want to kill myself" or "I'm going to commit suicide"
- giving verbal hints such as "I won't be a problem much longer," or "If anything happens to me, I want you to know . . ."
- becoming suddenly cheerful after a period of depression
- expressing bizarre thoughts
- writing one or more suicide notes

It is imperative to note that any statements of suicidal feelings, thoughts, behaviors, or plans should be taken VERY SERIOUSLY.

If someone close to you displays any of these warning signs, immediately refer to a trusted adult or mental health professional.

How are Suicidal Feelings and Behaviors Treated?

Many factors such as age, health, medical history, extent of symptoms, seriousness of any attempt, tolerance for specific medications or therapies, and expectations regarding any future suicide risks are taken into consideration by doctors when treating suicidal feelings and behaviors. Treatment will initially begin with a physical evaluation of the patient followed by a psychiatric evaluation. After that, individual and/or family therapy may be needed. Sometimes extended hospitalization can occur if the patient needs a more supervised and safe environment to recover.

How Can Suicide Be Prevented?

The recognition and intervention of mental and substance abuse disorders is key to preventing suicide further down the road as it gives a person the proper support and treatment needed to become a well adjusted individual. There are also specific steps that parents/guardians can take to prevent suicide too. Parents can keep medications and firearms away from their children, get their children professional help, support their child (listening, avoiding criticism, remaining connected), and be informed. Teenagers can take specific steps to help prevent suicide amongst their friends too. Teenagers should take a friend's suicidal behaviors or discussions seriously. They should encourage their friend to seek professional help and accompany them if needed. They should also talk to a trusted adult and keep in mind that it is not their sole responsibility to help their friend.

What is Self-Harm?

Self-harm or self-injury, specifically called a non-suicidal self-injury (NSSI), is when someone hurts themselves on purpose. When someone self-harms the intent is not to die. Actually, it can be thought of as the opposite. People often self-harm to reduce, manage, or escape from intense emotions.

Why Do People Self-Harm?

There are a number of reasons why someone may decide to self-harm. Some of the reasons why a person may turn to self-harm are to:

cope with stress
control upsetting feelings
disassociate from their problems
- to distract themselves from emotional pain with physical pain
reduce anxiety and tension
reduce sadness and loneliness
alleviate angry feelings
punish oneself due to self-hatred
get help or show distress to others
escape feelings of numbness
- to feel something

What Are the Symptoms of Self-Harm?

Not everyone self-harms the same way. Some of the symptoms of self-harm are:

burning oneself
hitting oneself
scratching or picking scabs to prevent wounds from healing
overdosing on medications
pulling one's hair (eyelashes, eyebrows, etc) with intent to harm
inserting objects into one's body

What Are the Risk Factors for Self-Harm?

Several things can put someone at risk for self-harm. Self-harm usually begins during early adolescence but it can happen at any time. Things like past or present abuse or neglect and bullying can increase someone's chances of turning to self-harm. Losses (such as death, break-ups, etc) and the inability or difficulty to cope can drive a person to self-harm as well. People with high self criticism or addictive behaviors and substance abuse are more likely to self harm. Being surrounded by peers and family members who self-harm can increase the chances that a person will self harm. People who have a mental illness (depression, anxiety, etc) or a history of self-harm are more likely to self-harm too.

How Do You Know If Someone You Love Self-Harms?

It can be difficult to tell if someone is self-harming because they usually try their best to hide it. Here are some things that you should be looking out for:

cuts or scars on the arms, legs, and/or stomach
wearing long sleeves or covering legs in situations where it doesn't make sense (like on a hot day)
finding razors and other sharp objects in their possession
unexplained or poor excuses for injuries
emotional warnings
- difficulty handling emotions
- problems with relationships

What Is the Difference Between Suicide and Self-Harm (NSSI)?

There can be some misconceptions about the relationship between suicide and self-harm. Self-harm is not a failed suicide attempt, it is not an attempt to die. In fact, people can be self-harming as a way to prevent themselves from suicide. Self-harm behaviors can be similar to suicide, but the difference is in the motivation. People self-harm as a way to feel better because they think it will help them, not as a way to end their lives.

What Can You Do If Someone in Your Life Self-Harms?

If you know someone in your life who self-harms, encourage them to seek help. Express concern to them, but try not to seem overly dramatic as it may make them feel uncomfortable. It is important to know that self-harm can become addicting, so be aware that their behavior will not change instantly. Remind your friend to try and avoid certain emotions of behaviors that drove them to self-harm too.

How Is Self-Harm Treated?

Self-harm can be treated in a number of ways. Psychotherapy (talk therapy), specifically dialectical behavior therapy and cognitive behavior therapy, can be used to treat self-harm. Dialectical behavior therapy teaches about the philosophy of balancing, acceptance, and change. Cognitive behavior therapy teaches people how to understand, problem solve, and change the relationship between thoughts, emotions, and behaviors. Medication can be used to treat symptoms for things like depression and anxiety which may be underlying reasons for self-harm. Having school supports or a regulated routine to help with mental health are effective ways to treat self-harm too.