If you've already hurt yourself many times - the best thing to do is to come up with a plan of what you're gonna do instead next time when you're calm. So right now maybe you're calm, you need to come up with a plan of what you're going to do next time when you get really, really upset and you feel like there's way too much pain going on and you don't really know what to do. You could plan to go exercise, you could plan to call a friend, you could plan to draw, you can plan to lay there and listen to music and sit on your hands. You can plan anything. But you need to come up with a plan when you're calm. What I would recommend is that you play this sort of game with yourself - this is cognitive behavioral therapy: for every week that you don't hurt yourself, you get a little gift or a prize or whatever encourages you. For every month that you go without hurting yourself, you get something else. The longer you go, the more rewards you get. Also, you have to think of it in your mind as I've been clean for a month, clean for two months, clean for three months from hurting myself so that you don't think to yourself, I'll just do it once and it doesn't really matter. I don't care. Also, if you're already hurting yourself, you do need to go talk to your parents. You need to go talk to an adult. Especially depending on the severity - sometimes it's very easy to cut too deep and need stitches. Also, we're just talking about superficial hurting yourself. If you're suicidal or you're cutting your wrist to die, then you absolutely need to call 9-1-1 or go talk to your parents or go get help from anybody you can find.
Unfortunately it's fairly common to have thoughts of self-harm. Many people don't act on them, which is a good thing, but some do. Generally, the underlying reason for self harm is when you feel so much emotional pain, you're just going to explode and you'll do anything to get rid of it - so you change the pain into physical instead. Physical pain is easier to feel than emotional pain. Typically that's the idea behind cutting or scratching or burning or picking or something like that - the idea is you're trying to turn your emotional pain physical. What you would want to do about it: when you have so much emotional pain and you feel like you're crawling out of your skin, the best thing to do is try to get it out. You can get it out in multiple ways: you can talk to a friend about it. You can scream into your pillow. You can go to a boxing class - that really helps with anger. You can create something with art. Whether that means that you write a whole bunch of journal pages or you paint a picture that you're trying to get intentionally, like how can I get this feeling that's in me portrayed on paper? How do I get it out of me? If you're not the type of person who wants to create anything, go looking at what other people have created. Look for music where the lyrics describe how you're feeling. Look for music that matches your feeling - sometimes if you feel super amped up and you find amped up music, it makes you feel relaxed. Go looking for things that can help you get rid of the feeling inside your head. Another thing that you'd want to look at is if you do have a constant urge to cut - so you cut your wrists - not for suicide, but just across - you can put a hairband there and you can snap your hair band. That's not my favorite go-to, but it can help if you do really have the urge of I need to do something that physically hurts.
Suicide is one of the most feared complications of depression and it unfortunately is more common in people who struggle with depression than in the general population. Some estimates say it may be up to 27 times more common in people with depression as opposed to the general population. While there is no way for any mental health professional to know whether any given individual will commit suicide, there are certain risk factors that can increase or decrease the likelihood and that a mental health professional will look at in trying to help stratify the risk of an individual towards suicide. Some of the risk factors that we think about are prior attempts of suicide being a high risk factor, male gender, hopelessness, and access to firearms can all increase (among other things) the risk of a person's likelihood of committing suicide. Ways to decrease the risk would include obviously treating the depression, removing access to dangerous items like firearms or pills in the appropriate situation. Frequent mental health follow up with a professional and trying to mobilize as much support as possible in the person's life.
Suicide is a devastating and tragic event. There's been more emphasis on awareness about suicide in our current society and culture - which is very important. Some warning signs of suicide include: if you notice that someone is isolating (so spending more time alone, not wanting to do things with friends and family) - that's a very concerning sign. If they're talking about death, wanting to die, wanting to kill themselves or hurt themselves - these are also warning signs for suicide that needed to be taken very seriously. If people start giving away their possessions or you notice that they suddenly have no interest in things that they used to have interest in, this can also be a warning sign for suicide. People experiencing extreme emotional reactions and feeling out of control those emotions and using substances to try to feel more in control of their emotions also are at higher risk for suicide. All of these are signs for suicide but the most important thing is being able to directly ask someone: Do you feel like hurting yourself? Do you feel like killing yourself? It's a myth that asking people about suicide makes them more likely to commit suicide.
Thinking about suicide and death is actually much more common than you may think. Acting on it - luckily is not as common. What you want to do is if you have thoughts of suicide: you want to talk about them. You want to talk to a friend, a family member - anybody you can find to be honest, just get it out of you. Because when you have thoughts inside your head and you express them out loud (you can even write them down), they're much less likely to be acted on. So the same is true with - it comes up a lot because of celebrities who have committed suicide lately or some of you may know people personally who have committed suicide, you maybe the parent of a child who has said that they're suicidal - what's very, very important to know is common instinct says: don't ask those people because you don't want to put the idea in their head. That's false. One hundred percent false. You will not put the idea in their head. That's not possible. You need to ask them so that if they are thinking about suicide, they'll talk to you. The more you talk about something like that, the less likely you are to act on it. So I urge you: ask anybody you know who you're worried if they're potentially thinking about suicide.
If someone you know is contemplating suicide or you suspect that they may be wanting to commit suicide, it's very important that you talk to them. It's a myth that talking to people about suicide makes them more likely to commit suicide. You talking about it is only going to help them get treatment and get the help that they need. So how do you go about doing that? Because that feels very overwhelming and stressful and it may feel like you don't want to make the other person feel uncomfortable. Ways to bring it up: the best way would be to just directly ask the person: I'm concerned about you. Are you thinking about hurting yourself or killing yourself? Showing empathy, showing that you care about the person is very important. If you are watching this and you are contemplating suicide, call a suicide hotline immediately. They can get you the help you need. If you are concerned about someone you love or someone you know committing suicide, take them to the nearest emergency room and there they will get the help they need as well.
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