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Understanding self-harm and suicide

As a youth or young adult, the changes in our lives as we explore various study pathways, search for job opportunities, step into the workforce, or form new relationships can cause mixed feelings. These experiences can make us feel large amounts of stress, self-doubt, uncertainty and fear.

To cope with these unsettling experiences, some of us may talk to friends and family. Others, on the other hand, may take it out on themselves and their bodies to express the thoughts and feelings not said aloud.

Learn about youth self-harm, youth suicide, suicide hotlines available to youths, youth suicide warning signs and more

What is self-harm?

Self-harm means causing harm or injury to one’s body on purpose, usually as a way to cope with difficult or distressing thoughts and feelings. Some examples of self-harm behaviours are:

Scratching or cutting one’s skin

Burning the skin

Swallowing sharp objects

Consuming toxic substances (e.g. bleach or detergent)

Starving themselves or purging

Hitting parts of the body on hard surfaces or objects

Pulling hair out

Binge drinking

Having casual sex

Consuming drugs in a manner or dosage higher or lower than prescribed

Understand why youths and young adults self-harm, ways the youth and young adults can stop self-harm, cope with suicide thoughts and more

Why do people self-harm?

Some people may harm themselves to cope with intense emotions and distressing situations. Here are reasons why they may harm themselves:

To distract oneself from difficult situations, experiences, or emotions

To seek a sense of belonging

A self-punishment due to feelings of guilt or shame from past traumatic experiences

An attempt to regain some sense of control in their lives (e.g. being able to decide when, where and how to hurt oneself)

To experience a temporary sense of relief

A means of self-validation (e.g. to show strength and toughness in managing the pain associated with self-harm)

There are several stressors that can make someone more vulnerable to hurting themselves. Be mindful of the person’s behaviour if they are facing any of these stressors:

School or workplace pressures (e.g. heavy workload or bullying)

Relationship problems (e.g. with family, friends, or romantic partners)

Confusion and insecurity about self (e.g. one’s identity and role)

Transitional changes (e.g. changing schools or stepping out into the workforce)

Financial difficulties (e.g. inability to find a job, debt, or retrenchment)

Bereavement and grief (e.g. losing a loved one to death, divorce or breakup)

Mental health conditions
(e.g. depression and anxiety)

Social isolation

Alcohol or drug use

Why do people self-harm?

When left unchecked, constant self-harming can become a habit due to the sense of relief it may bring. However, this sense of relief is only temporary. It does not address the issues that make someone self-harm.

It is important to remember that self-harm is dangerous – a cut too deep or a drug overdose could put a person’s life at risk.

Why do people self-harm?

Understanding self-harming behaviour

Understanding what causes self-harm thoughts is the first step in coping better and stopping self-harm behaviours. Let’s be mindful not to associate self-harm with comfort and control, as this could make quitting harder.

One way we can try to stop self-harm is to list the reasons for and against it. This helps us clarify our intentions and its consequences, allowing us to make well-informed decisions on why we should reduce (or even stop) self-harming.

Some reasons to discourage self-harming behaviour:

“It might cause more physical and mental harm to me in the long run.”

“I might end up hurting myself more than I intended.”

“The scars and injuries to my body can be permanent.”

“It doesn’t help to solve the problems I have.

“I have to constantly hide my injuries from others.”

“I will feel worse after hurting myself.”

From providing comfort to control, these reasons for self-harm initially appear convincing. However, seeing and rationalising the reasons against self-harm can help us realise that it may not be the best to cope, and that relief can be derived from other activities. For example:

While self-harm may provide temporary comfort, it does not solve my issues.

Going for a run can also give me the control and comfort I desire.

How can one stop self-harming behaviour?

Self-harming behaviour is a response to one’s feelings and thoughts. While the first step to keep one from hurting themselves is to identify and understand what leads to thoughts of self-harm, there are also other measures they may consider to protect themselves.

Throw away objects that can cause self-harm or ask a trusted friend or family member to help store them away. If these are daily household items, they can help to lock these items away.

Stay safe from the objects used for self-harm
Triggers are what gives one the urge to hurt themselves like:

Triggers are what gives one the urge to hurt themselves like:

  • People
  • Situations
  • Occasions (e.g. anniversaries)
  • Specific thoughts or feelings (e.g. being bullied)
Urges include physical sensations like:

Urges include physical sensations like:

  • Racing heart, shallow breaths
  • Strong emotions (e.g. sadness, despair, anger)
  • Repetitive thoughts about harming oneself to feel better
  • Feelings of disconnectedness or numbness

Noting down what had happened before someone self-harms can help them recognise their triggers and urges. This can help them manage these urges when they occur again.

For someone facing difficulties in identifying their emotions, they can use the feelings tracker to explore how they are feeling and understand it better by using the emotions explorer.

One can distract themselves with other activities to manage distressing emotions or thoughts in the moment.

Some activities to consider include:

Expressing intense emotions frequently

Taking a walk

Having trouble calming themselves down

Journaling

Having trouble identifying their emotions

Taking a shower

Having trouble controlling their attention

Talking to family or friends

Being impulsive

Listening to songs or music

Being impulsive

Watching a show

Being impulsive

Eating some favourite food

Here are some coping techniques we can try to help us feel more positive:

Exercise regularly
Exercise not only improves our health but releases endorphins (‘feel good’ hormones) that can elevate our mood. Check out these exercise ideas to stay active.

Mindfulness
Pay attention to the present moment, to our thoughts and feelings without any judgement.
Note: While some people benefit from mindfulness practices, some may experience adverse effects such as increased anxiety or dissociation, especially when practised in an unsupervised manner. It is important to practise mindfulness under the supervision and guidance of trained personnel, especially for children, teens and youths.
Learn relaxation exercises and guided imagery
Pick up deep breathing exercises as a method of relaxation. Follow the audio exercises or the steps below:

Place one hand on your upper chest and the other just above your belly button

Take a deep breath slowly through your nose for 5 counts, feel your stomach rise

Breathe out slowly for 5 counts, breathe out fully

Repeat until you feel relaxed

Practise progressive muscle relaxation where a group of muscles is tensed as we breathe in and relaxed as we breathe out. Follow the audio exercise or follow the steps below:

Sit comfortably on a chair

Scrunch up your face for 5 seconds, then relax it

Raise your shoulders up to touch your ears for 5 seconds, then relax them

Clench your fists and tighten your arms for 5 seconds, then relax them

Take a deep breath and suck your stomach in for 5 seconds, then relax

Raise your legs and curl your toes for 5 seconds, then relax them

Breathe in slowly through your nose and breathe out slowly

Other exercises:

It is understandable to want to hide our actions or injuries to avoid confrontation or rejection, and to fear that others would not understand why we self-harm.

But confiding in others can be a huge relief as they could be a source of support and help us through our difficulties.

We could speak to them about the reasons and emotions behind our self-harming behaviours.

Sometimes, these may shock our loved ones, and they may respond in unexpected ways. We could try to be understanding and allow them time to process.

Reach out to a trusted family member or friend

Seeking support from mental health professionals helps as they can provide professional advice such as safety plans and healthy coping methods.

Reach out to a healthcare professional
How can one stop self-harming behaviour?

Let’s learn more about suicide, an extreme form of self-harm

Let’s learn more about suicide, an extreme form of self-harm

Suicide is the intentional act of ending one’s life. While people who self-harm usually do not intend to end their lives, constant self-harm can increase the risk of developing suicidal tendencies.

Before the act of suicide, suicidal thoughts and behaviours may occur. These include having thoughts of ending one’s life, planning suicide, and enacting the plan. However, some suicidal behaviours may occur suddenly and impulsively.

But help is available and suicides can be prevented.

What increases the risk of suicide?

Suicide is complex and usually results from multiple factors such as:

Family history of suicide or previous suicide attempts

History of trauma or abuse

Existing mental
health conditions

Dealing with multiple stressors over a prolonged period (e.g. relationship problems, unrealistic pressure, financial worries, school/work difficulties)

Social isolation or rejection

Unrealistic expectations from ourselves or others

Facing legal or criminal charges

While these factors do not necessarily cause one to attempt suicide, they increase the risk of suicidal tendencies — especially when they are combined. It is important for us to understand and notice these behaviours to reduce the risk of suicidal behaviour.

What reduces the risk of suicide?

Strong and supportive relationships with family, friends, colleagues and mentors

Life skills such as problem-solving skills, coping skills, ability to adapt to change

Beliefs that discourage suicide (e.g. cultural or religious)

Healthy self-esteem

Sense of purpose, hope and meaning in life

Limited access to lethal means

Warning signs of suicide

There are warning signs to suicide. Here are some examples of the thoughts and actions of someone considering suicide:

What can one do when struggling with suicidal tendencies?

Always prioritise safety first

Always prioritise safety first

Reach out to a trusted family member or friend

Reach out to a trusted family member or friend

Seek professional help

Seek professional help

Have a safety plan in place

Have a safety plan in place

Have hope things can get better

Have hope things can get better

Go easy with expectations

Go easy with expectations

Develop self-kindness

Develop self-kindness

Practise gratitude

Practise gratitude

Let us remind ourselves to appreciate every moment, and learn to accept the fact that life is short and we need to make the most out of it.

Overcoming our struggles will take determination, persistence and time. It can be made easier with the help of the people we love and trust.

When overwhelmed with emotions, know that there are always people around us who can help us as long as we reach out.

What can one do when struggling with suicidal tendencies?

Mental health services

Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, you may find the help you need via Belle.

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You may also visit here for more mental health resources or download the list of community mental health services including your nearest GP here.


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