MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
- Helplines
- Understanding self-harm and suicide
- What is self-harm?
- Why would someone self-harm?
- Understanding self-harming behaviours
- How can we stop self-harm?
- What is suicide?
- What contributes to the risk of suicide?
- How can we reduce the risk of suicide?
- What are the warning signs of suicide?
- How can we manage suicidal tendencies?
- Mental health services
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.
Let’s read on to find out what self-harm and suicide are about and how we
can cope.
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:
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
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.
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.
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:
- 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:
Taking a walk
Journaling
Taking a shower
Talking to family or friends
Listening to
songs
or
music
Watching a show
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, this
may shock our loved ones, and they may respond in
unexpected ways. We could try to be understanding
and allow them time to process.
Seeking support from mental health professionals helps as they can provide professional advice such as safety plans and healthy coping methods.
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
What can one do when struggling
with suicidal tendencies?
Always prioritise safety first
Reach out to a trusted family member or friend
Seek professional help
Have a safety plan in place
Have hope things can get better
Go easy with expectations
Develop self-kindness
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.
