Saturday, 28 December 2013

12 Days of Mental Health : Day 3 - Self Harm

Please note that some readers may find this post triggering - remember to take care of yourself first and foremost. Please call 999 if you are in immediate danger, 101 if you have a non-emergency but still require healthcare advice, call your local Mental Health Crisis Team or the Samaritans on 08457 90 90 90. 

You will find additional help and support at the bottom of the post. 

Where has Christmas gone? It's amazing how quickly the festive period passes by, and I'm certainly feeling it today. Thanks to my body clock deciding it wants to act up again, I woke up before 5am and couldn't nod off, despite a five hour trek in the sales yesterday and then going to bed at 12.30am. At least it meant I could get lots done and get today's blog post done a little earlier than usual.

Today's personal story comes from Jen and her experiences of living with self-harm. First up, here's some information.

What is self-harm?

Self-harm describes when someone intentionally hurts, damages, or injures themselves as a coping mechanism, whether it be to express distress, relieve insufferable tension,or to communicate when no other words seem quite right. It's extremely difficult to narrow down what self-harm is in just one blog post, as the causes behind self-harming are very different for each individual. Not only can self-harm take a physical form, but it could also involve individuals generally not taking care of themselves or taking unnecessary risks, for example.

It's important to remember that self-harm doesn't necessarily equal suicidal, nor should it be take for "attention seeking." I found this very important point on Mind's website on self-harm - "The size of the wound isn't a measure of the size of the conflict inside."

What are the types/"symptoms" of self-harm?

This is not an exhaustive list, but self-harming may involve:

  • Cutting and/or burning the skin
  • Small overdoses and/or poisoning
  • Using objects to hit against or swallowing or putting objects in themselves
  • Hair pulling (trichotillomania) or skin-picking excessively (dermotillomania)
  • Substance misuse/addiction
  • Deliberately under or over eating  
  • Taking unnecessary risks (for example, staying in an abusive relationship)
  • Less "obvious" forms include smoking, drinking too much, working excessively or anything else that means an individual is not taking care of themselves and to avoid addressing the problem at hand. 

Those who self-harm tend to try and conceal it due to the stigma associated with it, and for fear of being "found out." They may wear long sleeves despite how hot the weather is, or they may use heavy makeup to cover up bald patches or cuts/bruises. They may also show signs of depression, such as being tearful and have poor self-esteem. 

Many use self-harm as a way to regain some control in their lives at one point, and so, they do not want this coping mechanism taken away. If you feel that someone you know is self-harming, remember to be sensitive and understanding. Remain sympathetic and be patient. Don't judge, just listen. Do not react in anger.

What's the treatment?

As previously mentioned, this varies greatly depending on the individuals circumstances. As usual, always see a GP for further information and always call 999 in an emergency.

The most important thing to remember though is to not judge and lend a listening ear whenever needed. Offer to support them if they choose to seek professional help.

Self-harm usually indicates a personal struggle for someone, for example bullying, substance misuse, mental health disorders, or bereavement. Many find working on this underlying cause helps them in their recovery towards not self-harming. 

There are some fantastic tips online as to how to manage self-harm urges. Here are some I've picked out: 
  • Tangle toys. I have one of these and love it! My husband has one too that he keeps at work and plays with whilst he's in meetings. You can get them cheaply from Amazon in a whole range of colours and textures. Mine is the same as this one. They only cost about £3 or so. 

  • Get creative. Lots of people find that writing, drawing, scribbling, painting or anything that involves using your creative skills and your imagination will help provide you with a distraction. 
  • Ground yourself. Use techniques such as the STOPP method, and Mindfulness, to ground yourself, aiming to rid yourself of tension and anger. Google "grounding techniques" for lots of ideas. Try calling someone to distract your mind, or eating something with a very intense flavour or temperature (try a really sour sweet or an ice cube).
  • Snap rubber bands against your skin when you feel the urge to self-harm. It gives the same "effect" without the lasting consequences. You could also try drawing where you'd normally self-harm in a red pen. 

Jen's Story

Trigger warning: If you are currently struggling with self harm, please make sure you are safe before reading. 
"So, apparently if you get the urge to self harm you should try not to act on it for 15 minutes. This can be enough time to let the urge subside, and may mean that you can avoid hurting yourself. I thought I’d try to spend 15 minutes writing, and see what happens. And since self harm is the reason I’m writing, it seems like as good a time as any to talk about it. 
I am now 27 years old, and I have tried to stop self harming quite a few times. I actually managed to stop cutting for about two years (although I do admit to a couple of slip ups). But the urges never seem to go away completely, and recently things have become more difficult again. 
I don’t know when I started self harming. I can’t remember. As a child, overwhelming feelings very often led to me hurting myself in some small way. It made me feel more in control. When I was a teen, this escalated as I became more depressed, and by the time I was 18 I was cutting frequently.  
It’s important to realise that we all have ways of coping. Some are healthy, some aren’t. People turn to drugs (both legal and illegal), alcohol, violence, restricting or purging food, and also to self harm 
Everybody’s experience of self harm is different. People cut, hit or burn themselves. Some people take smaller overdoses (something which can be really dangerous, and definitely not to be recommended).  
When I deliberately cut myself, it’s a release. I am still working on stopping, on developing less destructive coping mechanisms and using them. 
I feel that it’s important to say that although I get the urge to, I no longer self harm every day. Or even every week, or month, actually. Over the years, I have become more aware of my thoughts and feelings, and things that work for me. I don’t tell myself that I will never self harm again, I just say that I won’t do it right now. But using this kind of thinking I can sometimes put off hurting myself indefinitely. And every time I want to self harm, and don’t, I feel a huge sense of achievement, which makes me feel stronger and more able to put it off for even longer. 
There is a huge amount of stigma surrounding self harm. I’ve lost track of the number of jokes I’ve had to grit my teeth through, and the strong opinions that people have expressed without having any consideration for who may be around to hear it. It’s seen as attention seeking (even though most people who self harm, myself included, work hard to keep it hidden). Even some doctors and nurses fail to act appropriately when faced with someone who self harms. I know for a fact that my current psychiatrist struggles to work with me because of my self harm. I’m hugely lucky that my partner is supportive and that I have an understanding therapist. 
Stigma is the main reason I’m allowing this to be published. Because it’s important that people know they’re not alone, that they’re not the only ones who are struggling. No matter who you are, how old you are, or how much physical damage you’re doing to yourself, it is so so so important to ask for help – whether it’s a friend, family member or a doctor or counsellor. If you come up against a negative reaction, ask someone else. And keep asking ‘til you get the help you deserve.  
Well, that’s been longer than 15 minutes, and you know what? I feel a bit better. "
You can read Jen's blog by visiting her website - jendotwilson or follow her on Twitter by clicking here.
Further Information