Deliberate self-harm: Is it serious?


Yes, yes, yes.


The group most likely to successfully commit suicide in the next year or two are those who have survived a previous attempt at suicide, no matter how half hearted the attempt may have seemed at the time.


For a human being to harm himself or herself, such as sticking pins into oneself, burning oneself, or cutting oneself, there must be a sense of great emotional distress and turmoil.  We have been strongly programmed by thousands of generations to intensely protect the integrity of our bodies, and something is obviously very wrong for us to do otherwise.


In a minority of people with depressive illness, picking at their skin repeatedly is a well-known phenomenon.  Skin specialists see many people who indulge in this form of behaviour, indicating internal distress.  The mechanism is probably similar to trapped animals and hens who damage themselves.


Teenagers and young adults who are inflicting self-harm are indicating severe levels of internal personal distress.  Sometimes, the person themselves is not even clear what it is that is distressing them, or why they are behaving in this way.  Some very disturbed people are able to state that inflicting physical pain on themselves temporarily blocks out the mental and emotional pain they are experiencing.


Forms of self harm which indicate they were an attempt to end one’s life are even more serious, regardless of the physical damage that may or may not have resulted from the attempt.  What matters is the degree of determination with which the person involved went about the attempt to end their lives.   Indications of any planning that went into the attempt are very serious, as it shows the attempt had been considered for some time, and was not just a spur of the moment decision.


It is particularly serious when an individual has carried out some self destructive behaviour, such as taking an overdose, which they believed would be fatal, and has avoided contacting anybody afterwards (by telephone or in person) and has avoided seeking help.  If that person had more knowledge of what is fatal, presumably he or she would in fact have died.


suicide note implies that the person involved did not expect to be alive to verbally say the things they had written in the note.


Do not be misled by the fact that the person did not use the most fatal option available.  In many cases, suicide attempts are the outcome of a battle between the depressive illness, which wants the person to die, and the healthy mind, which wants the person to live.  The resultant action is therefore not one hundred per cent determined in most cases.  Furthermore, many people do not accurately know whether or not what they are doing to themselves is in fact going to be fatal, but they are seeking immediate escape from the way they feel, or the situation in which they find themselves.  In effect, many people are forced to play Russian roulette, as to whether or not the state of oblivion they seek is going to be temporary or permanent.  


There is very good research evidence that people who see a counsellor or mental health professional after an episode of self-harm have a better outcome than people who have no medical intervention, or only a single visit to a doctor who is not a mental health professional.


In far too many cases around the world, the diagnosis of depressive illness is missed, even when deliberate self-harm has occurred, although of course not every person who has harmed himself or herself is actually suffering from depressive illness at the time.



Important Disclaimer:  This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.

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