Thread by @Rachel_Luby

#LifeOffOfThePsychWard
As mentioned earlier, this a 10 point thread about #SelfHarm and #Suicide.

It comes with a #TriggerWarning.

I will be using my own experience to TRY and educate and encourage reflection, particularly in those who work in #mentalhealth or encounter
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individuals who may self harm.

Those with lived experience may find it unhelpful and may want to not to read it.

So here goes...

1) Self harm can take many forms; and one person can use multiple across their life span. I have engaged in at least 7 different behaviours
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from my teenage years up until now.

2) Just as the method can change so can the function. 15/16 year old me self harmed for punishment - the belief that I had been the reason for my parents separation. I have self harmed in order to feel in control; to release a build up
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of tension and emotion; out of habit, to trigger endorphins, for self nurturing and more recently to quieten intrusive thoughts around suicide - it actually helped me stay safe.

3) Self harm can be addictive: I replaced one addictive behaviour with another.
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4) Self harm can be dangerous to stop without substituting/ replacing the behaviours with something else. In the two weeks prior to my suicide attempt I hadn't self harmed once. (I was due a medical examination and didn't want anyone to question whether I was suitable for
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the procedure). I do not believe things would have escalated quite so badly. (Which makes me concerned about the use of 'self harm contracts' for informal admissions to inpatient wards, or threat of discharge for engaging in self harming behaviours.)

5) The see-saw analogy
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When I engaged in self harm on the ward, the doctor said that pressure would be put on the team to discharge me. I explained the above.
He described how my self harm and suicidal thoughts appeared to be on a see-saw; self harm goes up the risk of suicide goes down and vice
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versa. It was the most accurate way of describing my distress and attempts to cope with it at the time.

6) I distinguish between self harm and harming myself. I don't think this is something that is really considered by others. For example and another #TriggerWarning here
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if I punch a wall (it's not something I make habit of) because I am feeling agitated/angry in order to avoid self harming, I am harming myself. 'We' view things such as reckless driving, alcohol or drug use as self harm; but it's crucial to explore what it means to that
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Individual. For me it is distinct and not overlapping although consequences can be the same.

7) People that self harm are not always suicidal but at higher risk of suicide. The first 10 years of self harm I hadn't contemplated suicide.

8) I never self harmed to make me
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ugly. I include this because I have seen it too often as a 'reason people self harm'. I find that stigmatising and hurtful. I struggle to look in the mirror and am unattractive but that was never my motive.

9a 😉) Self harm HURTS. I'm not any less sensitive to pain than
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The next person. I suffer just as much afterwards.

9b) It is okay to ask about self harm. In fact I WANT you too. Professionals seem to shy away from this question, perhaps because they do not know how to manage the answers. But when you avoid asking, you avoid assessing
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risk, offering alternative strategies andcdiscussing mitigation or ensuring the person knows what to do in an emergency. You reinforce shame/stigma. PLEASE be curious it's okay

10) Medication actually can help. Unfortunately I can't say which as I had 3 major changes in a
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short space of time. Or perhaps it is the combination... Lithium, Lamotrogine, Quetiepine, and Sertraline. My thoughts of suicide are about 20% and of self harm about 40% of the intensity that they were 4 months ago. I believe I am in a safer position to start therapy
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- DBT.
And that gives me hope.
Thank you for reading.
Feel free to ask questions.
💜
*if you are struggling with self harm or suicidal thoughts remember you are loved. You matter. You don't have to suffer in silence.
Images courtesy of @GrassrootsSP
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➡️nhs.uk/mental-health/…
➡️nhs.uk/mental-health/…
For information/resources relating to self harm and #SuicidePrevention.
➡️ stayingsafe.net to create a safety plan - online or by download
➡️samaritans.org/how-we-can-hel…
For tips on supporting someone who has self harmed.

➡️mind.org.uk/information-su…
Tips for those who may be wanting to avoid self harm, and guidance for family.
➡️ mentalhealth.org.uk/publications/t…
For a FREE dowloadable guide that includes further information about self harm and breaks down some myths.
#MentalHealthMatters #mentalhealth

@threadreaderapp please unroll (again 😉)

* I feel unatractive.
My self harm is also a reminder of survival. That my story isn't over yet.
Others have described it as earning their tiger stripes.