Depression: Management and Treatment Options

 
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What help is there for me?

If you’re struggling with depression, there are options out there for you to get through this. Below we take a closer look.

 

There are many different management and treatment options for depression. Try to remember that overcoming depression will take time, and you’ll need to stay strong through some of the tougher days. Still, overcoming depression is possible!

Check out the Depression: Causes, Symptoms and Types article for more information about depression.

Management and treatment options

Types of depression that are linked to biological factors (melancholic depression and psychotic melancholia) are more likely to need medical treatments like antidepressants, and are less likely to be resolved with counseling alone. Non-melancholic depression may be treated equally effectively with medical treatments or with psychological treatment.

Psychological treatment

Psychological treatment provides either an alternative to medication or works alongside medication, and is usually provided by a mental health professional, like a psychiatrist, psychologist or counselor.

Psychiatrists are physicians who are also trained as mental health professionals. Psychiatrists have special training in mental illnesses, including depression, schizophrenia and suicidal behavior. Psychiatrists are the only mental health professionals who can prescribe medications.

Clinical psychologists, counseling psychologists, and professional counselors are also trained to be able to help people with depression.

In some cases, psychiatrists, psychologists and counselors work together to help someone who is depressed. The psychiatrist manages the medical part of treatment, with the other mental health professional (psychologist or counselor) providing the psychological treatment.

There are a number of psychological treatments or therapies used for depression, including cognitive therapy and cognitive behavior therapy. As always, talk to your doctor or therapist about the best approach for you.

Medical treatment

Medication. Medication may be helpful in managing depression. There are several different types of antidepressant medications, which are prescribed by doctors or psychiatrists. Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclics (TCAs) and Irreversible Monoamine Oxidase Inhibitors (MAOIs) are three common classes of antidepressants. They each work in different ways and have different applications. Like most medications there can be side effects. It’s best to ask about what options you have, how the medication will affect you, and how to take the medication safely.

Hospitalization. Hospitalization may be necessary if your depression is particularly severe or if you are suicidal. If you begin taking medication, you might also spend a short amount of time in the hospital so your doctors can make sure it’s working effectively and gauge your side effects. Check out the Psychiatric Hospitals and Wards article for more info.

ECT. ECT is short for Electro-Convulsive Therapy, sometimes called “shock therapy.” While under anesthetic, you receive a brief, mild electric shock, which lasts only a fraction of a second and is delivered to the brain through electrodes placed on the head. ECT has been shown to be effective in treating severe depression. Like any treatment it’s important to discuss the benefits, side-effects, and other options for ECT treatment. ECT is generally only used when no other treatment has helped to alleviate the depressive symptoms.

Things you can do for yourself

Along with seeking treatment to manage depression, there are a number of things you can do for yourself that may help when you are feeling depressed. Some of these include:

Eating well and being active. Even though you might not feel like it, exercising and eating well can help when you are feeling down. Biological factors, as well as social factors, influence how you will feel and think about things and yourself. Exercise helps stimulate hormones like endorphins, which help you feel better about yourself and your life. If you haven’t done a lot of exercise before, it might be a good idea to start doing something small a couple of days each week—for example, a 15-minute walk or two or three laps in a pool.

Share your struggle with others. Although it can seem hard, sharing how you feel and hanging out with someone you trust can help you get through the hard times, see alternative ways of solving or thinking about a problem, and help to make you a happier person. If you’re having difficulty talking about what you’re going through, you might start with sentences such as, ”Right now, I’m feeling…”; ”I think it started when…”; ”I’ve been feeling this for…”; ”My sleep has been…”; or ”Lately school/work has been…”

There’s numerous online forums, groups, pages, apps and servers where you can also get support 24/7 from peers that have been through something similar and can empathize with you.

Although it can be good to find support through others, be mindful of what content you’re subscribing to online and see regularly in your social media feed. For instance, following a bunch of blogs that put out depressing content (even though it’s relatable) won’t help you find ways to cope and manage your depression like you might by following a blog centered on positive mental health.

Get outside. Evidence shows that when you have some sort of contact with nature—like pets, plants, gardens or parks—your mood improves and you feel less stressed. Even just going for a walk in the park may help.

Write down your feelings. Writing down your feelings or keeping a journal can be a great way to understand your emotions. It can also help you think about alternative solutions to problems.

Take time out to relax. It’s a good idea to try and take a bit of each day to do something you enjoy. When you are feeling down, it may be hard to be social or motivate yourself to be active. It might help to make a list of all the things you enjoy doing and then plan to do something from this list each day.

Support groups. Along with family and friends, support groups can be a place to share experiences and inspiration with others going through similar times. Talk to your doctor for details on support groups in your area. Also, if you are a college student inquire at your campus counseling center to see what kind of support groups the center might be sponsoring.

Call a crisis line. If you’re having difficulty talking to people you know or you’d like to talk to someone outside of your situation, Lines for Life has a Suicide LifeLine that can be reached at 1-800-273-8255, as well as a YouthLine at 1-877-968-8491. They are staffed by highly trained volunteers that can offer support and assistance 24/7/365, over the phone, text or through an online chat. If you’d like more resources, check out our crisis helpline directory.

Set small goals. Sometimes people set goals that are almost unachievable and then feel even worse when they can’t reach them. Try to set goals that are attainable for you, even if it’s on a day-by-day, or hour-by-hour basis. And remember to reward yourself, too.

Reduce stress. It might be a good idea to try and reduce the level of stress you’re feeling. You might want to check out the Stress fact sheet for some ideas on how to manage stress.

Go easy on drugs and alcohol. Try not to use drugs or alcohol in an attempt to feel better. The feeling you get from drugs and alcohol is usually temporary, and the after effects often make problems worse.


Acknowledgements: This article was originally developed by youth and staff for us.ReachOut.com

Myths About Depression

 
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What’s the truth?

There are misunderstandings and myths about mental health out there, which make living with depression and other mental illnesses a lot harder.

 

The Myths

MYTH: All young people get depressed. It’s just a normal part of growing up.

TRUTH: Feeling sad or unhappy is a normal part of growing up. In fact, it’s a normal part of the ups and downs of life, no matter how old you are. Depression, however, is more than just feeling sad. It’s feeling miserable or upset to the point where it gets in the way of your day-to-day life for two weeks or longer. Depression is an illness like asthma or diabetes. It can affect people at any age, and it needs to be recognized and treated.

MYTH: If you’re depressed, it just means you’re going through a tough time at the moment.

TRUTH: Tough times—like a break up with a boyfriend or girlfriend, or your parents’ divorce—can lead to depression. The tough time itself is not necessarily the only factor involved. A physical illness, feelings of loneliness or isolation, being bullied or abused can all lead to depression. Sometimes depression can have no obvious cause at all, but it could be the result of biological or genetic factors.

We all deal with stress differently. Some of us have stronger coping skills or support systems to help us through tough times, but no matter how well equipped we are to handle stressors in our life, sometimes we still need extra help. So whether you’re going through a tough time or experiencing depression, it’s important to talk to someone and get the help you need.

MYTH: It’s normal for teens to want to spend a lot of time on their own.

TRUTH: Sometimes it’s nice to chill out and have some alone time. However, if someone isn’t spending as much time with friends and family as they used to, or if they’ve dropped out of the crowd or aren’t doing the things they used to enjoy, then it might be a sign they aren’t feeling great and are at risk of depression or are already depressed. Isolation is a key symptom of depression.

MYTH: Telling an adult that a friend is depressed is betraying that friend’s trust. If someone wants help, they’ll get it themselves.

TRUTH: Depression saps energy and self-esteem, so it can get in the way of a person’s ability to ask for help when they really need it.

If you’re worried about someone, it’s far better to share your concerns with a trusted adult like a parent, teacher, supervisor or counselor or other mental health professional. No matter what you promised to keep a secret, someone’s life is more important than a promise.

MYTH: People who are smart or emotionally strong don’t get mental illnesses.

TRUTH: Mental illnesses, including depression, can affect anyone. It doesn’t matter how smart a person is. It doesn’t matter if a person has a strong character, if they’re old or young, or what gender they identify as.

It has been found, however, that some individuals are more resilient to developing a mental illness than others. Being optimistic, having good problem-solving skills, high self-esteem, having close relationships with people you can turn to for support, and being involved in school or community activities you find meaningful can help decrease your risk of depression. It’s important to note that these things don’t guarantee you won’t get depression, but they do reduce the risk.

MYTH: You’re born either an optimist or a pessimist. You can’t change how you think.

TRUTH: One of the most effective treatments for depression is called cognitive behavioral therapy (CBT). CBT involves targeting negative thoughts you might be thinking, like “I’m not good enough” or “I’m not going to get better”, and changing those negative thoughts to positive ones. CBT helps you learn different and more positive ways to respond to what’s happening in your life. In severe cases, medication may be required alongside CBT to correct chemical imbalances in the brain.

MYTH: All depression needs to be treated with antidepressants.

TRUTH: For mild to moderate depression, the first choice of treatment should be counseling or talk-therapy. The issues you’re facing might be worked out through talking about the issues. However, if your depression is severe, your counselor or other mental health professional will probably refer you to a psychiatrist for further evaluation to determine if medication is warranted.

It’s important that you get along with and trust your counselor and psychiatrist, so you can work with them to find a treatment plan to keep you well.

MYTH: Talking and listening to your friends and family will be enough to treat depression.

TRUTH: Talking and listening to your friends and family is a really important way to deal with the day-to-day ups and downs of life. However, if you think you might be experiencing depression, it is important that you seek professional help. Talk to a trusted adult, your doctor, or your school counselor about the choices available.

MYTH: Binge drinking is just a normal part of growing up and does not have an impact on depression.

TRUTH: Binge drinking can put you at greater risk of depression because alcohol is a depressant. If you are depressed, alcohol consumption and binge drinking can exacerbate the symptoms.

MYTH: A medical doctor is the best person to speak to if you think you might be depressed.

TRUTH: A medical doctor is a good person to talk to about depression and the treatments available, but not all doctors will necessarily be as good as others in diagnosing, talking about and treating depression. It might be more helpful for you to speak with a trained counselor, psychiatrist or psychologist about your depression. Your doctor can refer you to one of these.

If you’re having difficulty talking to people you know about how you’re feeling, call a crisis line: Lines for Life's Suicide Lifeline (1-800-273-8255) or their Youthline (1-877-968-8491) are both anonymous, free 24-hour helplines. They also offer texting and online chat options if speaking on the phone is too uncomfortable or you’re otherwise unable to do so.

MYTH: People who are depressed need to wake up and stop feeling sorry for themselves.

TRUTH: People don’t choose to be depressed. Depression is an illness, and as such, it can be treated with the right help from mental health professionals. It’s not something that people can just “snap out of.” Knowing how to recognize the signs and symptoms of depression in yourself and others, and getting help early can help reduce the long-term effects of the illness.

MYTH: People who have depression can’t hold down a job.

TRUTH: If left untreated, depression can affect a person’s social life, grades, work, interests and a whole variety of things. However, with the right treatment and support, a person with depression can have a normal job and get on with life.

 

Information for this article was provided by:

  • Dr Jane Burns - Director of Research and Policy, Inspire Foundation; VicHealth Public Health Research Fellow, Nossal Institute for Global Health

  • National Institute of Mental Health

 

Acknowledgements: This article was originally developed by youth and staff for us.ReachOut.com

Worried About Someone Feeling Depressed

 
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Worried your friend is depressed?

A closer look at what depression is and how you can support your friend (and yourself)

 

Depression affects thousands of people everyday. According to a 2017 National Survey on Drug Use and Health, an estimated 13.3% or 3.2 million adolescents from ages 12 to 17 had at least one major depressive episode. Regarding adults, those aged 18 to 25 hold the highest prevalence of major depressive episodes, sitting at 13.1%. When a friend is feeling down for a long period of time or is behaving in an unusual way, it can be hard to know what you can do for them.

If your friend has mentioned suicide, it’s important you tell someone who can help so that your friend can remain safe. Check out the When a Friend Is Thinking of Suicide article for more info.

Suggestions for helping

Like other illnesses, everyone’s experience of depression is different. It’s important to remember that helping someone who is not ready to recognize they need help may be difficult, and the decision and responsibility for them to get help is ultimately theirs. However, there are some things you can do that may help you to help your friend who is feeling depressed:

Offer your support. It can be scary when someone realizes they need help. Let your friend know you’re worried about them, and that you’re there to listen without judging them.

If your friend talks to you about how they’re feeling, it might help if you acknowledge that they’re sad and that things might seem hard, while at the same time try and remain positive and encouraging.

If you are having difficulty speaking about it with your friend, you might start with sentences such as ”I’ve noticed you’ve seemed a bit down,” or “Lately, I’ve noticed you haven’t been interested in hanging out with your friends or enjoying things like you used to. What’s going on?” This can invite them to share their feelings with you.

Choosing when to talk. Timing can be an important part of talking to someone about sensitive stuff. If possible, try to choose a time when you are both open to talking about serious subjects. Avoid talking with them during an argument or if they are upset—you may end up getting a bad reaction where they choose to distance and isolate themselves further.

Don’t ask them to cheer up or forget about it. When people are sad, our first reaction may be to tell them to cheer up or forget about it because everything will be fine. If someone is depressed, this may be impossible.

Asking someone to cheer up may appear as if you are not taking their feelings seriously and have a negative effect. It’s important to know that depression isn’t something someone can just snap out of. It is serious and takes a toll on the person physically, mentally and emotionally.

Get informed. Finding out more about depression might help you better understand the reasons for the reactions you might receive and what your friend might be going through. Check out our article on Depression for more information.

Encourage them to get professional support

If your friend is depressed, it is important that they seek help. Your local doctor is a good first step. Mental health professionals, such as psychologists, counselors, psychiatrists, and social workers, are trained in assisting young people with mental health difficulties and could also be helpful.

If you feel comfortable doing so, you might offer to go with your friend when they speak to someone about how they are feeling. Even walking with them to the school counselors office might be the support they need.

Give it time. It might take time for your friend to accept help, either from you or someone else, and that’s okay. They are walking their own path and will come to terms that they need help in their own time. It might also take some time to find a treatment that works best for them.

Take care of yourself

When you are worried about a friend you might feel stressed or overwhelmed and forget to look after yourself. It is important that you take care of how you are feeling. Speak to someone you trust, such as a family member, friend or counselor. Having time away from your friend can be an important way to help you relax. Make sure you spend some time doing what you enjoy. You may want to play a sport, hang out with other friends, listen to music, or go for a walk.

You are not responsible for your friend

It’s also important to remember that even though you can offer support, you are not responsible for the actions or behaviors of your friend. If they aren’t willing to help themselves, it is NOT your fault. There is only so much you can do for a person. The real work has to be done by them.

Concerned your friend might be suicidal?

If you are concerned that your friend is suicidal, your first action should be to ask the question outright. If you think they’re suicidal, ask them “Are you thinking of killing yourself?” This tactic cuts right to the chase to know if this person is at risk or not.

If they would like to talk to someone outside of their situation, Lines for Life has a Suicide LifeLine that can be reached at 1-800-273-8255, as well as a YouthLine at 1-877-968-8491. They are staffed by highly trained volunteers that can offer support and assistance to you or your friend. They are available 24/7/365 and ready to help. If you’d like more resources for your friend, check out our crisis helpline directory. If you’re looking for more information on signs that your friend may be suicidal, check out our article on Suicide Warning Signs or nineoutoften.org.

 

Information for this article was provided by:


Acknowledgements: This article was originally developed by youth and staff for us.ReachOut.com


Living with Someone Experiencing Depression

 
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Are you living with someone that’s depressed?

Let’s take a closer look at how to take care of yourself while trying to be understanding of their situation

 

Living with someone who is experiencing depression is not easy. When they are struggling, it can often be hard to know what to do or say, and it’s not uncommon to feel angry, guilty or overwhelmed from time to time.

Learn about depression

By having an idea of how someone is affected by depression, you might be able to better recognize why they behave the way they do. Understanding more about depression might also help you separate the illness from your family member, partner or friend, and realize that their mood and behavior might not be directed at you personally.

Everyone is affected by their depression a little bit differently. Sometimes it can be physically draining to move much, so the house might not get picked up as often as it normally would. Perhaps being around people is exhausting, so they might need more time alone than usual.

Try not to blame them or shame them for what they’re experiencing, as it’s not something they can control. Just try to be as compassionate as you can for their experience, while also taking care of yourself.

Put yourself first occasionally

As a family member or friend of someone who’s going through depression, it’s important that you look after yourself. This can be hard and you might find that you feel guilty when you do something for yourself, but taking time out for yourself is an important part of taking care of yourself and your loved one.

Having time away from your friend or family member can be important and allow you to relax. Try to spend some time doing what you enjoy. You might want to play a sport, hang out with friends, listen to music or go for a walk. Our Developing Coping Strategies can give you some ideas on what self-care might be best for you.

It may also be helpful to write down your thoughts and feelings in a journal, since you likely won’t be able to express those properly with the person who is depressed. Remember that your mental health is also important, and you’re allowed to set boundaries for yourself.

Talk about what your loved one finds helpful

Make conversations about depression easy and open. Try asking what helps them get through their depression. By talking openly, you are letting the person know that you love and support them. You may like to talk about what you have read about depression, and ask how they feel about it.

Find a support group

If you are living or caring for someone who is experiencing depression, you may sometimes feel you are alone. Friends may not understand what you’re dealing with. Talking to people who are in a similar situation may be helpful. The National Alliance on Mental Illness might be a good place to find some support. You can also call Lines for Life’s YouthLine at 1-877-968-8491 or their Suicide LifeLine at 1-800-273-8255 for more information on how to talk to your loved one about depression or if you suspect they’re feeling suicidal.

Talk to someone

It might be helpful to talk to someone you trust, like another friend or family member, about how you’re feeling regarding your loved one’s depression. If you feel like you are having trouble doing day to day activities or the stress of caretaking for this depressed person is too much, you could also consider seeing a counselor or therapist.

 

Acknowledgements: This article was originally developed by youth and staff for us.ReachOut.com

Loneliness

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Feeling lonely

A closer look at loneliness and how to develop connections with others

I feel lonely

It’s not unusual to feel lonely every now and then. However, if you’re feeling this way for an extended period of time, it can lead you to feel socially isolated. You might feel isolated from people your age, or society as a whole, for a number of reasons. You might be new to a school, city, or town. You might be geographically isolated in a rural area that is far from other people that are your age. You might be ethnically, racially, culturally or religiously different from the people around you, or you might just feel like you don’t have similar values or experiences as the people in your day-to-day life. You may also feel socially awkward, like you’re not sure what to say or do or quite how to fit in with a group you would like to connect with.

Feeling connected to a group of people is important for your health and well-being. People are naturally social beings, and those who have a strong support group are more likely to be happy and physically healthy. Social isolation can also be connected to depression and social anxiety.

How do I feel less lonely?

Depending on your circumstances, it might be hard to connect with people. For example, if you live in an isolated location, far from a large metropolitan area, your social resources might be limited. At the same time, though, big cities can feel just as lonely.

Here are a few ideas to help you connect with others, no matter where you are:

  • Join online forums and groups. Many people today find like-minded friends to connect with through the internet. The internet can bring you into touch with people all over the world, and gives you a chance through chat rooms to practice conversational skills. There are numerous online groups, pages, blogs, apps, servers, and other social media platforms that can offer connection and solidarity through mutual interest. Just remember to practice internet safety. The internet is widely anonymous and people can pretend to be whoever they want. Never give out your information or address to a stranger online.

  • Talk to a family member, teacher or youth leader. Even though you feel lonely, remember that you don’t have to go at it alone. The first step in ending your loneliness is simply talking to someone from your family, a teacher, a school or campus counselor, or your spiritual mentor/leader. Tell them how you’re feeling. Chances are they’ll be happy to help you and can give you some ideas for how to meet people and feel more connected.

  • Start small. You don’t need to find a best friend or go out with people every night of the week. Start small by finding something in common with your peers—it could be something as simple as a T.V. show, your favorite band or even the homework you had last night.

  • Challenge your negative thinking. You might feel like no one will ever understand you. But chances are that you are your own worst critic. Try to look at each situation objectively to avoid being too hard on yourself. For more tips on how to do this, check out the Challenging Negative Self-Talk article.

  • Get outside. Sometimes, even if you’re not talking or interacting with anyone, just being around other people can make you feel good. Try going to a park, a coffee shop or a library to do some people watching!

  • Join a club or a team. The best way to meet people that have the same interests as you is to join a club or a team. You can join groups through your school, local community center or faith center. Some groups you could join might be a dance group, tabletop tournaments, starting a band, joining 4H, or trying out a club your school offers. Volunteering for a cause can also be enriching for your mental health, as well as help you develop connections to others with similar values and passions.

  • Seek help. If you need immediate help and you aren’t sure where to turn, try calling Lines for Life’s Suicide Lifeline at 1-800-273-TALK (8255) or Youthline at 1-877-968-8491. Both helplines will keep your information private and have trained volunteers who can talk to you about how you’re feeling 24/7.

Developing social confidence

If you are feeling socially awkward, there are things you can do to develop more social confidence. Social skills can be learned. Things like how to start a conversation or how to join-in on a conversation, and how to listen well to others are all things you can learn to do. You can also learn about nonverbal skills like eye contact, head nodding, and smiling, as well as when and when not to use these. While some people learn these things easily through their interactions with others, others find these skills take more deliberate rehearsal and practice. If this sounds like you, you may find it helpful to speak with a counselor or other mental health professional who can help you identify skills to develop and even help you practice those skills step-by-step before trying them out in new social situations. Often times, the more practice you have and the more you do it, the easier it will become.

 

Acknowledgements: This article was partially developed by youth and staff for us.ReachOut.com


Depression: Causes, Types and Symptoms

Depression

A closer look at depression and what it looks like for different people

What is depression?

Everyone goes through tough times at different points in their lives, and we all feel sad every now and then. It’s important to understand that feeling sad temporarily is very different from being depressed or having depression.

Depression is a mental disorder that is more severe and longer-lasting than normal sadness. Depression interferes with other aspects of your life like work, school, or relationships. With the right kind of treatment, many people can overcome it and lead happy, healthy lives.

What causes depression?

Sometimes depression has no apparent cause. However, in other cases, it may be caused by one or a number of factors, which include:

  • Genetics: If there’s a history of depression in your family, it could be that there’s a genetic or biological link that makes the illness more common among your relatives;

  • Biochemical: In certain cases, the chemicals in the brain that control your moods might be out of balance

  • A stressful event: Or chain of events, such as a family divorce or conflict, physical or sexual abuse, bullying, rape, the death of a loved one, or a relationship break-up

  • Personality: Certain personality types are at a higher risk of depression than others. This includes people who tend to be anxious, shy, perfectionists, or those who have low self-esteem.

Symptoms of depression

People experience depression in different ways depending on the type of depression and individual differences. Common symptoms across all types of depression include:

  • Sadness that won’t go away

  • Boredom

  • Feeling irritable or anxious

  • Loss of interest in usual hobbies and activities

  • Loss of appetite

  • Irregular sleeping habits

  • Unexplained outbursts of yelling or crying

  • Reckless or risky behavior like alcohol and drug abuse

Everyone feels or acts like this from time to time. But for people experiencing depression, the feelings might be more severe and constant-they don’t go away over time and they’re not easily explainable.

Types of Depression

In 2017, it was reported that about 11% of youth in the United States, ages 12-17, had suffered from at least one major depressive episode. There are different types of depression and each of them have their own symptoms, causes, and treatments. However, it’s important to remember that depression affects people in different ways, and not all scientists agree on how these illnesses should be defined.

Dysthymic disorder is a type of depression that may not completely prevent someone from functioning normally, but keeps someone in a constant low mood. Dysthymic disorders are chronic and long-lasting-sometimes for up to two years at a time.

Seasonal affective disorder (SAD) is a type of depression that surfaces during the winter months when there’s less natural sunlight. People with SAD typically come out of their depression during the spring and summer months.

Major depressive disorder is a severe form of depression that interferes with a person’s ability to eat, sleep, work, study, or take part in daily activities like he or she normally would. Major depressive episodes usually last at least two weeks. For most people, a major episode of depression can occur only once, but for some, it can recur throughout a person’s lifetime.

Postpartum depression is a type of depression that occurs in new mothers within one month after they give birth. Postpartum depression is likely caused by major shifts in hormone levels after delivery. According to the U.S. Department of Health and Human Services Office of Women’s Health, there are several factors that can contribute to postpartum depression including hormonal changes, a history of depression, young age, and little support from family and friends.

Bipolar disorder is a form of manic-depressive illness that can be characterized by extreme “highs” and “lows” in a person’s mood.

If you think you might be experiencing depression, talk to your doctor, counselor or other mental health professional. These professionals can help you sort through your feelings, make a diagnosis, and provide you with the support for managing your depression.

Depression and suicide

For some people, depression may lead to thoughts of suicide. Try to remember that you don’t have to act on these thoughts, no matter how overwhelming they might be. If you’re considering ending your life, it’s important that you talk to someone right away. If you’re in a crisis, call the Youthline from Lines for Life at 877-968-8491, text teen2teen to 839863, or chat online here. You can also call The National Suicide Prevention Lifeline at 1-800-273-TALK to get immediate help.

For more information, check out the Suicidal Thoughts: Wanting To End Your Life fact sheet for what you can do to keep yourself safe and get the help that you need. If you know someone who is thinking about taking his or her own life, encourage them to get help.

 

Information in this article was provided by:

Acknowledgements: This article was partially developed by youth and staff for us.ReachOut.com

Deliberate Self-Harm

Self-Harm and Coping

What is self-harm? What if my friend is self-harming? What can I do if I don’t want to self-harm, but still have the urge?

What is deliberate self-harm?

Deliberate self-harm (also known as self-injury or non-suicidal self-injury) is when you deliberately inflict physical harm on yourself, usually in secret. Some examples are cutting, burning, biting or hitting your body, pulling out hair, or scratching and picking at sores on your skin.

Deliberate self-harm is not necessarily a suicide attempt, and engaging in self-harm may not mean that someone wants to die. Most commonly, deliberate self-harm is a behavior that is used to cope with difficult or painful feelings.

Why do people deliberately harm themselves?

People who deliberately harm themselves have often had tough experiences or relationships in their lives. They may have:

  • Been bullied or discriminated against;

  • Lost someone close to them, such as a parent, sibling or friend;

  • Broken up with a boyfriend or girlfriend;

  • Been physically or sexually abused;

  • Experienced a serious illness or disability that affects the way you feel about yourself;

  • Experienced problems with family, school or peer groups.

Deliberate self-harm may be used as a way to cope with experiences and strong feelings. Self-harm might:

  • Provide a way to express difficult or hidden feelings. It’s not uncommon to feel numb or empty as a result of overwhelming feelings you may be experiencing. Engaging in deliberate self-harm may provide you with a temporary sense of feeling again. It may also provide a way to express anger, sadness, grief or emotional pain;

  • Be a way of communicating to people that you need some support when you feel unable to use words or any other way to do so;

  • Act as a form of self-punishment for times you feel you may have failed;

  • Be a way of proving to yourself that you are not invisible;

  • Provide you with a feeling of control: You might feel that self-harm is one way you can have a sense of control over your life, feelings or body, especially if you feel as if other things in your life are out of control.

Deliberate self-harm can bring an immediate sense of relief, but it is only a temporary solution. It can also cause permanent damage to your body if you injure nerves. Psychologically, it may be associated with a sense of guilt, depression, low self-esteem or self-hatred along with a tendency to isolate yourself from others.

Coping without harming yourself

Along with support from a friend, family member or health professional, it might also be helpful to write a list of alternative strategies to self-harm for managing your emotions.

If you feel like you want to harm yourself, there are a number of things that you can try to distract yourself until the feelings become more manageable. If you can, make sure that you’re around other people and remove any sharp objects from the area.

Some ideas for releasing energy or feelings include:

  • Choose to put off harming yourself until you’ve spoken to someone else or waited for 15 minutes. See if you can extend it for another 15 minutes beyond that, continuing to do it again until you no longer feel the urge. Delaying it or putting yourself in a place where you can’t do it may help the urge pass.

  • Write in a journal. If you’re fearful someone may read a hard copy of your journal, there’s lots of other options you can use. You could try to using an online journal or blog that is password protected or anonymous. There are also a lot of apps where you can vent about your feelings anonymously and receive support from people going through similar things.

  • Draw or write in marker over your body. Expressing difficult feelings through actions can be helpful. However, if you are able to verbalize and symbolize difficult feelings through words and/or artwork, this can be a healthier, more sophisticated way of coping. Sometimes, writing a message of support over your scars can also be helpful, such as using a semicolon to represent not giving up, writing lyrics that speak to you, or drawing the word “love” in a special font.

  • Exercise. Go for a run or walk in the park to use up excess energy.

  • Play video games. This might be a good way to distract yourself and help until the anxiety passes.

  • Yell or sing at the top of your lungs on your own or to music. You might do this into a pillow if you don’t want other people in the house to hear. It might be a good idea to create a playlist that’ll make you feel better.

  • Use relaxation techniques. Activities like yoga or meditation are often helpful in reducing anxiety. Taking a hot shower or bath can also be soothing.

  • Cry. Crying is a healthy and normal way to express your sadness or frustrations. Allow yourself to let it out.

  • Talk to someone. Sometimes it can be helpful to talk about what you’re feeling with a trusted friend or by calling a helpline. Talking about things other than your problems can also help in the short-term, distracting you from wanting to self-harm. It is important, however, to find someone you can share things with so you don’t feel alone in your struggles.

Alternatives to deliberate self-harm

If the above suggestions don’t help and you still feel the need to self harm, there are a number of things that you can do that won’t cause injury like:

  • Punching a pillow or punching bag

  • Squeezing ice cubes until your fingers go numb, or holding them over your scars

  • Eating a chili, or something really spicy

  • Taking a cold shower

  • Putting vapor rub under your nose (it stings and makes you cry)

  • Waxing your legs (or getting them waxed)

  • Painting your nails (keeps you from doing much with your hands)

  • Love on your pets

Finding help

Although it might seem hard, it’s important that you reach out to someone who can help you find healthier, positive alternatives to alleviate the pain you feel inside. It may take time, but it’s important to remember that you can move to a happier and healthier outlook.

Speaking to someone about your self-harm might be hard, and it’s important to trust the person you’re speaking with.

If you’re having a hard time talking about what you’re going through, you might start with sentences such as ”Right now, I’m feeling…”; ”I think it started when…”; “I’ve been feeling this for…”; ”My sleep has been…”; “Lately school/work has been…”

Like any relationship, building trust with your counselor, psychologist or psychiatrist may take time and it is important you find someone you feel comfortable with. This may mean seeing several people before finding the one that you “click” with.

If there is a family member you feel comfortable telling, it might be helpful for you to have their support in finding a counselor that is right for you. It’s likely that the person you feel comfortable telling will already be worried about you and will be relieved to have the opportunity to listen and help.

If you don’t get a positive response, try to remember that it’s not because you’ve done something wrong, but because the person you have told may not know how to respond to what you have told them, or might not understand much about deliberate self-harm.

Don’t give up! Either try again or speak to someone else you think you might receive a more supportive response from.

If talking with someone is too overwhelming, an alternative is to e-mail or write down what you want to say. Otherwise, a first step might be to call a 24/7 helpline, such as Lines for Life at 1-800-273-8255 if you are feeling in crisis or having suicidal thoughts, or youth helpline YouthLine at 1-877-968-8491 or by texting teen2teen to 839863.

If you or a friend are harming yourselves, it’s also important that you take care of the injuries caused and if necessary, seek medical help through your doctor or, if it’s serious, a hospital’s emergency department.

In most situations, doctors and other health professionals must keep your information confidential. However, they are required to report information they receive if they have serious concerns about your safety.

Take care of yourself

It’s important to eat well, exercise and be kind to yourself. While not a solution in itself, doing all these things contribute to a higher sense of self-worth, increased stability of moods, and a general better sense of well being — making you feel more happy on the outside and the inside.

Acknowledgements: This article was partially developed by youth and staff for us.ReachOut.com