Coping Strategies for Depression: Managing Self-Harm Thoughts

I would like to inquire about issues related to depressive episodes in depression?

I'm a patient with depression, and sometimes I become aware that my thoughts are constantly leaning towards self-harm, but I find myself unable to control it.
What can I do in such situations? Should I go to a hospital with an emergency department that has a psychiatric unit? Or can I ask my psychiatrist for additional sedatives to take during these times? I know I shouldn't harm myself, but it seems like that's the only way to calm my emotions.
I also understand that I should have someone with me to prevent any accidents, but I find myself alone.
To be honest, my colleagues would rather see me gone than help me.
The only reason I persist in living is that I refuse to give up.
However, there are moments when the urge to harm myself overwhelms my rationality, and I'm afraid I might take a drastic step.
Please advise.
Thank you.

Liao Hsiu-Chuan, 20~29 year old female. Ask Date: 2003/01/07

Dr. Tang Xinbei reply Psychiatry

Dear Miss Liao,
After reading your letter, it seems that the people around you do not fully understand you, and their support appears to be limited, or they may not be able to provide you with sufficient help.
This has left you feeling lonely and helpless.
It also seems that you have a strong inner drive and are unwilling to acknowledge your feelings of powerlessness, not wanting to be looked down upon, which leads you to seek other ways to cope with your emotional lows.
However, at times, the feeling of despair and helplessness makes you contemplate ending everything.
It appears that this situation has persisted for quite some time.
If your condition indicates the need for a physician to prescribe some sedatives for use when necessary, I am concerned that over time this may lead to a dependency on the medication.
If you consider going to the psychiatric emergency department, you might worry about being a burden and being turned away.
I recommend discussing your medication concerns with your primary physician, but I strongly urge you to seek further psychological therapy.
Through a deeper understanding of yourself, you can learn effective emotional regulation mechanisms and gain better control over your emotions.
Wishing you peace and joy!

Reply Date: 2003/01/07

More Info

Coping with depression and self-harm thoughts is a complex and challenging journey, and it's commendable that you are seeking help and looking for strategies to manage these feelings. It's important to recognize that you are not alone in this struggle, and there are effective ways to cope with these overwhelming emotions.

First and foremost, it's crucial to prioritize your safety. If you ever feel that you are in immediate danger of harming yourself, please seek emergency help right away. This could mean going to the nearest hospital with a psychiatric emergency department or calling a crisis hotline. These resources are equipped to provide immediate support and can help you navigate through your feelings in a safe environment.

When it comes to managing self-harm thoughts, here are several strategies that may help:
1. Identify Triggers: Understanding what triggers your self-harm thoughts can be a powerful first step. Keep a journal to track your emotions and situations that lead to these thoughts. This can help you recognize patterns and develop strategies to cope when you feel those triggers arise.

2. Develop Healthy Coping Mechanisms: Instead of resorting to self-harm, try to find alternative ways to cope with your emotions. This could include engaging in physical activities like walking or exercising, practicing mindfulness or meditation, or expressing yourself through art or writing. Activities that promote relaxation, such as listening to music or taking a warm bath, can also be beneficial.

3. Reach Out for Support: While you may feel isolated, it's important to connect with others who can provide support. This could be friends, family, or mental health professionals. If you feel that your colleagues are unsupportive, consider seeking out support groups or online communities where you can share your experiences and feelings with others who understand what you're going through.

4. Communicate with Your Healthcare Provider: If you are currently seeing a psychiatrist or therapist, be open about your self-harm thoughts. They can work with you to adjust your treatment plan, which may include medication or therapy specifically designed to address these feelings. If you feel that additional medication, such as a sedative, might help during particularly difficult moments, discuss this with your doctor. They can provide guidance on safe and effective options.

5. Practice Self-Compassion: It's essential to be kind to yourself during this process. Understand that experiencing these thoughts does not define you, and it's okay to seek help. Acknowledge your feelings without judgment and remind yourself that recovery is a journey that takes time.

6. Establish a Safety Plan: Create a plan for what to do when you feel overwhelmed by self-harm thoughts. This could include a list of people to call, activities to engage in, or places to go that make you feel safe. Having a plan in place can provide a sense of control when you feel like your emotions are taking over.

7. Consider Professional Help: If you haven't already, consider seeking therapy from a mental health professional who specializes in treating depression and self-harm. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two evidence-based approaches that have been shown to be effective in treating these issues.

Remember, it’s okay to ask for help, and taking the step to reach out is a sign of strength. You deserve support and care as you navigate through these difficult emotions. Recovery is possible, and with the right strategies and support, you can find healthier ways to cope with your feelings.

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