Seeking Help: Coping with Anxiety and Self-Harm in Mental Health

I would like to inquire about psychological counseling issues?

I have been feeling anxious frequently and have been engaging in self-harm.
It seems to calm the anxiety in the moment, and what initially felt like just small marks has turned into a pattern.
When I get angry again, I resort to self-harm, thinking about how I wish I could just die.
My arms are now covered with numerous cuts from a utility knife, and I find it hard to breathe.
I don't like talking much, often have trouble sleeping, and frequently think that if I were no longer in this world, it wouldn't matter.
However, I have family, and I don't want to make them sad.
I'm very scared and don't know how to tell my family.
What should I do?

Chen, 10~19 year old female. Ask Date: 2023/03/19

Dr. Tang Jiahong reply Psychiatry

Hello.
Based on your age, it is recommended that you visit a hospital that has a child and adolescent psychiatry department, which is typically available at medical centers.
Family support is very beneficial for mental health, so it is advisable to discuss your decision to seek treatment with your most trusted family members.
During your visit, in addition to medication that may be helpful, you might also learn non-harmful emotional regulation strategies through psychotherapy and other methods to improve your condition.
Tang Chia-Hong

Reply Date: 2023/03/19

More Info

It sounds like you are going through an incredibly difficult time, and I want to acknowledge the courage it takes to express your feelings and seek help. Coping with anxiety and self-harm can be overwhelming, but it’s important to know that you are not alone and that there are ways to find relief and support.

Firstly, it’s crucial to understand that self-harm is often a coping mechanism for dealing with intense emotions, such as anxiety, anger, or sadness. While it may provide temporary relief, it does not address the underlying issues and can lead to a cycle of pain and distress. It’s commendable that you recognize the impact of your actions and are seeking a way to cope more healthily.

Here are some strategies that may help you manage your anxiety and reduce the urge to self-harm:
1. Reach Out for Professional Help: It’s essential to talk to a mental health professional who can provide you with the support and guidance you need. Therapists can help you explore the reasons behind your anxiety and self-harm, teach you coping strategies, and work with you to develop healthier ways to manage your emotions. If you feel uncomfortable discussing this with your family, consider reaching out to a trusted friend or a helpline where you can speak to someone anonymously.

2. Practice Mindfulness and Relaxation Techniques: Mindfulness practices, such as meditation, deep breathing exercises, or yoga, can help calm your mind and reduce anxiety. These techniques encourage you to focus on the present moment and can help you manage overwhelming feelings. For example, try taking slow, deep breaths when you feel anxious, inhaling for a count of four, holding for four, and exhaling for four.

3. Engage in Creative Outlets: Since you mentioned that you have a history of self-harm with a blade, consider channeling your emotions into creative activities such as drawing, painting, or writing. These activities can serve as a healthy outlet for your feelings and provide a sense of accomplishment and relief.

4. Develop a Support System: While it may be difficult to talk to your family about your feelings, consider confiding in someone you trust, whether it’s a friend, teacher, or counselor. Having someone to talk to can alleviate feelings of isolation and provide you with emotional support.

5. Establish a Routine: Creating a daily routine can provide structure and stability, which can be comforting during times of anxiety. Include activities that you enjoy and that promote well-being, such as exercise, hobbies, or spending time with loved ones.

6. Identify Triggers: Take note of situations or emotions that lead to self-harm or increased anxiety. Understanding your triggers can help you develop strategies to cope with them more effectively. For instance, if you notice that certain stressful situations lead to self-harm, you can work on developing alternative coping strategies for those moments.

7. Limit Exposure to Stressors: If certain environments or situations increase your anxiety, try to limit your exposure to them when possible. This might mean taking a break from social media, avoiding certain places, or setting boundaries with people who contribute to your stress.

8. Consider Journaling: Writing down your thoughts and feelings can be a therapeutic way to process your emotions. It can also help you identify patterns in your feelings and behaviors, making it easier to address them.

9. Emergency Plan: If you ever feel overwhelmed and consider self-harm, it’s crucial to have a plan in place. This could include a list of people to contact, activities to distract yourself, or safe spaces where you can go to calm down.

10. Educate Yourself: Learning more about anxiety and self-harm can empower you to understand your experiences better. Knowledge can help demystify your feelings and provide you with tools to cope.

Remember, seeking help is a sign of strength, and it’s okay to ask for support. You deserve to feel better and to find healthier ways to cope with your emotions. If you ever feel like you are in crisis or having thoughts of harming yourself, please reach out to a mental health professional or a crisis hotline immediately. Your life is valuable, and there are people who care and want to help you through this.

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