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Deliberate self harm or DSH is a common 'cry for help' behaviour among youngsters (illustration pic only). — Bigstock pic
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THIS week’s Wellness Wednesday focuses on the trend of self-hurt among youngsters.
A 2013 study on suicidal behaviour among Malaysian adolescents, published in the Asia-Pacific Psychiatry Journal, revealed that suicidal behaviour is a growing cause for concern here since suicide rates have increased by 60% over the past 45 years. The study said Malaysia has a moderately high suicide rate of approximately 12 per 100,000.
It also reveals that girls are at higher risk of thoughts of suicide and self-harm whereas boys are at higher risk of completed suicide which can be attributed to males’ choice of extreme methods to alleviate pain and help-seeking behaviour among females.
Researches indicate that types of self-harm can be as minor as incessant nail biting to something extreme like amputating and poisoning. Other types of self-hurt include skin cutting, skin burning, self-hitting, pin sticking, interfering with wound healing, incessant skin scratching, head banging and hair pulling.
The Rakyat Post speaks to clinical psychiatrist Dr Sumeet Kaur on the scenario of self-harm.
Q: What is self-harm?
A: Self-harm, also known as Deliberate Self Harm (DSH) refers to individuals deliberately hurting their body tissue, whether by self-poisoning or self-mutilation and it’s usually without any suicidal intent. Basically, it’s a cry for help.
Although there is no deliberate attempt to commit suicide, the condition has to be taken seriously and the individual has to be assessed thoroughly. About 50% patients who commit suicide have had a history of DSH.
Q: Why do individuals self-harm?
A: People have different motives for DSH, but in most instances, it’s seen as ‘a way out’. Inflicting psychical pain is easier to deal with than psychological pain for some people.
Q: What are the most common types of self-harm?
A: This varies from country to country. A study in Malaysia reported 89% of DSH was due to self-poisoning. The Malaysian government’s effort to limit access to paraquat, which is a highly toxic substance used in insecticides, is lauded as it has reduced the number of deaths due to DSH.
Q: What are the risk factors of DSH?
A: DSH can occur at any age but it is notably higher among young adults. Religion — especially Islam and Christianity — strictly forbids suicide. Whereas, in Hinduism and Buddhism, the body is regarded as a temple and any form of harm are not encouraged. However, these thoughts seem to be waning, especially among the urban population
Individuals who live alone and have had a history of childhood abuse are more susceptible to DSH. Substance abuse (drugs and alcohol) is also a contributing factor.
Q: How do we approach and manage such individuals? Is this a psychiatric condition?
A: DSH may be a complication of an underlying psychiatric disorder — most commonly major depressive disorder or bipolar mood disorder. It is absolutely important to engage a mental health professional in this situation in order to manage them accordingly.
Even if there are no psychiatric conditions, improving individuals’ coping skills is essential in preventing further episodes of DSH. This enables them to effectively deal with their life stresses, usually with the aid of a counsellor.
Wellness Wednesday is a column that focuses on health, wellness, lifestyle, and environment matters. Write to us at email@example.com for feedback or suggestions.