I really need to know more about this. My daughter is 21 .. she self harms. It upsets me so much and all i want to do is make her feel better and take the pain away. But i guess she is doing this to take the pain away. I dont know much about it .. and i wanted to know if anyone could offer some advise. She has bi-polar and on the whole when she sees me .. she seems fine. Then i hear later .. always later that shes had to go to hospital with a friend as the cuts are too deep. Shes a beautiful girl and so popular and so much more confident than i was at her age. I dont know anything about self harming or bi-polar. I dont know what to say to her accept to let her know i am here for her. But often she keeps things from me. Any help or advise would be appreciated. Thanks x
I'm not exactly very experience about all this, but I am learning. I'm sure you already know that it would be incredibly difficult for her to cope when her mood is fluctuating in both extremes so often, and perhaps not so often. I see by your message that you don't know anything about bipolar, so I'll explain it:
There are two poles, hence bipolar, which is a high state of elation where everything is perfect in the world. Then there's the extreme depression where... you know. Each pole can last for weeks or just hours before it changes - very often without any cause whatsoever. I've just had a look on Wikipedia, which explains that neurones (cells which signal other cells in the brain to have things happen such as a muscle reflex or even a single thought) are firing electrical signals rapidly in the 'happy' phase, and firing slowly in the depressive state. So as you can see, it's hard to control the symptoms as they are erratic.
I must say that it is best to stop her from harming herself as it seems to become addictive. I wouldn't know, though! My guess is that if she continues, she'll harm herself even though she's happy and everything seems to be alright for her, and does it for no reason at all other than it 'feeling good'.
It is difficult in terms of medicine to 'cure' her. I don't know if you've heard of lithium: it supposedly cures bipolar for so long, but it's very risky to use since it has to be measured up very accurately for what's right for her. What's more, as lithium is used again and again, a bigger dose has to be used, so that should be avoided. It can also cause problems if she's given too big a dose.
What I can suggest is that you get her to confide with you if she feels she's becoming depressed. Explain that you know that she feels there is nothing in the world that could make her feel better (trust me, I know how it feels), but that you could try to help her pull out of the depressive episode. You could try to have her lie on her bed and her keep her thoughts silent. Yes, meditation in a way. I've suffered from a SEVERE depressive episode where I thought my whole life was inevitably crumbling because the whole world despises me, and my mind just shut down completely. I'm serious. And what I did was, I lay on my bed and listened to my favourite album. I was in that state for two days, but I managed to pull out of it because all negative thoughts were being drained from my mind, making it safe for my mind to open up again.
I'm sorry I can't help much, but I hope I have helped in a way. I assume you're not living together by the words you're using, so do check her often and just stay by her side even if it means being sat next to her in silence for two hours.
She needs to fight back on her own thoughts. I think meditation would help her. It does appear to help people, so perhaps it could help her. Even ten minutes a day could help. Get her to try it, and if she's able to clear her mind of negativity, even temporarily, it means that she's fighting back.
I do really hope she gets better. It's such a horrible state of mind to be in. 
Firstly im sorry to hear about your situation and i hope you are well on the road to feeling better.
Thank you so much for your advice ginger. She is on medication for bi-polar but it doesnt appear to be helping. I see her as much as i would like due to work. I will see what i can do to help her and meditation would help her. She is one of those that if anyone lets her down, she takes it the wrong way. She feels that everyone is against her most of the time. She does respect me though and i feel she does listen to me. She really hates feeling down and it frustrates her too! She does live on her own but always has to have people around her and usually have one very good friend who stays with her .. until they fall out. Then it will be another friend .. until they fall out. This happens alot. I hope i can `get through'' to her and help her. Thanks for the advice! x
Thank you Averielle. I take everything you say on board and will see what i can do to help her. Some good tips there :-) - I may contact you for more guidance at some point too! Glad to hear you have overcome it!! x
Hello,
I dont know about bi polar either, but generally I would advice seeing a professional and if you do, maybe discuss with him what can be done to make her bit cope with what she is going through. I went through really depressed stage of my life in the past and professional help was bit helpful, as there are ways you can use to cope. But it needs to be someone she can trust and she feels comfortable with. Sometimes medication does not help. A friend was raped many years ago and she needed both medication and professional to get her out of the mess she became. She can still be scared at times, but she was really bad. I sometimes found her also with her hands cut. So I know how worried you are. Maybe also meeting with others who are in the same situation may help, as she will get tips on how to cope. Not sure if there is e.g. internet forum for people suffering bi polar. She may find it easier to talk over the internet, rather than person, but I dont know her so not sure which she would prefer.
If she keeps things from you, it could mean she is bit scared to actually tell you about what she is doing, she is not sure how would you react. So if you want to approach her, I would do it carefully.
Also it would be good if you tried to find out about bi polar by talking to a doctor, so you know exactly what the illness is about. Alternatively you can try books first. And then go with questions.
And I agree with AA for the advice to change the cutting. My friend ended up slapping her wrist with a ruler, which hurted, but did not cut her anymore.
I must agree with the elastic band idea. Not sure about the red pen, but I guess it's worth trying. I don't know why I overlooked that idea. Probably because I haven't done it myself. I guess sharp, stinging pain would substitute the cutting. Even though she's still hurting herself, at least she's not cutting herself. But she may feel the need to cut, simply to see the blood.
It is a difficult situation to be in. She just needs to remember the times when she's happy and realise that everything's going to be okay. People tend to forget about when they were happy when they become depressed.
I can't say for certian that the antidepressants will help her at all. Unipolar depression tends to be due to a lack of serotonin (the feel good chemical, or neurotransmitter, in the brain), whereas bipolar depression is something else in the brain. So I think antidepressants only help people with unipolar depression. There are antipsychotic drugs, but again, I think that's lithium, which I suggest you stay away from unless she's becoming worse. I don't think it's bad to use it a few times, but when she's on lithium for too long, she'll essentially become addicted to it, but not in the sense of drug addiction. Just that she needs bigger doses to recieve the same effect.
Looking at the 'anipsychotic' page on Wikipedia, it does specifically say 'bipolar disorder', but the effects of withdrawal are bad. I'm not exactly sure what antipsychotics do. You could speak to the doctor about antipsychotics so that you can understand them much better than I do.
I know you can't get addicted to antipsychotic drugs, I just worded it badly. I should've just simply said tolerance levels (did I use the right word?) increase and that there are withdrawal symptoms. I don't really know much about antipsychotic drugs. I did Psychology at college, and lithium was the one that cropped up quite often for treatments for bipolar disorder.
Dee, I think your daughter need to see a psychologist of whatever sort. If she's using drugs that are effective in controlling her behaviour, it can be made further effective with professional help to change her automatic thoughts.
All the major points have been covered by others; one thing I will clarify is that if her mood swings are intra-day (i.e one extreme to another and back within hours) then it's more likely that she has borderline personality disorder than bipolar - there's a large degree of commonality between symptoms and one is often misdiagnosed as the other.
if she's not already, she needs to be referred to a psychiatrist for evaluation, full diganosis of either disorder usually takes a period of years of observing patterns, trends, identifying the cycle and seeing how various types of life event/external stimulus affect mood, in terms of both stability, lability and directionality.
Some sufferers respond well to drug treatment alone, some better to talking/cognitive behaviour therapy alone (in milder cases - there's no uniform presentation/manifestation of either disorder), others to some balance of the two.
A mood stabiliser and/or AD that works a particularly way for one sufferer may not do so for the next, lithium is far from a panacea for the condition. In the case of bipolar I/ bipolar II and cyclothymia, one must balance the stabilising effect against the side effects of a drug or a combination of them - some side effects of some ADs and stabilisers can actually exacerbate symptoms to further extents than previously experienced.
The condition arises from a defective chemical mechanism in the brain for regulating either the production (not enough or too much) or reabsorption of seratonin - the happy hormone. So when there is too much of it in the system - mania sets in, when it drops, then comes depression/suicidality/self-destructive behaviour.
Quite often undiagnosed sufferers end up unconsciously "self-medicating" the condition by seeking out things that tend to produce happiness (i.e. seratonin), which can be drugs, gambling, promiscuity or other forms of temporary stimulation, likewise other drugs like alcohol depress mood, so they drink to alleviate mania - which then swings the pendulum back to depression/suicidality, so then they engage in the other pursuits and so the overall destructive pattern goes.
Self-harming has a couple of aspects to it: some times it is a person's tentative attempts at suicide, but more usually it is the sufferer trying to alleviate emotional pain by producing physical pain, with the cutting/harm - physical pain is felt, but emotional relief comes from that displacing mental torment - albeit temporarily.
It's a brutal condition and the effects upon not only sufferers, but their loved ones/carers can be immense. It usually presents itself in late teenage years to early adulthood, but in milder cases can be simply diagnosed as periods of depression (unipolar depressive disorder) withthe occasional period of happiness not noticed because nobody goes to the doctor for feeling happy do they?
That's often the case with Bipolar II sufferers who don't get the full mania, but "hypomania" instead and psychotic features are usually absent. In bipolar I, psychotic features are a defining feature (as they are in borderline personality disorder). Such symptoms are feelings of invincibility/"god-like" delusions of grandeur, hallucinations (visual, auditory or sensory). Do note that whilst psychosis is a scary word - it is not interchangeable with psychopathy (antisocial personality disorder).
I type the above not as a mental health professional, but as a bipolar II sufferer with a bipolar I half-sister and borderline personality disordered half-brother (which sits between bipolar and antisocal disorders) and other family members variously diagnosed. Bipolar is a mood disorder, borderline is a personality disorder, but as ever there's not a crystal clear line between them.
Do lots of homework and talk to both sufferers and carers of them. There is an excellent forum for knowledge and support at:
http://www.bipolar4all.co.uk/
or
http://www.mind.org.uk/
There is no cure, but the condition can be managed. The degree of success of that management is hugely dependent upon the sufferer's attitude and role in their own care - which unfortunately can become a bit of a vicious cycle at times, especially in the early days of accepting a psychiatric diagnosis (yet we accept somatic ones quite freely, the brain is just another organ, albeit a phenomenal one, both figuratively and literally).
It does get better - but it's not easy and it's a hard road. through life and takes a lot of love from those close to sufferers - and a toll on them too. It's telling that there are support groups for those supporting sufferers of these mental health conditions, let alone the sufferers themselves.
Excellent post Ellipsis, i for one appreciate it! I've never been to a doctor/psychiatrist about my moods but in more recent times i've thought more about it ( i've long believed i have some form of bipolar, and know a few others with forms of it ). Unfortunately i suffer from paranoia and delusions when it attacks me so i'm never really trust what my brain tells me.
It's changed over the years, and so has how i've dealt with things. I used to drink heavily, now i hardly do at all. I try to keep things balanced now, and am thankful to a fantastic wife who's very understanding and helpful. The hardest thing at times is trying to not enjoy the feeling of depression, if that makes sense. Probably doesn't! But it sucks you in.
I can understand the want to cut yourself, even though i've never done anything like Dee's daughter. Like was said above, it kinda relieves mental pain, in a way that probably seems odd to most. The best thing i could suggest is not letting things build up, but they do so quickly sometimes. It's very difficult to find an outlet for thoughts, it can feel like you shouldn't tell anyone, especially parents. Or partners. You think you're gonna scare people away. People you hardly know are easier to talk to in my opinion.
Not sure what else to say to help, other than trying the links Ellipsis has provided. I hope she can find a balance soon and hold on to it.
Self harming is really complicated. It has a mix of so many emotions involved in it. It really does become addictive almost like a drug and like a drug the amount you need can start to escalate. The mix of release, the physical sensations, the temporary sense of control, are amazingly strong but can be very short lived. There are then the very complicated emotions of shame and desperation that can follow afterwards. Stopping self harming is really hard. Most therapists advise ensuring that the self harm is limited and the dangers minimised rather than stopping suddenly. I self harmed for years. I hid it from everyone. I stopped when I finally admitted that I used self harming as a defence and an escape from some unbearable feelings I had about myself. I was only able to stop by making some very strict rules. I made it so that if I needed to self harm, I would use the rubber band first, then when the need resurfaced I would write down a plan of exactly how I would hurt myself and wait for at least an hour afterwards. Making myself go through these steps first meant that I reduced how often I self harmed. Eventually after reducing it a lot, I was brave enough to admit it to 2 people, my husband and my best friend. The final part of stopping self harming was agreeing that I would never do it wthout speaking to them first. I can now never do it, knowing that I have to tell them first and the way they would feel.I am a survivor. After 24 years of secretly self harming, I have now managed 2 years and 10 months self harm free.
Knowing your daughter self harms must be very hard to bear. Try to see if she will agree to some steps to delay the instant self harming - it won't stop her doing it completely but it might reduce the depth of her cuts. The therapist I saw said that self harming can be a survival tactic when no other way to cope seems to exist for the person. The professional help your daughter needs can start to help her to build less destructive coping mechanisms.
I hope this makes sense. It can be really hard to explain it.
Hugs for both you and your daughter.
I have not read the other posts due to the fact there long and go in to details that I know all to well could triger my own issues.
As far as self harm goes it really is about sort of distracting your self from the sometime's inbarable mental pain that can not really be described in words.
Normally there always tends to be underlying issues for these things I found that out my self when one day something fell apart in my head and a load of memories came flooding back.
And I can tell you sometimes it really can be a case of you find something to take it away or you think about stoppping it permantly.
My twin sister used to do it a LOT and adventually got caught and was given counseling. That did not work for her though.
Thankfully now thats in her past though I dont think we ever really can forget the past.
One thing I find vital to my very survival when I go in to severe moments of depression is somone to vent everything on mostly my friend gets it poor guy.
However there are always times when you will think what the hell's the point you will never get better nothing changes your just prolonging the pain.
But it is in our darkest moments that we need to stay strongest as hard as it is and easy as it would be to grab the lighter and burn yourself or cut yourself with a knife.
The fact is you need to be there for her which you are and you without realizing it are helping her in a masive way.
Thank you guys for your input. Really appreciate it. I found out shes on medication called Citalopram. Its hard to understand why my daughter would want to cause harm to herself especially as I have never suffered with depression but both my sisters and my mother have., so that could be a factor. Its hard to know if someone suffers from it .. unless they tell you.
Has she been prescribed Citalopram in response to telling her GP she's depressed/has mood swings/self harms - or have those symptoms been induced/exacerbated by the drug?I take it as it seems to be the AD that keeps me most balanced for the greatest proportion of the time, with minimal side effects - however the price I pay is in the first paragraph here:
http://en.wikipedia.org/wiki/Citalopram#Adverse_effects
I know it depends what sort of relationship you have with your daughter (some parents and children just can't talk about their own sexuality with each other), but it might give a clue as to things being worsened by the drug and she needs to be prescribed a different AD, either another SSRI or an MAOI (as mentioned above and linked to in the Wiki article).
Note that:
"Citalopram and other SSRIs can induce a mixed state, especially in those with undiagnosed bipolar disorder"
Mixed state = exeperiencing depression and mania together, rather than rapidly alternating between them.
Talk to her and the GP/consultant psychiatrist ASAP as getting the right drug treatment is a trial and error process. I was initially put on Fluoxetine which sent me into a worse/more dangerous state than I'd ever been in when unmedicated for instance.
Dee_licious, I am very sorry to hear about your daughter. Bi-polar is a very traumatic illness to have to deal with. I read a very good book, "An Unquiet Mind" by Kay Redfield Jamieson.You should have a look at that, she is a psychologist who suffers with Bi-polar, and it deals with her experiences, especially with lithium treatments.
I have self-harmed all my life, my first recollection was aged about 6 when I cut my arms to gain attention. As others have said, it becomes an addiction. When I had my kids I stopped for about 10 years, but stress and general depression caused me to start again 6 years ago, and it has got so bad I have needed hospitilization twice. I became very inventive using all kinds of things to injure myself and make it look like accidents.
I really hope your daughter gets to grips with it before it gets out of control. xx
Thanks guys for your advice and all the recommendations. I really want to help my daughter get better.
Ellipsis - she was on something else before Citaopram and that wasnt working. Im sure she has been advised to try it and see how she gets on with it. I am trusting her doctor knows what is best for her. I will keep encouraging her to seek the best medication and if something isnt working them to try an alternative. I would prefer her not to be on any medication but if it helps in the short term then its worth it.
Thanks to all of you who have posted and offered advice - :-)
I cant add anything thats already been said!
I too possibly suffer from Bipolar or Borderline Personality disorder,
& I used to self harm.
The medication is going to help long-term, not short term. ( not being pedantic. )
I really hope things get easier for you soon :) xxx
Dee_licious333 wrote:
Ellipsis - she was on something else before Citaopram and that wasnt working. Im sure she has been advised to try it and see how she gets on with it. I am trusting her doctor knows what is best for her. I will keep encouraging her to seek the best medication and if something isnt working them to try an alternative. I would prefer her not to be on any medication but if it helps in the short term then its worth it.
I would guess that was Fluoxetine as it's quite often the first AD of choice. They're usually green capsules if that rings a bell.
Trusting her doctor "knows best" is well and good, however they have to know exactly how a particular drug is affecting an indivudual to be able to fine tune a viable and "best compromise" course of medication for the long term - bipolar isn't a condition that goes away, it's just managed to better or worse degrees. Get used to drugs being a feature, it's rare for a bipolar sufferer to be able to remain unmedicated for significant lengths of time.
I understand the reluctance to commit to it as a lifelong thing as feelings that the "real you" is being suppressed can arise or you start feeling that you don't need them any more because you're not having any symptoms (because they are working). So you take yourself of them - and you stay OK...
...for a while anyway, then the cycle kicks off again. Everyone who takes psychopharmaceuticals would generally rather not be on them - if your symptoms are mild and you're self aware enough to be able to pre-empt your cycle, then you can of course help yourself a great deal.
It's rough and the aspect of talkign therapy helps too - however, just as with the drug side being a trial and error process, you need a counsellor with whom you can develop a meaningful rapport and importantly, trust - because you need to be able to open up and talk about painful things and irrational and sometimes shameful - or even illegal - behaviours.
It's not a quick or simple process like a broken arm - because those healing processes take care without your conscious input, an atypically functioning brain is infinitely more complex. Note that's not saying sufferers' brains are "broken" - they just work differently to most people's and need a bit more help to retain the balance that most are fortunate enough to be able to take for granted.
There's also one medicine that in my opinion is as vital to successful management as any drug or the best counsellor - that's the love, support and understanding of those closest to us however much we at times try and push you away or retreat into ourselves. That's when we need it the most.
It'll take time and it's no picnic. But there IS light at the end of the tunnel and it does get better eventually. As a sufferer or carer alike, you are never far from someone else who is or has been where you are before. Read up as much as you can and don't be too afraid. There's a world of help out there.
Hello there...
I am 20 years old (almost 21) and I am also bipolar and have self harmed in the past, actually I still do very rarely to this day... I also tried to take my own life two years ago.
I'm not sure what advice I can offer really. I just read this post and knew I wanted to help. Does your daughter take any medication for her bipolar? I used to take mood stablisers and anti-depressents, but that is when my bipolar was at it's worst. I stopped all my medication after my sucide attempt and have actually gotten much better since...
People often think the answer to everything is medication, I think I'm living proof that, that is often wrong. But I guess it is just different for everyone. If your daughter hasn't tried medication maybe she should think about trying something from a doctor...
I found what helped me the most was just talking to someone. Councelling is great for that reason, maybe you could look into getting your daughter some councelling or something, people often say it is much easier to speak to a stranger about things like this than your best friend.
I would just like to say that I think your daughter is very lucky to have a parent like you who clearly cares so much. When I was first diagnoised I told my mum and her words to me were "I don't see why you have to make such a big deal out of it, everyone gets a bit down sometimes" However in October 2009 I tried to kill myself with an overdose of sleeping pills. If one of my friends didn't call me at that time to ask how I was I would be dead right now.
The moment things changed for me was later that same evening of when I tried to kill myself I was laying on a trolly in the hospital in A&E and a man got bought in, he had had an accident on a local road, there were 3 men in the car 2 died, he was the only one alive and he was in a life threatening condition. He was being prepared for surgery literally right in front of me... There was me laying there wanting to die and right in front of me was this man who was dying and desperatly wanted to live... it changed my whole view on life...
Unfortunatly it took something that extream for me, and it's not really something that can help your daughter... I guess all you can do is make it known to her that you love her and that you will do anything to support her...
I hope things get better for you and your daughter xxx
Hi Kathy - i appreciate your input and i am glad you are on the road to recovery, but it took something so drastic for your life to be turned around.
My daughter is on medication, its called Citalopram. Shes just changed over to these.
Re: counselling - my daughter had counselling for bullying at school around age 14 in secondary school but really the bullying she tells me started much earlier. She missed alot of school, would often complain of stomach pains. She was in and out of hospital more times than i can remember with severe pains but they couldnt find anything wrong, she was a very sick teen. She did tell me yesterday shes going to the doctors again to get counselling .. so this may work. I think i kind of tried to ignore her pains.. after so many years and nothing physically wrong i thought it must be in the mind. The doctors said there is something (cant remember the medical term) whereby they do experience actual physical pain but nothing is wrong physically, all in the mind perhaps. I do tell her to try and be more positive, shes got a lovely personality and shes a beautiful girl. She also has a 3 year old daughter who she doesnt see often, if at all. That plays on her mind im sure but i have told her how rewarding it will be to see her regularly when she feels able to cope. Thanks for your advice!
Dee_licious: I have been bullied for years (7 to be honest) at school, but I never missed any. But it does have serious effect on me up to this very date. I had to learn how to control me sometimes spiralling into the dark thoughts I am worthless, noone can like me - yet my mom have always been surprised how confident I am in many respects and how people like me and how easily I make friends. Yet she never knew I went through a period when nothing mattered and I did have thoughts about suicide. It is hard to notice these symptons, but being confident to the world does not mean the person is confident inside. She very likely has some insecurities and some events in the past can affect people many years later. It is even possible, but it may not be so, that the bullying plays some part in what is going on today. It may not be the cause, but these things do tend to come back when the person is weakened and suffering a depression is one state when it can come back - again, personal experience. You thinking she is lovely unfortunately may not stop this. It is in the mind of the person.
I think she should see someone who is used to long term conselling, not just to see if another medication will help. I think a professional psychologist who would work with the doctor and be aware of the medications would be the best idea. I found if there are issues in the mind, simple medication is not going to help. You should combine it.
I hope she is able to get better.