Your health

Many people experience thoughts of suicide or self-harm. You are not alone in feeling like this.  People struggle to cope at one point or another and going through a range of emotions during this time is common.

Self Harm

There is no magic solution or quick fix for self-harm, and making changes can take time and involve periods of difficulty. It is common to make some progress and then get back into old behaviours again. If this happens to you, remind yourself that this is all part of the process.

It can help to:

• Work out your patterns of self-harm. Are there certain times of the day or week when you are more likely to self harm? It might help to keep a diary to chart this.

• Learn to recognise triggers – What situations are likely to trigger the urge to self harm?
• Learn to recognise urges – What feelings do you have before you self harm? Whereabouts in your body do you feel them?
• Distract from the urge to self-harm –You will often find that the urge will reach a peak and then pass.  Listen to music, do housework, exercise, cook a meal, phone a friend.  Relaxation techniques like yoga or meditation can help.
• Build your self-esteem –You might want to seek counselling or support for this or use a self-help book or website.
• Look after your general wellbeing – eat regular healthy meals, ensure you get enough sleep, take regular exercise.
• Reach out for support– If you are self-harming regularly it is important to get help.  You can speak to your GP or call a support helpline such as the Samaritans (116123 freephone) or Breathing Space (0800 838 587 freephone)

• Do something creative this can help you to express your feelings. For example, write a song, story or blog, paint or draw.
• Spending time every week doing things that you enjoy, such as seeing friends or going for a walk, is also important. Try to make time to do this, no matter what else is going on.

Suicide

Thoughts of killing yourself can be complex, frightening and confusing. Many people have thoughts of suicide at one point or another.   Not all people who die by suicide have mental health problems at the time of death. However, many people who kill themselves do suffer with their mental health, typically to a serious degree.  

Sometimes, if a person has been feeling low for a long time, suicide can seem like the only logical way to stop feeling like that. However, feeling actively suicidal is often temporary, even if someone has been feeling low, anxious or struggling to cope for a long period of time. This is why getting the right kind of support at the right time is so important.

If you’re reading this because you have, or have had, thoughts about taking your own life, it’s important you ask someone for help.  It’s probably difficult for you to see at this time, but you’re not alone and there is help available.  

• Samaritans 116 123
• Breathing Space 0800 838 587 (Freephone)
• If you find yourself in an emergency please call NHS 24 on 111.

Thoughts of harming yourself can be deeply distressing.  Having these thoughts and urges can make you feel isolated from other people as you don’t want to worry them or burden them with your difficulties.  This can make it difficult to be supported by others at the time you need it most.  It is important to remember that feeling actively suicidal is often temporary, even if you have been feeling low or struggling to cope for a long time.  The urge often reaches a peak and then passes.  This is why getting the right kind of support at the right time is so important. 

The same applies to living with the urge to harm yourself. Self harm often develops as a way of managing difficult feelings.  Once you become dependent on it as a way of managing these feelings, it can be difficult to stop.  Again, it is important to remember that the urge often reaches a peak and then passes.  Acknowledging that you are struggling and seeking help and advice is an important first step towards recovery.

If you’re reading this because you have, or have had thoughts about taking your own life, it is important you ask someone for help.  It’s probably difficult for you to see at this time, but you are not alone and there is help available.  

If you find yourself or someone you know in an emergency please call NHS24 on 111

These are free phone numbers, which offer confidential listening, advice and support: 

Samaritans 116 123

Breathing Space 0800 838 587 (Freephone)

It can be very upsetting to be close to someone who self-harms – but there are things you can do. The most important is to listen to them without judging them or being critical. This can be very hard if you are upset yourself – and perhaps angry or frightened – about what they are doing. Try to concentrate on them rather than your own feelings – although this can be hard. It is important to remember that most people who self harm do it as a way to cope and live with difficult feelings.  It does not mean that they are suicidal. However, self harm should always be taken seriously and it is important not to minimise or dismiss the behaviour.

Things that you can do to help include:

• Let your friend or family member know that you are there, if and when they are ready to talk. It is common for people to worry that they will be judged for their self-harm or that they will be a burden on others, so it’s important to let them know you are there for them if they want.
• Show concern for their injuries, but at the same time, relate to them as a whole person rather than just someone who self-harms.
• Offer them a chance to talk about how they are feeling. Try to understand and empathise with what they are saying even when it is hard to hear.
• Try to understand that they may be scared of stopping self-harm if they use it as a way of coping. If they are finding it hard to stop, try to help them find other ways of coping and to seek help if they need it.
• Let them be in control of decisions about support and any plans to reduce or stop their self-harm.
• Emphasise other parts of their life where they are doing well and the good qualities that they have.

Supporting someone who is self-harming can be a long process with many ups and downs. It’s important to take care of yourself– this will help you to be able to stay involved for longer and avoid becoming unwell yourself.

Supporting and caring for a person who is thinking about suicide, or may have attempted suicide previously can be very stressful and difficult.  You may feel alone and scared and not know how best to help the person in your life. There are organisations, which can help you.

One of the best things you can do if you think someone may be feeling suicidal is to encourage them to talk about their feelings and to listen with patience to what they say. Try to understand how they must be feeling and try to engage with any part of them that wishes to live.   

If there is immediate danger, make sure they are not left alone and contact NHS 24 (111) for advice

Further information for carers is available on the NHS Greater Glasgow and Clyde carers site

At times in our life we can all find it difficult to cope, sometimes we harm ourselves or think of ending our lives, for help with these feelings please try the following sites.

Self Harm

There is more information about self harm from MIND

The Royal College of Psychiatrists provides a helpful leaflet with information about seeking help for your self harm.

MIND provides information about what family and friends can do to try to help someone who self harms.

If you feel you are drinking too much alcohol or taking illegal drugs these websites may be useful. 

• Alcoholics Anonymous
• Narcotics Anonymous

There is more information if you are harming yourself through restricted eating or excessive exercise, restricted eating and then bingeing or if you are self harming through intentionally poisoning yourself.

Domestic Violence

• If you are a female experiencing domestic violence here is some information that may be useful for you. 
• If you are a male experiencing domestic violence there is some information that may be useful for you.

Personality Disorder

There is information should you feel you may be experiencing a personality disorder. 

Survivors of Trauma

For survivors of trauma and abuse these websites may be helpful. 

• Rape Crisis Scotland  

There is information on improving your general self esteem and confidence.

If you have been bereaved or affected by suicide these websites may be helpful.

• Cruse Scotland
• UK Sobs

Self Help Resources

There are self-help guides from Get Self Help, NHS Inform and Help Guide

NHSGG&C BSL A-Z: Mental Health – Self-Harm

At times in our life we can all find it difficult to cope, sometimes we harm ourselves or think of ending our lives. Self-harm is a way of coping with very deep distress. The ways in which people harm themselves vary and can be physical such as cutting or less obvious such as putting themselves in risky situations or not looking after their physical or emotional needs.

NHSGG&C BSL A-Z: Mental Health – Suicide

Please note that this video is from a range of BSL videos published by NHS Greater Glasgow & Clyde

EMERGENCY – If you, or someone you know, need an immediate response call the emergency services on 999.

CONFUSED / DISTRESSED – If you are experiencing confusing or distressing thoughts, or if people around you have expressed concern about your well being, arrange an appointment with your GP or call NHS 24 on 111.

If you, or someone you know, are currently being seen by someone from a community mental health team and require urgent attention, please contact the Out of Hours Team by the number you will have been provided with.

SUPPORT – If you just need to talk with someone, then the following organisations are here to help:

Samaritans – 116 123 (freephone)

Breathing Space – 0800 83 85 87 (freephone)

Please note: if you go to an Accident and Emergency Department because of worries about how you are feeling or what you are experiencing, they will be able to assess your difficulties and arrange for you to see a specialist if needed. But Accident & Emergency is a busy and stressful place, and you may have to wait a long time. It can be quicker to phone NHS 24 on 111, as they can arrange for you to get to the right help.

Heads Up is not continuously monitored and is not able to provide direct advice or support to those in mental health distress.

The ‘Flight or Fight’ response

The ‘fight or flight response’ is our body’s own protective response to danger and, in essence, it is a mechanism designed to protect us, and not as it feels, destroy us.

Our bodies are designed to respond to danger; we have an inbuilt defence mechanism known as the ‘fight or flight response’, which triggers psychological and physical changes in our bodies.  The release of chemicals can give very real physical symptoms such as rapid heart rate and breathing. These symptoms are designed to give us the ability to ‘fight or flee’ a specific danger, however for a panic attack sufferer, someone who suffers from anxiety or someone experiencing stress, these feelings can feel intensified and with no present danger.

Why do we have the “Flight or Fight” response?

This sudden burst of adrenaline, the increased oxygen and heart rate, gives our bodies increased abilities and sensory perception – which if you need to flee a wild beast or save your family from a burning building will indeed be used to maximum effect. If however you are simply doing your grocery shopping, taking your child to school, or sat watching TV for example, these frightening feelings can be extremely difficult to cope with or explain.

If there is no need to use the excess chemicals; adrenaline or the increased oxygen supply, then our bodies begin to act against us, the decreased carbon dioxide levels in our lungs and blood causes us to feel dizzy and disoriented, we can begin to hyperventilate and a panic attack can ensue.

There are a range of things you can do if you feel like you are stressed regularly. There are physical activities and mental tricks you can try to help; some are activities you can implement when you are in a stressful moment and others are things you can do to try and reduce your overall stress levels and prepare for future challenging times.

• Be Active
• Take Control
• Connect with people
• Have some me time
• Challenge yourself
• Avoid unhealthy habits
• Work smarter not harder
• Be positive.

Stress is frequently described as the feeling of being under pressure. Some people describe feeling under threat, anxious, tense, tearful or agitated. Often these feelings are accompanied by physical sensations. It is important to note that these reactions are normal but everyone experiences stress in their own way so your reaction may appear to be different from a friend or family member’s.

If stressful times pass, the body will usually return to normal functioning after a period of time. However if you feel that you have been stressed for some time you make be advised to seek support from your GP.

When people are stressed they can make choices they would not usually make and behave in a way that is a little different from usual.  From the outside you might notice a person saying or doing things that are out of character, someone struggling to concentrate, physically appearing more tired than usual, eating and drinking more or less than usual, taking more or less time over their general presentation than usual and/or appearing to be rushing or forgetful.

Stress is something many people feel for short periods in life but difficulties arise if this experience persists.

Further information for carers is available on the NHS Greater Glasgow and Clyde carers site

Whilst the above resources will be helpful for your understanding of stress, the award-winning Power of OK campaign from Scotland’s See Me programme gives some very practical advice and contains an accessible video resource to explain all (videos contains strong language)

One resource you may find helpful for coping with stress is the Glasgow Wellbeing resource, which includes a free guide to download, and relaxation videos. In addition, the website has a range of other support materials to help you think about the causes of stress.

Glasgow Wellbeing is full of helpful and informative resources

NHS Choices suggest 10 tips to beat your stress.

This is an NHS resource with instructions for breathing exercises, which are recommended to help ease the feeling of stress

Resources created specifically for young people

The Royston Stress Centre which offers an outreach service to 11–18 year olds in North Glasgow have made an excellent film to help young people understand stress:

Ayemind website contains child-friendly resources explaining stress and includes information on child-specific stressors such as school exam stress

The Royal College of Psychiatrists have a leaflet for young people who are managing stress

A free mobile application called SAM – Self Help for Anxiety Management – has some useful resources and can be carried around with you subtly on your phone

SafeSpot is a brand new app for iPhone and Android that promotes positive mental wellbeing in children and young adults. 

If you need someone to talk to

Breathing Space Scotland has a phone line and an associated therapy service called Living Life

Samaritans offer a 24/7 confidential support service which includes a phone line: 0141 248 4488, a freephone number: 116 123 and an email service: jo@samaritans.org

Childline

NHSGG&C BSL A-Z: Mental Health – Stress

Stress is normal and it affects everyone. It usually happens when you are in a situation that puts you under pressure. It can happen when you have lots to think about or do or when you don’t feel you have much control over a situation. It usually happens when you have things to do that you find difficult to cope with. Many situations can cause stress including relationships, work demands, financial worries and so on. It can have an effect on our emotions, thoughts, behaviour and physical wellbeing

Please note that this video is from a range of BSL videos published by NHS Greater Glasgow & Clyde

Often, beliefs about ourselves are conclusions we arrive at due to the things that have happened to us in our lives. If you’ve encountered negative experiences in your life, particularly in your childhood, you may hold very negative thoughts and beliefs about yourself.

If you have been neglected, mistreated, abandoned, abused or punished in extreme or unpredictable ways, you can come to believe very negative things about yourself and these experiences may cause you to develop low self-esteem.

Constantly being criticised can also cause you to develop negative beliefs about yourself. Your parents, carers or other family members making fun of you or highlighting your weaknesses instead of acknowledging your successes and strengths can also have a negative impact on your self-esteem.

Other factors that cause low self-esteem are:

• Feeling as if you do not fit in anywhere (at home, at school)
• Feeling intellectually inferior to or less talented than your siblings or peers
• Feeling that you or your family is considered different or less socially acceptable by others
• If your family was on the receiving end of prejudice or hostility
• If you had an emotionally distant parent or carer
• If you had a parent or carer who was not physically affectionate or able to spend time with you
• If you did not receive enough attention, encouragement, warmth or praise as a child.

If your parents had to give their attention to dealing with stressful or difficult life events and were therefore unable to give you much attention.

In young people?

In late childhood and adolescence, physical appearance and how you feel about your body may start to become very important. People around the same age can also influence how you see yourself. If the people around you say negative things about you or tease you about your physical appearance, you may start to feel you are ‘unlikeable’ or ‘ugly’. This is often made worse by messages conveyed by the media, for example, that we should be slim and physically attractive to be worthwhile.

Later in life?

Negative beliefs tend to develop in childhood. However, being bullied or intimidated at work, being in an abusive relationship, experiencing prolonged financial hardship, continuous stressful life events, traumatic events, or life-changing illnesses or injuries can trigger low self-esteem later in life.

What helps overcome low self-esteem?

Low self-esteem is underpinned by negative thoughts relating to how you view yourself and how you believe others view you. One of the main ways of dealing with low self-esteem is to try and work on these thoughts.

Ways to work on your thoughts

One way of overcoming low self-esteem is to appreciate yourself more and notice your own personal qualities, everyday. Record all the good things about yourself and ask others in your life for help.

At the end of each day, think about what you have done and what personal qualities you displayed. For example, if you went to work that day and arrived on time, the quality you showed was good time management. If you listened to a friend’s worries, then you display qualities such as kindness, empathy, being a supportive friend and a good listener, as well as many more.

The key is to continuously develop a record reflecting your worth so that you can look at this when the negative thoughts creep in.

When the negative thoughts about yourself creep in, challenge them, put them to the test, are they as true as you believe, would they stand up to scrutiny in court. Put your thought (not you) in the dock. Pretend that you are a lawyer paid lots of money to prove to a jury that the thought is true. What would you say? Remember the judge is watching. The judge will only allow evidence to be presented in court, not your opinion. Evidence from expert witnesses can be given, so who would you call to the stand? Next pretend you are the other lawyer, being paid lots of money to prove that the thought is not true and to contradict your fellow lawyer’s evidence. What would you say, what expert would you put on the stand?

You are now a jury member, you’ve heard what the lawyers and their expert witnesses have to say, what will you conclude?

There is more information on this technique and information about facts versus opinions.

Ways to work on your thoughts about your appearance

We are constantly being told if you want to be happy you need to look a particular way or fit a particular style of clothing. Try and see this for what it is, marketing to sell a product. You will never fit into clothes in all shops or match the ideal image that they are portraying because the shops on your high street originate from many different countries where the ideal image and body shape differs greatly.

Ways to work on your behaviour

Try to be assertive and project confidence as this will encourage others to treat you with more respect, which in turn will help you feel more confident and of greater worth. Even if you do not feel confident, you can “fake it until you make it” with some simple behavioural strategies to give the allure of confidence. The Centre for Clinical Interventions has information on the skills in assertiveness that everyone can do no matter how they feel inside.

People with low self-esteem tend to withdraw from the world in general. You may tend to do less of the things you find pleasurable. One way to improve your self-esteem and sense of achievement is to start doing things again a little at a time.  Try to make a list of the things you did previously but stopped or new things you would like to do.  Use this weekly planner to start reintroducing these activities.

Engaging in physical activities is a great way to build confidence. In fact, a recent study found that women aged 18 to 24 are twice as likely to be confident and have high self-esteem if they play sport. You can get a sense of achievement from physical activity. Due to the chemicals released during exercise, you can also experience an improvement in your mood. If you prefer to exercise alone, you may benefit from downloading an exercise app, such as Runkeeper or Nike+ Training club – workout & fitness plans. These allow you to track your achievements. You can also join the social media forums available so you can get encouragement from others.

How to support someone with low self-esteem

There are several ways to support people with low self-esteem. You can help by continuously pointing out their positive qualities and achievements.  You can encourage them to write these compliments down as a record of their own personal qualities.

There are several ways to support people with poor body image. You can point out what their body enables them to do rather than what their body looks like and highlight that everybody looks different.

Advice for parents trying to nurture self-esteem in their children:

As a parent you will be aware that young children are being bombarded with messages about how they should look and behave. Disney characters are often female and beautiful or male and strong. In teenagers there is often talk of the amount of muscles a boy has.

It is important to let our children know that everyone matures at a different rate and everyone has a different body shape, that your looks do not determine your value but rather it is what you achieve and contribute in life and the person that you are that counts.

• Here is more advice for parents on nurturing positive self-esteem
• Here is more advice for parents on nurturing positive body image
• Here is more advice specific to nurturing girls self-esteem from The Amighty Girl.

The Amighty Girl Facebook page is also helpful, as each day information about inspirational girls and women is posted and not one is inspirational because of their looks but rather because they are different and have achieved something great.

Further information for carers is available on the NHS Greater Glasgow and Clyde carers site

If you would like to find out more about self-esteem and ways to improve low self-esteem either in yourself or others, there are several websites listed below that may be helpful.

• Centre for Clinical Interventions 
• MIND 
• NHS choices 
• Kidshealth.org 
• Overcoming self-esteem 
• Overcoming low self esteem by Melanie Fennell is a self help book and is available online for free and is held by many Glasgow libraries