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DELIBERATE SELF-HARM

DELIBERATE SELF-HARM

Suicide is one of the top five leading causes of death in the 15–19 year group, and around 90 per cent of these individuals have underlying psychiatric disorders. Completed suicide is extremely rare before puberty, rising to 4–8 per 100 000 in the 15–19 age groups.

About three-quarters of these are males, and young people who commit suicide are four times more likely than the general population to have a family history of suicide.

The most common comorbidities are mood disorders, alcohol and substance abuse, anxiety disorder, eating disorders, and chronic physical diseases. About one-third of completed suicides had made at least one previous attempt to end their life. Factors that are thought to be involved in the aetiology of suicide and attempted suicide are BELOW:

BIOLOGICAL

  • Family history of suicide or deliberate selfharm
  • Self-harm in close friends
  • Familial mental health problems
  • Neurotransmitter dysregulation: low serotonin Psychiatric disorders

PSYCHOLOGICAL

  • Depression
  • Substance abuse
  • Conduct disorder
  • Anxiety disorder
  • Schizophrenia
  • Past suicide attempt Cognitive factors
  • Low selfesteem
  • Hopelessness
  • Guilt
  • Bullying
  • Confusion regarding sexual orientation
  • Physical, emotional, or sexual abuse Stressful life events

SOCIAL OR ENVIRONMENTAL

  • Family discord
  • Parental divorce
  • Death of loved one Poor care or neglect Imitation— exposure to real or fictional accounts of suicide

The strongest predictor of future suicide risk is past suicide attempts. Deliberate self-harm (DSH) is any act with a non-fatal outcome, which is undertaken with the intention of causing harm to self. It is hard to obtain accurate figures of the prevalence and incidence of DSH as most young people never present to psychiatric services.

Surveys of schoolage teenagers suggest 10 per cent of 15–16 year olds have harmed themselves in the previous year, with the majority of these having done it more than once. Females Are four times more likely to self-harm than males.

The most common methods of self-harm are cutting and taking paracetamol overdoses.

HOMOEOPATHIC MANAGEMENT:

ALUMINA : Suicidal tendency or impulses when seeing a knife or blood. Alumina patients are sad, apprehensive, wants to get away, everything is viewed in  sad light.

AURUM METALLICUM : Aurum met. is one of the best remedies for depression, which leads to suicide. Aurummetallicum patients are very serious people, strongly focused on work and achievement, who become depressed if they feel they have failed in some way. Nervous breakdown. Thinks of committing suicide but fears death greatly. Disgusted of life and thoughts. Profound despondency. Peevish. Rapid and constant questioning without waiting for answers. Oversensitive to noise. Discouragement, self – reproach, humiliation and anger can lead to feelings of emptiness and worthlessness. The person may feel worse at night with nightmares or insomnia.

NATRUM SULPHURICUM : Suicidal impulses, has to use self-control to prevent shooting himself. Mental troubles arising from injury to head or ill effects of falls. Depression worse music or subdued light, sitting near a stained-glass window. Natrum sulph. patients are sensitive and suspicious. Dislikes to speak or to be spoken to.

NUX VOMICA: Suicidal tendencies in alcoholics. Very irritable. Nervous and excitable. Suicidal, homicidal impulses. Fear of knives, lest she should kill herself or others. Impulses to shoot himself with a gun or jumping from a height.

SEPIA: Wants to commit suicide. Nobody knows what she will do next. Sepia patients are irritable, angry and sensitive, easily offended and miserable. Indifference to those love ones, aversion to occupation and family.

SILICEA: Mood changes due to hormonal imbalance. Loss of self- confidence, dreads failures. Fixed ideas. Sad, hopeless. Disgust for life, wishes to drown herself. Cries when telling her symptoms. Disgust of life. Anxious towards evening. Bearing down sensation in pelvic region.

THUJA OCCIDENTALIS : Dullness of mind. Fixed ideas. Thinks his blood is dirty or poisoned. Emotional sensitiveness, music makes weeping and trembling. Mental depression after childbirth. Over-excited, she is tempted to kill herself, till she bleeds.