This is the second installment of our blog series on the differences between self harm and suicide. Last week we covered four factors that influence self harm and suicide; intention, method, frequency and emotional pain. This week we are covering four more factors that differentiate the two.

1. Thoughts?
   In addition to emotional pain there are also differences in the thought processes of those who are suicidal and those who are self harming. People who are suicidal tend to think in black and white terms, their thinking is restricted and they might not be able to consider alternatives. People who self harm are generally more flexible in their thinking, they are more able to consider a wide range of options but might feel overwhelmed by their thoughts.
2. Hopelessness & Helplessness
   People who are suicidal usually experience feelings of hopelessness and helplessness, they may feel as though nothing will ever change and they may feel helpless to make a change. These feelings may lead them to consider suicide. On the other hand, people who self harm do so as a way to cope with hopelessness and helplessness. The act of self harming gives them control over their lives, making them feel less helpless and less hopeless.
3. How Do They Feel After the Fact?
   Someone who is suicidal but didn’t die as a result of their attempt may feel the same as beforehand or they might feel even worse. They may feel increasingly self critical following an attempt. Additionally, they may regret their actions, feel embarrassed and guilty. If someone feels self critical and disappointed in themselves following an attempt they are higher risk of another attempt compared to those who feel guilty, embarrassed and regret their actions.
   In contrast, someone who self harms may feel relieved after the fact because self harm is their coping strategy. That being said they might also feel guilty for engaging in self harming behaviours. Shame and guilt play a large role in the self harm cycle. See the chart below for more information.
4. Support & Prevention
   Prevention is a bit more straightforward for those who are suicidal vs. those who self harm, that being said both situations are difficult. If the tools that suicidal people need to carry out their plan aren’t accessible they are less likely to act on their plan. This is due to the fact that their thinking is likely constricted, it is unlikely that they will use an alternative method.
   The same is not true for those who self harm. As their thinking is less restrictive they are able to be more creative. If their usual method isn’t accessible they will find another way to harm themselves.
   Intention, method, frequency, emotional pain, thoughts, hopelessness and helplessness, feelings after the fact and support and prevention are the key factors that differentiate self harm from suicide. We now understand the differences between self harm and suicide, next week’s installment will cover how these two concepts overlap.

Caring for someone who is suicidal or self harms is incredibly scary, review our help section for more information or call 911. Make sure you take time to care for yourself during this time. You will be better equipped to help your loved one if you are healthy as well.

This is a heavy and serious topic. Both suicide and self harm should not be taken lightly. If you are worried about yourself or your friend reach out for help: mindyourmind.ca/help

If you want more information about self harm check out “Self Harm and Coping Tips”.

This article from our Illnesses section has information about Suicide.

References:
Notar, M. (2019). Suicidal or self-harming? Assessment and treatment of “at risk” teens [Course handout]. Kitchener, ON: Wilfrid Laurier University.