Understanding Self Harm and Suicidal Thinking
This fact sheet discusses suicide and self harm in individuals with eating disorder, and provides tips for supporting an individual with these thoughts as well as contact details for support services.People with eating disorders are at high risk of both self-harm and suicide. Although not everyone with an eating disorder will engage in self-harm or think about suicide, it is important to be remain vigilant. If you are concerned about a family member or friend, it can be useful to develop strategies you can use.
Self-Harm and Eating Disorders
Self-harm (or non-suicidal self-injury) is a deliberate act of self-inflicted injury intended to cause physical pain as a means of managing difficult emotions.
Self-harm is often used to seek relief from emotional pain, to ‘feel something’ when otherwise feeling numb, or as a way of communicating distress to others. Some eating disorder behaviours can also serve as a means of self-injury (e.g. purging).
Self-harm and suicide are not the same thing. An act of self-harm is not necessarily an indication of suicidal thoughts or intentions.
Acts of self-harm should be taken seriously and not misinterpreted as attention seeking behaviour. Talk to the person about what is going on for them without judgement or trying to fix the problem. Encourage them to talk to a health professional about the self-harming behaviour so that they can get the treatment and support they need.
Suicide and Eating Disorders
Rates of suicide and suicide attempts are high among people experiencing an eating disorder, especially Anorexia Nervosa.
While the reasons that people take their own lives are complex, there are a number of factors that may increase the risk of suicide for people with an eating disorder. These include the severity and duration of the illness, substance abuse, excessive exercise and impulsive behaviour.
It is important to take any thoughts of suicide seriously. Comments such as “I can’t do this anymore” or “I just want to die” should be taken seriously. Often suicide stems from the person feeling desperate to end their emotional pain, but not knowing how to effectively deal with distressing feelings.
If you are worried that someone might be thinking about suicide:
- Identify what is making you worry. Be specific. Is it their behaviour, a lack of communication, the way they are talking, or how they are treating other people?
- You may not understand self-harm and suicidal thoughts and behaviours, but do not let that get in the way of talking about it. These issues should be talked about openly and with health professionals.
- Talk to the person you are worried about in an open, non-judgemental and honest way. Create a private space and find time to talk as soon as possible. Tell them what you have noticed that is causing you concern and ask if they have been feeling stressed or overwhelmed.
- If you are worried they are suicidal, ask them calmly and directly. For example: “I am worried that you are thinking about harming yourself. Is this how you are feeling? Have you thought about suicide?”
- Validate the person’s distress and pain so that they know that they have been heard and understood. Thank them for their honesty and openness. Talking about suicidal thoughts takes courage as it often brings up thoughts of guilt and shame.
- Asking someone if they are suicidal may feel difficult, but it shows that you care about them and you will not be doing any harm. It is often a relief for people to be given permission to talk about their feelings.
- Encourage the person to use other, healthy coping strategies to ease their emotions and distress. Encourage the person to talk to their health professional team, or to connect with a health professional.
If someone is suicidal, act now!
Let the person know that thoughts about suicide are often experienced by people with eating disorders, and that they are not alone.
Decide what action to take. If they have a safety plan set up by their health professional team, look at that for ideas. If you are unsure what to do, stay with the person while you ring a telephone crisis support service or a local health professional for advice.
If the person is in immediate physical danger, call emergency services on 000.
If you would like further information on talking about suicide, visit the Conversations Matter website at www.conversationsmatter.com.au for practical resources.
National 24/7 Counselling Services
Lifeline
13 11 14
Suicide Call Back Service
1300 659 467
www.suicidecallbackservice.org.au
Beyond Blue
1300 22 4636
www.beyondblue.org.au/get-support/ get-immediate-support
Kids Helpline
1800 55 1800
