Self harm and self soothing

[Daedalus28]

One problem I always have in dealing with bipolar depression is that depressive episodes come on quickly with very little to bring me out of it. I find that I end up relying on brief periods of binging (usually just smoking a lot of cigarettes giving me a nicotine high and then cutting) to keep me mentally stable. The positive side is that I experience no lows afterwards - if anything I stay in a much better mood than I would otherwise. That is to say that although I’m frequently in a state of depression I am not in a crippling, debilitating state that I would be in otherwise.

One problem I have with all other forms of self soothing, therapeutic modalities is that they are very much based in the moment (I think of DBT in particular) and aren’t particularly powerful. You feel a little better when you do it but then after that are back to your usual miserable state.

I’m wondering to what extent others have had the experience of living genuinely happier lives because they engage in “unsafe” behavior. (I’m not advocating it)

I find the kind of binging mentioned above is the only thing I can do to counter extreme negative mental states (sticking your hand on ice or using a rubber band on your wrist - both from DBT - simply doesn’t cut it - in fact often makes things worse and more ruminative).

My question is about what sort of techniques people use that are intense enough to counter very negative emotions that if gone unchecked could lead to suicide.

I understand where ur cuming from I'm currently on Dbt n I often get frustrated that the distress tolerance skills just get u through the moment
But then my therapist reminds me if my long term goals do I wanna b doing destructive behaviours for the rest of my life n that the fact emotions do go up n down like a wave n might altar etc

But I do understand where ur cuming from sorry I don't have much useful things to say

[sherlock holmes]

If some DBT strategies are based 'in the moment' then I don't see how your methods of self harm are any different? You're self harming in the moment.

I tend to use different DBT techniques when I struggle with depression, urges etc. Distraction sometimes works for me, but I tend to use Mindfulness to clear the negative thoughts for a while. I tell myself that how I'm feeling wont last forever, and that the urges and negative thoughts come like waves. I just have to let the wave hit and then recede, which it always does.

Self harming might make you feel like you've pushed that wave back quicker, but the wave will still recede by itself without any intervention. You have to ride it out but bad peaks only tend to last for 10-15 minutes or so. It seems incredibly hard the first few times you try, but once you've done it a few times you can trust the fact that it works and nothing awful happens when you don't self harm.

It's ultimately about taking responsibility for yourself and knowing that self harm is not inevitable or the only thing you can do to reduce your distress. You might feel that after using coping skills you go back to your 'miserable state' but it's about realising that you CAN cope with the bad times, and eventually you will naturally get through the other side. You will have to sit with your emotions, you can feel depressed and not panic and self harm because emotions by itself cannot hurt you.

If you've done DBT before can you go back to your therapist and revisit some skills that you feel are more helpful?

[Daedalus28]

Thanks for the suggestions - I haven't done DBT for awhile though my therapist is well-versed in it. Maybe next time I see her I'll try to come up with DBT skills/responses to use with a variety of problematic emotional situations. It's always difficult because whatever seems to feel best is that which is the worst for you (me anyway).

[talaiporia]

Sometimes it needs 'topping-up' I believe, or at least regular practice to keep it working. It might be worth refreshing it.

[Serendipity.]

I am wondering what it is about the self harming behaviours that mean you stay in a better mood whereas other techniques don't have that effect? If you can work that out, maybe you can use it to find other things that might help.

I know this probably isn't terribly uplifting, but the only reason I don't self harm anymore is because I learnt to accept my feelings and be able to sit with them. I relate to what you're saying about self soothing etc not really making a great deal of difference overall, and I used to get really frustrated with that. But now I can accept that I might feel like **** for a long while but that it will pass eventually and no matter how bad it feels it isn't going to kill me. Knowing that I *can* bear it even when it feels unbearable means that I don't feel the need to hurt myself. I'm still searching for a way to not get so low, though.

I hope you find something else that helps.