Ana Death

 How do you feel right now.........

Angry 

• Squeeze ice.
• Do something that will give you a sharp sensation, like biting a lemon.
• Excercise.
• Take a walk.
• Crumple pieces of paper. Rip them up.
• Take a cold shower. (But make sure the presence of razors won't make the urge worse.)
• For some people, it works to imagine getting even with the person who is making them so angry. For others, though, this only makes the urge worse.
• Listen to angry music. Sing along with the tape or CD. Dance.
• Scream. Loudly.
• Snap a rubber band against your wrist.
• Cry. This releases emotions as well s making you feel drained and tired, and if you sleep, things will usually seem better when you wake up.
• Clean or do other housework.
• Beat up something that isn't alive, like a pillow.
• Play a musical instrument, or bang pots and pans.
• Cut up cardboard or an old piece of clothing or fabric.
• Flatten aluminum cans for recycling.
• Pick up a stick and hit a tree.

The logic behind these things is that when you are angry, you have a lot of energy. Most of these are ways to release that energy without self-injuring.

Sad, Depressed 

• Take a bath. Put bubbles in it.
• Read a book that you like. Read a children's book - they always have happy endings.
• Get yourself a present.
• Watch a funny movie.
• Watch cartoons.
• Go out somewhere. Bring a friend.
• Write, draw, play a musical instrument ... express yourself creatively.
• Hug a stuffed animal.
• Hug a loved one.
• Hug yourself.
• Do something that you loved to do when you were a kid.
• Think about a time when you were happy. Try to mentally transport yourself back to that time/place.
• Read jokes or funny stories. You can find lots of those online.
• Go out to eat.
• Talk with a friend. You don't have to talk about SI ... talk about something cheerful.
• Think about things that make you happy. Make a list.
• Do something nice for someone else. That usually cheers people up.
• Call 1-800-TACOBELL. (This suggestion came from someone else a long time ago...)
• Curl up under a comforter.
• Listen to cheerful or calming music.
• Buy a happy meal.
• Play with a pet or a younger child.

The idea behind most of these is to cheer yourself up somehow...

Empty, Unreal, Unable To Feel 

• Do something that creates a sharp sensation. Bite a lemon. Squeeze ice.
• Focus on one thing. Try to describe it like you would to a blind person.
• Put a finger or a hand into a frozen food, like ice cream.
• Put your hands under cold water. Take a cold shower.
• Focus on your breath, on how your chest and stomach move when you breathe in and out. If you weren't real you wouldn't be breathing.
• Eat something mindfully. Pat attention to how it tastes and the sensations that it creates in your mouth. Try to describe it to someone who has no sense of taste.
• List as many different uses as your can for a random object. Give yourself a number to reach - like twenty, forty, or fifty. Try to surpass that number. Don't stop after two or three uses.
• Interact with other people.

Guilty, Feeling Like A Bad Person

• List as many good things about yourself as you can. Give yourself a number to reach - like twenty, forty, or fifty. Try to surpass that number. Don't stop after just a few good things.
• Read something good that someone has written about you, like a letter, a recommendation, or an evaluation.
• Talk with someone who cares about you.
• Do something nice for someone.
• Remember times when you did something good.
• What are you feeling guilty about? Can you change it somehow? Try talking with the person you feel guilty towards. Maybe they don't feel as bad as you think they do.
• If you want to hurt yourself to punish yourself, punish yourself by not allowing yourself to self-injure instead.

Addicted 

• Draw or write on yourself with a red pen or marker.
• Paint yourself with red paint.
• Squeeze ice.
• Snap a rubber band against your wrist.
• Cry.
• Exercise.
• Buy a cheap tattoo, the kind that comes off after a few days, and put it on.
• Look at your old scars. This may trigger you more, so be careful. It may also make the urge go away because you are seeing and experiencing scars, even though they are old.

The point here is to create feelings and sensations similar to those you experience while hurting yourself. Some of these things create visual images like those you may want to see, like scars or blood. Others release endorphins, which is what happens when you hurt yourself and what gives you the feeling of euphoria.

Distractions 

• Read the section about feeling sad or depressed. Most of those things also distract you.
• Look through an old photo album.
• Read old letters or e-mails.
• Clean your inbox.
• Play a game like Solitaire.
• Do random searches online.
• Read about something you know only a little bit about and that you find interesting.
• Open the dictionary in random places and learn new words.
• Make a list. Make many lists. List as many foods as you can think of. List all the online screen names that you have ever had, or all the ones that you know of people you talk with. List all the articles of clothing that you own. List ... you get the idea.
• Think in a language that you don't know very well.
• Try to solve a puzzle.
• Go to a playground. Swing on the swings. Go down the slide.
• Spin around in circles.
• Color in a coloring book.
• Make snow angels.
• Do homework or work on a project for school.
• Make a website.
• Write your autobiography or short stories about yourself.
• Cook.

Waiting

• Play the 15-minute game. Tell yourself, "I will not hurt myself for fifteen minutes." Then see if you can go for another fifteen minutes, and another, and another. Sometimes breaking time down into little chunks makes it easier to manage.
• Pick a favorite singer or band and tell yourself that you will not hurt yourself while listening to them.
• Pick a day of the week and don't hurt yourself on that day. Eventually, add a second day. And then a third. And so on.
• Buy a calendar and give yourself a sticker for every day that you don't hurt yourself.
• Pick a place to be your safe place, a place where you won't cut ... like the kitchen, your room, etc. Go there when you have an urge.

The idea is to wait before hurting yourself ... the urge may go away or be easier to deal with later.

As much as we'd like it to be, self-injury isn't something that can be tucked away in a little corner of your life where it doesn't touch anything else. Even after you've stopped, it continues to affect who you are and how you interact with people. Scars fade but never disappear entirely. Feelings of alienation may subside but still lurk in the background. If you're still actively hurting yourself, life gets even more complicated. This page is meant to offer some answers for the unique dilemmas self-injury brings into your life. I am not a medical professional and these pages are presented for informational purposes only. No diagnosis or treatment is intended.

Admitting to the people in your life that you self-injure is analogous in many ways to the process of coming out as gay or bi. This list of things to consider when deciding to tell those you love about your way of coping with stress is adapted from a coming-out list in Bass and Kaufman 1996.

The assumption here is that you'll tell people about your SI in a conversation, but that's not the only way to come out. Some people have found that writing down everything they want to say and presenting it to someone has worked for them. If you choose this approach, follow the general guidelines below and be sure you remain available for discussion after the person has read what you've told them. If you want to come out to someone via email, I'd suggest you follow up immediately with a chat session or a telephone call.

Be willing to give the other person some time to digest, though -- if you follow up with them and they say "I'd like to think about this for a while," give them space. Ask them to let you know when they're ready to talk, and let it go.

For some people, scars aren't an issue -- they self-injure in ways that don't leave permanent marks or they only injure in places that are normally covered by clothing (the torso, shoulders, etc). For most people who cut or burn, though, scars happen. Some people like their scars and look on them as battle wounds or even life-maps. Many others hate their scars and want to find ways to get rid of them. Both attitudes are equally valid.

The two most common scar questions I hear are "How do I explain them?" and "How do I make them go away?"

It happens sooner or later - you're at school or work, on the bus, in a shop, and someone notices. "What happened to your {arm, leg, face, whatever}?"

People aren't usually trying to make you uncomfortable. Quite often, they're just making conversation; they don't really want to know why you have scars, but it's something to say. Nevertheless, you're stuck coming up with an answer.

Quite often, the easiest solution is to half-laugh or make a rueful face and say "It's a long story." Then change the topic. This deflects most people; if they persist, you can say, "I would really rather not discuss this." You can be a bit icy here -- after all, they're being a bit rude by asking you personal questions and not letting you gracefully avoid answering.

On the other hand, you could try some of the suggestions that came up during a discussion of excuses on the bus email list. You prolly won't use most of them, but read them for the laughs:

If you hate your scars and want to do something about them, you have two options: You can find ways to conceal your scars, or you can try to heal/minimize them.

Sometimes it's possible to hide scars.

The first step in healing scars is probably good wound care. Wash with Betadine if appropriate, and use a good antibiotic ointment (like Neosporin) on the wound daily. Johnson & Johnson make a new bandage, Band-Aid Advanced Healing, that seals the wound completely. Fluids from the wound are absorbed by special particles in the bandage that turn them into a gel to cushion the wound. This keeps the wound moist, which reduces itching and helps it heal faster. It also can reduce the urge to pick at the wound, because you are meant to keep the bandage on continuously until the wound has healed, or about a week.

For some types of scarring, special creams or bandages may help. Mederma  http://www.mederma.com is a cream designed to minimize scarring, but it must be used when the scar is very new. Reports on its efficacy are mixed.

If you are still using self-injury as a way to cope with overwhelming situations, you need to pay attention to your health and monitor yourself for symptoms of anemia or dehydration.

If you cut, you're losing two important things: fluid (plasma) and red blood cells. Your body can replace the plasma in about 48 hours if you drink enough liquid. The red cells will take about two months to be replenished.

Dehydration can send you into shock. The most common symptom is dizziness, especially when changing positions (for example, standing up after having been lying down for a while). You may also have a very rapid pulse. If the dehydration is severe (you're very dizzy, your eyes look sunken, you can't keep fluids down, your skin is clammy and you feel weak), go to the doctor immediately -- they'll give you IV fluids and you'll be fine in a few hours. To avoid getting to that point, be sure to drink 8 glasses of water daily (more on days you've lost blood). If you feel dizzy after SI, drink as much water or juice as you can and monitor yourself for symptoms of shock.

Anemia happens when you lose too much iron by losing too many red cells. If you are anemic, you will be pale and feel very weak. You might be irritable and short of breath and just feel bad. If you have these symptoms, you can see a doctor and have the anemia confirmed; the doctor will then give you iron supplements and vitamin C and tell you that you'll feel better in a couple of months. If you want to avoid becoming anemic, but you're not ready to stop cutting, you should take a multivitamin with iron and vitamin C daily and stop the bleeding on your cuts as quickly as possible.