Saturday November 18, 2017

Can Pain Make You Feel Better ? Understanding Deliberate Self Harm Practices Among Adolescents

What do children and young adults do when the level of emotional pressure becomes increasingly high? According to studies, an increasing number of adolescents indulge in self harm to relieve stress.

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Societal pressure and lack of support often forces young adults to indulge in impulsive self-harm mechanisms like drug overdose and self cutting. Pixabay

– by Dr. Rajeev Nagpal, Australia

  • Deliberate self harm (DSH), also known as self injury is the act of intentionally inflicting damage to the body
  • It has become a common practice among children and teenagers across the globe
  • DSH among teenagers can be attributed to lifestyle and technology changes, peer pressure and lack of support

Australia, September 1, 2017: Dr. Rajeev Nagpal expresses his opinion on the dangerous practice of self-harm increasingly affecting children and young adults across the world.

What is Deliberate Self-Harm (DSH)?

Self-harm is described as an expression of situational crisis or personal distress which leads to harming oneself. NICE clinical guidelines from the UK have defined it as self-poisoning or injury, irrespective of the apparent purpose of the act.

Deliberate Self Harm (DSH) is not a clinical condition but a response to a stressful situation in the life of a young child or adolescent. It can occur after long term stress like abuse or domestic violence or after an acute single event like the loss of a near one or failure in examinations. It is primarily a coping mechanism in which they try to release tension by trying to self-harm.

Self harm
Dr. Nagpal views self-harm not as a clinical condition, but as a coping mechanism adopted by children and young adults to vent their tension.

Already there are reports of Indian children losing their life after playing games like the blue whale challenge on the internet. It is time for the general population, including the parents of young children to understand the issues of this very complex condition called deliberate self-harm.

Public Health Issue

In recent years DSH has become a major public health issue in most developed countries. However, although less reported, this problem is a major under-recognized epidemic in low and middle –income countries like India, Nepal.

According to a retrospective study conducted at the Emergency department of CMC, Vellore, India from Jan 2011 to Dec 2013, among the total 1228 patients who were admitted, consumption of pesticides was the most common cause of DSH in men. Consumption of plant poisoning and drug overdose was more common in women.The study involved all population, therefore, the actual number of pediatric population was difficult to ascertain.

Other international studies have also revealed that adolescents, who experienced anxiety or low mood, were six times more at risk of self-harm in young adulthood compared to those without depression or anxiety disorders.

Approximately a million lives are lost to suicide annually, worldwide.

Deliberate self-harm (DSH) is the single most important risk factor for suicide and is associated with huge health service resource utilization. Deliberate self-poisoning in children continues to remain a significant part of the workload of emergency departments, especially in adolescents, even though fewer children need admission now as compared with earlier decades.

Presentation of DSH

Many young adults find it difficult to express their feelings. Some examples of self-harm behavior are:

  • Self-cutting or scratching
  • Burning or scalding
  • Poisoning with drugs like paracetamol, anti-depressants
  • Swallowing objects

Relatively little information is available about the characteristics and long-term outcome of children and adolescents aged under 15 years who present to general hospitals because of deliberate self-harm (DSH).

Depressive disorders in pediatrics fall in ranges from mood changes in response to persistent mood change accompanied by suicidal ideation or intent.

The difficulties faced by adolescents are getting more complex with lifestyle and technology changes globally. Peer pressure along with family expectations can aggravate this sense of worthlessness.

Deliberate self harm
Feelings of helplessness, stemming from a variety of social and cultural factors can force an adolescent to indulge in self-harm. Pixabay

Lack of support networks can lead them to opt for impulsive self-harm mechanisms like poisoning. Intentional overdose to commonly implicated drugs like Paracetamol in the UK, or organo- phosphorous compounds in Nepal and is a cause of grave concern.

How to Deal with this Issue

As young children are unable to deal very well with emotional stresses, they will need a supportive team to help them in understanding their feelings and the possible outcomes from them.

This requires a multidisciplinary team approach.

  • Understanding the issues by holding awareness sessions of this condition in schools and other organizations
  • Creating referral pathways that all school staff are aware of
  • Confidential telephone lines /NGOs dealing with mental health of adolescent’s
  • Government policies and procedures for treatment of acute cases in Accident and Emergency departments
  • Provision of developing CAMHS(Child and adolescent mental health services ) like services at state level in Indian government hospitals.
  • Increased research particularly in pediatrics and adolescent’s needs to be conducted at state and national level.

ALSO READ Suicide is Preventable: Alarming Effects of Self-harm on Families, Communities, Societies

Conclusion

DSH is an under-recognized, major public health problem in low and middle-income countries. National level medical protocols and increasing the awareness amongst the public and agencies dealing with such conditions can be the first step in saving millions of lives from the untimely death of the most vulnerable yet productive younger sections of the society.

Dr. Rajeev Nagpal  is a Pediatrician and MHID (Masters OF Health and International Development-Flinders University, Adelaide, Australia) 

 


 

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Do you regularly take opioids and anti-depressants? This study says it may increase bone diseases

The researchers evaluated 11,049 rheumatoid arthritis patients, aged 40 and above, with no signs of osteoporotic fractures prior to the tests. After a median follow-up time of 5.7 years, the study found 863 patients affected with osteoporotic fractures.

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Anti-depressants may increase the risk of developing bone fractures, says a new study

New York, November 6, 2017 : Consuming opioids and anti-depressants may increase the risk of developing bone fractures among people who are already suffering from rheumatoid arthritis, says a new study.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints and organs of the body.

Chronic inflammation and pain in arthritis patients further leads to several diseases like cardiovascular, mental and gastrointestinal disorders. People take multiple medications in such cases that sometimes influences the risk of osteoporotic fractures or a disease caused due to reduced bone density, the researchers noted.

ALSO READ Importance of Magnesium in Human body, Strenghtens bones

“Even at younger ages, rheumatoid arthritis is associated with a two-fold increased risk of osteoporosis and fractures due to chronic inflammation and glucocorticoid use. More importantly, osteoporotic fractures significantly contribute to the disability, health-related costs and mortality with substantially higher complication in rheumatoid arthritis patients,” said Gulsen Ozen, researcher at the University of Nebraska Medical Centre.

The researchers evaluated 11,049 rheumatoid arthritis patients, aged 40 and above, with no signs of osteoporotic fractures prior to the tests. After a median follow-up time of 5.7 years, the study found 863 patients affected with osteoporotic fractures.

The patients who developed fractures were significantly older and had higher disease risk and bone fracture risk at the baseline than those patients who did not experience fractures.

The results presented at the ACR/ARHP annual meeting 2017 in San Diego mentioned that the osteoporotic fracture risk increased within 30 days when the patients were given opioids. The associated medications also led to falls in certain cases.

“Knowing the risks associated with the use of these medications can guide rheumatologists and other physicians in choosing the most appropriate management strategies in patients, particularly the ones who have a high fracture or fall risk,” Ozen added. (IANS)

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Twitter issues Apology for Censoring ‘Bisexual’ Hashtag

Twitter has been constantly brinigng out new rules for things like unwanted sexual advances, non-consensual nudity, hate symbols, violent groups, and tweets that glorify violence

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Twitter app on a mobile phone. Pixabay

San Francisco, November 6, 2017 : Twitter which updated its policies last week to fight abuse in an efficient way has come under fire for censoring LGBTQ terms like “bisexual” on its platform.

According to The Verge on Monday, while updating its policies, the micro-blogging website also censored the “bisexual” hashtag under its adult content rules.

The biggest updates on the platform included abusive behaviour, self-harm, spam and related behaviours, graphic violence and adult content.

ALSO READ Twitter Toughens Abuse Rules – and now has to Enforce Them

Angry Twitterati posted against the move.

“If you search #bisexual and click on photos or news there are no results. This is bi-erasure. @Twitter has done this. We exist,” tweeted one user.

The updates last week were part of revamp to Twitter’s policies surrounding online abuse.

Reacting to the latest controversy, Twitter posted: “We’ve identified an error with search results for certain terms. We apologize for this. We’re working quickly to resolve & will update soon”.

Earlier in October, Twitter CEO Jack Dorsey had said that the social media platform would take a more aggressive stance in its rules and its enforcement of them.

Dorsey, in his announcement which was a response to the #WomenBoycottTwitter protest, said that the platform would develop new rules for things like unwanted sexual advances, non-consensual nudity, hate symbols, violent groups, and tweets that glorify violence. (IANS)

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‘At one point, I even had suicidal thoughts and wanted to end things’, says Bollywood Actress Ileana D’Cruz

Actress Ileana D'Cruz was once suffering from depression and Body Dysmorphic Disorder. Watch out what she has to say.

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Actress Ileana D'Cruz
Actress Ileana D'Cruz . wikimedia commons
  • Actress Ileana D’Cruz, who suffered depression and Body Dysmorphic Disorder, says at one point in her life she felt suicidal.
  • But once she accepted herself, she started feeling better.

Actress Ileana D’Cruz suffered from Body Dysmorphic Disorder

At the 21st World Congress of Mental Health here on Sunday, Ileana had a tete-a-tete with Organising Chairman Sunil Mittal on her struggle with depression and Body Dysmorphic Disorder. Ileana was also awarded the Woman of Substance Award for her efforts towards raising awareness about mental health, read a statement.

She said: “I was always a very self-conscious person and was picked on for my body type. I used to feel low and sad all the time but didn’t know I was suffering from depression and Body Dysmorphic Disorder till I got help. All I wanted to do was to be accepted by everyone.

“At one point, I even had suicidal thoughts and wanted to end things. However, all of it changed when I accepted myself and what I was going through. I think that is the first step towards fighting depression.”

The “Barfi!” and “Rustom” actress said depression is “real” and people shouldn’t shy away from seeking help.

“It is a chemical imbalance in your brain and needs to be treated. Don’t sit back and think it will get okay but go get help. Like you have a sprain and go get yourself checked if you have depression, seek help,” she said, urging people to be like Winnie the Pooh. “He wore a crop top, ate his favorite food all day and loved himself, you can too.”

Ileana D’Cruz, whose mother was her biggest pillar of strength throughout, also said imperfections are a part of life.

“I am not saying that I had this miraculous recovery, every day is a process, every day is a step towards healing yourself and getting better. You are a human being and are allowed to be imperfect, and you are allowed to be flawed. There is a lot of beauty in your imperfections, in your uniqueness.

“You may look at us actors and think that ‘Oh my God, they are so pretty, so perfect’. But that’s not how it is. It takes two hours to get ready and look like this. Love yourself for who you are and trust me if you are happy from within, you are the most beautiful person and your smile is your best asset.”

Ileana D’Cruz said she decided to open up about her struggle because “as someone people look up to, even if I can help a handful of people cope, it is worth talking about it”.

The World Congress was organized by the World Federation for Mental Health (WFMH), a global alliance of mental health professionals, national health associations, NGOs, policy experts and other institutions.( IANS)