suicide and self harm

Self-Harm and Suicide

It is true that people with severe depression are more at risk for cutting and suicide but this does NOT mean that people who experience depression will have either or both of these things.

First of all,  I want to say, good for you for reading this. I think these topics scare a lot of parents and they would much rather it didn’t effect them and turn to something else. So taking a little time to just see what I have to say is a big step. My intention here is not to scare anyone. And I think it should be said that depression, suicide and self harm does not happen for everyone. Sure, everyone has the blues now and then but not everyone experiences the kind of clinical depression that interferes with everyday life. Still, it is important to talk about because it does happen and no one should be shamed. It is the purpose of this article to help frame and understand the connection between self harm, depression, and suicide; help parents know how to talk to their college students about this—whether it’s for themselves or a friend they are concerned about.

Self Harm & Suicide

Something that is common in my practice is that parents find out their adolescent is cutting and quickly assume that it means that they want to die or commit suicide. Seeing cuts on the arms or wrist, or a person accidentally cutting too deep and having to go to the hospital: these things can make it quite easy for people to correlate suicide and cutting. But cutting doesn’t necessarily mean the person is trying to commit suicide or even thinking of it. What both things have in common is that both are a result of pain and both are an attempt to end that pain. Cutting is intended to cope with life stressors. Some people actually self harm as a way to feel their emotions even more because they feel disconnected or numb. Let’s take a closer look at the specifics of what self harm and suicide like and what motivates each act.


Self Harm is a voluntary act to hurt one’s self in order to cope with pain. This may be through cutting, burning, picking, hitting, pulling hair, or carving into skin.

Reasons for self harm may include: To get away from feelings, to express pain, to punish themselves, to feel the positive chemical effects. When a person self harms, endorphins are released and a person can feel an organic high. (**this is what makes self harm very addictive and one of the reasons it is so dangerous is because a person may need to cut more and deeper in order to get that same high.**)

How to support your  college student when you know they may be cutting: 

TIP #1: Check in. If your child experienced self harm during middle school or high school, it could be a good idea to check in about it even if they haven’t done it in a long time. College is a new place and is common for old behaviors to come up. Signs of cutting include seeing wounds or cuts on their body, excessive or sudden use of loose baggy clothes, seeming to get hurt a lot and making excuses.


Tip#2: Don’t ignore self harm AND Tip #3 don’t hyper-focus on it!  In my experience, it is good to let your child know you are aware of the self harm and you are concerned but hyper-focusing on the cutting itself doesn’t usually help.  Rather, be sure to validate the stressors that are causing it and teach other ways to cope with pain. It may be hard for college students to be taught things by their parents at this point but you can help encourage them to get necessary support.

  • Try to not just focus on their actions but ask about their stressors and listen.
  • Mention that you know self harm can be very addictive and that you are concerned but also validate that you know they are trying to help themselves feel better. It may help them open up or be willing to ask for help if they know that you know they are trying to do something positive.
  • Don’t focus on getting them to stop cutting. Tell them that you want to make sure that they have a variety of ways to cope with feelings and express pain. Encourage counseling as a way to learn other strategies.

Suicide is an act in which a person is trying to end their own life on purpose. This can be done through overdosing on drugs or medication, hanging, a gun, jumping off something.

Reasons for suicide may include significant mental health issues such as depression or psychosis, a need to punish themselves, they are in so much pain they are needing to get someone’s attention; impulsivity.

How to talk to and support your college students around suicide: 

Tip #1: Talk about it. A good way to start the conversation is ask your college student if they have ever known anyone to feel suicidal. You can mention that you heard of a recent suicide and it got you thinking. Ask them about their thoughts on suicide and why a person would make that decision. Try to focus on their answers and less on expressing your opinions. 

Tip #2:  Know the signs. Suicide doesn’t usually come out of nowhere. Look for the signs of change in your college student. Signs include increasing drug or alcohol use; isolating, mood swings (from rage to sadness).  Are they telling you that they are really unhappy or stressed? Or do they mention death or appear to be saying goodbye.

Tip #3: Be proactive. If you have any concern whatsoever, be honest with your college student and tell them you really want them to talk to someone.  If they are resistant, tell them if there’s nothing to worry about then it won’t hurt to do so. And if they do ever talk about wanting to die or a specific way they plan on doing it, call emergency services.

Helping others:

Your college student may end up talking to you about a friend or roommate. These are important moments because whatever message you send your own child at this time about how to respond to their friend you are also sending them that same message. And the suggestions are similar.

  • Validate their feelings of fear and powerless about their concern for another.
  • Encourage them to identify their own feelings.
  • Encourage them to not be afraid to ask their friends about what’s going on and to listen.
  • Remind them that it is okay to seek a professional’s help if they feel someone is in true danger. We need to teach young people that sometimes people are not in the best state to know when they need help and we need to get help for them (especially if a person’s at risk of hurting themselves).   

So again, my intention is not to scare anyone and I know this particular topic can be very hard to talk about. Still, it is good to understand these things. Both suicide and cutting are serious acts.  Both are indicators of significant emotional pain. Even superficial cutting or scratching means that there is something going on. Studies do show that people who self harm are at increased risk for suicide in the same way that people who are struggling with addiction, major depression and other mental  health are also at increased risk. Emotional pain needs to be addressed. It  can feel so hard if your child isn’t living at home and is experiencing these things but if you a parent or any kind of previous care giver or emotional support, it can be invaluable for you to express your concern. Knowing what to say can help them find the support they need.

Thanks for reading and please let me know if have any questions.

Carey J Cook, LPC has a Masters from Pacifica Graduate Institute and has been working with children, adolescents and families  since 2008.  Carey has a private practice in Asheville, NC and is the co-founder of Bridge Box. Carey is dedicated to provided mental health education to parents and students of all ages and help college students succeed during this exciting and vulnerable time of their life. To get in touch with Carey, you can email her at 



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Carey J. Cook, LPC

Carey J. Cook, LPC

Carey J Cook is a Licensed Professional therapist in Asheville, NC. She has a private practice and is the co-founder of Bridge Box which was inspired by her work with college students. In different capacities, Carey has provided education and therapy to college students and families for over a decade. Carey seeks to understand and support college students during this phase of life and provide tangible tools to students via Bridge Box.

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