• Early recognition is important.
• Best to refer for specialized help.
• Both medication and 'talk therapy' can help.

• Giving room for the friend to ventilate.
• Minimize Bulling.
• Help in academic activities.
• Forming a safety network.
• Providing companionship.

• Can be verbal or physical.
• Mainly directed towards family members and rarely towards mates.
• History of distress tolerance and failed relationship can be seen.
• Aggression should be eliminated at its earliest or else there is bound to be no stopping.

How to manage aggression in family

• Identify situations that can give rise to frustrations.
• Look into the behaviours of the persons around.
• Consequences of persons will decide if such behaviours will recur.
• Clear limits should be highlighted in the family.
• All members should adhere to the same levels of limit setting.

How to recognize if someone is in distress

• They might discuss the issue.
• Change in behaviour such as withdrawn, aggressive, distracted.
• Reveal of self harm ideas.
• Reveal of new onset substance use.
• Reveal of ideas for leaving home.
• School absenteeism.
• Ask for help.
• Avoid pleasurable activities.
• Crying episodes.

Recognizing self-harm/suicide has very low predictability. Best predicted by past attempts.

How to recognize suicidal ideas,

• Direct revelations.
• Indirect revelations in the form of jokes, suggestions.
• Inquire into possible acts.
• Self-harm episodes or abolished attempts.
• Giving away belongings which are dear to persons.
• Become overly generous, overly concerned.
• Possible plans of saying goodbye.

What should I do if my friend reveals a thought / idea of self-harm?

• Appreciate that he sought help/ talked to you about it.
• You might be the most closest to help at that point.
• Do not panic or do not joke about it.
• Ask if he is willing to get help.
• Some times it might be very helpful to open up conversation and let the person to ventilate.
• Be non-judgemental.
• You have a duty to let a responsible person know. This will need to be done even if the Friend disagrees about revealing the facts to others. Best if you can get
• him to consent for sharing of the information.
• Direct him to services such as psychiatry clinic, NGO (Sumithrayo), NIMH.