Having both been a long term cutter and had a near death OD, I can tell you a little bit, but don't know if it is the same for her.

When I was 19, (I'm forty nine now), I purposely overdosed on an asthma medication. By the time the cops were called, they had to break in the door to get me. Because of that one bad decision, I now have heart palpatations. It skips beats, even at rest, and at times the skip is long enough to cause pain and panic. Your friend needs to know that suicide attempts are not limited to "it works" or "it doesn't" with no in between. Sometimes you are left with problems that are worse than you originally OD'd for.

Self harm is just as bad. No matter how careful she is, the chance of hitting an artery or cutting a nerve or tendon is still there. Its not a matter of being careful. Cutting has a tendency to get worse over time if the underlying cause is not found and corrected. Every time a person cuts, their body releases endorphins, which are the body's own natural "high". That is one reason why the person feels better for a while afterwards. Over time, the body starts to build a tolerance to the endorphins and it takes deeper or more frequent cuts to acheive the same "relief". In essence, she is addicted. Two years ago, I went on a four day binge of cutting, the last of which nearly killed me. Up til then, the cuts had been bad but not life threatening. This time I went through skin, subcutaneous tissue and muscle. I also cut a vessel, all in my calf, so it was a pretty deep gash. I wasn't trying to kill myself, but had my friend not seen blood running out from under the bathroom door, I would have sat there stupidly watching myself bleed to death. As it is, there is permanent nerve damage, some painful and some numb areas.

Its great that you are there for her. If ever teen in trouble had someone willing to work with them, there would probably be less successful suicides. Don't worry about scaring her. She should be scared. Once you lose the use of a hand, arm or leg, its gone and she will have the rest of her life changed forever because she made a wrong decision. Both of her problems are serious, as you know, but she is young enough to have that invincible attitude and denial that anything truly bad could really happen as a result of her behavior.

Good luck and keep us informed on how she is doing.

Sam2