What You Should Know About Self-Harm

Information presented in this article may be triggering to some people. If you are struggling with self-harm or experiencing uncomfortable or painful thoughts, contact the crisis text line. 

If you are having suicidal thoughts or ideation, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) to speak with a trained counselor. 

Dealing with difficult situations, painful memories, or challenging experiences can take a serious toll on anyone. Sometimes, this struggle becomes too much to handle and some individuals respond to these circumstances by deliberately hurting themselves — often described as self-harming behavior. Some see self-harm as a way to ease overwhelming emotions, maintain a sense of control, escape memories of traumatic events, or punish themselves for having negative thoughts. 

Self-harm is more common than many realize. In a society where there’s still a great deal of stigma attached to self-harm, people who need help tend to feel isolated. Help is available, however, and it’s possible to live without self-harming, or to get help for a loved one who’s dealing with self-injury.

What Is Self-Harm?

Self-harm or self-injury is any behavior that involves someone causing direct harm to oneself, mostly without a suicidal intention. Self-harming behavior usually serves as a coping mechanism for difficult thoughts, feelings or situations. It could take several forms including: cutting, branding, or burning the skin; non-lethal drug overdose; hitting the body against hard surfaces; or deliberately preventing injuries from healing. Self-injury could also involve other ways of putting yourself in danger, like reckless driving or binge drinking.

The cycle of self-harm often starts with a person hurting themselves to ease the pressure from distressing thoughts or feelings. There may be some initial relief from the emotional distress, but this is only temporary as the underlying cause for that distress remains. Feelings of shame or guilt often follow self-harm, which can lead to a continuous pattern. While many self-harm only a few times and stop, it can become a long-term cycle for others.

Many people keep their self-harm a secret. They suffer alone and in silence, believing that self-harm is a rare or unusual behavior but, in fact, it is quite common, especially in adolescents and young adults, although it can also occur later in life. According to a 2015 study, over 17 percent of people engage in self-harming behaviors in their lifetime. Although self-injury can make you feel alienated, there are many others who have also experienced self-harm and might understand what you’re going through. Consider joining a support group, whether online or in-person, or attending a group therapy session to connect with others who might have had similar experiences.

Why Do People Self-Harm?

There’s no single unifying reason for self-harm; each person faces different difficult, triggering personal experiences. Although some might choose to manage these challenging situations by talking to a close family member, friend, or therapist about them, others find it difficult to understand and express their emotions, bottling them up until the pain becomes overwhelming. This process can express itself via self-harming behavior, a channel to express the thoughts and feelings one is unable to voice.

Shirley Manson, lead singer of the rock band Garbage, described this feeling in her New York Times essay about self-harm. “I had a desire to speak but could not find my voice,” she wrote. “My fury was such that I knew intuitively if I directed it at any one person, I would more than likely land myself in jail. It was a natural, practical step to turn that rage inward, toward myself,” she added.

If you’re going through a difficult period, talking to someone you trust or a mental health professional can help you come up with better coping strategies for the pain you’re experiencing. With Talkspace, you can message a licensed therapist any time you feel like it from the comfort of your home. 

Who Is at Risk of Self-Harming Behavior?

Self-harm can affect anyone, but some are at a higher risk than others as a result of certain correlating indicators. For instance, some go through life events that make them more likely to self-injure, such as sexual, physical, or emotional abuse; living in a toxic environment; dealing with social isolation; facing an identity crisis; experiencing bullying; or struggling with a low self-esteem.

Self-harm is not a diagnosable mental illness, but it could be a sign of an underlying mental health condition. Several illnesses are linked to self-injury, such as borderline personality disorder, depression, eating disorders, anxiety, or post-traumatic stress disorder.

In addition to these conditions, the use of drugs or alcohol misuse, as well as negative peer influence, can put a person at risk of harming themselves intentionally.

How Can I Tell if a Loved One Is Self-Harming?

Many who self-harm tend to come up with several ways to keep it secret. However, there are certain signs that indicate someone you know might be self-harming, particularly if they’re cutting or directly injuring their skin. The person may have frequent fresh cuts, especially on the arms and legs, or scars from previous cuts. They may also regularly cover up their skin, with long-sleeved shirts or long pants, even in hot weather. Keeping sharp objects like razor blades or knives around can also frequently be a sign of self-harm.

Some signs may also be observable, like scratching the skin or picking at wounds, pulling out hair or burning oneself. There are also several emotional signs a person who is self-harming may show, such as frequent self-criticism, impulsive behaviors, emotional instability, feelings of guilt or hopelessness, questioning identity or sexuality, or having troubled relationships. 

It can be difficult to find out that someone you care about is hurting themselves. It also may not be easy to find the right words to say, but it’s important to avoid making judgemental or stigmatizing comments. Find out ways to show them support and encouragement and remind them that you’re here for them in a non-judgmental way. 

What Can I Do to Help?

In all cases, self-injury is something to be taken seriously, even when it doesn’t appear to be a regular habit. If you find out that a loved one or someone close to you is self-harming, it helps to reach out to them, and express your concerns calmly. It’s an issue that can be too big to ignore or let someone deal with on their own; showing that you care can go a long way.

Those who self-harm may feel guilt and shame about their behavior, so it’s especially important to respond without anger or intrusive questions when they open up to you. Encourage the person to consult a mental health expert who can help with any underlying issues that could be pushing them to self-harm. Let them know that you’re available to communicate whenever they need someone to talk to, and try to show up when they reach out.

Self-harm is one issue that’s still surrounded by a lot of myths and half-truths. It helps to equip yourself with as much knowledge as you can, so you can have open and honest conversations with a loved one who’s dealing with self-injury. 

Although self-injury doesn’t usually mean a person is suicidal, don’t hesitate to call 911 or contact other emergency services if you think the person is at risk of inflicting a serious or life-threatening injury on themselves.

Debunking Self-Harm Myths

The inaccurate portrayal of self-injury in popular culture has led to many negative stereotypes, and has made many people avoid speaking about their issues and reaching out for help. For instance, it is widely believed that self-injury is a way of seeking attention. This is untrue, as most people who self-harm do not find it so easy to talk about what they’re going through. 

Another myth about self-harm is that it’s enjoyable to people who engage in it, and others believe that people who self-harm are suicidal. There is no evidence that these suppositions are true, as many turn to self-injury as a way to cope with difficult feelings and traumatic experiences.

Treatment for Self-Harm

Self-harm can lead to a number of issues, including fatal injuries, permanent scars, infection from wounds, or other serious mental health problems. Reaching out for help as soon as possible can prevent these deeper complications. There are effective treatment options that can allow a person to build new coping mechanisms for their thoughts and emotions.

The first step to getting treatment is reaching out to a mental health professional, who will carry out a diagnostic interview and assessment to determine a suitable treatment plan. This interview usually involves questions about the person’s health history, life experiences, and self-harming behaviors throughout their life. If there are other underlying mental health issues, the doctor may prescribe medication, such as antidepressants, to help treat the symptoms.

Therapy may also be recommended to teach new ways to cope, with different options like psychodynamic therapy to help unpack experiences and emotions from the past, or cognitive behavioral therapy which focuses on replacing negative thought patterns with more positive coping skills. Dialectical behavioral therapy can also help in teaching new strategies to manage your feelings.

While seeking treatment, there are several alternative ways to control self-harm triggers. It can help to talk to someone you trust when you feel the urge to self-injure, or distract yourself by going for a walk, playing a game, or visiting an online self-harm support group. When you feel like self-harming, journaling or writing down your feelings can also be a helpful way to release negative emotions.
If you’re also dealing with suicidal thoughts, contact the National Suicide Prevention Helpline at 1-800-273-8255 for assistance from a trained professional.