Self-harm is a nonsuicidal act of intentionally harming oneself, such as cutting or burning one’s self. Usually, it does not involve suicide. Self-injury instead is a harmful way to cope with the intensity of emotion, anger and frustration.
In spite of the momentary relief that self-harm offers, it is often followed by guilt and shame and a recurrence of painful emotions. Although it is usually not the intention for self-harm to cause life-threatening injuries, it can lead to more serious and even fatal self-aggression.
You may be able to learn healthier ways of coping if you receive appropriate treatment.
Self-harm symptoms
Self-injury may be characterized by the following signs and symptoms:
- Scars that usually take the form of patterns
- Cuts, bruising, bite marks, scratches, etc.
- Burning an area by excessive rubbing
- Always keep sharp objects handy
- Keep your arms and legs covered, no matter what the weather
- Accidental injuries are common
- Problems with interpersonal relationships
- Instabilities of behavior, impulsivity and irrationality
- Feelings of hopelessness, worthlessness or helplessness
Read: Pyromania Disorder
Forms of self-injury
There are several types of self-injury, but they are usually done in private and are usually controlled or ritualistic. Some examples of self-harm are as follows:
- Cutting (cuts or scratches caused by sharp objects)
- Scratching
- A burning object (for example, a lit match, a cigarette or a heated knife)
- Engraving the skin with words or symbols
- Punching, kicking or hitting yourself
- Poking your skin with something sharp
- Putting something under your skin
It is most common to self-harmthe arms, legs, and front of the torso, but you can self-harmanywhere on your body. It is possible for self-injurers to harm themselves in more than one way.
When we become upset, we may feel the urge to hurt ourselves. Self-injury is a common practice that most people indulge in only a few times. While others may turn to self-injury as a repeating habit.
When a friend or loved one self-harm
Someone close to you who self-injures may shock and scare you. Self-harm is a serious matter. Self-injury is a problem that will not be solved by ignoring or attempting to deal with alone, even if you feel like you’re betraying yourself. Here are some solutions.
- Your child: Consult your pediatrician or another health professional for an initial evaluation or a referral to an appropriate mental health professional. Make sure you express your concern without yelling or threatening your child.
- Preteen or teenage friend: You may suggest your friend talks to their parents, their teachers, a school counselor, or another trusted adult.
- Adult: Inform the person of your concern and urge them to seek medical treatment.
Causes of self injury
People who self-injure don’t have one single or simple reason why they do it. Some of the most common reasons include:
- Poor coping skills: Self-harm that is not suicidal usually results from an inability to cope with psychological pain in a healthy way.
- Difficulty managing emotions: Emotions are difficult to regulate, express or comprehend for the individual. Mixtures of emotions trigger self-harm. It is possible to feel worthless, lonely, panicked, angry, guilty, rejected, or to have a confused sexuality, for example.
It is possible that the person is trying to:
- Assist in managing or minimizing severe distress or anxiety
- Provide comfort to a hurting person through physical pain
- Feel in control of their bodies, feelings, or life situations
- Even if you’re physically hurt, feel something even when you’re feeling emotionally empty
- Make an external expression of your inner feelings
- Talk about your depression or distress
- Accuse someone of wrongdoing
Read: Schizophreniform Disorder
Risk factors
Young adults and teenagers are the most likely to self-injure, but people of all ages do so as well. Teens facing increasing peer pressure, loneliness, and conflict with their parents or other parental figures often begin self-injuring during their preteen or early teenage years.
There is a risk of self-injury associated with certain factors, including:
- Being friends with someone who self-injures: Self-injury is more common in people who have friends who intentionally hurt themselves.
- Life issues: Traumatic events can cause people to injure themselves if they have been neglected, abused, physically or emotionally abused, or if they have suffered other traumas. It may be that they have left an unstable family environment or that they are young people who are unsure of their personal identity or sexuality. They may be socially isolated.
- Mental health issues: Self-injurers tend to be deeply self-critical, as well as poor problem solvers. Additionally, self-injury is frequently associated with certain mental disorders, which include borderline personality disorder, post-traumatic stress disorder, depression, and anxiety disorder.
- Alcohol or drug use: When people harm themselves, they are often under the influence of recreational drugs or alcohol.
Complications
Self-injury can lead to a variety of problems, including:
- Low self-esteem and feelings of shame are exacerbated
- Wounds or sharing of tools can cause infection
- Disfigurement or permanent scarring can result
- Serious, even fatal injuries may occur
- If not treated properly, underlying conditions can worsen
Read: Anticipatory Anxiety
Suicide risk
Even though self-injury is not usually a suicide attempt, the emotional problems that trigger it can increase the chance of suicide. Suicide is more likely when the body is damaged during times of distress.
Diagnosis
Even though some individuals may seek assistance, sometimes family members or friends become aware of self-injury. In some cases, doctors performing routine medical exams may notice signs, such as fresh injuries or scars.
It is impossible to diagnose self-injury through a diagnostic test. This can only be done through a psychological and physical evaluation. Your doctor may refer you to a mental health professional who has experience treating self-injury in order to evaluate you.
Additionally, you may also be evaluated by a mental health professional for disorders associated with self-injury, like depression or personality disorders. In that case, psychometric tests or questionnaires might be included in the evaluation.
Self-harm treatment
Getting help is the first step in treating self-injuring behavior. However, there isn’t one best treatment. There are several treatment options available depending on your specific issues and any related mental health disorders, such as depression. You should seek treatment from a mental health professional who has experience treating self-injury issues because self-injury can be a major part of your life.
Self-injury behaviors that are related to a mental illness, such as depression or borderline personality disorder, are treated along with self-injury behavior.
You need patience, hard work, and a desire to recover if you wish to overcome self-injury behavior.
Here are more details about treatment options.
Read: Clinical Psychology
Psychotherapy
The benefits of psychotherapy, also called talk therapy or psychological counseling, include:
- Self-injury triggers underlying problems that need to be addressed
- Develop skills for managing distress
- Become proficient in managing your emotional state
- Boost your self-esteem
- Become more socially adept
- Learn how to solve problems effectively
Psychotherapy for individuals may consist of several types, such as the following:
- Cognitive behavioral therapy (CBT): It provides you with a way to identify unhealthy, negative beliefs and behaviors and replace them with beneficial ones.
- Dialectical behavior therapy: This type of cognitive behavioral therapy teaches you ways to handle distress and manage and regulate your emotions as well as improve your relationships with others.
- Mindfulness-based therapies: You are able to reduce your anxiety and depression by living in the present, observing and responding appropriately to those around you, and improving your well-being.
It may also be recommended to have family therapy or group therapy sessions.
Medications
Self-injuring behavior cannot be treated with medications. The doctor may prescribe antidepressants or other medications to treat the underlying disorder if you’ve been diagnosed with a mental health disorder, such as depression or anxiety. If you are being treated for these disorders, you might feel less inclined to hurt yourself.
Psychiatric hospitalization
If you suffer a serious or repeated injury, your doctor may recommend that you be hospitalized for psychiatric treatment. An inpatient stay, often short-term, can provide more intensive treatment until you can find your way out of a crisis. Some mental health programs offer day treatment.
Read: Seasonal Affective Disorder
Lifestyle and home remedies
The following self-care tips complement professional treatment:
- Follow your treatment plan: Make sure you attend therapy sessions and take prescribed medications as directed.
- Self-injury may be triggered by certain situations or feelings: Prepare yourself for the next time you feel the urge to self-injure by finding other ways to soothe or distract yourself or to get support.
- Seek assistance: Be sure to inform your doctor or mental health professional about all self-injurious incidents. When you feel the urge to self-injure or if self-injuring behavior recurs, contact a close family member or friend.
- Take care of yourself: Get in the habit of exercising regularly and trying to relax as part of your daily routine. Maintain a healthy diet. If you suffer from sleep problems, your behavior can be affected significantly.
- Don’t use alcohol or drugs: Self-injury can occur because of them. They interfere with your ability to make good decisions.
- Get medical care if you hurt yourself, or take care of your wounds: Seek out support and help from family and friends. Do-self-injurious instruments should not be shared – this can lead to infectious diseases.
Coping and support
Please consider these tips if you or someone you care about needs help coping. Taking immediate action and seeking help if thoughts of suicide are present is necessary.
Here are some tips for dealing with self-injury:
- So you do not feel alone, speak to others who can help you: Consider reaching out to a family member or friend, contacting a support group, or speaking with your doctor.
- Avoid websites that promote self-harm: Find sites that encourage you to move forward.
- Express your feelings positively: You may want to consider becoming more physically active, practicing relaxation techniques, or engaging in art, music, or dance in order to improve your emotional balance.
These are some tips for dealing with self-injuries if your loved one does it:
- Get information: It’s important to understand why self-injury occurs so that you can help your loved one stop this damaging behavior by developing a compassionate, but firm approach. Encourage your loved one’s relapse prevention plan and the strategies they have developed with the therapist.
- Do not criticize or judge: The act of criticizing, yelling, threatening, or accusing others may increase the risk of self-injury. Try to be supportive, praise healthy ways of expressing emotions, and spend as much time together as possible.
- Show your love no matter what: You are available to speak with the person and assure him or her that he or she is not alone. You can support the patient in finding resources, identifying coping strategies, and offering support during treatment, even if you cannot change their behavior.
- Be supportive: It’s important to remind your loved one to take their medication and to keep their therapy appointments. Removing or limiting access to matches, knives, razors, or other items that might be used to self-injure.
- Discuss coping strategies: If your loved one feels distressed, he or she may appreciate hearing about how you cope. A good role model is also one who uses appropriate coping strategies.
- Seek support: It might be helpful to speak with people who have been through the same situation as you. If you have trusted family and friends, you may be able to share your experience. You might also wish to seek help from a counselor or therapist if your loved one has self-injurious tendencies, or ask your loved one’s doctor or mental health provider if local support groups exist for parents, friends, or family members of self-injurious people.
- Take good care of yourself, too: Make sure you get enough rest and get physical activity as well as doing the things that you enjoy.
Read: Different Types of Bullying
Setting up your appointment
If you are experiencing any issues, it is recommended that you first see your primary care provider, another health care provider, a school nurse, or a counselor. Since self-harm can often be severe enough to require special mental health care, you may be referred for treatment to a mental health professional.
Prepare information regarding your self-harm and your behavior that is accurate, thorough, and honest. For support and to help you remember information, a friend or family member might be a good idea.
What to expect from your doctor
Many questions will be asked by your doctor, such as:
- Do you remember the first time you hurt yourself?
- Do you harm yourself in any particular way?
- Have you ever cut yourself or injured yourself?
- Do you have any thoughts and feelings before, during and after self-harm?
- If so, what makes you do it?
- How does it make you feel? Are there any downsides?
- What are your social networks like?
- Do you have any emotional issues?
- What is your outlook on the future?
- Have you ever self-injured before?
- Does depression trigger suicidal thoughts for you?
- Are you a drinker, a smoker, a drug user or a recreational drug user?
Depending on your answers, symptoms, and needs, a doctor or mental health professional may ask you additional questions. You will be able to make the most of your appointment with the doctor if you anticipate and prepare your questions in advance.
