There are many methods people use to self-harm themselves. Some of those methods are:
People who self-harm often feel embarrassed or ashamed of their behavior, and will go through great lengths to hide it. If you worry that someone you care about is harming themselves, some of the signs you can look for include:
If you suspect that someone is self-harming, they are going to need support and understanding. You want to avoid expressing anger or judgment, but instead, show compassion and a willingness to listen. Professional intervention from a therapist or a physician may be necessary since self-harming is often a sign of something deeply troubling going on beneath the surface, so overwhelming that it creates the urge to hurt themselves.2
Occasionally self-harming is a fluke thing – something a teenager tries once or twice because of peer pressure, or to mimic something they’ve seen on television. Some teens report their self-harming as an act of rebellion, or an experiment.5
However, there are often larger issues at play, sometimes in the form of personality disorders, substance abuse issues, or Post-Traumatic Stress Disorder (PTSD).
Kat describes herself as a cutter. She is in her mid-thirties now, and no longer self-harms. She reports cutting herself on and off from ages 13-19. She had this to say:
When my parents divorced I was completely overwhelmed with negative feelings. I didn’t know what those feelings were, and I certainly didn’t know how to express them. Sometimes I felt so much pain inside I thought I was going to explode. One day I just randomly picked up a knife and sliced my leg a little bit. It wasn’t a deep cut, but it somehow made me feel better. I felt much calmer, almost euphoric. It was like the physical pain let some of the emotional pain leak out. I never planned on cutting myself, it was always very compulsive, almost unexpected. And my intention was not to hurt myself – I was desperately trying to make myself feel better. When I drank alcohol or took drugs it was more likely that I would cut myself, and those cuts would usually be deeper.
People who drink alcohol or take other drugs are more likely to self-harm than those who do not. Alcohol and other drugs can lower inhibitions, as well as contribute to compulsive and dangerous behaviors since it minimizes the fear of consequences.8
Poor decision-making and impulsive behaviors are risk factors for self-harm on their own.8 Intoxication can exacerbate those attributes, making self-harm even more likely to occur. When inhibitions are lowered and one is not thinking clearly, the desire to self-harm can become overwhelming, and in some cases the injuries will be more severe.
Self-harm may become an addictive behavior in itself. Some people start craving the feelings of euphoria, and the release of endorphins that can occur during self-harm. Just like with addiction to alcohol and drugs, self-harm can be progressive – the sufferer may need to self-injure more often, and more severely in order to get those same feelings of relief and release.8
Also similar to abusing alcohol and other drugs, self-harming can lead to feelings of deep shame. That shame and regret can trigger even more urges to self-harm, and so the spiral continues.
People who self-harm refer to their activities very similarly to those who speak of substance addiction. The need to cut or injure themselves may become stronger the longer they abstain. They speak of “triggers”, or troubling events that create the urge to self-injure. They speak of being “self-injury free” for days or even weeks at a time, but without intervention it is difficult to stop.8
Self-harm does not cause mental disorders, nor does everyone with a mental disorder self-injure themselves. The two often coexist however, and it’s important to take a look at some of the disorders that are most frequently linked to self-harm.
Post-Traumatic Stress Disorder occurs after experiencing a traumatic event. That event can be life-threatening – such as a serious car wreck, the loss of a loved one, or sexual assault. Countless different experiences can lead to PTSD, and sufferers can experience many different symptoms as a result; depression, avoidance, hypervigilance, and insomnia to name just a few. Self-harm can be a way to release some of that angst, or to feel in control again.
Borderline Personality Disorder presents with extreme mood swings, distorted self-image, and erratic behavior. People with BPD may have trouble forming or maintaining meaningful relationships. They may experience severe anxiety and depression, and bursts of uncontrollable anger. BPD sufferers tend towards impulsivity and dangerous behaviors, including substance abuse and self-harming. Please note that BPD needs to be diagnosed by a professional; just because someone is moody or reckless does not mean they have a personality disorder.12 , 2
Inention
People who self-harm are trying to feel better. People who attempt suicide don’t think they will ever feel better – this is why suicide feels like the only option.
Injuries resulting from self-harm are generally superficial, involving the surface of the body. Rarely are the injuries life-threatening, or even require medical treatment (Life-threatening injuries can occur, but it is not typical).
Suicide attempts involve potentially lethal methods, such as swallowing pills, that have more adverse and lasting effects, even when the attempt fails.
Frequency & Lethality
Self-harm is a coping mechanism and can occur quite frequently, sometimes even daily. In severe cases, people may acquire scars from cutting or even break a bone, but generally, self-harm wounds are superficial.
Suicide attempts are rare, and typically much more damaging to the body than self-harm. Recovering from a suicide attempt is more intensive than recovering from an act of self-harm.
Level of Emotional Distress
Self-harm is a coping mechanism used to ease psychological pain and to make it easier to function. People who self-harm want to feel better about life – they haven’t completely given up on it.
People who attempt suicide feel completely hopeless, and no longer wish to keep going through the motions. They can’t see any possible way out of their pain, and it is seemingly endless.
The End Result
There are many different reasons that people self-harm, and there isn’t always a mental disorder behind those reasons. Some people who have poor impulse control think that self-harming is the only thing that helps, or they simply lack the tools for managing their emotions in a healthy way.
There are other ways to self-soothe, and to ease the burden of overwhelming emotions; ways that don’t cause physical injury. Emotions are temporary, they won’t last forever. Here are some suggestions for minimizing the occurrence of self-harm, and perhaps even ceasing it all together:
If you need a physical expression of inner anxiety or pain try finding other outlets that won’t hurt you. Rip up a bunch of paper, invest in a stress ball or two, dig your hands deep into clay, or build a sandcastle. You can try rubbing an ice cube on your skin to help ease the compulsion to cut.
Feeling alone and isolated is never a good thing for those in emotional distress. Try and find a connection with someone or something. Call a friend, play with your pet, perhaps even delve into a good book or a movie you know will make you laugh. It can help to get out of your head and focus on something outside of yourself until the impulse to self-injure subsides. 5
Get some exercise. Walk or run around the block, jump rope or kick a punching bag. Exercise produces endorphins, one of the things that contribute to the “feel good” aspect of self-harm.
If you’re in need of soothing or comfort, try some relaxation techniques. Take a shower or bath, cuddle with your dog, listen to some music that you love. Baking can be very calming, so can painting or knitting. It is important to discover self-soothing techniques that don’t cause injury or harm.
Remember, many people who self-harm do suffer from severe depression, PTSD, or other mental and emotional disorders. These tips aren’t going to help get to the root of the behavior in those cases. It is important to seek professional help when self-harming becomes unmanageable.
Depending on the root cause that compels someone to self-harm, treatment options can vary. For some, lifestyle changes will be enough. Learning to cope with troubling emotions with the help of exercise, healthy eating, sleeping enough and sustaining healthy and supportive relationships can do a lot towards ensuring that self-harming becomes a thing of the past.
For others, such as those who have experienced trauma, or suffer from chronic depression, therapy may be necessary for helping to alleviate the compulsion to self-harm.
Dialectical behavioral therapy is a form of therapy that was first developed to treat suicidal patients with Borderline Personality Disorder. It is now used to treat many different disorders, including addiction, PTSD, and eating disorders.
DBT focuses on teaching people specific life skills that will aid in better dealing with feelings and situations that used to be overwhelming and led to dangerous behaviors. Those skills are mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. 16 Incorporating these skills into ones daily life will help those who self-harm react to their specific triggers with healthier and less dangerous coping skills.
Whether you, your child, a friend, or a loved one is struggling with self-injury or self-harm, know that you are not alone, and there is help available. Self-harm can be treated; countless people have addressed their self-harming tendencies and gone on to live perfectly normal, functioning happy and fulfilling lives.