Nonsuicidal self-injury disorder, better known as self-harm, is characterized by the purposeful actions of causing physical harm to oneself without the intention of committing suicide. Cutting and burning are the two most common types of self-injury behavior. This behavior is more common in teenagers and adolescents and occurs due to severe underlying emotional pain and a lack of healthy coping skills. Self-harm behaviors are coping ways to release emotions related to anger, sadness, neglect, pain and frustration; after the harmful act is completed, the teenager experiences emotional and mental relief quickly followed by shame or guilt resulting in more negative emotions; repeating this viscous cycle. Research has shown that the majority of teenagers who engage in self-harm behaviors do so because they want to have a mental escape from their problems and it helps them release tension and stress. Individuals who practice self-harm usually have a history of emotional, sexual or physical abuse, neglect, or trauma resulting in feelings of insecurity, excessive worry and extreme anger. According to statistics, approximately 15-30 percent of adolescents in the United States engage in some form of self injury and 70% of teens who engage in self-injury behavior have made at least one suicide attempt and 55% of teens who engage in self-injury have made multiple suicide attempts.
Self-harm and co-occurring disorders
Self-harm behaviors commonly occur with other mental health disorders such as depression, anxiety, borderline personality disorder, eating disorders and substance abuse disorders. When two or more mental health or substance abuse disorders occur simultaneously it is known as co-occurring disorders, formerly referred to as dual diagnosis.
Cutting in relation to substance abuse
Cutting is actually a form of addiction as many teenagers crave the release that self-harm behaviors elicit. Studies have shown that it can be an outlet for an escape allowing teens to release negative feelings of anger, frustration, sadness and stress however once this act is over, teenager crave more, just like an addictive drug. Studies have shown that approximately nine percent of teenagers who engage in self-harming behaviors also abuse drugs and alcohol. Teenage abuse drugs and alcohol for similar reasons they engage in self-harm behavior; to alleviate stress and numb the pain and emotions they are experiencing. Marijuana and nonmedical prescription drugs are the most commonly abuse illicit substances among teenagers with alcohol and tobacco being the most commonly abused substances overall. Drugs and alcohol are known to slow reaction times, increase impulsivity and disrupt the connections in nerve endings potentially resulting in worsening injuries. For example, individual who cut may cut too deep under the influence of drugs or alcohol resulting in serious wounds or too much blood loss.
Warning signs associated with self-harm behavior in teens
- Noticeable wounds that aren’t easily explained
- Wearing long-sleeved clothing at inappropriate times in an attempt to hide wounds
- Avoidance of social situations
- Isolation or a lot of time locked in a room or bathroom
- Feelings of worthlessness or hopelessness
- Personal identity issues
- Tools such as razors, bits of glass, lighters, knives or scissors in places they don’t belong and usually in easily accessible places
Warning signs of substance abuse in teens
- Unexplained, confusing change in personality or attitude.
- Sudden mood changes, irritability, and angry outbursts
- Periods of unusual hyperactivity or agitation.
- Lack of motivation; inability to focus, appears lethargic or “spaced out.”
- Appears fearful, withdrawn, anxious, or paranoid, with no apparent reason.
In order to learn to give up self-injury behavior, individuals need to substitute other healthy behaviors that can be equally soothing and provide a similar emotional release. Similar to substance abuse, the underlying reason of why there is an addiction needs to be addressed in order for the unhealthy compulsive behavior to stop. Recognizing past trauma, assault, extremely high stressors, mental health disorders, substance abuse or any other triggers is the first step in treating the self-harm addiction and with any co-occurring condition, both disorder must be treated at the same time.