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Self-Harm Signs  |  Symptoms  |  Treatment  |  Recovery

Self-Harm
Signs | Symptoms
Treatment | Recovery


Self-Harm and Mental Health Treatment

If you know someone who is demonstrating self-harm, keep in mind that they most likely have a deep underlying disorder or additional signs of emotional distress. It is important to listen to them without judgment, express how much you care for them as a person and communicate that this behavior is not uncommon. There are many types of treatments available including psychotherapy and social support. Psychotherapy approaches include cognitive behavioral therapy (CBT) specifically dialectical behavioral therapy (DBT) to focus on controlling thoughts and impulses and to understand how individuals interact in their environments and relationships. Social support is extremely important in self-harm as it is necessary for individuals to receive comfort and love from friends and family. There is no specific medication used to treat self-harm however medications may be prescribed to treat the underlying psychological disorder such as depression or anxiety.

What is Self-Harm?

Self-harm is the deliberate action of causing physical harm to oneself and is a very dangerous sign of emotional distress. According to the Statistical and Diagnostic Manual of Mental Disorders, Fifth Edition (DSM-5), self-harm is formally known as nonsuicidal self-injury disorder (NSSID) as these self-destructive behaviors are carried out without any intention of suicide. Adolescents are at the highest risk for self-harm injury as many studies state that roughly 15% of teenagers and 17-35% of college students have inflicted self-harmful behaviors on themselves. Males and females have comparable rates of self-harm behavior. Cutting, skin carving, extreme scratching, or burning oneself as well punching or hitting walls to induce pain are examples of self injurious behavior. Other examples include ingesting toxic chemicals, extreme skin picking, hair pulling and deliberate interference with wound healing. These self-injurious behaviors are extremely troublesome for clinicians as well as parents as it can be tremendously difficult to decipher whether the individual is trying to die or inflict pain on themselves.

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What are the causes of self-harm?

The underlying causes of self-harm can be difficult to recognize without thorough assessment and therapy. Many adolescents who engage in self-harm behavior have severe underlying emotional pain and lack adequate coping skills. It is an impulsive act to regulate mood and attempt to overcome underlying anger, sadness, pain or frustration. Individuals most as risk for self-harm experienced trauma, neglect or abuse in the past and use this self-destructive behavior to hide or express their repressed emotions. Self-harm is strongly linked to other disorders, specifically, borderline personality disorder (BPD) and eating disorders such as anorexia and bulimia nervosa. Approximately 70% of individuals with borderline personality disorder and approximately 30% of females with eating disorders are known to participate in self-harm behaviors. Self-harm has also been linked to depression, anxiety and suicide however the statistics for these co-occurring disorders have not yet been set in stone.

Warning signs of self-harm

The underlying causes of self-harm can be difficult to recognize without thorough assessment and therapy. Many adolescents who engage in self-harm behavior have severe underlying emotional pain and lack adequate coping skills. It is an impulsive act to regulate mood and attempt to overcome underlying anger, sadness, pain or frustration. Individuals most as risk for self-harm experienced trauma, neglect or abuse in the past and use this self-destructive behavior to hide or express their repressed emotions. Self-harm is strongly linked to other disorders, specifically, borderline personality disorder (BPD) and eating disorders such as anorexia and bulimia nervosa. Approximately 70% of individuals with borderline personality disorder and approximately 30% of females with eating disorders are known to participate in self-harm behaviors. Self-harm has also been linked to depression, anxiety and suicide however the statistics for these co-occurring disorders have not yet been set in stone.

  • Isolation and avoiding social situations
  • Wearing baggy or loose clothes to conceal wounds
  • Finding razors, scissors, lighters or knives in places where they do not belong
  • Multiple cuts, burns or scars on the wrists, arms, legs, hips, or stomach
  • Always making excuses for having cuts, marks or wounds on the body
  • Spending long periods locked in a bedroom or bathroom
  • Isolation and avoiding social situations
  • Wearing baggy or loose clothes to conceal wounds
  • Finding razors, scissors, lighters or knives in places where they do not belong
  • Multiple cuts, burns or scars on the wrists, arms, legs, hips, or stomach
  • Always making excuses for having cuts, marks or wounds on the body
  • Spending long periods locked in a bedroom or bathroom

The vicious cycle of self-harm

Self-harm behavior is an impulsive act that often is associated with premeditative thoughts and negative feelings that need to be unleashed through the act of cutting or carving. Oftentimes, if the individual does not commit the self-injurious act, he or she will obsessively think about self-injury. An individual engages in self-injury expecting to either gain relief from negative emotion, to deal with a personal issue or create a positive feeling however after the self-injurious act is performed the individual will often feel shame or guilt resulting in significant distress leading them to self-injure once again; and the cycle repeats itself. It is an emotional rollercoaster of shame, guilt and self-deprivation followed by relief and emotional release. In order to be diagnosed with nonsuicidal self-injury, an individual must engage in at least five days of self-injurious behavior within a one-year period without any intent to commit suicide.

Suicidal behavior and self-injury

Although self-injury is diagnosed without the intent of suicide, this harmful and dangerous behavior has a strong association with suicide. Approximately 40% of individuals who self-harm have experience suicidal thoughts during this behavior and approximately 50-85% of these individuals have a history of suicide attempt.

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