Self-harm, also known as self-injury, is the act of hurting oneself on purpose. The most common form of self-harm is cutting the skin with a knife or another sharp object, according to the National Alliance on Mental Illness (NAMI), but anytime someone deliberately hurts themselves it is considered self-harm. Other common methods of self-harm include hitting or banging the head and burning oneself. Less common forms of self-harm include:
- Excessive scratching
- Consumption of harmful or poisonous products
- Intentional infection
- Breaking bones
Self-harm occurs in roughly 4 percent of adults in the United States, according to Mental Health America (MHA). Teens are more at risk for this kind of behavior than adults, as the teen age group has a 15 percent self-harm rate. College students see the highest rate, as studies have found self-injury rates between 17 percent and 35 percent in this demographic. Most people who practice self-harm begin in their adolescent or teen years. According to Healthy Place, approximately 2 million cases of self-injury are reported on an annual basis in the United States alone.
Some signs of self-harm are:
- Unexplained burns or cuts
- Self-esteem issues
- Trouble expressing oneself
- Relationship problems
- Issues at home or in the workplace
Self-harm is usually a coping mechanism for the person practicing it. Many of these people report feelings of emptiness and loneliness. It is also common for a person using self-harm as a coping tool to feel either overstimulated or understimulated in life. Self-injury provides temporary relief from whatever negative feelings an individual is trying to escape. However, the relief eventually subsides and the feelings return, which leads to a person getting wrapped up in a cycle that includes more self-injury. Self-harm is not usually done in a suicide attempt, according to the U.S. National Library of Medicine; however, it can be a precursor for suicide in adults.
Self-Harm and Substance Abuse
Substance abuse among those practicing self-harm is not uncommon, as substance abuse is essentially another way to harm oneself. The same emotional issues that can cause self-harm can also lead to substance abuse. Substance abuse is often a form of self-medication, and it is common to see someone who is struggling with substance abuse also have some kind of co-occurring mental health disorder, according to the National Institute on Drug Abuse (NIDA).
Self-harm early in life has been found to be a warning sign for substance abuse in the future, according to a study done by the University of Bristol. The study found that those practicing self-harm with no intent of suicide still had a higher likelihood of developing mental health issues, which can often lead to substance abuse. While the study would not go as far as to say that the self-harm was a cause for issues later in life, a correlation was found.
Substance abuse in combination with self-harm can be especially dangerous. Many substances affect motor functions and reaction time, which can result in the harm inflicted becoming more serious than intended. Those under the influence of a substance would be more likely to make a mistake and cut themselves too deeply when practicing self-harm, for example.
Alcohol abuse is very common among those struggling with self-harm. According to a study published in Social Psychiatry and Psychiatric Epidemiology, alcohol abuse puts an individual more at risk for self-harm. In this study, females appeared to be more prone to this relationship than males. The study period covered more than a decade, and during that time period, alcohol abuse related to self-harm increased significantly among females though not in males. In 2013, more than 17.3 million people in the United States had an alcohol abuse problem, and underage drinking (the age group where self-harm is most common) occurred in about 22 percent of individuals.
Methamphetamine, more commonly known as “meth,” has been associated with self-harm. According to a study published in the Journal of Drug Issues, meth users were significantly more likely to participate in self-harm. Methamphetamine is a stimulant that increases the amount of dopamine present in the brain, which can result in a rush of euphoria. This drug is extremely addictive and can be very dangerous.
Benzodiazepine abuse has also been associated with self-harm. Benzos are central nervous system depressants that can result in physical dependence and addiction, and emergency room visits related to self-harm injuries in Ireland are commonly a result of benzo overdose. Depression, a common symptom of benzo withdrawal, can also lead to intentional self-injury.
An individual can become addicted to the act of self-harm. The rush of endorphins that can accompany such behavior can have an addictive quality, but this rush is often followed by feelings of shame or guilt. This can result in more self-harm in an attempt to punish oneself, perpetuating the cyclical nature of this problem.
Responding to Self-Harm
If you encounter an individual who is practicing self-harm, it is important not to overreact or make them feel ashamed of what they are doing, according to Healthy Place. Approaching them in a calm fashion will have the best effect, and use of a caring tone can be very effective. Compassion is crucial in discussing this issue with something dealing with it while reacting with shock or panic will only alienate them. A healthy and safe interaction with a person can be the first step toward getting them help for their self-harm issues.
Treatment for Self-Harm
There are several treatment methods that have proven effective in dealing with self-harm. One of these methods, Cognitive Behavioral Therapy (CBT), is also an extremely effective tool in treating addiction. Someone struggling with co-occurring substance abuse problems and self-harm issues can often benefit greatly from this form of treatment.
CBT focuses on behavioral patterns and how these patterns affect the decisions an individual makes. A person undergoing CBT is taught how to identify problematic behaviors that produce undesirable results, such as excessive drinking, drug abuse, or self-harm. Correcting these behaviors and the patterns that result from them is key to long-term recovery.
CBT is effective in helping an individual develop coping strategies to deal with stressors and potential triggers that can result in relapse. The anticipation of problems that may arise is a vital element of this kind of therapy. The exploration of consequences, both positive and negative, of behaviors and decisions can help an individual understand the correlation between what their thoughts and subsequent behaviors result in. The tools learned in CBT follow an individual throughout their lives, even after treatment has ceased.
Dialectical Behavior Therapy (DBT) is a specific kind of Cognitive Behavioral Therapy that may be appropriate for those suffering from self-harm. DBT involves the identification of strengths and other positive qualities in a person in an effort to boost their confidence and sense of self-worth. It also deals with assumptions an individual might make that result in their life feeling more difficult, as well as how that relates to their decision to practice self-harm. Consistent collaboration between the client and therapist is crucial to the success of DBT.
A study published in Addiction Science & Clinical Practice found that DBT could also be effective in treating people dealing with substance abuse. This study covered those dealing with substance abuse and suffering from borderline personality disorder. Borderline personality disorder and self-harm are often associated with one another, and deliberate self-harm is considered a potential sign of borderline personality disorder.
Psychodynamic therapy is another treatment used to combat self-harm. This type of treatment deals with the subconscious and underlying emotions that can result in self-destructive behaviors. Increased awareness of these emotions and behaviors can help an individual make appropriate changes. Identifying patterns of behavior, as done in CBT, is also an important part of this kind of treatment.