People often keep it a secret, but the urge to self-harm isn’t uncommon, especially in adolescents and young adults. Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting themselves, they may be at an increased risk of feeling suicidal. Whether a person has recently started hurting them self or has been doing it for a while, it is possible to overcome it with treatment.
What Is Self-Harm?
Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themselves, it is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing.
Hurting yourself—or thinking about hurting yourself—is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term.
Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended. Skipping classes or avoiding social occasions to prevent people from seeing your scars is a sign that your self-harming behavior is negatively affecting work and relationships.
Signs and symptoms of self-injury may include:
• Scars, often in patterns
• Fresh cuts, scratches, bruises, bite marks or other wounds
• Excessive rubbing of an area to create a burn
• Keeping sharp objects on hand
• Wearing long sleeves or long pants, even in hot weather
• Frequent reports of accidental injury
• Difficulties in interpersonal relationships
• Behavioral and emotional instability, impulsivity and unpredictability
• Statements of helplessness, hopelessness or worthlessness
Why do it?
The urge to hurt yourself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring yourself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. Or if a person doesn’t feel many emotions, they might cause themselves pain in order to feel something “real” to replace emotional numbness.
Once a person injures themselves, they may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt themselves again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it.
Treatment and Coping
Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms. There are effective treatments for self-harm that can allow a person to feel in control again. The first step in getting help is talking to a trusted adult, friend or medical professional who is familiar with the subject.
A medical professional will ask you questions about your health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. A doctor will also recommend therapy to help a person learn new behaviors. Several different kinds of therapy can help:
• Psychodynamic therapy focuses on exploring past experiences and emotions
• Cognitive behavioral therapy focuses on recognizing negative thought patterns and increasing coping skills
• Dialectical behavioral therapy can help a person learn positive coping methods
If your symptoms are overwhelming or severe, your doctor may recommend a short stay in a hospital. A hospital offers a safe environment where you can focus your energy on treatment.
What to do when someone self-harms
Perhaps you have noticed a friend or family member with frequent bruises or bandages. If someone is wearing long sleeves and pants even in hot weather, they may be trying to hide injuries or scarring. They also might say they feel hopeless or worthless, have poor impulse control, or have difficulty getting along with others. Don’t dismiss their emotions or try to turn them into a joke.
Ask if the way they’ve been feeling has led to any self-harm. Acknowledge that it may be hard to talk about, but you’re prepared to listen, and while you may not fully understand, you’ll there to help.
Let them know that self-harm isn’t uncommon and doctors and therapists can help. If possible, offer to help them find treatment. But don’t try to make the person promise to stop, as it takes more than willpower to quit.