Understanding Self-Harm and Self-Injury
Non-Suicidal Self-Injury (NSSI), commonly referred to as self-injury or self-harm, may be confusing and difficult to understand. Many people have a hard time talking about self- injury because it seems unnatural to them. It is important to understand what motivates someone to harm themselves because not all people do it for the same reason. The best way to help someone to stop self- injuring is to help them address the underlying issues.
When someone self-injures, they do not intend to die. People who self-injure may do so as a method to cope with stress– hurting themselves is often seen as a way to control their upsetting feelings. Others do so to dissociate from their problems (e.g. to distract themselves from emotional pain). Research suggests that self-injury can activate different chemicals in the brain which relieve emotional turmoil for a short period of time.
Other motivations why a teen may self-harm:
- To reduce anxiety/tension
- To reduce sadness and loneliness
- To alleviate angry feelings
- To punish oneself due to self-hatred
- To get help from or show distress to others
- To escape feelings of numbness (e.g. to feel something)
What are symptoms of self-injury?
There are many ways in which a person can engage in self-injury behaviors, but the most common is cutting the skin with razor blades or pieces of glass. Injuries can range from moderate to severe.
Other forms of self-injury include:
- Burning and hitting oneself
- Scratching or picking scabs (to prevent wounds from healing)
- Overdosing on medications
- Pulling out one’s hair, eyelashes, or eyebrows with the intention of hurting oneself
- Inserting objects into one’s body
Who is at-risk for self-injury behavior?
Self-injury has become more common than most people suspect. People who self-injure often begin in early adolescence, although they can be any age, ethnicity, or socioeconomic status.
People who have symptoms of Depression, Anxiety, or low self-esteem are more likely to self-injure. There isn’t one absolute predictor of self- injury, but the following predictors increase someone’s risk for self- injury:
- Abuse/neglect (past/present)
- Past episodes of self-harm
- Losses (e.g. deaths, break-ups)
- Inability or difficulty coping
- High self-criticism
- Addictive behaviours/ substance-use
- Peers/ family members who self-harm
- Mental illness
Information about the prevalence of people who self-injure varies. This is because not everyone who self-injures seeks help or treatment, and because some jurisdictions combine data on self-injury with data on suicide making it difficult to obtain an accurate picture of either concern. A Canadian study conducted in 2002 found that 13.9% of high school students reported having self-injured. Females are more likely to self-injure than males.
How do you know if someone you love self-injures?
It’s often difficult to know if someone you love self-injures because many people are very secretive about the behavior. The person may go to great lengths to hide any evidence and cover up any physical injuries. Keep an eye out for:
- Cuts/scars on arms, legs, and/or stomach
- Wearing long sleeves/covering legs in situations where it doesn’t make sense (e.g., on a hot summer day)
- Finding razors and other sharp objects
- Unexplained or poor excuses for injuries
Emotional warning signs are important to consider as well. Some indicators may include difficulty handling emotions, or problems with relationships. It is critical to recognize the signs and get help early so that the person’s behavior does not escalate or lead to other serious injuries.
How do you tell the difference between suicide and non-suicidal self-injury?
It is common for those unfamiliar with self- injury to assume that self- injury is a suicide attempt that didn’t work – but that is incorrect. Self- injury is not an attempt to die. People often say that they self-injure so that they don’t attempt suicide.
This can be confusing to onlookers because self- injury and suicide often involve the same behaviors, but the key difference is the motivation behind the behavior. Individuals who self-injure engage in these behaviors so that they can feel better, not so that they can end their life.
Although self- injury is different than suicide, many people who self-injure may be depressed and may indicate that life is not worth living. They may have thoughts of death but no actual intention to die.
People who self-injure have a hard time dealing with their feelings. Self- injury is used to reduce, manage or escape from intense emotions. If someone you know self-injures, listen to what they are saying, talk about their emotions, and encourage the person to get help. If the person is at immediate risk of hurting themselves in a life-threatening way, they should be taken to the hospital.
What treatment options exist for teens that self-harm?
A variety of treatment options exist for people who self-injure. Determining which course of action is appropriate for each individual should be done with the guidance of a trained health professional.
Treatment options for teens who self-injure may include one (or a combination) of the following:
- Psychological Treatments: Psychotherapy or “talk therapy” works by helping your brain better control your thoughts and emotions. There are two different types of psychotherapy that have been found to be effective for treating self-injury:
- Dialectical Behavior Therapy (DBT), a type of therapy based on a philosophy of balancing, acceptance and change.
- Cognitive Behavior Therapy (CBT), a type of therapy which helps people understand, problem solve, and change the relationship between their thoughts, emotions, and behaviors
- Medication: Medication may be used for people who have symptoms of Depression and/or Anxiety along with their self-injury behaviors. Rather than treating the self-injury directly, medication helps with the underlying issues that are contributing to why someone chooses to self-injure.
- School Supports: Sometimes certain adaptations can be made by the school to assist a student in coping with and managing their self-injury.
- Regular Routine: Maintaining a healthy, regular daily routine is very important for someone who is struggling with mental health issues.
According to a 2020 study, boys and girls that hit puberty earlier are more likely to self-harm.
If you have exhausted your local resources and your teen is still struggling with self-harm behavior, it might be time to consider residential therapy. Contact us for more information.