Understanding Self-Harm and How to Help

Self-harm isn’t an official mental health condition, but it’s more common than you might think. About 17 percent of people will manifest self-harming behavior at some point in their lives. Those who do it repeatedly feel trapped in a cycle of habits to relieve overwhelming emotions or pain. But education and awareness can ensure more people get the help they need. Support and understanding are crucial to recovery if you or someone you know is at risk of self-harming.

Warning Signs

Self-harm can take many incarnations – including cutting, burning, scratching, or a non-fatal overdose. There are also more subtle signs of self-harming that are often overlooked or ignored, like:

•   Talk about self-injury
•   Unexplained cuts, bruises, or marks
•   Anxiety/depression
•   Alcohol or drug abuse
•   A drastic change in eating/sleep habits
•   Withdrawal from daily life or isolation
•   Mood swings
•   Lack of motivation
•   Putting the needs of others first
•   Risky behavior (breaking the law, having unsafe sex)

While these warning signs may indicate self-harm, remember that they can also mean something else. For example, a person may change eating and sleeping habits due to work stress or personal trauma. Others may experience depressive symptoms because of an underlying mental illness.

Recognizing the warning signs can help you know when a loved one is struggling. Be honest if you suspect someone is self-harming. But it’s important to understand that there might not be any warning signs at all. People who do this tend to keep their habits secret. It can be challenging to determine if a friend or loved one is struggling. That’s why raising awareness about it is essential, and creating a safe environment for people to share their self-harm experiences is very important.

Why Do People Self-Harm?

People who do not do it may find it difficult to understand why people do self-harm. This lack of awareness leads to the misconception that self-harming is a form of “attention seeking” or a suicide attempt. It is not seeking attention, nor is it an attempted suicide.

Often, this behavior is an outlet for people to cope with overwhelming thoughts and feelings. When someone is experiencing emotional pain and a buildup of distress, they may temporarily relieve the pain through parasuicide. Once a person repeatedly self-harms in response to life’s challenges, it can trigger the start of a regular cycle of self-abuse.

Labeling someone who self-harms as “suicidal” can be misleading. Non-suicidal self-harm is not the same as suicidal thoughts. While non-suicidal self-harming involves intentional self-injury (which may or may not result in death), suicide means a person attempts to harm themselves to end their life. But there is a strong association between this behavior and suicide attempts. The higher the rate of self-injury, the higher the likelihood of a suicide attempt.

A recent study of college students found that undergraduates who engaged in 20 or more of these behaviors were 3.5 times more likely to attempt suicide than those who did less. Teens, college students, gays, bisexuals, and women all have higher rates of parasuicide. The study unveiled that other groups – like adults and men – are more likely to underreport their conditions.

How to Talk About Self-Harm

Talking about self-harm, worthlessness, and mental health can be challenging. It’s not easy being the first person to start a conversation. However, reaching out to someone who feels trapped in a self-injury habit cycle may be your opportunity to provide support.

Before discussing their behavior with someone you think is struggling, remember to be open, calm, and supportive. Here are a few pointers to help you have an honest conversation about the subject:

•   Start by mentioning the things you notice that worry you.
•   Admit how difficult it can be to talk about mental health.
•   Please don’t focus on their specific self-injury behavior. Ask how they feel, and try to start a discussion about what they are going through.
•   Try not to be shocked or disgusted. Adverse reactions can increase the other person’s sense of shame and cause them to avoid the topic.
•   Know when to seek help. If you think someone is in immediate danger or injured and needs medical attention, assist by getting them the help they need.
•   Stay positive and proactively seek professional support for them. You can offer to help them with a mental health appointment, but don’t force them to do anything.
•   Avoid ultimatums. This can break the other person’s trust in you and make it look like you’re trying to punish them.

Talking to someone about their self-harm doesn’t always result in a positive response, but showing them they’re not alone is key to their recovery. It is an opportunity to build stronger bonds and support each other. If it’s hard to start a conversation about self-injury with someone close, share your story with a licensed mental health provider. With professional help, treatment and the path to recovery becomes clearer. You just need some guidance to help you develop new habits.

How to Help a Teen Who Self-Harms

Parents, guardians, teachers, and other adults should be aware of the signs and know what to do if a child engages in the behavior. For teachers, coaches, and other professionals, you should first talk to the child about your concerns. Tell them you are there as a support person, and they can speak to you about anything troubling. Whether or not they admit to self-harm, you should share your concerns with other adults who can help, like the school nurse or a guidance counselor.

For parents or guardians, you’re understandably alarmed by your child’s self-injury behaviors. It’s essential to remain calm when speaking about the issue. Ask non-judgmental questions about their reasons for this behavior to uncover what contributes to it. You can also talk with a physician or a mental health professional to determine if there may be an underlying mental health condition.

Therapy for Self-Harm

The first step in getting help is to talk with a trusted adult or medical professional familiar with this type of psychosis, such as a counselor or physician. The doctor may prescribe medication to help with any underlying illnesses or conditions, such as depression or anxiety. Therapy is often recommended. Some standard therapies to treat these symptoms include:

•   Psychodynamic Therapy involves exploring past experiences and emotions.
•   Cognitive Behavioral Therapy (CBT) focuses on recognizing negative thought patterns and developing coping skills.
•   Dialectical Behavioral Therapy (DBT) is more specifically focused on positive coping skills.

Psychotherapy is the mainstay treatment for individuals who engage in these behaviors, whether it is physical or emotional self-harm. A recent study identified that psychological treatments specific to self-injury have better success than those more general.

Cognitive-behavioral Therapy (CBT) is a short-term treatment approach that is very goal-oriented. This treatment approach focuses on identifying dysfunctional emotions, behaviors, and thoughts underlying these behaviors and then analyzing them and replacing them with more positive and healthier ways of dealing with the underlying triggers and stressors contributing to the behaviors.

For instance, an individual may tend to magnify a negative situation rather than see it as part of reality. Cognitive-behavioral Therapy (CBT) would work to identify that negative thought pattern, challenge it, and replace it with a thought pattern that is more realistic and positive.

Road to Recovery

If you or someone you know is self-harming, it’s vital to seek professional help. Effective intervention can teach positive coping skills and reduce self-injury behaviors. Recovery may not be easy, but the decision to get help is the first step. By understanding self-harm and identifying when to seek help, you can help dismantle the stigma surrounding self-harm and begin the path to wellness.