Self-Injury Awareness Day: Understanding Self-Harm

In light of Self-Injury Awareness Day, we’re taking a holistic look at self-harm, including what it is and what it is not. We’ll dive into symptoms, causes, the connection to eating disorders and resources for help.

Let’s start with the basics:

What is Self-Injury?

In a recent episode of our Mental Note podcast, Dr. Delia Aldridge, MD, FAPA, CEDS-S, medical director at Eating Recovery Center, shares:

“First of all, self-injury is separate from suicidal thoughts or behaviors in which individuals want to end their lives. People usually report that they have no expectation or no intention to cause death when they engage in self-injury. In fact, in some cases, self-injury may be used to manage intense distress they may associate with suicidal thinking. Non-suicidal self-injury is a term often used interchangeably with self-injury, though it is important to bear in mind that self-injury may carry lethal and non-lethal intent.”

Essentially, what she is saying is that although suicide is not typically the objective of self-harm, there is increased risk of suicide in individuals engaging in these behaviors.

Why Do People Self-Harm?

People engage in self-injury for different reasons. Common reasons include coping with difficult feelings, including sadness, anger, negative thoughts and self-criticism.

Many people experience self-injury and self-harm as a form of relief. If you or someone you care about is engaging in self-injury, treatment can help you build skills to find other forms of relief from difficult feelings.

Self-Injury Signs & Symptoms

Self-harm often refers to a person harming their own body on purpose. About 5 percent of adults report self-harm at some point in their life. Self-harm tends to begin in the teen or early adult years.

The CDC reported that children and youth with developmental disabilities, such as autism and intellectual disability, are more likely to engage in self-injury than children without these disabilities. Young people with depression, anxiety, and conduct disorder have higher rates of self-harm, including suicide, than children without these disorders.

Self-Injury and Mental Health

Self-injury is often associated with a host of other mental health disorders, including depression, anxiety, obsessive compulsive disorder and PTSD. Typically, self-harming behaviors are maladaptive techniques used to cope with painful, overwhelming emotions and frustration. For example, feelings of guilt and low self-worth are common features of major depressive disorder. When depression is untreated, patients can be at high risk of self-harm or suicidal ideation. This is why we encourage anyone who is experiencing self-harm or self-injury to seek help for their mental health.

Self-Injury and Eating Disorders

Eating disorders (while different in their behaviors and symptoms) can be related to self-harm. In the same Mental Note episode, Dr. Aldridge confirmed that both self-harm and eating disorder behaviors can be used as ways to escape, avoid or otherwise regulate negative emotional states. She explains:

"Patients with self-harm and eating disorder behaviors often describe experiencing strong negative emotions, or emotional ability that is feeling out of control. They also tend to judge themselves harshly for having feelings or are afraid of their emotions, which leads them to feel desperate to find relief.”

The connection between eating disorders and self-harm is backed up by data: one study found that almost half of all eating disorder patients self-harm. This insight has a profound impact on mental health and eating disorder treatment as well as the relationship between non-suicidal self-injury and the eating disorder. Typically, treatment involves stabilizing one’s mental and physical health along with nutrition counseling and education as the individual learns new coping skills to handle challenging emotions.

Self-Harm and Suicidal Thoughts

Risk of subsequent suicide from self-harm is particularly high in those with high unresolved suicidal intent, depressive disorder, chronic alcohol and drug misuse, social isolation, and current physical illness. Patients with one or more of these risk factors should be offered enhanced care that may include inpatient or outpatient follow-up care, a list of local support resources and, where possible, self-help material.

Get Help for Self-Harm

If you or someone you know is struggling with self-injury or mental wellness and need professional support, please contact us for a free assessment at 1-866-477-0793. If you are interested in outpatient referrals or additional resources and support, please send us an email at [email protected] and we would be happy to help.

Resources for Self-Injury

• To Write Love on Her Arms is a nonprofit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury and suicide.
• The Jed Foundation (JED) is a nonprofit that protects emotional health and prevents suicide for our nation’s teens and young adults, giving them the skills and support they need to thrive.
• MentalHealth.gov provides one-stop access to information mental health and mental health problems information, including suicidal behavior.
• One of the goals of The National Institute of Mental Health and Substance Abuse and Mental Health Services Administration is to provide health education to families and professionals on a variety of issues, including suicide prevention.
• The National Suicide Prevention Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24/7.