Self-harm is a profoundly troubling condition where a person inflicts injuries on themselves. The condition can be deeply distressing, not only to the individuals experiencing it but also to their loved ones and in severe cases, it may even pose life-threatening risks. The roots of self-harm are varied and complex, stemming from a multitude of causes that can devastate health, relationships and overall quality of life. Unfortunately, far too many individuals struggle with self-harm in silence, held back by feelings of shame, fear of judgement or uncertainty about where to turn for help. This isolation can exacerbate the condition, making it imperative for those affected to seek support. In the UK, there are various effective treatment options available for self-harm that can offer hope and potentially save lives.
What is self-harm?
Self-harm, also known as self-injury or self-mutilation, encompasses a range of behaviours individuals engage in with the intent to cause harm to themselves as a way of dealing with overwhelming emotions or situations. The condition can manifest in numerous forms, including but not limited to cutting, burning, scratching or hitting yourself and engaging in risky behaviours that lead to injury.
Self-harm is not usually considered a mental health disorder in and of itself; rather it is a symptom of mental health issues and deep emotional distress. Some people may engage in self-harm as a sporadic response to stress, while for others, it may become a repetitive, compulsive act. Understanding these complexities is crucial for recognising the telltale signs of self-harm and providing the appropriate support and intervention.
Symptoms and signs of self-harm
As with all mental and emotional disorders, identifying the symptoms and signs of self-harm is crucial for early intervention and support. While self-harm can be a hidden behaviour, several indicators may suggest an individual is harming themselves. Physical signs are usually the most obvious and may include:
- Unexplained cuts, bruises or burns, typically on the wrists, arms, thighs or chest.
- Frequent “accidents” or injuries
- Wearing long sleeves or pants to hide injuries, regardless of the weather.
- Possession of sharp objects or other tools that could be used for self-harming.
Beyond the physical signs, various emotional and behavioural indicators can also suggest someone is self-harming. These may include:
- Behavioural changes such as isolation or withdrawal from friends and family.
- Expressions of helplessness, hopelessness or worthlessness.
- Unusual mood swings or emotional instability.
- Difficulty managing emotions or expressing feelings in words.
Recognising these signs provides an opportunity to offer support and encourage the individual to seek professional help. However, it is important to approach the subject of self-harm with sensitivity and care, as individuals struggling with self-harm may feel ashamed or fearful of judgement. Effective communication, showing empathy and providing a safe space for them to share their feelings are crucial steps in supporting someone who may be harming themselves.
Why do people self-harm?
Understanding why people engage in self-harm is essential for effectively addressing the situation. The reasons behind self-harm are complex but are often rooted in an attempt to manage overwhelming emotional pain or stress. Some common underlying causes include:
Mental health conditions
Self-harm is commonly associated with various mental health disorders, including depression, anxiety, borderline personality disorder and post-traumatic stress disorder (PTSD). For some, self-harm is a symptom of these conditions, while for others, it is used as a way to cope with symptoms.
Emotional regulation
For many sufferers, self-harm is a coping mechanism to deal with intense emotions such as anger, sadness, loneliness, shame or guilt. It can serve as a temporary escape or a way to express their feelings. For some people, self-harming can release endorphins, “feel-good” chemicals, and these can temporarily mask negative emotions too.
Sense of control
Individuals who feel helpless or powerless in certain aspects of their lives may turn to self-harm as a means to exert control over their bodies. This is often the case when they can’t control external circumstances or are having intense emotional experiences. For example, some people with addiction or eating disorders may self-harm to try and recover some semblance of control.
Communication
Self-harm can also be a non-verbal way of communicating deep distress, a cry for help or a way to make internal pain visible. This can be particularly true for individuals who struggle to verbalise their feelings or feel that their verbal communication has been ignored or invalidated.
Punishment
Some individuals use self-harm as a form of self-punishment due to feelings of guilt, shame or a deep-seated belief that they are unworthy or deserve to be hurt.
Trauma and abuse
Experiences of trauma, including physical, sexual or emotional abuse, can lead to self-harm as individuals struggle to process and cope with the pain of their experiences.
Peer influence
Especially among adolescents, peer influence or exposure to self-harm through media and social networks can play a role in initiating self-harming behaviour.
How is self-harm treated?
The treatment of self-harm involves a multifaceted approach that addresses the underlying emotional distress and any co-occurring mental health conditions. As each individual’s reasons for harming themselves are unique, a personalised approach to treatment and recovery is required, acknowledging the depth and complexity of the condition. Some of the primary forms of treatment for self-harm include:
Psychotherapy
This is a cornerstone of treatment for self-harm because it delves deep into the root causes of the behaviour. Different types of psychotherapy can be effective, including:
- Cognitive-behavioural therapy (CBT): Helps individuals identify and change negative thought patterns and behaviours, teaching them healthier ways to cope with emotional distress.
- Dialectical behaviour therapy (DBT): Particularly effective for those with borderline personality disorder, DBT focuses on teaching coping skills to manage emotions, reduce self-harm behaviours and improve relationships.
- Psychodynamic therapy: Explores the underlying psychological roots of emotional suffering and self-harm, helping individuals understand and heal these foundational issues.
Medication
While there are no medications specifically designed to treat self-harm, medications may be prescribed to address co-occurring conditions such as depression, anxiety or bipolar disorder. Antidepressants, anti-anxiety medications and mood stabilisers can help manage symptoms that contribute to self-harm, providing much-needed relief and a stable platform for therapy and other support.
Support groups
Participating in support groups can give individuals a sense of community and belonging. Sharing experiences and coping strategies with others who understand the struggle with self-harm can be incredibly validating and help to prevent isolation and loneliness.
Family therapy
Involving family members in treatment can be beneficial, especially for children and adolescents. Family therapy aims to improve communication and understanding, teaching family members how to support their loved ones during treatment.
Inpatient treatment
For individuals who are at high risk of seriously harming themselves, inpatient treatment can provide intensive care and monitoring. These programmes offer a structured environment where individuals can receive constant support and therapy, and steps can be taken to ensure they are unable to self-harm.
Mindfulness and stress-reduction techniques
Practices such as meditation, yoga and mindfulness can help individuals develop a healthier relationship with their thoughts and emotions, reducing the urge to engage in self-harm.
Recovery from self-harm is a journey that involves learning to cope with emotional distress in healthier ways, understanding and addressing the root causes of the behaviour and building a supportive network. It is important for individuals to work with healthcare providers to find the treatment that best suits their needs.
Get help and support for self-harm today
If you or someone you know is struggling with self-harm, it is crucial to seek help right now. Your GP can provide an initial assessment and refer you to appropriate treatment, or you can contact a private mental health centre for specialised care. You are not alone, and support is just a step away. Don’t hesitate to take that step today for yourself or someone you care about.
Call our admissions line 24 hours a day to get help.