Deliberate self-harm behavior also referred to as, ‘non-suicidal self-injury disorder,’ ‘self-abuse’ or ‘self-mutilation,’ is the intentional and repeated self-injury to one’s own physical body, to likely induce bleeding, bruising, or pain and expecting only minor physical injuries to occur.

Although non-suicidal self-harm behavior is not in itself classified as a mental health disorder, it is usually motivated by a mental health condition.

Typically, it is not intended as a suicide attempt per se but rather as a way to cope with or reduce difficult negative feelings or emotional distress such as stress, anxiety, sadness, or self-reproach.

 

What Happens When People Self-Harm

A person who self-harms may experience a brief and immediate sense of calm and release of physical and emotional tension. But these feelings maybe followed by negative feelings of guilt and humiliation.

The majority of the time, life-threatening injuries are not intended, yet more serious and even deadly self-injury can still happen. Self-harm is usually associated with physical and mental health problems.

Self-harmers are far more likely to have suicidal thoughts or attempt suicide in the future. As a result, medical care will be needed.

 

Types of Self-Harm Behavior

The most common behaviours among those who self-harm include:

  • Cutting or burning oneself
  • Head banging, or striking any part of the body against something
  • Breaking bones
  • Pricking oneself with needles or inserting objects into the body
  • Ingesting harmful substances
  • Starving oneself purposefully
  • Engaging in excessively strenuous activity

Why People Self-Harm

Self-harm is a widespread issue that impacts a far larger population than one may think. People who deliberately harm themselves frequently feel helpless and as though there is no other option but self-injury.

Other motivations may include feeling better about painful emotions like hurt and rage, resolving relationship issues, punishing oneself, or feeling more in control.

Self- injurious behavior is also a way for some people to cope with things that have happened, or happening and is frequently connected to specific life experiences.

Furthermore, people’s life experiences are unique. Different concerns and sources of stress serve as motivation for self-harm which differ greatly from one person to another.

While some people find that talking to friends and family about their problems helps them deal with their emotional distress, others may not have that level of support, or find that their problems are so overpowering that they feel there are no other ways to vent their emotions as the pressure mounts.

For someone who self-harms, emotional distress such as anxiety, worry, or sadness may encourage more self-harm behaviors.

Risk Factors for Self-Harming Behavior

Situations that may create an enabling environment for self-harm behaviors may include the following:

Trauma:

  • Sexual, physical, emotional or mental abuse
  • Bereavement

 

Psychological:

  • Borderline personality disorder (also known as emotionally unstable personality disorder)
  • Depression, anxiety, anger, or detachment
  • Alcohol or drug misuse
  • Low self-esteem
  • Poor problem-solving abilities
  • Significant levels of stress
  • Recurrent thoughts or voices instructing people to hurt themselves

 

Social:

  • Financial concerns
  • Bullying
  • Pressures at work or school
  • Job loss
  • The breakup of a relationship
  • Illness or serious medical health condition

 

Self-Harm Behavior Telltale Signs

It can be difficult to tell if someone is self-harming because there may occasionally be no indications at all. As a result, it’s important to keep a close eye on our loved ones.

Note that not all of the signs listed below always indicate self-harm. Instead, some of them serve as red flags that someone may be self-harming. Red flags will include the following:

  • Unknown bodily markings, bruises, or injuries
  • Pulling hair, body areas of baldness
  • Covering one’s body constantly, especially in extremely hot weather
  • Low self-esteem, including failure or self-blame manifestations
  • Seclusion or withdrawal from regular life
  • Low spirits, a lack of ambition, or a general lack of interest
  • Unexpectedly violent behavior
  • Alterations in eating or sleeping habits
  • Expressing a lack of motivation to live or a desire to “end it all.”
  • Risky actions, such as misusing drugs or alcohol or engaging in careless sexual behavior

 

Persons at Risk of Self-Harming Behaviors

Anyone, regardless of age, gender, or ethnicity, can suffer from self-harm.

However, it has been discovered, that young people are more prone than other age groups to engage in self-harming behaviors and are more likely to be affected by challenging circumstances.

The average age of onset for self-injury is 12–13 years old, and young people, or teens have the highest rate of self-injurious behaviors.

Such high levels of self-harm behaviors among teens may be explained by the significant physical, psychological, and social changes that their bodies undergo in this phase of their adolescent lives as they evolve from being a child to becoming an adult. When these pressures become overwhelming to a person, they may be prone to self-harm.

University or college students tend to follow this age group and girls/women are more prone to self-harm than boys/men.

Contributing factors for such results among girls/women will include gender discrimination, stigma and gender inequality in our society, and they are unable to find a suitable outlet to adequately express their sorrow.

Regardless of the reasons why people do it, self-harm is not a joke and should be taken very seriously,

 

Effects of Self-Harming Behavior

Self-harm can have a variety of long-term and short-term effects on one’s physical and mental health.

The majority of the short-term effects are physical, such as bleeding, burns, wounds or scars, infections, broken bones, hair loss or bald spots, internal injuries from overdosing or poisoning, and so forth.

In addition to worsened physical repercussions that could result in death; long-term impacts will also include negative feelings such as low self-esteem, self-hatred, feelings of guilt and shame, depression, suicidal ideation and even suicide.

 

What to Do If Someone Is Self- Harming

You might experience feelings of despair, anxiety or hopelessness if you believe a family member or a loved one is self- harming. But there is hope because there are things that you can do to help.

First, ask them directly about it without assuming or passing judgment. People who self-harm are very sensitive to how others may react. So be careful not to assign blame or make assumptions about their intentions.

It is likely that you will not understand why they self-harm, so do not minimize their experience. Such reactions can make your loved one feel isolated and make it harder for them to let you in and ask for your help whether in the present or future.

 

Second, do not pressurize or push them, but encourage them to talk to you about it. Persons who self harm frequently experience negative feelings of guilt or embarrassment.

If they try to avoid the topic or deny that they self-harm, express your sincere desire to support and care for them.

Create a welcoming space where they can openly express their feelings to you and make sure your loved one understands how much you love them and that you are always available to help them if they need it.

 

Third, pay attention and listen to them. Self-harmers typically feel alone and afraid, and they find it difficult to rely on others. Assure them that they are in a safe place and let them know you care about them and want to be there for them. This might help them feel more at ease and open up to you.

 

Fourth, it can be challenging for those who self-harm to ask for help. They might be open to talking to you, but they might not be ready to accept assistance.

Ask them about what they need; do they just want you to listen to them or do they need your help? But always encourage them to seek the support of mental or medical health professionals.

 

Final, be proactive in making medical and mental support available to them if they say they want it. Self-harm typically requires medical attention of some kind. Minor injuries like cuts or bruises, may only require basic first aid which can be administered at home.

However, serious wounds will need emergency care at the hospital. Mental health support is recommended for EVERYONE who self-harms.

This is because usually there are psychological factors that contribute to self-harm behaviors, as well as the disorders or diseases that may result from such self-harm behaviors.

 

Is Deliberate Self-Harm Curable?

Without medical assistance and mental health support, the road to recovery from self-harming behaviors can be incredibly tough.

To manage to survive self-harm and eventually thrive, treatment will entail learning the proper tools and adopting mental health practices that will help a person replace self-injurious behavior with better-coping mechanisms.

Treatment for self-harm will typically involve psychotherapy, medication, or a combination of both. Some therapy strategies have shown to be more effective than others, but treatments will typically include a multifaceted strategy that will involve the patient, his or her family, social networks, and medical specialists.

Expectations for the course of therapy should be realistically controlled because the habit may not end right away.

Whatever the course of treatment, the type of self-harming behavior that was being performed and the underlying medical and mental health issue that led to the self-harming behavior will inform the appropriate course of treatment to be taken.

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At HFH, we genuinely care for our patients and we strive to leave them better than we met them.

Meet our director

Dr. Charlotte Nwigwe is an MBBS degree holder from the University of Benin and a fellow of the National Postgraduate Medical College in Psychiatry.

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