It is not uncommon for people who are struggling with their mental health to engage in intentional acts of self-harm. At Carolina Dunes Behavioral Health in Leland, North Carolina, we think it is important for our patients and their families to understand what self-harm is, why people engage in self-injury, and what should be done to help a person who hurts themselves on purpose.
Common Self-Harm Behaviors
There are a variety of different ways that people engage in non-lethal self-injury. Some of the most common include:
- Cutting, stabbing, or scratching their skin until it bleeds
- Hitting or banging their head
- Burning themselves
- Inserting objects into their body openings
- Drinking something dangerous
- Breaking their bones on purpose
- Biting themselves
- Pulling out their own hair
Who Engages in Self-Harm?
In the United States, research has indicated that self-harm occurs at different rates among various age groups and that young people may be influenced to try self-injury if they have peers who hurt themselves or access to online communities where they witness self-harm. Self-harm is estimated to occur in:
- Less than 5 percent of adults
- Up to 17 percent of adolescents
- 17-35 percent of college students
The rates are significantly higher among people with documented behavioral health disorders, especially:
- Borderline personality disorder
- Bipolar disorder
- Anxiety
- Obsessive-compulsive disorder
- Schizophrenia
- Dissociative disorders
- Eating disorders
- Major depression
- Alcohol use disorder
Why People Hurt Themselves
Self-harm typically occurs when a person:
- Feels emotionally out of control
- Uses physical pain to cope with emptiness or deep emotional pain
- Believes they deserve to be punished for something they have thought or done
- Doesn’t know other ways to express themselves
- Craves a distraction from negative feelings
- Has a history of trauma that they aren’t sure how to address
Self-Harm and Suicide
People who engage in intentional self-injury are not typically trying to kill themselves, at least not in the beginning. They may become suicidal, however, if they do not receive support for the underlying causes of the self-mutilating behaviors, and they are also at risk for medical complications related to their injuries. This risk increases over time because the relief that self-injury provides is fleeting, and it is often replaced with feelings of guilt and shame, which can escalate the intensity of future self-harm in a cycle that can be difficult to break alone. For these reasons, people who engage in self-harm should receive medical and mental health evaluations.
Signs of Self-Harm
When a person engages in self-injurious behaviors, there are often indicators, such as:
- Scars clustered together in a specific area, especially on the arms, abdomen, or upper legs
- Fresh wounds, which could include bite marks, cuts, burns, scratches, or bruises
- Keeping objects close by to use for the purpose of self-harm, such as sharp objects like knives or razors, lighters, or cigarettes
- Wearing long pants or shirts with long sleeves, even when it is hot
- “Accidental” injuries that seem to happen too often or with explanations that don’t seem to make sense
- Impulsivity, unpredictability, and instability
- The person saying that they feel helpless, hopeless, or worthless
Treatment for Self-Harm
Self-harm can be treated. Medications may help with underlying behavioral health conditions. Therapies, such as mindfulness, cognitive behavioral therapy (CBT), and especially dialectical behavior therapy (DBT), are also typically used to help people discontinue self-injurious behaviors, by teaching them:
- Distress tolerance
- Emotional regulation
- Coping skills such as grounding exercises, talking to a trusted person, taking a shower, getting outside, or using a weighted blanket.
Depending on the severity of symptoms, interventions for self-harm may occur in:
- Outpatient therapy
- Partial hospitalization
- Inpatient treatment
Supporting a Loved One Who Self-Harms
If someone you know has engaged in self-harm, the first step is to determine if they need medical care for:
- Bleeding that isn’t stopping
- Deep puncture wounds
- Extreme pain or fever resulting from skin wounds
- Serious burns
The next step is to lovingly address your concerns without judging the person.
- Choose a calm, quiet setting
- Ask them how they are doing
- Listen to their answer without trying to change their mind
- Express that even if you don’t fully understand, you want to support them
- Tell them that self-harm is not uncommon when people are struggling and that there are professionals who can help
- Offer to help them get connected to treatment
- Do not demand or make them promise to stop self-harming because it takes more than willpower to quit, and if they break the promise, this could increase their guilt and isolation
At Carolina Dunes Behavioral Health, we offer inpatient treatment for several behavioral health conditions that can be accompanied by self-injurious behaviors. Our staff is trained to support patients and their families with not just their behavioral health diagnosis, but also the other needs that they may have, which could interfere with their full recovery.
