Understanding Self Injury

Learn More About Self Injury

Self-harm, also known as “self-injury,” “non-suicidal self-injury” and “cutting,” is the act of intentionally harming one’s own body such as head banging, cutting, or burning oneself, that is not intended as a suicidal act. Self-injury is an unhealthy form of coping with strong emotions such as anger, emotional pain, and frustrations. The most common form of self-injury is skin cutting, but self-harm does include a variety of other types of self-inflicted harm. Other forms of self-injury may include a wide variety of behaviors such as burning, scratching, trichotillomania, dermatillomania, drinking bleach or other poisons, or hitting oneself. While the intention for those who self-injure may not be suicide, some of the self-injurious behaviors may lead to life-threatening consequences and death. While self-harm is most commonly seen in adolescence and the teen years, often beginning between the ages of 12 and 24, this behavior is not limited to the teen years. Self-injury may occur at any age.

Many people are confused by the notion of intentionally causing physical pain to oneself, but self-injurious behaviors may be a way for some people to express and cope with feelings of marked distress such as self-loathing, guilt, shame, rage, and emptiness. It may sound counterintuitive, but the physical manifestation of deeply distressing emotional pain makes some people feel relief. Unfortunately, the feelings of relief noted by those who self-injure don’t last very long and often create additional problems in their lives. People who self-injure often carry the burden of self-injury alone; keeping their behaviors private and secret. This is often a huge load to shoulder as the self-injury begins to plague relationships with loved ones and may change how you feel about yourself. These feelings can lead to further isolation, sadness, and intensely distressing emotions.

With proper treatment and therapies, most people are able to stop self-injurious behaviors and learn more healthy ways of tolerating intense emotions and stress. While self-harm may have helped you in some way, there are other ways to handle your feelings and go on to live a happy, self-injury free life.

Statistics

Statistics on Self Injury

While self-injury is typically thought of as an act done by those in their teens and young adult years, it can occur at any age. In the U.S. the number of emergency room visits for self-inflicted injury was roughly 713,000 in 2010. It’s estimated that every year, about 2 million people living in the U.S. deliberately injure themselves in some manner. It’s been estimated that approximately 1% of the population are habitual self-injurers, with typical age of onset at puberty.

Causes of Self Injury

What are the Causes and Risk Factors of Self Injury?

There is not one single root cause that leads to the development of self-injurious behaviors. The coagulation of emotions that trigger someone to engage in self-harm is often deeply personal and complex.

Physical: The act of injuring oneself or experiencing physical pain cause the brain and central nervous system to react to the injury by inhibiting ascending nerve signals and blocking pain. Then, our body’s natural pain-relieving opiate neurotransmitters – endorphins, enkephalins, and dynorphins – are released, which can offer the sensation of being intoxicated.

Environmental: The urge to self-injure is often attributed to strong emotions that an individual has no other way of expressing. They may be triggered by events such as a breakup of a romantic relationship, death of a loved one, or bullying. Additionally, those who have friends who self-injure are at a higher risk for self-injurious behaviors. Some people who engage in self-injury may have grown up in a home in which emotions were not allowed to be expressed.

Risk Factors:

Substance use and abuse
Age – most who self-injure are teens or young adults
Mental illnesses – PTSD, eating disorders, borderline personality disorder, anxiety, and depression
Women are more likely to self-injure than men
Childhood abuse or neglect
Poor impulse control
Poor problem-solving abilities
Limited social network
Low self-esteem

Signs and Symptoms of Self Injury

Learn More About the Signs and Symptoms of Self Injury

As self-injury takes many forms, it may be a challenge to determine when you or a loved one is engaging in self-injurious behaviors. Some of the most common symptoms of self-harm include:

Behavioral symptoms:

Spending greater periods alone
Withdrawing from once-loved activities
Blood-stained clothing, bedding, or towels
Frequent “accidents”
Sharp objects in the person’s belongings
Withdrawing from friends and loved ones
Wearing long-sleeves or pants in all types of weather
Compulsively picking at scabs
Risky sexual behaviors
Extreme substance use and abuse
Increasingly secretive behaviors
Impulsive behaviors
Unpredictable behaviors
Binge drinking
Decreased functioning at work, home, or school

Physical symptoms:

Fresh cuts, scratches, or bruises
Unexplained scars or wounds – especially on arms, wrists, thighs, and legs
Broken bones
Hitting your head or banging your body into walls
Punching walls
Sticking things into your skin
Swallowing poisons
Scratching or cutting your skin
Wounds that won’t heal
Pulling hair
Biting

Cognitive symptoms:

Questions about personal identity
Beliefs of inadequacy
Distorted self-image
Negative worldview
Belief that their needs are unimportant
Fear of change
Difficulty handling feelings
Magical thinking

Psychosocial symptoms:

Hopelessness
Pervasively low self-image
Self-loathing
Emotional instability
Guilt
Anger
Shame
Secrecy

Effects of Self Injury

Understanding the Effects of Self Injury

While self-injury is not a suicidal act, it can be a very dangerous way of coping with intense feelings. Some of the long-term effects of self-injury include:

Infected cuts
Broken bones
Scars
Permanent disfigurement
Worsening feelings of shame, guilt
Worsening of underlying mental illnesses and emotional well-being
Increasingly low self-esteem
Life-threatening complications such as blood loss if a major vessel is nicked

Co-Occurring Disorders

Self Injury and other Co-Occurring Disorders

People who engage in self-injury are often coping with an undiagnosed or undertreated mental disorder. The most common co-occurring disorders include: