Self-Injury Awareness

Self-Injury Awareness Day (SIAD), is an international awareness day that takes place every year on March 1 and is a day meant for learning about self-injury behaviors and for providing resources to those who are in need of help. An orange ribbon, representing a sign of hope for a misunderstood problem, symbolizes this awareness day.

What is self-harm?

Self-harm is the deliberate act of causing physical harm to oneself and is a very dangerous sign of emotional distress. It is done in an effort to regulate emotional distress and is not an attempt to take one’s life or only a cry for help. It is, in fact, an attempt to cope with painful or hard-to-express emotions.

According to the Statistical and Diagnostic Manual of Mental Disorders, Fifth Edition (DSM-5), self-harm is formally known as non-suicidal self-injury disorder (NSSID) as these self-destructive behaviors are carried out without any intention of suicide. Adolescents are at the highest risk for self-harm injury as many studies state that approximately 15% of teenagers and 17-35% of college-aged students have inflicted self-harmful behaviors on themselves and this can continue well into the adult years.

Males and females have comparable rates of self-harm behavior. Classic self-harm is identified as cutting, skin carving, self-medication, extreme scratching, or burning oneself as well as punching or hitting walls to induce pain are examples of self-injurious behavior. Less frequently this behavior includes ingesting toxic chemicals, extreme skin picking, hair pulling and deliberate interference with wound healing. There is also indirect self-injury, like reckless driving, substance abuse, unprotected sex, putting self into dangerous situations in order to get re-traumatized and therefore punish self. Self-injury, therefore, comes in many different forms with the same goal being to cope with severe emotional distress.

The relief felt with self-harm is temporary, and usually, a self-destructive cycle often develops without proper treatment or intervention. Self-injury can also be a way to have control over one’s body when it is impossible to control anything else.

The consequences of self-harming are both immediate and long term. Short-term consequences include guilt and shame while long-term consequences are the inability to learn to regulate emotions in a healthy way, relationship struggles, poor self-esteem, and stigma. Most individuals who self-harm report that they want to stop but find it extremely difficult because this is their only coping mechanism. One of the reasons it is very hard to stop intentionally injuring oneself is that the act of self-harm (often cutting) produces endorphins, which gives a rush, and a sense of calmness and relief that makes one feel like everything is manageable and ok. The problem is that the feeling of calmness and relief is only temporary and frequently followed by shame and guilt.

Self-harm is strongly linked to other disorders, specifically, borderline personality disorder (BPD) and eating disorders such as anorexia and bulimia nervosa. Approximately 70% of individuals with a borderline personality disorder and approximately 30% of females with eating disorders are known to participate in self-harm behaviors. Self-harm has also been linked to depression, anxiety and suicide however the statistics for these co-occurring disorders have not yet been released.

The statistics

• Each year, one in five females and one in seven males engage in self-harm behaviors
• 90 percent of individuals who engage in self-harm begin during their teen or pre-adolescent years
• Nearly 50 percent of individuals who engage in self-injury activities have been sexually abused
• Females comprise 60 percent of individuals who engage in self-injurious behavior
• Approximately 50 percent of those who engage in self-harm behavior begin 14 years of age and continue into their 20s
• Many individuals who engage in self-injury behavior report learning how to do so from their friends or pro-self-injury websites or social media pages
• Approximately two million cases are reported annually in the United States.

What are the signs of self-injury?

• Withdrawal or isolation from everyday life
• Signs of depression such as low mood, tearfulness or a lack of motivation or interest in anything
• Changes in mood and activity
• Changes in eating/sleeping habits
• Talking about self-harming or suicide
• Abusing drugs or alcohol
• Signs of low self-esteem
• Unexplained cuts, bruises or marks
• Covering up the body all the time

What to do when you know someone who might be self-harming?

Most importantly ask for help. It is important to validate the person who is self-harming, offering a safe environment to share their struggles, seek professional help and provide non-judgmental support while keeping healthy boundaries. Try not to be a therapist nor give ultimatums. The underlying causes of self-harm can be difficult to recognize without thorough assessment and therapy.

Treatment

One of the most effective treatments for self-harm is Dialectical Behavior Therapy (DBT) which was originally developed by Marsha Linehan to treat adolescent females who engaged in non-life-threatening self-harm. Since, DBT has been used to treat various other psychological problems, like anxiety, depression, trauma, eating disorders, substance abuse. DBT is a well-researched treatment modality with successful outcomes and teaches people core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills. DBT helps people to learn ways to tolerate uncomfortable feelings of anger, anxiety, and rejection without resorting to cutting or other self-harm behaviors.

Strong Hope offers DBT as well as a range of other therapy modalities for the treatment of self-harm. Please contact us for any additional questions at +246-280-0020.

Doyle, L., Treacy, M.P. & Sheridan, A. (2015). Self-harm in young people: Prevalence, associated factors, and help-seeking in school-going adolescents/. International Journal of Mental Health Nursing, 24 (6), 485-495.

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