A Guide to Understanding Self-Harm & Addiction

Non-suicidal self-injury (NSSI) is a self-destructive or self-punishing behaviour where the person intends to inflict physical harm on themselves to relieve emotional pain. This behaviour has a whole plethora of emotional and hormonal changes to it.

When a person suffering from mental problems inflicts self-harm in this way, they endure a short burst of endorphins, which makes the emotional pain more bearable.

NSSI is not a suicidal attempt. Instead, NSSI is a condition that occurs when people inflict physical harm on themselves for a variety of reasons, including expression, punishment, guilt, or shame.

The goal is to make underlying mental problems more bearable. NSSI is not a mental health disorder in itself, but it is indicative of a deeper issue at hand.

It’s a way of internalising external pain or emotion. And rather than trusting other people who could help, sufferers of NSSI inflict the wounds and then hide them with bandages or clothing. In some ways, it’s a means of communicating the unspeakable.

Self-Harm and Addiction go Hand-in-Hand

NSSI is often addictive behaviour. It doesn’t seem to make sense, but once a person inflicts the damage on themselves, they crave more. The ‘rush’ (i.e. the endorphin boost) is very short-lived, and people experience short periods of good feelings. But after that come shame, guilt, and embarrassment.

Self-harm actions have short-lasting effects with adverse long-term consequences. And to make matters worse, NSSI is often intertwined with other addictions. Studies show that 8.7% of people suffering from NSSI also suffer from other addictions. [1]

In some cases, those substances are also a form of self-harm, which is where the two go hand-in-hand and often intertwine.

Many NSSI sufferers also suffer from the effects of other addictions. These substances become a way of punishment, but the long-term effects of these substances still come. And it is those addictions that can become a serious health hazard.

Self-Harm is a Form of Addiction

Self-harm is a short-term way of relieving the pain that comes from mental problems. Inflicting self-harm to oneself has very short-term consequences and it includes the “feel-good” factor that it brings.

But that feeling goes away quickly, and what is left is the same pain that was before. Plus, the embarrassment and the guilt that comes from self-harm.

So you can see how it can become a repeating thing. The need to relieve the mental problems comes back, and so the person is more inclined to inflict self-harm again. It’s a never-ending cycle, and it only ends when they address the underlying problem(s).

Much like drug and alcohol abuse, the individual who self-harms not only has little regard for the physical effects of addiction – they thrive off the concept of damaging their body, for whatever reason. Addiction to harmful substances may actually be an effort to self-medicate, and to numb any pain that is causing distress.

Similarly to addiction, self-harm is turning emotional turmoil, unpleasant thoughts, or extremely distressing memories into physical actions or ailments that are visible and proactive.

The physical dependence on self-harm comes into play. It becomes an addiction in itself, as the sufferers find it a helpful coping mechanism, and something that eases the pain, at least for a short while.

The underlying problems can include depression, anxiety, substance abuse, anger, sadness, or other mental problems that need addressing.

Why Does Self-Harm Happen?

Why would someone harm themselves? That’s a question someone who doesn’t know about NSSI might ask. It might not make much sense, but it’s a very serious and real problem for many. Normally, it’s a way of coping, but the reasons for it usually differ from case to case.

Self-harm is most often a way of coping with the traumas of the past. Or, it can be a relieving mechanism for underlying mental problems, such as anxiety or depression.

In some cases, it’s not known why someone would inflict harm on themselves. Not even the individual doing the self-harming knows the reason behind it.

A thorough conversation about the problem might uncover some of the truths about the underlying cause. It requires deep reflection and quick action to address the underlying problems and stop the self-harm.

Who is at Risk of Self-Harm?

Almost anyone can inflict self-harm. These are some of the most endangered groups when it comes to self-harm:

Women
Youngsters
Men
People from minority groups
People with underlying mental conditions
People suffering from addictions

Young people are under a great deal of pressure from peers and parents. Girls are more prone to self-harm than boys. It’s just a form of coping, which includes other ways of coping such as anger, smoking, alcohol drinking, self-seclusion, and in the long-term, depression, and anxiety. [2]

Women are more common sufferers of NSSI than men, although there are plenty of men who also inflict self-harm. Sometimes, the pressure and the stress is too much for anyone, regardless of gender or age.

Is Self-Harm Common?

We still underestimate how common self-harm can be, especially among the adult population. It’s a well-known fact that young people are more prone to self-harm, but not many people would expect adults to do that.

It’s estimated that about 10% of all the young population (between the ages of 12-18) inflict self-harm. While this problem is prevalent among young people, there are still many adults that inflict self-harm.

But in these cases, there is a prevalence to inflict self-harm with substances rather than by inflicting physical wounds. [3]

How Do People Self-Harm?

Self-harm takes place in many different ways. In many cases, self-harm is not detected as it’s subtle and hidden by the individual. In other cases, the consequences are far clearer. These are the most common ways of self-harm. [4]

Hitting one’s body parts or head against a wall or other objects
Hair pulling or excessive hair tweezing
Skin picking
Self-intoxication (with drugs, alcohol, or other substances)
Water or food deprivation
Sexual behaviours that cause harm

Dangers & Risks of Self-Harm

NSSI is considered as non-suicidal, so there is no intention to kill oneself. But it still can cause severe adverse effects on the body and mind of an individual. As these effects can be severe, it’s crucial to recognize this behaviour as soon as possible and eradicate it or the underlying problems.

Even if suicide was not an intentional outcome, it can still happen in severe cases. Here are the most common effects of self-harm.

1. Physical

Broken bones
Injuries to tendons, nerves, muscles
Weakness or numbness in the pain area
Loss of limbs
Organ damage or failure
Infections
Septicemia
In severe cases, accidental death

2. Mental

Self-isolation and loneliness
Low self-esteem
Feelings of shame or disgust
Permanent scarring
Suicidal thoughts

Signs and Symptoms of NSSI

The physical symptoms and signs of NSSI might be hard to observe as the person tries to hide them. But we can inspect for behavioural signs. Recognizing the problem is crucial to stop it as soon as possible, and to prevent further damage it can cause.

There are warning signs that we can inspect, and these are some of the most common ones: [5]

Wounds on various parts of the body that are inexplicable
Long-sleeved clothing, even in the summer, to conceal the damage of self-harm
Avoidance and isolation
Excessive anger and impulsivity
Feelings of worthlessness, hopelessness
Self-harm tools such as razors or scissors that don’t belong to the place where we find them
Struggles with identity

Dual Diagnosis – What is it?

Dual diagnosis happens when we diagnose self-harm in correlation with other problems. These usually go hand-in-hand with NSSI or are a form of self-harm.

Some dual-diagnosis conditions that can result in self-harm include:

1. Self-Harm and Eating Disorders

Eating disorders are also a form of self-harm and often co-occur with physical self-harm such as cutting. Among the most common eating disorders are bulimia, anorexia, and binge-eating and obesity.

Eating disorders are also a way of displaying our emotions and denying mental problems. It’s a way of coping with mental diseases. People who suffer from these disorders experience a tornado of emotions that leaves them stranded.

Anorexia, for example, often happens when people don’t feel worthy. Bulimia is a result of denial, and binge-eating is a disorder that stifles one’s emotions.

All of these disorders can lead to serious health problems and need to be addressed quickly.

2. Self-Harm and Alcohol

Excessive alcohol consumption is also a way of self-harm. It’s a way of hiding emotions and feeling the “”positive”” emotions that mild drunkenness can bring.

But it often doesn’t end there; as the mental problems worsen, people feel the need to indulge in alcohol more often to ease the pain.

That’s how alcohol addictions can develop. And in the long-term, alcohol addictions can have severe adverse health implications.

But the more a person drinks, the more they are dependent on alcohol as a form of hiding their true emotions. Heavy drinking is also a form of self-punishment.

3. Self-Harm and Substance Abuse

NSSI can also manifest itself in excessive drug abuse. When a person feels heavy and has negative emotions, they try to hide them with various drugs.

These can be a short-term relief, but in the long-term, they too have negative consequences on us.

We can become depressed and anxious, leading to even more negative thoughts. This also magnifies the need to inflict self-harm.

More drugs are taken, and physical abuse can also happen. Drug overdoses are not uncommon.

I Don’t Want to Stop Self-Harming. What Can I Do?

Many people will be in denial and will want to continue self-harming. But self-harm doesn’t address the problem, it only gives a form of relief for a very short period of time. It causes a great deal of physical and psychological pain, in addition to the mental problems that lay beneath the self-harm.

That’s why it’s better to stop altogether. If you can’t, consider minimizing the self-harm as much as possible. But reconsider your stance often, and try to do something about it.

Do you have family or friends that can help you? Then ask them. Are there ways to reduce the pain, or can I stop it? Do it.

The Do’s & Dont’s for Helping Someone Who Self-Harms

Below we have listed some guidelines to follow if someone you love is struggling or suffering as a result of self-harm. These include:

Do

Talk to the person and try to understand their feelings and point of view
Help them find out about self-harm by showing them materials about it, or some books
Talk to them about getting help – talking to their GP would be a good start
Make them feel like self-harm is not a secret, but a problem that needs solving

Do Not

Don’t be their therapist. It’s a complicated issue
Force them to stop overnight
Express intense feelings of anger, upset, hurt; it can make matters much worse knowing they don’t have support from you
Struggle with them
Force them to make a promise not to do it again
Threaten to not see them unless they stop self-harm
Feel responsible for their thoughts or problems

Alternatives to Self-Harm

Although it’s difficult to perceive, there are alternative methods to self-harm that are a lot safer. These can be implemented at any time of day, and have been proven to curb strong desires and impulses to self-harm. These activities include:

Snap a rubber band around your wrist
Draw wounds where you wanted to do self-harm
Distract yourself when you want to do it
Listen to some music
Wait one day more for every cut you have
Do mindfulness
Take a shower
Play an instrument

What Help is There?

If you find yourself self-harming too often and want to end it, there is a lot of help out there, you just need to know where to look. The first step is to recognize that you have a problem. Then, you need to decide that you want to end it. [6]

But the problem here that many people who inflict self-harm don’t want to seek help. That’s where relatives and friends have to help. What help can one get?

1. Family Meetings

Here, you can lay your cards on the table and talk to your family openly. It might be intimidating, but your family should understand. You can arrange a family meeting with your therapist and say everything that’s on your mind.

2. Group Therapy

Connecting with other people suffering from similar problems can be the saving grace. You’ll be led by a professional, and you’ll find that you aren’t the only one with problems like this.

3. Cognitive Behavioural Therapy

CBT can help you transform your brain and how you think. It helps you recognize your negative thoughts and to embrace the positive ones. Keeping a journal of your thoughts is helpful, as is mindfulness meditation that will allow you to recognize these thoughts better.

Analyzing these thoughts and then shifting them towards helpful thoughts is the backbone of CBT.

4. Non-Professional Help

Finding someone you can trust and talk to them can be extremely beneficial. It must be someone close to you, and someone who won’t give everything away and will try to help.

In some cases, these people can have a better idea of what to do and might help you find a proper form of treatment if you’re incapable.

5. Dialectical Behavioural Therapy

DBT or dialectical behaviour therapy is similar to CBT in the sense that it helps us recognize our thoughts. But we aim to change our behaviours with DBT, which is extremely useful with self-harm.

Misconceptions of Self-Harm

Unfortunately, self-harm is similar to many mental health disorders in that people are reluctant to talk about it. This only promotes a lack of understanding on the topic, leading to widely formed misconceptions.

Some of the myths that we wish to dispel include:

Only women self-harm
You can’t treat self-harm
People suffering from self-harm enjoy the pain
Self-harm equals suicide
People will stop on their own when they outgrow it
Self-harming individuals are crazy
They are craving attention

Signs of Suicidal Attempt

Be careful to observe the potential signs of suicide. Self-harm can quickly escalate and go a level higher, which is suicide attempts. These are some signs to observe and be mindful of: