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Self Harm

Note: Self harm is not a mental illness, but is common and associated with many different mental health concerns.

Definition

When someone purposely injures themselves and not necessarily with the intention of dying, this is self-harm. Self-harm is not a mental illness, but it is usually a sign that someone is struggling and in need of a way to cope.

Important: People self-harm in different ways (cutting, burning, scratching, hitting, etc.) and for different reasons.

  • To cope with anxiety or depression
  • To cope with loss, trauma, violence, or other difficult situations
  • To ‘punish’ themselves
  • To turn emotional pain into physical pain
  • To feel ‘real’ and counter feelings of emptiness or numbness
  • To feel euphoria
  • To regain control of their bodies
  • To simply feel better                           -CMHA

Self-harm and suicide attempts are not the same thing. Although someone who self-harms may have thoughts of suicide, self-harm is usually used as a way to cope. Suicide, on the other hand, usually happens when someone feels desperate and like they cannot cope any longer.

One study of Canadian youth found that almost 2 out of every 10 youth aged 14-21 had hurt themselves on purpose at one time or another. Self-injury behaviours usually start between 13 and 15 years of age, and happen most often in teenagers and young adults. Children’s Hospital of Eastern Ontario

Self-harm is not:

  • “Just” a cry for attention.
  • A sign or result of low intelligence or weakness.
Causes

Self-harm is a behaviour that can occur among any person at any age, but is more common among young people. Because self-harm is used as a way to cope with numbness or overwhelming feelings, the causes of self-harm can be any number of things, like a stressful event, trauma, low self-esteem or mood, eating and/or anxiety disorders.

Self-harm could start because of a single stressful or traumatic event, or develop over time because of an ongoing issue.

Some people might self-harm because they feel numb or overwhelmed with feelings and need a physical pain release to cope. Some people might self-harm as a way to feel a sense of control when their life feels chaotic.

Self-harm continues and becomes a pattern with some people. If someone feels some kind of relief from self-harming, it can be hard to stop the impulse to keep doing it. It can turn into a troubling cycle.

Signs and Symptoms

Some people who self-harm take great care to hide their injuries, while others are not concerned with hiding their injuries at all. Below is a list of signs that someone might be self-harming. Please note that these signs could be explained by a number of different issues, not just self-harm:

  • Unexplained frequent injuries, such as cuts and burns
  • Unexplained scars
  • Wearing long pants and long-sleeved shirts all the time, even in warm weather
  • Low self-esteem
  • Problems handling emotions (tearful, moody, angry outbursts, etc.)
  • Problems with relationships
  • Withdrawing from activities, friends, family
  • Apathy, no motivation
  • Changes in eating and/or sleeping habits
Help

When any type of mental health concern or behaviour is interfering with a person’s life, it is time to get help. Injuring yourself on purpose is a medical concern regardless of how or why it is happening. If you or someone you know is self-harming, it’s time to get help from someone. That someone could be a friend you trust, a teacher, your family doctor, a crisis line, or counsellor.

Self-harm is a physical health issue as well as a mental health issue.

To get help for the physical health complications caused by self-harm, one may:

  • Find themselves in need of stitches, antibiotics (to fight infection) or other medical interventions as a result of hurting themselves.
  • Need to see a family doctor if wounds are not healing or seem infected.
  • Need to go to Urgent Care if in need of medical attention for non-life-threatening injuries like stitches or suspected infection.
  • Need to call 911 or going to the Emergency Room may be needed if an injury has gotten serious or is life threatening (like bleeding too much, losing consciousness, etc.) .

Self-harm is a coping strategy for many people when they are trying to deal with overwhelming emotions, numbness, stressful situations or personal issues. Self-harm isn’t a mental illness, but it’s a sign that someone might need some help coping with a situation or an underlying mental health issue.

Self-harm can lead to other health complications, scarring and feelings of shame or regret. For this reason, help might start with a family doctor, mental health professional, a family doctor, a friend or a trusted adult.

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. They might need you to make the first step. Talk to them, listen without judgement, and encourage them to seek help from a doctor. If you are not sure what to do, you might want to tell an adult you trust that you are worried about your friend. Remember that you cannot “force” someone to get help if they’re not ready, but you can suggest and try to help connect them to resources.

If you feel like you or a friend is in medical danger, call a crisis line or 911.

Visit our Help Section to find out how to get help for yourself or a friend.

Treatment

Self-harm is not a mental illness, but it is a mental health concern as it usually happens because someone is struggling and needs a way to cope. Like other mental health issues, self-harm and how it is experienced will differ from person to person. Because each case is unique, the treatment will likely be unique for each individual.

Self-harm is a physical health issue as well as a mental health issue. To deal with the physical injury, people who self-harm may find themselves in need of stitches, antibiotics (to fight infection) or other medical interventions as a result of hurting themselves. This treatment might be done by a family doctor, a clinic, urgent care or in the emergency department.

Because self-injury can be dangerous and have long-term effects (scars, accidental long-term injury, infection, etc.) the ideal way to help might be to figure out why a person is self-harming and to help them learn healthier coping strategies.

Self-harm can be connected to mental illnesses like mood, anxiety or eating disorders. To deal with the emotional/mental issue that may be causing the self-harming behaviour, treatment strategies might include any or all of the following: group or individual therapy, life coaching/learning stress management, inpatient treatment, medication, counselling, mindfulness, etc.

Family members of someone who is self-harming and/or has been diagnosed with a mental illness may benefit from therapy, support groups, learning about the issue and discovering ways to support their loved one at home.

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them.

A person who is self-harming, like any other person, will benefit from maintaining wellness and having good supports in their life. 

Myths

Self-harm can be very alarming and scary to those doing it and to the people who care about them. There are discussions and communities online regarding self-harm, and these may be useful and helpful for some, while for others they may be triggering, unhealthy or unhelpful. Having good information about self-harm can be the key to understanding and dealing with it. Some common myths about Self-Harm are:

Myth: People who self-harm are just doing it for attention.

Fact: This is not true for many people, as those who self-harm may actually be pretty secretive about it and go to great lengths to hide their behaviour from friends and family, sometimes for months or years. Some people who self-harm may be doing it and allowing people to see their injuries to draw attention to the fact that they are suffering or feeling overwhelmed. If a friend of yours is self-harming “just for attention” that is a pretty drastic thing to do and may be a sign that they want/need help. Wanting or needing attention when you’re not well isn’t a bad thing.

Myth: Self-harm only happens to certain people. My friends would never self-harm.

Fact: Self-harm is a behaviour that anyone can develop. People from all walks of life can develop this behaviour. It is not caused by your gender, the kind of clothes you wear or music you listen to. Regardless of who it is, anyone who self-harms deserves help if they need it.

Myth: Self-harm is always caused by a mental illness.

Fact: Self-harm is a coping strategy that some use to deal with stress, trauma or overwhelming feelings. Sometimes there is a mental illness causing someone to do this, but not always. 

Support

Supporting someone who is struggling through a tough time or experiencing a mental health issue can be challenging. Ways to support a friend who is self-harming:

  • Know the signs of self-harm.
  • Encourage professional help for your friend when needed (see Help Section).
  • Help your friend to avoid triggers or situations that can cause them to feel like self-harming.
  • Be a sounding board. Listening without judgement and without trying to “fix” their problems can be incredibly helpful.
  • Ask your friend how else you can help. It may be as easy as just providing a distraction, asking them to do simple, relaxing things with you (like hanging out, watching a movie, etc.).
  • If you are supporting someone who is self-harming, it can be really distressing. Set some boundaries for yourself, and take care. You can’t help someone if you’re feeling overwhelmed yourself.
  • If you don’t know what to do, go to a helpful adult, like a parent, Guidance Counsellor or teacher you trust. They might be able to support you and your friend to find a solution.

See the Help Section for more info about helping a friend and self-care. 

Resources

The content has been taken from CAMH, CMHA and the Children’s Hospital of Eastern Ontario. For more in-depth information, please visit these sources or speak to a medical professional.

Ontario – Call ConnexOntario to find out where there are mental health supports in your community.

Crisis - In any situation where someone is at risk of seriously hurting themselves or others, call 911 or a local crisis line.

Please see the Help Section for more information on how to seek help and Weblinks to find more information and resources. 

More on mindyourmind

Interview and Ted Talk with Dr. Stephen Lewis about self-harm.

A blog, by Daisies and Bruises writer Erin, about coping strategies and self-harm.

A poem written by a young person.

References

The information on this page is a simple overview of a complicated health issue. The content has been taken from CAMHCMHA and the Children’s Hospital of Eastern Ontario. For more in-depth information, please visit these sources or speak to a medical professional.