Coping With Depression and Self-Harm

Understanding and Beating Self-Harm

Kristen Schou and counselor Eric Patterson discuss depression and self-harm, and how to combat it.

How Counselor Eric Tackles Self-Harm

In small doses, symptoms of depression can be managed well, but if chronic, you will feel more hopeless and less in control of your current state. When people feel out of control for an extended period of time, they become desperate, which can encourage amazingly positive reactions — or profoundly negative ones.

Self-harm fits into the category of profoundly negative. Depression and self-harm commonly go together — people who experience high levels of depression are more likely to engage in this type of behavior.

Recent estimates state that as many as two million Americans currently engage in self-harm or self-injury. Self-harm is more commonly completed by adolescents and young adults, with woman outnumbering men, but it seems that overall self-injury is increasing.

What Is Self-Harm?

As illustrated already, self-harm goes by many names. Self-harm, self-injury and self-mutilation are essentially synonymous and can be used interchangeably.

They encompass a range of behaviors that someone does to intentionally and repeatedly to cause some sort of bodily harm to their person. Self-harm is generally a reaction to depressive symptoms and is a perceived way to gain control over uncontrollable situations.

Self-injury takes limitless forms. Certainly, cutting is the most common and widely known method to self-injure; others include scratching, burning, hitting your head or body against hard objects, ingesting dangerous cleaners or chemicals and intentionally avoiding medical treatment.

People will insert objects into their body and even remove their own blood with hypodermic needles. Some people will stay with a preferred way of self-harm, while others will explore and engage in an array of behaviors.

Some would argue that alcohol and drug abuse is a form of self-injury. Addicts repetitively put dangerous substances into their systems, and many do so in the name of self-medication.

As the methods are limitless, so are the degrees of injury. Some will cut, scratch or burn themselves superficially, barely breaking the skin. Others will impale themselves by sticking large knives or needles into their abdomen.

It is important to note that the degree of the injury does not matter as much as the act of self-injury itself. All self-harmful thoughts or behaviors must be taken seriously.

Why Do People Self-Harm?

Though counterintuitive, there are some positive aspects of self-harm. Consider that any behavior continued over time provides some direct or indirect benefit to you, no matter how negative it might seem on the surface.

To treat and eventually reduce self-harm, you must understand the role and function it serves. Reported positives of self-harm include: the ability to express strong feelings and emotions, relieve the built-up physical tension and pain, gain control, and feel alive.

Negatives of Self-Harm

If self-harm was purely positive, there would be no need for any further discussion on the subject. Of course, you know this is not the case.

As with any negative coping skill, the negatives of self-harm always outweigh the positives over the long-term. Reported negatives of self-harm include:

  • When the short-term feelings of relief wear off. You are more likely to continue feeling unwanted feelings like shame, guilt, worthlessness and helplessness after the initial positive feelings.
  • Impacted relationships. Dealing with depression and relationships often causes strain. Because self-injury is seen in a negative light usually, the measures taken to keep the behaviors secret harm the relationships you have with loved ones.
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  • Even seasoned self-injurers can accidentally harm themselves in more extreme or exaggerated ways. These accidents can lead to serious health concerns like infections, permanent damage, or even death.
  • Self-harm is avoidance and distraction from the real problem. Without addressing the issue directly, symptoms will worsen.
  • Negative coping skills must increase in frequency and intensity to continue achieving the same effect. Like with drug use, you will build up your tolerance needing more severe forms of self-injury.

Self-Harm Interventions

If self-harm is a part of your life or you have been contemplating it, work to realize the easy answer is usually not the best choice. Instead, choose to tell on yourself by talking to a trusted friend, family member or mental health professional. Allow them to give you feedback in a nonjudgmental, loving way. The act of disclosing this information helps to reduce the secretive nature that shrouds self-injury.

After you have built or reestablished your support network, challenge yourself and your team to figure out what role self-harm serves. As mentioned above, you are gaining some benefit from the behavior.

Are you avoiding a problem? Are you distracting yourself? Are you trying to draw attention to something you do not have the words to describe? Without gaining this understanding, any attempt at treatment is like putting a bandage on a broken leg, or putting an icepack on your head while your foot is throbbing. 

The next step of the intervention process is finding new, positive coping skills to utilize. Simply put, self-harm is too damaging and negative to continue.

Self-Harm Interventions

You can select the alternative based on what needs you have and what role you are trying to fill. New coping skills include:

  • Ways to express intense emotions. Rather than self-injury, choose art therapy for depression through writing poems, songs, raps, journal entries or short stories. Some find it beneficial to destroy their writings immediately after completion as a way to purge their feelings.
  • Ways to feel calm physically. What helps you feel relaxed and soothed? Try a hot bath or lighting candles in a dark room while peaceful music plays. Treat yourself to a massage or a day at the spa if financially able.
  • Ways to feel connected or alive. Experiencing intense sensations help make you feel alive, less numb and connected to the world around you. A tested way to decrease feeling numb is to hold an ice cube as it melts. This will shock your sensation of touch while being relatively harmless.
  • Ways to release tension or anger. If your depression has you feeling full of tension and anger, let it out through activity. Exercise is a great solution as it provides antidepressive effects along with tension reduction.

Kristen's Advice for Depression and Self-Harm

People often keep these habits secret, but the urge to self-harm is not uncommon, especially when you are experiencing depression. Whether you just started hurting yourself, or have been suffering many years in silence, there is always hope for recovery and wellness.

What Is Self-Harm?

Self-harm is not a mental illness, but a lack of coping skills. Self-harm is when you deliberately harm yourself for a variety of different reasons.

The most common type of self-harm is known as cutting, when you harm yourself with a sharp object, but there are many other types, including burning, scratching, overdosing, punching or hitting, head banging, and starving.

There are a number of different reasons people engage in self harm, including:

  • Punishing themselves
  • Getting rid of an overwhelming feeling of frustration, anger, or pain
  • Trying to cope with feelings of shame, guilt, or depression
  • Getting control back into their life if they feel powerless
  • Expressing negative emotions without the use of words

When you don’t know how to deal with your emotions, or you felt you were not allowed to express your emotions as a child, it can lead to self-harming.

When you injure yourself, your body releases endorphins — the body’s natural painkiller. These hormones help to elevate your mood and in turn make you feel better. You can get the same feeling when you do any physical activity, like exercise or sex.

Sometimes when people self-injure they feel very guilty about it, so they keep it hidden. If the shame or guilt makes you feel bad about yourself, it could lead you into a cycle of self-injury; people become addicted to self-harm because of this.

People who suffer with self-injury can accidentally make self-harm a long-term habit, which makes it extremely difficult to end.

How Can We Help Those Who Self-Harm?

Maybe you have suspected someone in your life is self-injuring. Maybe they are wearing long sleeves in the summer or have unexplained cuts or bruises.

There are a few things you can do to support and help your friend:

Educate Yourself

Sometimes it is easier to talk to someone about self-harm when you understand more about it. Learning about self-injury before you bring it up will make the conversation easier because you can throw all the misconceptions of self-harm out the window and just focus on the facts!

Ask How They Are Doing

I know this seems like a very simple answer, but sometimes all we need to reach out for help is someone expressing they care about us.

Ask how they are doing, express your concern and that you want to help them, and prepare to listen.

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Encourage Them to Seek Treatment

Recovery from self-harming behavior is totally possible with treatment and a caring support system. If you are able, help them find treatment, offer to go with them if they are scared, and offer your support.

Reducing Self-Injury

If you have come to this post because you are suffering with self-injury and you need to know how to cope with it, I want you to know that recovery from self-injury is 100% possible!

Here are a few tips to get you on the road to recovery!

  • Know your triggers. If we can understand what triggers us to self-injure, we can stop exposing ourselves to them; we can take back some of that control we feel we’ve lost. I suggest writing about what you felt before you wanted to self-injure in a journal and then look at patterns that come up.
  • Talk about it. Hiding self-harm from friends, family, or professionals is not going to help you get better. Find someone you trust and talk to them about what you are experiencing. Even just telling one person your secret can make the difference.
  • Forgive yourself. As you might know, recovery is a rollercoaster ride. Some days can be better than others, and that is normal. We sometimes might feel guilty about what we have done to ourselves; on those low days remember how far you've come and never give up on yourself, because you are stronger than you think you are!
  • Consider counseling. Counseling is extremely beneficial to anyone experiencing self-harming behavior. Remember, having the urge to self-harm is different than the actual self-harming behavior. A therapist can help you with those urges and get you on the road to recovery!

Let me know in the comments how you reduce your self-harm urges or how you have helped someone who was self-harming in the past!

Next page: Eric's self-harm interventions, and Kristen's advice on self-injury.

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