Self Harm as a Mental Illness

Self Harm occurs when an individual intentionally and repeatedly acts in a way that causes harm to themselves. It occurs in a way they can’t control and it is not intended to be dangerous.

It is usually done to cope with overwhelming thoughts and distress so its really never a suicide attempt or a cry for attention.

Most individuals who engage in non-suicidal self-injury hurt themselves in more than one way. Often, they keep their self-harm habit a secret.

This urge to injure self isn’t uncommon, especially in adolescents and young adults but many overcome it with treatment.

Forms of Self-Harm

  • Poisoning
  • Physical violence like punching or hitting themselves (with hammers or other objects), head banging etc.
  • Injuring their skins/reopening wounds
  • Hair pulling
  • Over-eating or under-eating
  • Inserting objects into body
  • Overdosing on medications or regular substances found around
  • Exercising excessively
  • Getting into fights where such individuals are likely to get hurt 

 Factors associated with developing self-harm behavior

  1. Overt depression
  2. Low self-esteem and sense of persistent hopelessness
  3. Impulsivity
  4. School influence of intimidation (such as bullying)
  5. Family dysfunction and conflict
  6. Poverty
  7. Abuse

 Some relevant statistics that gives some insight into this problem include:

  • 90% of people who engage in it begin during their teen or pre-adolescent years.
  • Nearly 50% of those who engage in self-injury activities have been sexually abused.
  • Females comprise 60% of those who engage in self-injurious behavior.
  • About 50% of those who engage in self-mutilation begin around age 14 and carry on into their 20s.

Reasons why patients engage in such impulsive behavior include:

  • To distract themselves from emotional pain by causing physical pain.
  • To punish themselves
  • Releasing tension associated with overwhelming thoughts
  • To feel real by feeling pain or seeing evidence of injuries
  • To feel numb, zoned out, calm or at peace.
  • A craving to experience euphoric feelings

 Effects of this condition

  • Increase feeling of shame, guilt, and low self-esteem
  • Infection either from wounds or sharing tools
  • Permanent scares, disfigurements, and weakness/numbness of affected part.
  • Could lead to suicide.

Self-Harm and the risk of suicide

Although the underlying causes vary widely, all youths with evidence of this condition must be carefully evaluated for risk of suicide.

If the underlying factors are not eliminated (such as psychiatric problems or long-term conflicts with peers or parents), acts of self injury can continue and lead to severe self-mutilation.

In addition, there is an increased risk of suicide.

Management approaches

All patients who exhibit recent self-harming behaviors need undergo a careful evaluation. This to determine management strategy that will be most effective for them.

Early intervention is vital and capable of preventing or reducing the incidence of self-harm behavior. So if left untreated for long would become more difficult to treat later.

The risk of suicide becomes higher over time with repeated episodes. Therefore ignoring it or delaying treatment can lead to preventable deaths.

Traditional interventions

Identification of self-harm behavior group therapy, school-based programs, hospitalization, art therapy, and drug treatment for underlying disorders, such as depression and anxiety.

The key to successful intervention can be summarized in the following points

Ø  Development of positive coping mechanisms such as the principle of share happiness.

Ø  The reduction or relief of underlying stress and improvement in communication skills.

Ø  Quick access to therapy during times of crises

Ø  A trusting relationship between patient and clinician

Ø  Effective management of accompanying psychiatric illnesses

Ø  Support from family members and friends.

Pharm Nwonkwo Endurance Stephen

(B.Pharm, UPH)