Up to 20 percent of all adolescents self-injure, with girls more commonly affected. Self-injury often occurs as a symptom of mental disorders or illness.
What is self-injurious behavior?
A self-injurious behavior refers to actions in which the surface of the body is deliberately harmed. A self-injurious behavior refers to actions in which the surface of the body is deliberately harmed. This means that the individual repeatedly inflicts injuries on himself or herself. This can be done consciously or unconsciously. Self-injury is not an independent clinical picture, but a symptom of disorders. However, these self-injuries do not have a suicidal background. Most often, they are caused by cuts with sharp or pointed objects, such as a razor blade, a knife or broken glass. This cutting or scratching usually occurs on the arms and legs. Burns or chemical burns are also a form of self-injurious behavior.
Causes
Causes of self-injurious behavior include highly stressful events and experiences that have often been ongoing for some time. These include, for example, neglect by parents that leads to a lack of security, the separation of parents, which children often cannot cope with, sexual abuse, low self-esteem, a tendency toward emotional instability, and the inability to express feelings, tension, or anger in another way. Adolescents with mental health problems or disorders are at very high risk of developing self-injurious behavior. Other causes include mental illnesses such as depression, anxiety, panic, obsessive-compulsive, eating, or borderline personality disorder. The reasons for self-injurious behavior are very diverse. Rarely is there only one single trigger. Often there are numerous causes and feelings behind it, which the affected person associates with the behavior. In this case, the emotional stress is relieved by physical pain. The body reacts to pain with an increased release of endorphins, resulting in a feeling of relief and relaxation. Often an addiction develops from the self-injurious behavior, which the affected person has to pursue again and again. Without outside help, the urge to hurt oneself cannot be alleviated.
Diseases with this symptom
- Borderline Syndrome
- Tic and Tourette syndrome
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
- Eating Disorders
- Anxiety disorder
Symptoms, complaints and signs
In self-injurious behavior, there are usually several injuries. Primarily, these are cuts or lacerations that are performed on easily accessible areas, such as the extremities. The depth of injury is usually the same and the injuries are often grouped, in parallel rows, or symmetrical. In terms of shapes, lines, letters, and words are often observed. It is difficult for parents to recognize the signs of this behavior, because the victims usually hide their injuries under their clothes and do not let anyone in on them due to shame. Therefore, it is very important to react to possible warning signs in order to get help at an early stage.
Diagnosis and course
In addition to the physical damage, which can be minor, but in some cases equally severe or even fatal, self-injurious behavior equally leads to psychosocial impairment, as feelings of shame, guilt, stigmatization or reduced self-esteem can arise. Those affected often suffer from disturbed sleep and mood swings. They neglect friends or hobbies and withdraw. Due to the scars created, which they wish to hide, they wear long clothing even on warm days. Diagnosis is made on the basis of the injuries inflicted on the body. Severe forms of the disease are due to repeated hurting over a long period of time. Often, an addiction develops from the self-injurious behavior, which the affected person must pursue again and again. Without outside help, the urge to hurt oneself cannot be alleviated.
Complications
As a rule, if self-injurious behavior is not treated, it often results in the ill person hurting himself to a very high degree and causing relatively great harm to himself. Such individuals usually injure themselves on the skin or other areas. When this behavior is not treated, the persons often do not realize what damage they are adding to themselves and do not stop it by themselves. In the worst case, this can lead to suicide or to injuries that can be life-threatening to the person’s own body. These people often do not think about the consequences of self-injury and inflict it on themselves without knowing that they can die from it in the worst case. Treatment for self-injurious behavior usually involves medication and talking to a psychiatrist. Most of the time, the medications used have severe side effects. These include fatigue, headaches or listlessness. These side effects are not particularly bad; they are primarily to keep the person from continuing to self-harm. If progress is made, weaker medications can be used in which there are not such severe side effects. In bad cases, treatment may also entail a stay in a closed psychiatric ward.
When should you go to the doctor?
In cases of self-injurious behavior, it is always advisable to see a doctor. If a doctor is not consulted, the person may suffer terrible and life-threatening injuries. In the worst case, this can also lead to suicidal thoughts and eventually suicide. As a rule, self-injurious behavior should always be examined and treated by a psychologist. A long period of time may pass before the cause of the behavior is found. In many cases, the patient does not realize that they need treatment and are suffering from the condition. In these cases, friends and family must force treatment and investigation. It is also possible to have treatment in a closed clinic. Urgent action is especially necessary if the patient has already sustained injuries and has been suffering from self-injurious behavior for a long period of time. In case of acute injuries, the emergency doctor can also be called or the affected person can be taken to a hospital.
Treatment and therapy
Often, sufferers are unable to free themselves from self-injurious behavior on their own. Through psychotherapy or behavioral therapy, there is a good chance of getting away from it. Here, the underlying problems are worked through, because it is basically very important that the basic disorders are recognized and eliminated. The person affected is helped to develop new coping strategies with which to react to stressful situations. Furthermore, they learn to talk about emotions instead of expressing them in the form of self-injurious behavior. The earlier therapy begins, the better the chances of recovery, although there are also people who cannot be treated. The prerequisite for healing is always a secure relationship of the affected person, for example with a partner, family member, friend or therapist. Therapy can be supported by medication if, for example, severe depression, an anxiety disorder or obsessive-compulsive traits are present. Relaxation techniques such as yoga can also help to strengthen inner balance. The motivation to change the self-injurious behavior is primarily decisive for the success of the therapy. Therapy that takes place against one’s will usually brings no help. Reproaches and reproaches on the part of the relatives are not advisable, because this can reinforce the addiction to self-injury. Showing understanding is of greater help.
Outlook and prognosis
The outlook and prognosis for self-injurious behavior depend greatly on the severity of the symptom as well as the patient’s will, and therefore cannot be universally predicted. In most cases, therapy with a psychologist is necessary to treat this behavior. It usually takes several months for the behavior to change. However, success cannot always be assumed. This also depends heavily on the patient’s background and his or her will. It is therefore not uncommon for those affected to have to be treated in special clinics.In this case, there is often a positive progression of the disease and control of the symptom. If the self-injurious behavior is not treated, the patient will continue to hurt himself. Often the behavior is accompanied by an aggressive mood. The affected person turns away from friends and family and limits himself socially very much. This leads to social exclusion and often to depression and suicidal thoughts. In the worst case, the patient may self-harm to the point of suicide. Therefore, affected persons should be left alone as little as possible to avoid life-threatening injuries.
Prevention
Basically, a change in pain perception cannot be prevented. However, people who suffer from insensitivity to pain can learn to avoid injury. First and foremost, a stable environment in which love and security prevail is always important to avoid the development of psychological problems from the beginning. Reacting immediately to possible signs can prevent self-injurious behavior from developing into an addiction. Relaxation techniques as well as exercise can likewise help in prevention, as this is a good “venti” to switch off, release frustration and anger, and clear the mind.
This is what you can do yourself
First, it is important to learn new coping strategies that can be used instead of self-harm. These should help you deal with the strong feelings without harming your body. If the urge to self-harm is acute, working out in sports can serve as an outlet. A creative activity, such as painting, can also serve as an outlet. Distraction or relaxation exercises are also conceivable to control the strong feelings. If possible, contact can be made with a trusted person. Talking about the current emotional state helps not to be alone. Doing something good for oneself, treating oneself to something can help sufferers to reduce the tension and the pressure to self-harm. If necessary, substitute actions for self-injury can be used, which provide a physical stimulus but do not harm the body. For example, a cold shower, something spicy to eat or a rubber band that the affected person can have strapped to his or her arm are conceivable. Which strategies help in individual cases must be tried out. In the longer term, it makes sense to deal with the triggers of the self-injurious behavior. Psychotherapy in particular can be a great help here. If self-injury has occurred despite everything, it is important to take good care of the wounds and, if necessary, to seek medical help.
