March is Self-Harm Awareness Month

Self-harm often flies under the radar because those who intentionally harm themselves go to a lot of trouble to hide their scars—and their emotional turmoil.

Referred to clinically as non-suicidal self-injury(NSSI) or deliberate self-harm (DSH), this behavior occurs most commonly among adolescents, although there is no age-limit on self-harm. Some estimates are as high as one in three teens will at some point harm themselves intentionally and as many as one in five adults. But why? And how can we help? March is self-harm awareness month—a perfect opportunity to educate and inform so that parents and loved ones can be on the lookout for this behavior in order to help.

Why Do People Hurt Themselves?

Research into non-suicidal self-injury (NSSI) has yielded a great deal of understanding about the brains of those who self-harm. Research suggests that the pain of self-harm calms the activated mind. Seeking emotional self-regulation to manage extreme anger, sadness, or frustration, feelings that disappear when the cut is made or the flesh burned. The aftermath of self-harm is contentment. Those who do not experience this cycle struggle to understand how self-harm makes someone feel better.

The pain and even the sight of blood, for someone who becomes a chronic self-harmer, lower the activity in the amygdala, the brain’s source of fight or flight emotions—those extreme and unsettling feelings of reactivity, fear, and alarm. Thus, NSSI can accomplish the following:

·       Soothe anger or rage

·       Reduce anxiety, panic, or stress

·       Provide escape from feelings of numbness

·       Ease depression

·       Acknowledge or justify self-hatred via self-punishment 

What Does NSSI Look Like?

There are many fairly common ways that teens and others may harm themselves. These include:

·       Cutting the skin with blades or shards of glass

·       Burning with flame or cigarettes

·       Self-battery

·       Preventing wounds from healing by ripping off scabs (excoriation disorder)

·       Inserting objects into the body

·       Pulling out hair, eyelashes, or eyebrows 

Because the vast majority go out of their way to hide signs of their self-injury, you likely won’t see the scabs and scars. Since this is not attention-seeking behavior, but serves a purpose in managing trauma, stress, depression, or anxiety, there are some warning signs you can look for. Self-injury may be taking place if you notice that someone you know:

·       Is covering up cold-weather style even in the hottest months

·       Has unexplained injuries

·       Experiences inexplicable infections

·       Pencils in eyebrows

·       Shows signs of hair loss

People with NSSI may also withdraw from relationships or show signs of other impulsive behaviors.  

Who Is at Risk of Self-Harm?

The data is skewed on NSSI because not everyone self-reports or seeks help. Because many people avoid discovery, we don’t necessarily know all the risk factors, but the following circumstances seem to increase risk:

·       Diagnosis of depression, anxiety, or other mental illness

·       Low self-esteem/high self-criticism

·       Addictive behaviors/substance use

·       Past or ongoing abuse or neglect

·       History of bullying or victimization

·       Painful losses

·       Family history of NSSI

Help for Those Who Self-Harm

This disorder lives in the shadows. There is tremendous stigma surrounding it and those who suffer often deal with profound shame. The good news is that self-harming behavior is treatable with therapy. Once the behavior stops, the person’s neurobiological responses go back to normal so that pain reactions are no longer blunted and the compulsion towards self-injury when stressed, lonely, or sad fades or disappears completely.


When people feel stressed, unsafe, or overwhelmed, their normal stress responses go on hyperdrive and underlying anxiety or depression can be amplified. This can be a perfect storm for self-injury. At Fairwinds we understand the enormous difficulties that many on Nantucket face every year due to the challenges of island life. We are always available to offer therapeutic support to everyone who needs it, regardless of financial or insurance status. Our same-day Urgent Behavioral Healthcare Clinic is always free and accessible remotely every weekday at 5:00. Just call or text to claim the time slot that day.


Information for this article came from:

Frontiers in Psychology

The Family Institute at Northwestern University

Psychology Today