Self Harm

How it can Become an Addiction

History of Self-Mutilation

Self harm is best understood as an attempt to relieve, rather than inflict, pain. About 2 million Americans today are estimated to self harm. One of the earliest scientific studies of self injury was reported in the late 19th century by George Gould and Walter Pyle. They reported that women all over Europe were puncturing themselves with needle girls. But the practice of self mutilation has been found all over history dating back as far as Ancient Greece. The practice has been done everywhere, from monasteries and nunneries to prisons, and done by people of both gender and every race, religion, and age. NPR's Alix Spiegel conducted an interview with a young named Rebecca Raye. Ms. Raye has participated in self harming activities for the past ten years. When she does it, it feels like "all the things that are really hurting me at the moment are just kind of leaving me." People who have hyper-reactive emotions or were raised in an emotionally chaotic environment may be more likely to participate in self injury. Ms. Raye describes the feeling as a balloon popping, all the stress is let go. She also says it helps her to centralize her thoughts and stops her mind from racing.

Biology Behind It

The neurobiology factors of Non-Suicidal Self-Injury (NSSI) are still poorly understood, but it is widely accepted that self-harm is a way of regulating stressful events. Patients who have NSSI are proven to have poor distress tolerance that could be monitored by a genetic predisposition for high emotional and high cognitive reactivity and by emotional adversities; although genetic tests have been inconsistent. Studies have shown that there is a different brain morphology and neuroactivity in patients with NSSI compared to healthy subjects, can be linked to divergent emotional and physical pain receptors. There seem to be abnormalities in the serotonergic, dopaminergic, and the opioid system as well as the hypothalamic-pituitary- adrenal glands. Tests showing serotonin deficiency and increased dopamine levels are common, but the most consistent are reduced levels of cortisol and endogenous opioids which causes an altered stress response. Several studies showed NSSI could be linked to hyper arousal in the limbic system. Greater numbers of parasuicidal behaviors were associated with an increased Pituitary Gland volume which results in higher levels of post-dexamethasome cortisol.

Treatment

There are many different types of therapies for people who self-mutilate. Many different types of psychotherapy that may be helpful, such as; cognitive behavioral therapy, dialectical behavior therapy, psychodynamic therapies, and mindfulness-based therapy. Medications may also be useful. There is no medicine that specifically treats self-injury. Your doctor may recommend antidepressants or another psychiatric medication. Psychiatric hospitalization may also be an option if an individual injures himself severely and repeatedly. These treatments are very useful one you find the right one for you. There are no real symptoms of withdrawal, but one may become hypersensitive and every little thing might make you want to hurt yourself.

Statistics of Self-Harm

It's almost impossible to say how many young people are self-harming. This is because very few teenagers tell anyone what's going on, so it's incredibly difficult to keep records or have an accurate idea of scale.


About 13% of young people may try to hurt themselves on purpose at some point between the ages of 11 and 16


In 2014, a 70% increase in 10-14 year olds attending A&E for self-harm related reasons over the preceding 2 years


Girls are thought to be more likely to self-harm than boys, but this could be because boys are more likely to engage in behaviors such as punching a wall


  • Each year, 1 in 5 females and 1 in 7 males engage in self injury
  • 90 percent of people who engage in self harm begin during their teen or pre-adolescent years
  • Nearly 50 percent of those who engage in self injury activities have been sexually abused
  • Females comprise 60 percent of those who engage in self injurious behavior
  • About 50 percent of those who engage in self mutilation begin around age 14 and carry on into their 20s
  • Many of those who self injure report learning how to do so from friends
  • Approximately two million cases are reported annually in the U.S.

Effects

Physical effects include:


  • Wounds or scars
  • Infection
  • Nerve damage
  • Broken bones
  • Hair loss or bald spots
  • Injury caused by overdose or poisoning


Psychological effects include:

  • Irritability
  • A desire to be alone in order to self-harm or to hide the evidence of self-harm. This often leads to feelings of loneliness.
  • Shame and guilt of having self harmed
  • The stress and difficulty of having to lie to those around you about the self-injury
  • Using self-injury to deal with any emotional stress instead of building positive coping techniques
  • An overwhelming desire to self-injure to the point where it feels like you can no longer control the behavior
  • Low self-esteem and self-hatred
  • Depression


Interesting Fact

Cutting is not the only form of self-injury. Things like starving, overeating, drinking too much, risk-taking, smoking and many others are also types of ‘self-harm’. Some coping methods (like burying yourself in work) may be more acceptable, but can still be harmful.

Why I Chose Self-Harm

I didn't know self-harm could be an addiction and I'm curious about what in the brain would cause an addiction to pain.

Citations

Centre, N. C. and Health, M. Self-harm. Available at: http://www.nice.org.uk/guidance/cg16/evidence/cg16-selfharm-full-guideline-2 (Accessed: 25 September 2015).


Gluck, S. Self Injury, Self Harm Statistics and Facts. Available at: http://www.healthyplace.com/abuse/self-injury/self-injury-self-harm-statistics-and-facts/ (Accessed: 25 September 2015).



Groschwitz, R. C. and Plener, P. L. The Neurobiology of Non-suicidal Self-injury (NSSI): A review. Available at: http://www.suicidology-online.com/pdf/SOL-2012-3-24-32.pdf (Accessed: 23 September 2015).



Somerset and Wessex (2005) Self Harm - The Facts. Available at: http://www.swedauk.org/leaflets/harm.htm (Accessed: 25 September 2015).


Spiegel, A. (2005) The History and Mentality of Self-Mutilation. Available at:

http://www.npr.org/templates/story/story.php?storyId=4697319 (Accessed: 23 September 2015).


Staff, M. C. (2012) ‘Self-injury/cutting Treatments and drugs’, Mayoclinic.


Tracy, N. Effects of Self-Harm, Self-Injury. Available at: http://www.healthyplace.com/abuse/self-injury/effects-of-self-harm-self-injury/ (Accessed: 25 September 2015).