Approximately 322 million people worldwide experience depressive symptoms every day. While depression can look different from person to person, those who experience symptoms identify with at least some of the following general list of symptoms that impact their ability to function in the world: sadness, irritability, hopelessness, decreased interest in previously pleasurable activities, difficulty sleeping or sleeping too much, poor appetite or too much of an appetite, restlessness, difficulty concentrating, slowed thoughts and body movements, changes in weight, and thoughts of death/suicide. Many people experience at least a few of these symptoms every day and it impacts their ability to conduct their school work, careers, friendships, and general day to day experiences in their lives. There is a pain that is identified with depression symptoms that is often hard to describe but it is related to experiencing these symptoms for a long period of time and feeling relatively helpless to see anything change in the future. This can cause people to feel as if they are in a state of distress and may seek out ways to reduce that distress that can create more problems for them in the long run.
People who experience depression and other mental health disorders often struggle to reduce their experience of distress in their lives; as a result, some people attempt to relieve their stress and symptoms by engaging in self-harm behaviors that temporarily relieve their pain. Self-harm behaviors are any behaviors that involve a person deliberately hurting themselves to relieve emotional distress. Some self-harm behaviors that are common involve cutting or burning arms or legs, or finding other ways to mutilate the body, such as scratching, hitting, etc. These behaviors serve a lot of functions for a distressed person, including trying to distract themselves from emotional pain, externalizing emotional pain, trying to communicate their distress and pain to others, trying to dissociate or numb themselves from their internal experiences, to feel a sense of control over a hopeless experience, or to punish themselves to reduce any shame or guilt that they may be experiencing. This coping strategy may relieve their symptoms for a brief amount of time, but does not fully treat the problem, thus creating a new and sometimes dangerous problems for them that could have long-term consequences.
When people think about self-harm behavior, they often think that self-harm is caused by suicidal thoughts or wanting to die, but this is not always the case. While some people can be suicidal and want to die and engage in self-harm behavior, it is common that someone engaging in self-harm does not have thoughts of actually wanting to die, but instead wants to have a break from feeling the impact of their emotional pain. While they are not always connected, self-harm behaviors can be dangerous enough to cause someone to lethally harm themselves, even if they aren’t meaning to do so, so it is a very serious behavior that requires treatment from mental health and sometimes medical professionals. Professionals who have expertise in self-harm will help those engaging in these behaviors to address the underlying symptoms of distress and help them to develop safer and healthier coping skills to reduce their distress.
Treatment for people experiencing self-harm impulses often involves helping them recognize their internal and external signs of discomfort, understanding how their thoughts attribute to these feelings, and how to change their behavior in an effort to have a healthier way to reduce their experience of discomfort. Mental health professionals can teach various coping strategies to improve their ability to emotionally regulate themselves, including challenging their negative and dangerous thoughts by stopping and thinking about their current emotional state, helping them to use mindfulness or relaxation strategies to improve their ability to decrease distress, and to help them train to resist the urge to engage in self-harm behaviors for as long as possible to learn how to tolerate discomfort without it. Helping people learn what is a trigger for their self-harm will help them to work to avoid them, and help them to prepare for how to handle it if a trigger is inevitably present. While self-harm behavior can be dangerous and indicates a person is suffering, there are many professionals that can help improve a person’s ability to cope.
Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events