3 things I'll bet you didn't know about self-harm (TW/CW: self-harm)

Self-harm is a complex condition and there are a lot of misconceptions floating around about it. Let's talk about a few of them.

Disclaimer: This article is based on my experience as someone with chronic depression who self-harms. It does not reflect the thoughts or opinions of anyone else. If you are or have considered self-harm, please talk to a medical professional.

Every time I go to my psychiatrist, I'm asked if I have self-harmed. I usually say yes. Sure, I'm depressed, but the reality is, millions of people face these questions every day.

According to The Recovery Village, about 17% of people worldwide will self-harm during their lifetime.

Here're three things you might not know about self-harm:

Self-harm isn't only physical
Self-harm doesn't (just) mean cutting
People self-harm for a millions reasons

1) Self-harm isn't only physical

First off, what is self-harm, exactly? I like Mind.org's take on it:

Self-harm is when you hurt yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences.

Self-harm is not the same thing as attempting suicide. In fact, in the vast majority of cases, people who self-injure are not doing so with the intent to die. There's even a medical term for it: non-suicidal self-injury disorder (NSSI).

The most popular conception of self-harm is physical. Shiny cutting scars and big knives. It's even still standard for medical practitioners. During my psych appointments, I have to answer the same questions every time about my NSSI. When did you do it? Where? What method did you use?

But there's more to self-harm than physical injury. There's also emotional/mental self-harm or intentional self-destructive behaviors such as:

Excessive alcohol or substance use
Excessive exercise
Fighting
Unprotected sexual behaviors
Dangerous driving
Withdrawing from people and social situations

It can also include negative self-talk, restricting personal needs like food and sleep, and negative thought patterns, such as catastrophizing (assuming the worst-case scenario).

Is that 17% starting to make more sense now? And let's be honest, that's probably a pretty low estimate.

2) Self-harm doesn't (just) mean cutting

In popular culture, self-harm has the same shock value as a gory, low-budget horror film. But it's not all angsty goths cutting themselves in teen dramas.

Although cutting is the most common form of self-injury (45%), self-harm is a very broad set of behaviors and can manifest in a lot of different ways, such as:

Scratching or burning
Punching or hitting (yourself or other objects)
Banging or hitting your head
Self-poisoning (drinking bleach or other toxic chemicals)
Pulling out hair or pinching
Picking skin or picking scabs to prevent injuries from healing
Starving or binge eating

Basically, anything you do to cause yourself pain or injury intentionally can be considered self-harm. Before my depression became a constant, chronic condition, I would often self-harm by digging my nails into my hands until I left deep marks.

Wouldn't exactly get me taken to the emergency room, but it was still a clear indication of my state of mind.

3) People self-harm for a million reasons

Our final misconception of the day is that people only self-harm when they're depressed. In reality, there are a million reasons someone might self-harm. Here are just a few:

To feel something
To avoid attempting suicide (remember, self-harm isn't technically suicidal!)
To cope with any negative feelings
To punish themselves or others
To communicate that they need help

For me, self-harm is about being able to disrupt my suicidal thoughts and help me stay alive. Even though it's a pretty terrible coping mechanism, it can be an effective way to "ground" me in the real world.

And in fact, that's what a lot of NSSI comes down to: an unhealthy coping mechanism. Every case is unique and tied to individual issues, histories, and motives.

Self-harm has many faces

I don't leave permanent marks. I have no scars. I'm receiving treatment and am on medication. If you didn't know me personally or read my articles, you'd probably have no idea I self-harm on a regular basis.

But the fact is, self-harm is a complex condition. Like many medical conditions, it can present differently for different people and there are a myriad of reasons why people self-harm. It may be incredibly unhealthy, but sometimes, sometimes, it feels like the safer alternative.

Read About Self-Harm