4 mental health conditions that increase the risk of self-harm

Self-harm is any behaviour where an individual causes harm to themselves, usually as a way to help cope with difficult or distressing thoughts and feelings. It most frequently takes the form of cutting, burning or overdose.

Cutting is the most common form of self-injury, more than 80% of people who self-harm choose this method, but it’s not the only form

Self-harm is not the problem, it is a symptom of some other underlying mental health condition.

Some factors that may make an individual at more risk are:

• Experiencing a mental health disorder. This might include depression, anxiety, borderline personality disorder, and eating disorders

• Being a young person who is not under the care of their parents or young people who have left a caring home

• Being part of the LGBT community

Some individuals can manage their troubles by talking to friends and family, while others may find these difficulties overwhelming. When we don’t express our emotions and talk about the things that make us distressed, angry or upset, the pressure can build up and become unbearable. Some people turn this in on themselves and use their bodies as a way to express the thoughts and feelings they can’t say aloud.

Studies have found, that self-harm is an important cause of admission to hospital. The peak age for self-harm is 15–24 years,and suicide is the third leading cause of death in this age group.

Psychiatric illnesses, especially depression, anxiety and alcohol abuse disorders, are well-known risk factors for self-harm.Previous studies on adults have shown associations between suicidal behaviour and chronic physical illness, such as asthma, type I diabetes mellitus, epilepsy and cancer.

Self-harm, also called non-suicidal self-injury (NSSI), is not the same thing as a suicide attempt. Suicide is a way to end your life. Self-injury is a coping strategy, however, individuals who self-injure are nine times more likely to attempt suicide, and many of our clients describe chronic suicidal thoughts at the time of injury.

While self-injury may bring a temporary sense of calm and a release of tension, it’s usually followed by feelings of guilt and shame and the return of painful emotions. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more-serious and even fatal consequences.

The four mental health conditions that can lead to one indulging in self-harm behaviour are:

Borderline personality disorder is a mental illness that significantly impacts a person’s ability to regulate their emotions. This loss of emotional control can increase impulsivity, it affects how a person feels about themselves, and negatively impact their relationships with others. They may experience intense mood swings and feel uncertainty about how they see themselves. They may act impulsively or recklessly; also indulging in self-harming behaviour.

Depression (major depressive disorder or clinical depression) is one of the most common mental illness and a serious mood disorder. It causes severe symptoms that affect how one feels, thinks, and handles daily activities, such as sleeping, eating, or working.Persistent sad, anxious, or “empty” mood, feelings of hopelessness, or pessimism, feelings of irritability, frustrationor restlessness, feelings of guilt, worthlessness, or helplessness,loss of interest or pleasure in hobbies and activities, and decreased energy, fatigue, and difficulty concentrating, remembering, or making decisions,sleeping problems, changes in appetite or weight changes, thoughts of death or suicide, or suicide attempts; are the symptoms of depression.

Anxiety disordersAnxiety can get worse over time if untreated. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships. Symptoms include stress that’s out of proportion to the impact of the event, inability to set aside a worry and restlessness. People may experiencehypervigilance, irritability, restlessness, lack of concentration, racing thoughts, unwanted thoughts, fatigue, sweating, insomnia, nausea and palpitations.

Post-traumatic stress disorder A disorder characterised by failure to recover after experiencing or witnessing a terrifying event. The condition may last months or even years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions. Symptoms may include nightmares, flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood.

If you’re injuring yourself, even in a minor way, or if you have thoughts of harming yourself, reach out for help. Any form of self-injury is a sign of bigger issues that need to be addressed. Talk to someone you trust —who can help you take the first steps to successful treatment. While you may feel ashamed and embarrassed about your behaviour, you can find supportive, caring and non-judgmental help.

This article is authored by Sana Rubiyana, Counselling Psychologist, Fortis Hospital, Richmond Road, Bangalore.

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