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Self-Harm & Substance Abuse

Self-harm or self-mutilation is when an individual purposely causes him or herself physical harm. It is often done by cutting with a knife or razor. Burning, picking or tearing at the body are also methods that may be used.

What is Self Harm?

Self-harm is a response to emotional or psychological discomfort. When the stress or discomfort becomes too much to bear, the person turns to cutting as a method of coping. Ultimately, self-harm behaviors are a coping mechanism, a destructive and dangerous one, but they are an attempt at emotional regulation.

Those that suffer from self-harm often feel intense shame and embarrassment about their behaviors. They may go to great length to hide their scars or fresh wounds and those around them may have no idea that they are hurting themselves. However, it is not an uncommon condition, approximately 2 million cases are reported annually.


The behavior usually occurs in adolescents or young adults and can last through the teenage years and early adulthood. It is important to not make an individual feel embarrassed or ashamed of the behavior, while also avoiding normalizing or trivializing it.


Diagnosing Self-harm

Self-harm is not a mental illness in and of itself, rather, it is a behavior that can accompany certain mental illnesses. Self-harming is most commonly associated with depression, anxiety, eating disorders, Borderline Personality Disorder and PTSD (Post-traumatic Stress Disorder). The harming behaviors often become worse over time, particularly if the underlying condition goes untreated.

Because this is a coping behavior, as a person’s overall mental health degrades, they may increase the frequency and degree to which they harm. This can mean an increase in overall danger and risk. Furthermore, when drugs or alcohol are involved there can be an uptick of harming behavior with an increase in the possibility of severe injury. Many ER visits from self-harm occur when the person has been abusing some substance and hurts themselves more severely than intended. Individuals who have a substance abuse problem and self-harm pose a risk to themselves and need to find an addiction treatment center for the substance usage and the self-harm behaviors.


Self-harm Cycle & Other Disorders

As mentioned above, certain disorders tend to coincide with self-harm. The self-harm tends to be an attempt to release or control feelings of overwhelming anger, frustration, sadness, fear etc. Those that self-harm often feel a sense of compulsion or an uncontrollable impulse to hurt themselves.

However, inflicting harm does not fully resolve the feeling. The action can leave its own sense of shame or guilt, and over time more intense or prolonged self-harm may have to be performed in order for the individual to feel the same release. Self-harm can become a cycle that the individual feels unable to stop. In many ways, it can resemble an addiction to a substance, and in fact many of the underlying pieces are the same.


Substance Abuse & Self-harm

It is not surprising that in addition to depression, anxiety, BPD, PTSD and eating disorders, substance addiction is also common for those that engage in self-harm. Some may start with self-harm and then move to substance abuse or vice versa. Drugs or alcohol may be used to mask the sense of guilt around self-harming, they may be used as an additional poor coping mechanism to escape from emotions, or they may be used as their own form of Self-harm.

Substance use in coordination with self-harm can quickly escalate and become very dangerous as substances tend to numb feelings of pain, and decrease sound judgement and fine motor skills. The results can be severe. For those suffering from a substance abuse issue and engaging in self-harm, an addiction treatment center that can offer rehab and counseling is necessary. The mental illnesses that coincide with self-harm and addiction need to be treated as well. If counseling and therapy for the fundamental disorders is not received, the destructive coping mechanisms will most likely return.

Finding Help for Self-harm & Addiction

If you or someone you know is self-harming and engaging in substance abuse, it is important to seek treatment as soon as possible. Self-harm is an attempt to regulate and control emotional responses. If the underlying factors that are fueling these actions are not treated, the individual will not have the skills or resources to seek out better and healthier coping options.

Self-harm is a serious and dangerous behavior that can lead to severe physical and emotional consequences. Successful treatment of self-harm among teens or young adults requires a strong mental health treatment plan in addition to treating addiction or substance abuse, so that a foundation can be set for long term sobriety and health. We are here to support you and your loved one through the process of getting help and starting recovery.

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Our virtual IOP program offers the same programming that we offer in person, all online – this is ideal for those who live too far to drive to an addiction center, have transportation issues, or have health concerns that make in-person treatment challenging.