Why do I self-harm?: Understanding no-suicidal self injury (NSSI)

Research from over 40 countries indicates that:

• Approximately 17% of individuals will engage in self-harm at some point in their lives.

• The average age at the first self-harm incident is 13.

• Cutting accounts for 45% of self-injury methods.

• Around half of those who self-harm seek help, but mostly turn to friends rather than professionals.

  
  

“It started as a good day. I did my morning prayers and bid my husband and children goodbye. Did my yoga and was planning to go out to meet a few friends. The phone rang, and it was my brother, who is going through cancer treatment in India. My mother joined the call; she cried out of helplessness. My younger sister called, who was going through a divorce in the USA. The call ended in distress. I felt an ang of distress, running into the kitchen. I have a cut on my arm, a long one, no blood, painful. I felt better. I covered my cut and walked out. It became a persistent habit. I started to like it. I looked for times to be alone to carve out a bit of time. A self-fulfilling habit. It took me many years of therapy and engaging in small, enjoyable sports, music, and friendship groups. I really wish I had not started doing it and knew the dangers associated with it.”

                                                                                                      Priya, 33-year-old housewife

“I could not stand the fact that my best friend got selected for the college team. We are always compared with each other. The thought of being left behind seemed very stressful. Now, the only thing that helped was pulling my hair. Gradually, I developed an urge to pull hair from the scalp, eyebrows, or other areas.

My family started to notice hair loss. It became a compulsion. I was doing it without my knowledge, out of boredom and stress. Luckily for me, my mother noticed it and brought it to my attention. She helped me seek an appointment with a clinic psychologist ASAP, and with her help, I was able to notice the mental health crisis and put a stop to it at the early stages."

                                                                                                     Joyce, 15-year-old student

"I was 13 years old when all my friends in school left. It was COVID, and a tough situation for me to make new friends. I started picking at the skin on my inner ear lobe, obsessively and repeatedly. A timely consultation with a skin doctor helped me understand that chronic itch is associated with increased stress, anxiety, and other mood disorders.

In turn, stress and anxiety exacerbate itch, leading to a vicious cycle. However, after many years, much psychoeducation, ear lobe piercings, and a few counseling sessions, I was able to control it. I learned healthy coping- exercise, music, movies, dance, sports, and all helped.”

                                                                                                      Ani, a 15-year-old student   

 Self-harm involves deliberately injuring oneself to cope with emotional pain, express feelings, or punish oneself. Sadly, this behavior is on the rise among teens. 

A recent CDC data analysis shows that as many as 30 percent of teenage girls and 10 percent of boys report having intentionally harmed themselves. 

Who Self-Harms?

While anyone can practice self-harm, rates tend to differ among certain populations:

• Adults, aside from very young children, are the least likely group to engage in self-injury, with only about 5% having done so in their lifetime.

• Adolescents, however, exhibit the highest rates of self-injurious behavior, with approximately 17% admitting to self-injury at least once.

• In college populations, around 15% report engaging in self-harm.

• Regarding gender differences, women are more prone to self-harm, but males may account for at least 35% of all self-injury cases. Men are also more likely to underreport self-injury and have others inflict harm on them.

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What Are the Different Types of Self-Harm?

There are different forms of self-harm, including one or more of the following:

• Scratching, biting, or burning the skin

• Hitting or punching themselves or the walls

• Piercing their skin with sharp objects

• Pulling out hair

• Picking at scabs and wounds

• Inserting objects into the body

• Overdosing on drugs or drinking to excess

• Exercising to the point of collapse or injury

• Getting into fights in which they are likely to be hurt

• Banging head or body against walls and hard objects

• Having unsafe sex

• Digital self-harm

  
  

Is Self-Harm a Mental Illness?

Self-harm is not classified as a mental health disorder; rather, it is a common symptom associated with various psychological conditions. It often acts as an unhealthy way to cope with distress and anxiety, typically linked to underlying mental health issues. Several mental illnesses, such as borderline personality disorder, depression, eating disorders, anxiety, and PTSD, are connected to self-harming behaviors. This behavior can appear in multiple mental disorders, emphasizing its role as an expression of deeper psychological problems.

What are the self-harm risk factors?

There is not just one factor that contributes to self-harm. Instead, there are a variety of biological and environmental issues known to cause self-harm, including:

• Having friends or family members who self-injure

• Experiencing stressful life situations like traumatic events, family instability, and sexual identity uncertainty

• Living in social isolation

• Mental health conditions, like depression, anxiety, and personality disorders.

• Drug and alcohol use or addiction.

  
  

The more of these factors a person has, the higher their risk of self-harm.

When to Seek Help

If you often scratch, pick at, or hurt your body to cope with emotional pain, anxiety, or stress, it may indicate self-injury. In such cases, it's advisable to consult a mental health professional. 

When in distress, urgent support care in Hong Kong:

• Emergency Service Hong Kong: 999

• Suicide Support, Samaritans: call 2896 0000 (24-hour hotline)

• MindHK, Crisis Support Services

• Harmony House, Domestic Violence Support 

• ACA HK, Child Abuse Support: 2755 1122 (hotline)

• Police Hotline: 2527 7177

• Prevention Services: 2382 0000

• Social Welfare Department Service Hotline: 2343 2255