Self-Harm and Mental Illness

Self-harm is often used as a way to cope with difficulties that the person is not, for whatever reason, emotionally equipped to handle. For many of those who use self-harm in this way, that reason is an underlying mental illness (or illnesses).

This may be an obvious connection to make but there still exists this idea that self-harm is an immature and melodramatic response to teenage angst. Even those who know better may tend to focus on the act of self-harming itself instead of the driving forces behind it. This is understandable due to the immediate physical danger that self-harm poses but a truly effective self-harm recovery model must and is able to move beyond the symptoms to identify the cause.

There are three mental health diagnoses that I can connect to my self-harm: depression, anxiety, and anorexia/bulimia. Though self-harm is also a common symptom of other conditions such as a bipolar disorder and borderline personality disorder (BPD), they are outside my personal realm of experience.

Self-Harm and Depression

Depression is the mental illness most readily associated with self-harm. Patterns of self-harm do tend to begin in early adolescence, not because those specific pre-teens and teenagers are more immature or melodramatic than their peers but because this is around the age that many people begin to experience depression.

There is also debate among both professionals and among people in general of whether self-harm is indicative of suicidality. Those who do not understand the impulse behind self-harm fall into the easy trap of conflating self-harm with suicidal gestures. But self-harm is not usually performed with suicidal intent. It is a way to dull the pain of depression, escape the numbness of depression, punish oneself for the guilt of depression, and other complex psychological functions that the label "failed suicide attempt" fails to grasp the nuances of.

Self-Harm and Anxiety

For reasons both physical and not, self-harm offers a powerful if short-lived relief from tension. Anxiety is all about tension. The tension can be acute or chronic, range from mild to debilitating, and can be either "rational" or "irrational."

Feeling anxiety in a situation that calls for it (e.g., experiencing or witnessing violence) is a necessary survival mechanism that prepares us for action. Feeling anxiety in a situation that does not call for it, seemingly without provocation, creates tension without an appropriate channel for release. So, the tension, with nowhere else to go, turns inward. Self-harm is anxiety turned against ourselves.

Self-Harm and Eating Disorders

Self-harm and disordered eating share several defining qualities: impulsivity, the need for control, secrecy, addictiveness, and physicality.

Given my extensive history of self-harm, I have always viewed my eating disorder as just another form of self-harm. The two serve very similar functions. When I quit one, the other one would start as if on cue.

Recognizing these connections is an important step toward determining whether your self-harm is a symptom of mental illness. Knowing this will open up new worlds of support, information, and tools that you can use as building blocks for a successful recovery.