Self-harm may signal need for mental health treatment

Tuesday, November 22, 2011

While one in every 12 teenagers purposely cuts, burns, poisons or hurts themselves in other ways, they typically end the practice by age 30. Unfortunately, the mental illness that usually accompanies such behavior likely remains. Self-harm behavior is usually associated with major depression and anxiety, and even emerging borderline personality disorder. These psychiatric illnesses often persist after self-harm subsides, interfering with healthy developmental growth, relationships, work and school.


Mental health professionals distinguish non-suicidal self-harm from suicidal behavior. Yet researchers from England and Australia found that self-harming behaviors are among of the strongest predictors of suicide for those ages 15-24. In fact, suicide is now the leading cause of death for this age group.


The most common reason for non-suicidal self-harm is achieving a feeling of relief from unbearable emotional pain. Hence, treatment must address the reasons for the emotional pain and must help the young person develop more effective coping strategies, according to Jon Allen, PhD, a senior psychologist at The Menninger Clinic. Cutting, burning and other self-harm behaviors tend to escalate, such that it can become lethal even without suicidal intent, Dr. Allen added.


Cutting and other non-suicidal self-harm also occurs frequently in conjunction with borderline personality disorder. Dr. Allen said a number of well-researched treatments for borderline personality disorder have been developed and have been shown to decrease self-injury as well as suicidal behavior. Two prominent and effective treatments are dialectical behavioral therapy and mentalization-based treatment. Menninger applies principles from these treatments in its comprehensive assessment and treatment programs for adolescents and young adults.


Signs of self-harm to watch for

  1. Cuts or scars on arms or legs
  2. Unexplained cuts, burns or broken bones, or claiming to have frequent mishaps
  3. Avoidance of short-sleeved tops or shorts, even in hot weather
    Spends a great deal of time alone
  4. Abrupt mood changes, out-of-control behavior, changes in important relationships or difficulty in school

Read more in this summary of the self-harm report.