March is Self-Harm Awareness Month. It's a good time to discuss this topic.

It’s no secret that mental health has been a hot topic during the pandemic. Stress about finances, job loss or work changes, and catching COVID-19 have been major drivers of increased reports of anxiety and depression

One mental health challenge that’s not discussed as frequently is self-harm or non-suicidal self-injury. March is Self-Harm Awareness Month, so it’s a good time to discuss this topic and dispel some myths.

As somebody with a history of depression, anxiety, and self-harm, I wanted to share 9 things to understand about those who self-harm and how to help them. 

Self-injury is a coping mechanism.

In other words, it’s a way people manage overwhelming, painful emotions. It’s also a way people deal with emotional numbness. One of the curses of depression is that you can alternate between intensely painful emotions and feeling dead inside. Both states can feel intolerable, so some people turn to self-harm to release negative feelings or to make themselves feel alive.

Other reasons people hurt themselves include feeling a need to punish themselves, gain a sense of control, or relieve stress. In all of these situations, however, the person is struggling to cope with something and turning to self-harm as a way to manage. 

It’s tough to understand why somebody would intentionally hurt their body—and keep doing it repeatedly—if you’ve never dealt with self-harm. But when our bodies get hurt, they release endorphins that minimize pain while creating calm, positive, even euphoric, feelings. So, for a few minutes, the injury can make someone feel better.

Of course, the relief is short-lived, often followed by a sense of guilt, shame, or failure. This can create a vicious cycle where somebody wants to stop self-injuring but feels unable to quit. 

It’s not the attention-seeking behavior people think it is. 

There’s a stigma that says self-harm is simply a way to get attention, but this is rarely the case. Many people who intentionally hurt themselves carefully hide their injuries. Most feel intense shame and embarrassment, often refusing to seek medical treatment when wounds are bad enough to require it. Remember, even if somebody doesn’t attempt to hide the evidence of self-harm, it’s still a very serious sign that they need help and support. 

It may not look like you expect.

Many people assume that self-injury is only a problem for teens and primarily girls. However, people of all ages, genders, and ethnicities have been known to engage in self-harming behaviors. 

It also isn’t just cutting, though that’s the most well-known type of self-inflicted injury. Unexplained bruises, burns, broken bones, pulling hair out, or scabs/wounds that seem to be picked at/not healed can all be signs of self-harm. 

It’s not the same as a suicide attempt. 

But it is a risk factor for suicide. Because self-harm is used as a coping mechanism for overwhelming feelings, people often use it to help them get through their hardest moments. However, one study found that those who self-harmed were 3.4 more likely to attempt suicide over the three-year study. That’s why self-harm should always be taken seriously. 

SO HOW DO WE HELP?

Say you’re concerned and you care. 

If you’re concerned that a friend or family member is self-harming, let them know. Whether they’ve opened up about it or it’s just a suspicion you have, communicate care and concern above all else. 

Validate their pain. 

You don’t have to understand or relate to somebody’s battle with self-injury to make them feel safe, cared for, and hopeful. Saying things like, “That sounds really hard” or “I’m so sorry you’re struggling with this” can help your loved one feel supported.

Ask open-ended questions. 

The shame associated with self-injury makes it hard to speak up, but talking about it is a crucial part of the process. Help the person open up by asking open-ended questions and leaving plenty of time for them to talk. “How long have you felt this way?” and “What makes you feel so overwhelmed that you feel the urge to self-harm?” Most importantly, listen without judgment.

Don’t try to support them alone. 

Intentional self-harm is a sign of serious emotional pain, so don’t feel like you need to support someone alone. Help find a good therapist, make an appointment with their doctor to discuss treatment options, and make sure they know how to get in touch with the Crisis Text Line (by texting HOME to 741741) if they need immediate support. 

Know your support and care matters.

When I struggled with self-harm, I didn’t know where to turn. But when I finally opened up to a young couple in my church, their support gave me the hope I needed to find help. They told me they weren’t disappointed in me and walked with me as I stumbled towards healing. 

Talking to a loved one about self-harm doesn’t have to be complicated. Simple, kind words and caring actions can help much more than you know. Your kind words and support matter immensely to friends and family who are struggling.

Sarah J. Robinson is the author of the upcoming book, I Love Jesus, But I Want to Die: Finding Hope in the Darkness of Depression. She writes and speaks on faith and mental health, helping readers fight for wholeness and cultivate joy despite mental illness. Sarah lives in Nashville with her husband. Find her online at sarahjrobinson.com or on Twitter and Instagram as @sarahjrbnsn.