Self harm is a growing problem worldwide. Statistics here in the UK suggest as many as 13% of 11 to 16 year olds purposefully hurt themselves, but it’s not just a problem that adolescents face. It can be a life-long battle for many.
I started to hurt myself by cutting my arm aged 13. At first I used safety pins to scratch my wrist; small half-centimetre scars that have now faded with time. Over time I progressed to using scissors and the self injury became a ritual I used to cope with the pressures of teenage life. At the time I told myself it was temporary, just a stop-gap to last only as long as it took me to grow up and learn to deal with the world.
I want to use this post to talk a little about the problems with self-harm I’ve faced as an adult. I stopped my teenage self-harm aged 17, and managed to stay away from it until I got unwell aged 22.
People tend to associate self injurious behaviours with depression. For me, I’ve found that I struggle more with it when I am manic or psychotic (or both, as they normally come hand-in-hand for me). My mind turns to it when I cannot cope with the high, wild level of mood and I’m looking for ways to calm myself down. I have learned great coping skills over the years but they are not always the first thing I turn to when I am ‘in the moment’. In adulthood I know I ‘should’ know better, but my insight when I am unwell isn’t always great.
As an adult, I’ve found that the extent to which I hurt myself is greater. I no longer use blunted blades for example – and so the resulting injuries are far worse. I also find that I can do more damage when I’m manic than when I’m depressed. When I am in a low mood, I feel the pain more. When I am in a dysphoric state I don’t feel it, and it’s hard to recognise when it has gone too far. It is also a control thing for me; a way of getting my head clear and bringing myself down to a normal level of functioning.
It is hard to talk about self-harm in public. Writing this feels like I am baring an aspect of my soul to the world and it’s not entirely comfortable. But it is a topic that is increasingly important to focus on. It is not something we should be sweeping under the mat.
There are so many great ways to cope with the urge to self-harm. The Butterfly Project is one such way; the idea is that instead of hurting themselves, the person copes with the urge by drawing a butterfly on their skin. Other ideas that I’ve tried in the past and had some success with include the ice method (whereby you hold an ice cube in the hand) and the elastic band one (you ping an elastic band against the skin). The only issue I have found with these moderation methods is that it’s not always the pain I’m craving – sometimes it is the damage I want to cause that makes me need to act on the urges. I’m still working out how to mitigate those situations; I would appreciate advice if anyone has it!
This piece has so far mostly focussed on cutting as a form of self-injury. There are many more forms; overdoses without the intention of suicide, punching walls and burning oneself are examples. Substance abuse can also be seen as a form of self-harm. As many as 30% of those with bipolar also abuse drugs or alcohol, compared with around 4% of the non-bipolar population.
Self-harm is a conversation many people are now getting involved in. The key to overcoming it is to learn healthy coping skills. If you are struggling with self-harm, you will be doing a great thing to look after yourself if you seek out help from your GP or a therapist.