Self-Harm Awareness Month: Understanding Self-Harm (And How You Can Help)

March is Self-Harm Awareness Month (also known as Self-Injury Awareness Month), and despite a recent cultural shift toward more open discussions about mental health, self-harm remains a significant and often misunderstood topic. It may be helpful to learn more about the behaviors surrounding self-harm and suicidal self-injury, how to recognize signs, and how to prevent it within your peer group and community. This month can also be a time to get involved and support those who are struggling with self-harm and related mental health challenges. 

What is Self-Harm Awareness Month?

Self-Harm Awareness Month is an unofficial awareness month that takes place annually during the month of March when mental health organizations and individual activists come together to educate the public about self-harm. This outreach often includes spreading awareness about the prevalence, signs and symptoms, and prevention strategies of self-harm, as well as resources for those affected by it.

Understanding self-harm

Nonsuicidal self-harm is a behavior where individuals intentionally inflict harm on themselves as a coping mechanism for dealing with emotional pain, stress, or trauma. 

Self-harm typically involves injuring oneself by actions like cutting, burning, picking at wounds, pulling out hair, or inflicting bruises. However, self-harm can also refer to other behaviors that might endanger one’s health and safety, such as consuming alcohol and substances, engaging in dangerous activities, or neglecting one’s physical or emotional needs.

Who is most at risk for self-harm?

While it can affect individuals of any age, teens are at an exceptionally high risk for self-harm. One meta-analysis involving 597,548 adolescents identified a lifetime prevalence of 16.9%, with girls at a higher risk. 

Members of the LGBTQ+ community represent another at-risk group. Multiple sources have found that bisexual women, gay or bisexual men, and transgender individuals are more likely to report self-harm than their heterosexual or cisgender peers. Self-injury is also known to co-occur with mental health conditions, including eating disorders, borderline personality disorder, depression and anxiety disorders, and conduct disorders. 

Self-harm is prevalent in those with autism spectrum disorder, with current estimates indicating that individuals with autism are more than three times more likely to engage in such behaviors. However, interventions for self-harm in autistic individuals may differ from those in the general population.

Why do people self-harm?

For those who have not experienced it, self-harm can seem perplexing. To understand this behavior, it might help to understand the biochemical mechanisms that underpin self-injury—namely, the body’s release of endorphins in response to pain.

Endorphins are natural painkillers produced by the brain, which can create a sense of emotional release or numbing. Because physical and emotional pain activates the same parts of the brain, those endorphins may bring emotional relief immediately following a self-harming behavior. For this reason, self-harm typically occurs in response to severe stress or psychological pain. A study from 1978 observed self-mutilation in animals that are subjected to stress, suggesting a broader biological or instinctual basis for these actions.

Those who self-harm often do so impulsively and compulsively, making it difficult to stop even when it causes shame, embarrassment, anxiety, or physical pain. Research from 2010 suggests that those who self-harm may have a higher pain tolerance, which may explain why the physical discomfort it causes may not be enough to deter the behavior.

Recognizing the signs of self-harm

For teens and those who care for them, as well as adults, it can be crucial to be aware of the signs of self-harm. Key signs to notice include the following. 

Physical injuries

Frequent cuts, bruises, burns, or scars can be a sign that a person is engaging in self-harm, particularly if the injuries are not easily explained or located in a place that is easily hidden. 

Different clothing and appearance

Those who self-harm often attempt to conceal their injuries. For example, they may wear long sleeves or trousers even during warmer months or use accessories like bandanas or wristbands to cover their injuries. 

Unusual excuses for injuries

Implausible excuses for physical injuries or a dismissive attitude towards noticeable wounds might be a sign. For example, someone might say their frequent cuts are due to their cat scratching them or from falling. 

Behavioral changes

Self-harm and the extreme emotional distress that causes it may be accompanied by behavioral changes, such as social withdrawal, decreased engagement with school or work, substance use, or risk-taking behavior. Those who self-harm may carry sharp objects, lighters, and other implements that can be used to inflict injury.

Emotional distress

Preventing self-harm

Preventing self-harm involves ensuring that people have the tools and resources to process emotional pain effectively. Below are a few ways you can make an effort to prevent self-harm for those you love and your community. 

Creating supportive environments

Parents, caregivers, teachers, and people in pastoral roles can prevent self-harm by modeling and teaching healthy coping skills, as well as fostering positive environments that are conducive to mental health and well-being. Education about self-harm and healthy alternatives may also be helpful in school and healthcare environments. 

Fostering open discussion about mental health

Individuals struggling with their mental health may experience shame or embarrassment related to their situation, which can be compounded by stigma, insensitivity, or lack of understanding. Creating a safe and supportive space for open sharing could encourage those experiencing mental health concerns to seek professional assistance rather than using unhealthy coping mechanisms like self-harming behaviors.

Early intervention for at-risk individuals

It can be vital to identify and monitor those who are at risk of experiencing hardship or trauma. Preemptive measures may be taken to safeguard the well-being of an individual, while timely interventions soon after such situations might lessen their impact. 

Ensuring the availability of mental healthcare

At the societal level, preventing self-harm may mean expanding the availability of mental healthcare. Enhanced availability may be achieved by ensuring public services are well-equipped to handle mental health issues, raising charitable contributions for nonprofits and NGOs, and encouraging alternative investment and innovation in different therapeutic methods and modalities.

Support, educate, and advocate during Self-Harm Awareness Month

This March, consider lending your support to those who may be struggling with self-harm, trauma, or poor mental health via the following steps. 

Support peers struggling with self-harm

If someone you know is self-harming, consider offering support. You might support them by listening while they vent about their struggles, providing them with helpful information or resources, or encouraging them to get help from a trusted adult or professional. 

Promote education and awareness

Advocacy may begin with increasing public awareness of specific issues, especially surrounding mental health. Social stigma, combined with barriers to mental healthcare, can cause significant obstacles to those who are struggling.

Sharing information, resources, and personal stories may break down these barriers and normalize seeking help. During March, consider educating your friends and followers about the importance of mental healthcare, social support systems, and proactive coping strategies.

Advocate for mental healthcare

Your advocacy can play a vital role in building systems that ensure each individual can receive available care. Consider researching the challenges preventing individuals in your community from receiving adequate support and connecting with others who can help. For example, you might write a letter to your representative, meet teachers or school officials, or donate to organizations in the mental health space.

Get involved 

Getting involved with community groups and organizations can be a way of providing material assistance to those who may be dealing with self-harm. You might consider participating in mental health first aid or crisis intervention training programs or volunteering for a mental health hotline.

Share your story

If you have personal experience with self-harm, sharing your story can be a powerful way to connect with others who might be going through similar struggles. It can offer hope, show that recovery is possible, and may reduce mental health stigma. Whether you choose to open up publicly or discreetly, doing so in a thoughtful and considerate way can be powerful.

Find support for self-harm

Recovery from self-harm can be intensive, often including psychiatric interventions from doctors, ongoing counseling and peer support, and lifestyle adjustments. However, early interventions that promote physical and emotional well-being can be crucial for preventing mental health from deteriorating in response to stress or trauma.

Reaching out for support from a mental health professional for mental health conditions or symptoms can be challenging in person. In these cases, online therapy platforms like BetterHelp for adults or TeenCounseling for teens aged 13 to 19 may be beneficial. 

While online therapy may not be appropriate as the sole source of support for those with severe self-harm or suicidal ideation, it can be a valuable source of emotional support and guidance, allowing clients to choose between phone calls, video chats, or in-app messaging sessions with a therapist from home. Dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mindfulness-based stress reduction (MBSR) are a few common therapeutic approaches that may be effectively used online. 

Studies also support the effectiveness of internet interventions. Online therapy has been found to be as effective as in-person therapy and may be preferable for teens with busy schedules, transportation limitations, or social anxiety. Young people may find it easier to open up to a neutral third person like a therapist, particularly if they can attend from the comfort of home.