Simplistically
Self-injury (SI) or self-harm (SH) when a person hurts their body on purpose. It is not suicidal (http://simple.wikipedia.org/wiki/Self-injury)
However what constitutes ‘harm’ or ‘injury’?
I feel sure most people will see either cutting or burning of your skin as self harm however how many of you would think that over exercising or picking scabs could be self harm I wonder.
I think most people would think on the face of it picking scabs was a fairly harmless though distasteful habit however for some people the intention is to maintain the injury as long as possible. This is a mild form of self harm for sure, but it is still a deliberate act to harm the persons’ body. Cause for concern?
Yes I would say so, whether the act is small or not the possible reasons for it, if unresolved, may result in an escalation of the behaviour into my serious self half harm. What may start as scab picking or hair pulling my end up with cutting or overdosing.
So why do people self harm?
...it is often hard to find an exact cause.[5] Sometimes, the self-harm helps relieve unbearable emotions, or feelings of unreality or numbness. Self-harm is often a symptom of other problems. These problems may include physical abuse, sexual abuse, or eating disorders. Self-harm may also stem from mental problems such as low self esteem or perfectionism (http://simple.wikipedia.org/wiki/Self-injury)
A study published in the lancet on self harm in teens found
1802 participants responded in the adolescent phase, with 149 (8%) reporting self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]).We recorded a substantial reduction in the frequency of self-harm during late adolescence. 122 of 1652 (7%) participants who reported self-harm during adolescence reported no further self-harm in young adulthood, with a stronger continuity in girls (13/888) than boys (1/764)http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61141-0/abstract
In the adult population is it estimated that 1% of the population self harm however it is not clear what they determine as self harming. In the study in the lancet with adolestants excessive drinking is considered self harm however I am unsure of what that criteria here would be, given that my experience of adults is that far more binge drinking occurs than 1% of the population. (I would guess the more serious forms of cutting, overdosing, self battery, that may resut in the need medical attention)
The main concerns are the reasons for why people self harm as many will self harm. I look upon it is a maladjusted coping strategy. These people are trying desperately to deal with the problems and have not found a significantly better option. This behaviour is not likely to improve their situation any and so escalation is very likely if the issues do not resolve.
An act of self-harm is a not necessarily an attempt or even indicator of suicide, indeed it can sometimes be a bizarre form of self-preservation. Nevertheless it covers a wide spectrum of behaviour, with harmful physical effects, and a person who repeatedly self-harms is at a higher risk of suicide. http://www.rcpsych.ac.uk/files/pdfversion/CR158.pdf
So is self harming an early sign of mental ill health?
Well I would say that depends on how you describe mental ill health and self harming.
Low level, infrequent hair pulling, occasional binge drinking may not be however these people are deeply distressed and it would be unwise to think of it as in any way normal or good.
More serious cutting or burning or more regular daily abuse I would say they are well on the way to diagnosable illness; but whatever level of self harming is occurring it should be discussed and help given and the sooner the better. People who self harm are very likely to hide what they do from the world. (see testimonial at the bottom of this article in the guardian http://www.guardian.co.uk/society/2011/nov/17/self-harm-in-adolescents-study)
so whatever you see is likely to have been going on for some time.
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