What is self harm?

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I have struggled with self harm since I was 13 years old. I started out as a cutter, using just small razors and other household things, added burning a few years later, and eventually started punching things to try and break my hand a few years ago. I do it because I’m in pain, and I am far from alone.

In 2013, about 3.3 million cases of self-harm occurred globally.[19] Self-harm is most common between the ages of 12 and 24.[1][8][9][20][21] Self-harm is more common in females than males with this risk being fives times greater in the 12-15 age group.

Self harm is a false friend. It provides temporary relief and permanent scars. It is something many of us obsess about, for different reasons each, and the act of self harming becomes compulsive. There are a variety of precursors to self harm.

The basic cycle of self harm goes like this:

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And there are many precursors.

When I am struggling, I end up self harming for a variety of reasons. The first is usually that I’ve been having a hard time emotionally, so I get overwhelmed and suddenly don’t know how to cope with all the feelings that I have. The thing I know will help for at least a while is the self harm. At least the pain will be real instead of in my head. The pain will be visible to me and others (though I try to hide as much as I can). The physical pain distracts me from the emotional pain. Second, sometimes I am so dissociated that I cannot bring myself back down to the ground so I want something physical to shock me out of the fog, to ground me. It usually helps for a while, but then I just feel that shame/guilt/grief about giving in. Third, I use it as punishment. When I feel badly about myself, I feel like I deserve the pain. I deserve the scars. I deserve the shame associated with it because I’ve done something wrong or bad.

What my therapist and I discovered recently is that I have some form of OCD, which I think plays into this cycle quite a bit. Below is an OCD cycle but it is very, very applicable for me with my self harm.

I obsess and obsess and obsess about self harm, day in and day out. Some days are easier than others but man, sometimes it’s literally the only thing on my mind and I sit here in agony hoping my valium will take me to a different plane of existence. These are my obsessive unpleasant thoughts, usually following some kind of other emotional turmoil. So then I turn to the self harm and I act on it compulsively, hurting myself often on and off for hours at a time, to the point where I desperately want to stop but I can’t or don’t know how. This compulsion and action gets the obsession out of my head for a while, providing some kind of relief. That is, until the emotions build again and I become obsessed, ruminating about it for the better part of each day, and I need to give in to the compulsions.

What constitutes self harm?

People self harm in an almost infinite number of ways, though there are some common forms that are found through the world.

Eighty percent of self-harm involves stabbing or cutting the skin with a sharp object.[8][35][36] However, the number of self-harm methods are only limited by an individual’s inventiveness and their determination to harm themselves; this includes burningself-poisoningalcohol abuseself-embedding of objects, hair pulling, bruising/hitting one’s self, scratching to hurt one’s self, knowingly abusing over the counter or prescription drugs, and forms of self-harm related to anorexia and bulimia.[8][36] The locations of self-harm are often areas of the body that are easily hidden and concealed from the detection of others.[37] As well as defining self-harm in terms of the act of damaging the body, it may be more accurate to define self-harm in terms of the intent, and the emotional distress that the person is attempting to deal with.

The thing about self harm that many people don’t understand is that self harm, though often related to suicidal thoughts, is not about being suicidal. It is about all of the reasons mentioned above and more, but it’s not an act of suicidality. It is harmful but not deadly unless you make a really big mistake. However all the people I’ve met don’t do it as a means to kill themselves, just to provide relief. Wikipedia has this to say:

Self-harm, also known as self-injury, is defined as the intentional, direct injuring of body tissue, done without suicidal intentions.

I have been held in hospitals for chronic self harm, the worst experience at 14, when I was pulled out AMA because they wanted to keep me just because I was finding ways to cut, though I was stable and no longer suicidal. For me, self harm has never been related to suicide.

Who suffers from self harm?

I have borderline personality disorder, and one of the hallmark symptoms of BPD is self harm. In fact, even I always suspect BPD in someone who mentions self harm but hasn’t been diagnosed. If you’re interested in some scholarly reading about BPD and self harm, check out this article. It is common amongst many other mental illnesses and even in some individuals who do not have underlying mental health issues. It is a flawed coping mechanism often used by people who have experienced abuse or emotional/physical trauma in their earlier life, as well as people dealing with grief or other major emotional upheavals.

How do you cope with self harm?

It’s not easy to live with self harm. For me it rules a great proportion of my life, filling my days with rumination and my mornings and nights with compulsive release. I can go for days, weeks at a time, but lately not more than that. What I have figured out along the way are a few positive coping mechanisms.

For me, cold showers and standing out in the cold are the most effective ways to jar myself back into reality and out of the compulsions, though it doesn’t always help, I’ll be honest. I used to hold ice cubes but it’s not the same. I do like drawing on myself with red sharpies. For whatever reason that really helps. What I have learned to do is to put my weapons out of reach because I get attached to particular items. Currently, I have something frozen in ice in my freezer so that I have to melt it to get at it to hurt myself. I think for me the key has been to build in barriers for myself when I’m feeling better, so that when I don’t feel great or I feel impulsive, I cannot immediately reach for something sharp or on fire. I would recommend this to anyone in the same position.

Resources

Crisis Text Line  : Text 741741 anywhere in the US

*1-800-DON’T-CUT – More info on self-injury

*http://www.selfinjury.com – Referrals for therapists and tips for how to stop.

*1-800-273-TALK – A 24-hour crisis hotline if you’re about to self-harm or are in an emergency situation.

*To Write Love On Her Arms (http://www.TWLOHA.com) – A non-profit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury, and suicide.

*1-800-SUICIDE – Hotline for people contemplating suicide.

*1-800-334-HELP – Self Injury Foundation’s 24-hour national crisis line.

*1-800-799-SAFE – Domestic violence hotline.

*1-877-332-7333 – Real Help For Teens’ help line.

Join us in The Haven, an 18+ mental health chat on Discord!

Where have you been

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I have been nowhere. Sometimes I fall into severe bouts of agoraphobia, and to be honest, it’s fairly sad and gross. I’m not ashamed to talk about it, but just as a warning, it’s not a pretty picture. I have a hard time writing about things when they’re actively happening to me because my brain is scrambled and I don’t like when people worry about me. It makes me uncomfortable. So I wait and then the episode passes and I can talk again. And this time I want to talk about what it’s like to become trapped in your own home.  Continue reading “Where have you been”

Impostor Syndrome

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Have you ever received a compliment and laughed it off? I do this all the time. I have learned how to accept compliments with genuine enthusiasm, but I am instantly dubious of the other person’s intent. I can’t possibly be worthy of a compliment, so what’s your angle? What are you trying to do to me by telling me this false nice thing? I’m a fraud, an imposter. I’m not good at anything. I’m not even good at being alive. I feel very ambivalent about it. Today, I don’t feel like I’ve accomplished anything. I spent hours trying to tell myself that my small goals were good enough, that I showered, went to my therapist, went to my psychiatrist, practiced my Ukulele, etc., which is more than I’ve done in weeks. I try to say well I’m back in school so I’m working on that goal. But it feels too slow and I still feel like I don’t know anything. I feel like I won’t be able to do the work in the fall and I’m just faking my way through these courses. Nevermind my actual grades. They don’t mean anything. I still know nothing. Continue reading “Impostor Syndrome”

Energy, Parents, and Charities

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Yesterday I had an energetic epiphany and decided to take a shower for the first time in a while. I will refrain from saying how long because it’s sad, and I don’t want to be sad. Suffice it to say this was an accomplishment for me, and I feel better for it. I had my cousin over for hang-out time last night and that was refreshing as well. We goofed around on my Ukulele (which I’ve been spelling wrong forever??). Today I got up and actually went to CVS to pick up my meds. It was the first time I’d left the apartment in over a week. It was nice to be a part of the world again. Sometimes I forget that it’s not the end of the world to leave.

This is a friendly neighborhood reminder that no matter how rough shit is, you just have to keep going. Eventually things will get easier. Continue reading “Energy, Parents, and Charities”

You are More

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Sometimes I feel as though my mental health issues rule my life. Bipolar can take over whenever it feels like it, sending me into spirals of mania or depression of its own will. I do lots of preventative things, like taking my meds, going to therapy regularly, sleeping appropriately, etc. But that doesn’t always keep the demons at bay. BPD is similar, because the rapid cycling moods and sensitivity can be more than I feel like I can handle. It makes it easy to write a blog about mental health because mine is constantly shifting, but it doesn’t make it easy to live in the world. It’s hard not to get my identity wrapped up in these diagnoses. For one, as someone with BPD I’m prone to an unstable sense of self, so sometimes identifying with a disorder is grounding, but it can become all encompassing. I want to remember that I am ME in all of my flawed glory. I am more than these disorders.

Continue reading “You are More”

Depressed?

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I asked my Twitter community if it was possible to be in denial about depression, and the consensus was yes. I am experiencing a depression without my most typical depression symptoms. I have some of the normal ones: difficulty showering, isolation, trouble getting out of the apartment, lack of affect. But I don’t have my usual sadness, hopelessness, lack of appetite, increased or decreased sleeping. What I’ve concluded is that I might be in a mild depression. My therapist has been pointing me in that direction. It’s not hindering my life too much right now, but she worries that it will continue to worsen until I’m not functional at all any more. I worry about that too but I don’t see it happening right now. I’m generally in too good of a mood.

Continue reading “Depressed?”

“There is a crack in everything”

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I am flawed. You are flawed. No one alive exists without flaws. But some of us actually feel broken. This quote by Leonard Cohen, “There is a crack in everything; that’s how the light gets in,” has really struck me. I’ve felt broken for as long as I can remember, with fleeting moments of certainty and wholeness that never last and leave echoes behind, tantalizing echoes of stable feelings and confidence. I am learning, however, that it’s my broken parts that allow the most wisdom to seep in. Without these breaks in my personality, life, experiences, mental health, what have you, I wouldn’t have learned what I’ve learned and accrued the emotional and intellectual knowledge that I have now, which I really wouldn’t trade for anything else.

Continue reading ““There is a crack in everything””

Dreams, Suicide, and Boredom

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I often have absurdly vivid dreams. Last night was one of those nights. They make me feel like I haven’t slept at all. It has taken me hours to wake up. And now I couldn’t even tell you what these dreams were about, just that they were exhausting. I used to have nightmares, recurring horrors that would sometimes cause me to wake in a cold sweat. After I was hospitalized when I was 14, I had a recurring nightmare about being in a hospital chased by a faceless someone or someones. For the last 18 years I’ve had that dream, which is not uncommon for someone reacting to trauma. And man was that traumatic. I was always so frustrated because I can’t really do anything about dreaming, only my waking mind. The nightmares have subsided but even Thursday night I had dreams about being chased, and I think they all go back to my first hospitalization. Continue reading “Dreams, Suicide, and Boredom”

BPD and Reactivity

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One of the alternate names for Borderline Personality Disorder (which comes from the archaic delineation between Psychosis and Neurosis), is Emotional Regulation (or Dysregulation) Disorder. Having BPD is like having all of your emotional protection stripped off, which makes every event a REALLY big deal, even the little ones that shouldn’t. Yesterday I had a fight with Husband, and it was mildly devastating. I don’t like to talk about our fights here because I don’t think it’s fair, but I will in the context of how it affects me and why.

With BPD I overthink everything and I, though I hate this word, tend to overreact to most things. I am very emotionally sensitive. A comment that might roll off your back sits in my psyche percolating until I am so convinced that I am a worthless human being that I feel like I might explode just from the pressure of pent up sadness and frustration. BPD has high octane feelings: they’re quick to spark, intense, and long-lasting. This becomes an issue when you actually have to live in the real world the rest of the time. Continue reading “BPD and Reactivity”

Staying Afloat

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In times of trouble, I always find myself writing. I journal, I write to people, I blog, I tweet, I go on Facebook, etc. Written words are how I exhale my feelings. I can process them because I put names to faceless feelings and give them life. It allows for a conversation instead of a monologue. It’s the best way I know to work on feeling better.

Yesterday I used a lot of words. I wrote, I talked to people, I saw my therapist, I was honest about the place I was in and the needs I had and it paid off. I feel better today. This is probably also because I’ve been taking my Xanax every day and doubled up on my Abilify, but I’m also sure that it’s a combination of me actively working to feel better and my meds helping me to get there.

Right now I am just afloat, waiting to see how functional I can be. I’ve talked to some incredibly thoughtful people in the last few days and they have helped support me tremendously. Even a bunch of likes on Twitter makes me feel better because I know I am connected to somebody (somebodies) and I’m not alone in my struggles. I want to help people, but sometimes I have to ask for help.

Continue reading “Staying Afloat”