March is Self-Harm Awareness Month—with March 1st designated Self-Injury Awareness Day—a time dedicated to educating the public about a misunderstood problem that affects numerous individuals worldwide [1,2]. This month provides an opportunity to dispel myths, provide resources, and encourage open conversation about self-harm.

What is Self-Harm?

Self-harm, clinically known as non-suicidal self-injury (NSSI), is defined as any deliberate act of harm to one's body “without suicidal intent and for purposes not socially sanctioned” [3]. While not considered a psychiatric diagnosis on its own, NSSI can be a symptom of numerous mental health issues, and the most recent Diagnostic and Statistical Manual of Mental Disorders (a.k.a. the DSM-5) recommends NSSI for further study [3,4]. 

Methods of self-harm involve cutting, hitting, burning, scratching, and preventing wounds from healing [3,5]. According to the Mayo Clinic, the reasons why people might engage in self-harming behaviors include the following:

• Providing a sense of relief from stress or anxiety

• Using physical pain as a distraction from emotional pain

• Regaining a sense of control over one’s body or life situation

• Communicating internal stress or anxiety to the outside world

• Inflicting self-punishment [6]

Self-harm is a problem that cuts across all age groups, classes, and genders, but it is most common among teens and young adults. Estimates vary, but it is believed that anywhere from 15% to 25% of young people engage in self-harming behaviors [3,7]. People with mental health issues, especially those characterized by emotional distress and dysregulation, are particularly at risk, as are people who struggle with self-directed anger and criticism [3]. 

Feelings of isolation can also play a part in self-harming behavior. For example, higher rates of NSSI were reported during the COVID-19 pandemic, and people who have experienced cyberbullying are considered to be at higher risk [4].

Misconceptions About Self-Harm

Though it's commonly thought that self-harm is the same as a suicide attempt, more often than not, the intent is not to die by suicide. Rather, people who self-harm are usually trying to cope with overwhelming emotions or situations, and the act of self-injury is a way to reduce emotional pain and bring a sense of relief [3]. 

That said, it’s important to note that while self-harm and attempted suicide may have different motivations, research strongly suggests that people who engage in self-harm have higher rates of both suicidal ideation (SI) and attempted suicide [7]. One meta-analysis found that nearly 48% of people who engaged in self-harm also attempted suicide within 4–5 years [8].

While it’s commonly assumed that females are more likely to engage in self-harm than males, research has found roughly equal rates of self-harm among males and females, with some studies suggesting that women simply tend to be overrepresented in the population samples used in research [3,8]. However, the data does suggest differences in the methods of self-harm by gender, with females more likely to engage in cutting and males more likely to engage in burning or hitting [3].

Another common misconception is that people who self-harm do so primarily to get attention, but in fact, self-harming behaviors most commonly occur in private [3].

Ways to Help

Education is a critical step in prevention. By understanding the reasons behind self-harm, we can better empathize with those who are struggling and provide them with the support they need. It's essential to remember that self-harm is not attention-seeking behavior; it's a cry for help from someone in distress.

The stigma surrounding self-harm often leads to those struggling with it suffering in silence. This is why awareness months like this one are so vital. By bringing the issue into the open, we can encourage individuals to seek help without fear of judgment.

There are many ways to support someone who self-harms. Listening without judgment, offering emotional support, and encouraging professional help are good starting points. It's also crucial not to react with shock or dismay, as this can lead to further feelings of guilt and shame. 

If you're a healthcare provider or educator, consider arranging workshops or seminars during March to spread awareness about self-harm. If you're a parent, take this time to educate yourself and talk openly with your children about the subject. And if you're a friend, be there for your loved ones. Sometimes, a listening ear can make all the difference.

Links to more information and resources—including crisis hotlines that can be reached 24/7—are available on the Resources page of our website.

Conclusion

Self-Harm Awareness Month serves as a reminder that self-harm is a serious issue that deserves our attention and understanding. It calls for a collective effort to educate ourselves, break the stigma, and offer compassionate support to those affected. Remember, awareness is prevention, and each of us has a role to play in this mission.

Sources:

[1] Serani, D., Psy. D. (2022, March 1). March is Self-Injury Awareness Month: Supportive Tips for Non-Suicidal Self-Injury. Psychology Today. https://www.psychologytoday.com/us/blog/two-takes-depression/202203/march-is-self-injury-awareness-month 

[2] Betts, L. (2023, March 1). Self Injury Awareness Day. IASP. https://www.iasp.info/2023/03/01/self-injury-awareness-day/ 

[3] NCBI1: Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: What we know, and what we need to know. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 59(11), 565-568. https://doi.org/10.1177/070674371405901101 

[4] Researchers see an increase in Self-Harm during the pandemic. (2022, January 26). https://www.psychiatry.org/news-room/apa-blogs/increase-in-self-harm-during-the-pandemic 

[5] Woodley, S., Hodge, S., Jones, K., & Holding, A. (2021). How individuals who self-harm manage their own risk—‘I cope because I self-harm, and I can cope with my self-harm’. Psychological Reports, 124(5), 1998-2017. https://doi.org/10.1177/0033294120945178 

[6] Self-injury/cutting - Symptoms and causes - Mayo Clinic. (2023, April 6). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950 

[7] Hetrick, S., Subasinghe, A., Anglin, K., Hart, L., Morgan, A. J., & Robinson, J. (2020). Understanding the needs of young people who engage in Self-Harm: A Qualitative investigation. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02916 

[8] Yan, H., Zhang, Y., Lu, Z., Li, M., Ge, Y., Mei, D., Kang, Z., Sun, Y., Li, Q., Yan, H., Yang, L., Song, P., Shi, C., Shang, S., & Yue, W. (2023). High-risk group and functional subtypes of non-suicidal self-injury in young adults with mental disorders. Frontiers in Psychiatry, 14, 1098178. https://doi.org/10.3389/fpsyt.2023.1098178 

[8] Victor, S. E., Muehlenkamp, J. J., Hayes, N. A., Lengel, G. J., Styer, D. M., & Washburn, J. J. (2018). Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults. Comprehensive Psychiatry, 82, 53-60. https://doi.org/10.1016/j.comppsych.2018.01.009