It is puzzling that many adolescents, especially girls, repeatedly self-harm with no explicit intention of committing suicide. The most common methods involve using blades or scissors to cut one’s arms, wrists and thighs, lighters to burn oneself, or fingernails to scratch deeply. Some may occasionally bang their heads or fists against walls hard enough to cause extensive bruising. Most of this happens in the privacy of their bedrooms. Girls are more likely to create superficial wounds on their legs and arms, while boys are more prone to aggressive acts, such as burning and beating themselves.
During the developing years of adolescents in Western nations, approximately 18% intentionally harm themselves without having suicidal thoughts. In countries like Spain, this has become a pressing public health problem. According to the Ministry of Health, hospitalizations for self-harm between the ages of 10 and 24 have more than tripled in the past two decades, reaching 4,048 in 2020, up from 1,270 in 2000.
Explaining why people engage in nonsuicidal self-harm can be difficult. Those who engage in this behavior often seek relief from negative emotions such as anxiety or distress, or simply to experience something new. It is a pathology of self-harm used to regulate emotional pain. Teens may do this to express emotions such as anger, rage, guilt, or loneliness. These emotions are typically triggered by hostile or negative thoughts, followed by physical symptoms such as an increased heart rate and an urge to self-harm.
The underlying reason for self-harm in adolescents is often a feeling of loneliness and helplessness. They feel that their emotional struggles and everyday problems are not being taken seriously by those closest to them. The pain they inflict on themselves is a way of expressing their psychological suffering. It can also be a form of self-punishment, for example, due to poor body image and low self-esteem. It could be an attempt to atone for the alleged wrongdoing. Self-harm offers temporary relief and the illusion of emotional control, but it is a desperate plea for urgent help and support from family or society.
It is alarming that some young individuals, while in a dissociative state, do not feel physical pain but find self-harm pleasurable. Unfortunately, this aberrant pattern of self-regulatory behavior can be addictive, leading to an escalation in intensity and frequency. In severe cases, they will experience irresistible urges to harm themselves and increase the severity to get the same relief. The addictive components of self-harm and the clinical harm it causes are indicators of the severity of the addiction.
There are often specific reasons that cause this type of behavior. Teens with eating disorders may do this to mitigate feelings of guilt about overeating or the distress they cause their parents. Other young people, especially those who have suffered traumatic events, may feel an existential void and hurt themselves in order to feel alive.
Stressful situations can trigger young people with emotional instability.
Self-harm in adolescents may stem from a desire for attention, often when their home lives are unhappy, or to cope with the stress of bullying and online gaming addictions. Emotional instability leads to harmful acts that provide temporary relief from stress. Mental health struggles can stubbornly persist until comprehensive help is sought.
Self-harming behavior most frequently emerges among adolescents struggling with low self-esteem or underlying medical conditions such as borderline personality disorder, eating disorders, autism, and substance abuse. Additionally, feelings of loneliness or a perceived lack of support can also act as catalysts for this behavior. In short, stressful situations can trigger young people with emotional instability.
The increase in self-harm among vulnerable adolescents is partly due to the rampant use of the Internet, especially the sharing of explicit images on Instagram and other social networks. This type of content can have a contagious effect, prompting others to replicate the behavior they’ve seen on the Internet. When young people, especially those with large followings, cut themselves and share the photos or videos on social media, they motivate others to copy them.
While self-harm and suicidal gestures can often be confused, they are two different things. Self-harm is a coping mechanism in response to emotional turmoil such as anger and despair. Suicidal gestures, on the other hand, result from repeated suicidal ideation, overwhelming feelings of hopelessness, and a persistent desire to die. Methods of self-harm are usually less serious and not typically fatal.
While self-harm is not inherently intentional, it can be a precursor to suicide. This is especially true for people with depression or a family history of psychiatric problems and suicide. Counseling can offer tools for coping with stress, emotional regulation, and problem solving. It’s also important to cultivate healthy habits and establish a strong family and social support network. Ultimately, the key is to identify sources of stress and to use adaptive psychological resources to overcome emotional struggles.
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