Breaking the Silence: March is Self-Harm Awareness Month

By: Delilah De Kay, MSW Intern Therapist

ORCHA Health. (2024). Illustration depicting self-harm awareness [Image]. ORCHA Health. https://orchahealth.com/raising-awareness-of-self-harm/

Trigger Warning: This post discusses self-harm and related mental health topics. If you find these topics distressing, please read with caution or seek support from a trusted person or professional.

Self-Harm Awareness Month, observed in March, emerged as part of broader mental health advocacy efforts to raise awareness about non-suicidal self-injury (NSSI), reduce stigma, and encourage support for those struggling with NSSI. NSSI can be defined as “the direct, deliberate destruction of one's own body tissue in the absence of intent to die”, and these characteristics set it apart from behaviors where harm is unintended－for example, developing lung cancer from smoking, and from suicidal behavior (Nock, 2009). Common forms of NSSI include intentional cutting of the skin, burning oneself, scratching oneself, and most commonly occurs on the hands, wrists, stomach, and thighs (Cornell Research Program on Self-Injury and Recovery, n.d.). According to a 2014 meta-analysis, the prevalence of Non-Suicidal Self-Injury (NSSI) was found to be “17.2% among adolescents, 13.4% among young adults, and 5.5% among adults” (Swannell et al.) 

Self-harm is a coping mechanism people turn to when their emotions become too overwhelming to manage in healthier ways. It is often linked to conditions like borderline personality disorder, depression, anxiety, eating disorders, and post-traumatic stress disorder (PTSD) (National Alliance on Mental Illness, n.d.). While most common in teenagers and young adults, self-harm can occur at any age, particularly among those who have experienced trauma, neglect, or abuse (National Alliance on Mental Illness, n.d.). The urge to self-harm often stems from overwhelming emotions, a lack of healthy emotional expression, or a desire to feel something in response to emotional numbness, and while some may experience a temporary mood boost due to the release of endorphins, but this can lead to a cycle of guilt and repeated self-harm (National Alliance on Mental Illness, n.d.) While NSSI is not the same as a suicide attempt, it is a serious sign of emotional distress and may increase suicide risk, and signals a need for proper support and treatment.

NSSI can be difficult to detect as many people who engage in NSSI have learned to hide it well. However, some indicators of NSSI include:

• Unexplained cuts, burns, or bruises, often hidden under long clothing (Whitlock & Gershkovich, 2009).

• Possession of sharp objects or tools associated with self-injury.

• Emotional distress, mood swings, or social withdrawal (Muehlenkamp et al., 2012).

To provide compassionate support to someone who may be struggling with NSSI, it’s essential to approach them from a place of empathy and understanding. Create a safe, nonjudgmental space for them to share how they are feeling. You may say something like, “I’ve noticed you’re struggling, and I want you to know I am here for you”. Make sure to validate their feelings and acknowledge their emotions without minimizing their experience. Finally, while respecting their readiness and comfort level, gently encourage them to seek help by suggesting therapy or support groups. 

Seeking Professional Help & Alternative Coping Strategies

• Therapy: Evidence-based approaches like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have proven effective in managing self-harm behaviors (Linehan, 2014).

• Crisis Support: Immediate help is available—call 988 or text HOME to 741741 for 24/7 assistance.

• Support Groups: Organizations like NAMI (https://www.nami.org/) and Self-Injury Outreach & Support (https://sioutreach.org/) offer guidance and a sense of community.

Healthier Coping Alternatives

• Mindfulness & Relaxation: Breathing exercises, meditation, and grounding techniques can promote emotional regulation.

• Creative Outlets: Expressing emotions through writing, art, or music can serve as a therapeutic release.

• Physical Activity: Engaging in exercise can help reduce stress and release built-up tension.

• Safe Substitutes: Using ice cubes, rubber bands, or stress balls can provide a physical sensation without causing harm (Kilburn & Whitlock, n.d).

NSSI is a challenging issue that deserves compassionate attention and support. Encouraging professional help and creating a safe space for open conversations can play a crucial role in the journey toward healing and recovery from NSSI.

References:

Cornell Research Program on Self-Injury and Recovery. (n.d.). About self-injury. Cornell University. Retrieved March 27, 2025, from https://www.selfinjury.bctr.cornell.edu/about-self-injury.html

Kilburn, E., & Whitlock, J. (n.d.). Distraction techniques and alternative coping strategies. Cornell Research Program on Self-Injury and Recovery. Retrieved from 

https://www.selfinjury.bctr.cornell.edu/perch/resources/distraction-techniques-pm-2.pdf

Linehan, M. (2014). DBT skills training manual (2nd ed.). Guilford Press.

Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 6(1), 10. https://doi.org/10.1186/1753-2000-6-10​

National Alliance on Mental Illness. (n.d.). Self-harm. NAMI. Retrieved March 27, 2025, from 

https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm/

Nock, M. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self- injury. Current Directions in Psychological Science, 18(2), 78-83. https://doi.org/10.1111/j.1467- 8721.2009.01613.x

Swannell, S., Martin, G., Page, A., Hasking, P., & John, N. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis, and meta-regression. Suicide & Life- Threatening Behavior, 44(3), [page numbers if available]. https://doi.org/10.1111/sltb.12070

Whitlock, J., Purington, A., & Gershkovich, M. (2009). The cutting edge: Non-suicidal self-injury in adolescence. Cornell University. Retrieved

from https://www.selfinjury.bctr.cornell.edu/publications/2009_1.pdf ​