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What to Do if You Suspect Someone Is Engaging in Self-Harming Behaviors

Witnessing a loved one engage in self-harming behaviors can leave you feeling scared and helpless. You may find yourself questioning how it happened, thinking, “How did it get this bad?” Moreover, you may wonder what you can do to help your loved one get the support they need. Nevertheless, reaching out to a loved one about their self-harming behaviors can feel daunting. It is understandable that the stress and fear you feel for your loved one can make it easy to assume the worst-case scenario.

At The Guest House, we know self-harming behaviors often stem from traumatic life experiences. When we get overwhelmed with life stressors and adverse experiences, it becomes more difficult to manage our daily lives. Thus, your loved one may be engaging in self-harming behaviors as a means to cope with these traumatic stressors. We believe deepening your understanding of self-harming behaviors can give you the tools you need to support your loved one.

What Are Self-Harming Behaviors?

According to chapter three of Trauma-Informed Care in Behavioral Health Services from Substance Abuse and Mental Health Services Administration (SAMHSA), self-harm can be any type of intentional self-inflicted harm. Moreover, self-harm is typically an attempt to cope with physical and or psychological distress that stems from trauma. For instance, a car accident, health issues, sexual abuse, and divorce are some broad examples of distressing, traumatic experiences. Further, emotional and physical distress can leave a person feeling overwhelmed, trapped, and helpless, which makes managing daily life difficult.

Self-harming behaviors are often thought of as external self-injuries. Some examples of this include:

  • Cutting
  • Burning skin
  • Hitting or punching oneself
  • Punching other objects
    • Walls
  • Head banging
  • Hair pulling
  • Excessive scratching and or nail biting
  • Preventing wound healing
  • Self-poisoning
  • Breaking bones
  • Tying off body parts to stop breathing and or blood flow
  • Inserting foreign objects into one’s body
  • Ingesting sharp objects
  • Attempting suicide

However, self-harming behaviors or self-destructive behaviors can include responses to distress that do not present immediately. As noted in the article “Risk Factors for Non-Lethal Self-Harm by Substance Abuse” by Ciuhodaru, Lorgab, and Romedea, substance use is a non-lethal form of self-harm. Therefore, the use of substances is a form of self-defeating behavior that can harm physical and psychological well-being.

Additionally, as noted in the article “Understanding Self-Harm” by Luna Greenstein, typical self-harming behaviors and substance use are maladaptive coping mechanisms that form when someone has difficulties managing mental health symptoms. If this is the case for your loved one, you may wonder what has led to your loved one’s substance use disorder (SUD).

Risk Factors for Self-Harming Behaviors

According to another publication by SAMHSA, there are many factors in a person’s life that can influence the development of SUD and/or a mental health disorder. In addition, there are macro and micro-level risk factors that can increase the chances of self-defeating behaviors. Macro risk factors include biological, psychological, cultural, community, and family factors, whereas micro or individual-level risk factors include individual exposure to substance use, like genetic predisposition and prenatal exposure. Moreover, some SUD risk factors are fixed, like biology, and others are variable as they can change over time, like financial resources.

Listed below are some of the risk factors that can increase an individual’s likelihood of abusing substances or developing SUD:

  • Low-income status
  • Unemployment
  • Poverty
    • Community poverty
    • Family poverty
  • Barriers to economic opportunities
  • Adverse childhood experiences (ACEs)
    • Neglect
    • Maltreatment
    • Physical, sexual, and or verbal abuse
  • Parents or caregivers with SUD
  • Community violence
  • Racism
  • Systemic barriers
    • Societal norms and laws
      • Barriers to resources and education
      • Increased access to substances
      • Encouraged criminalization of substances for marginalized communities

Moreover, knowing the risk factors for SUD can give you insight into the root of your loved ones self-harming behaviors. Furthermore, recognizing the signs and symptoms of SUD can help you recognize if your loved one has an addiction.

Signs and Symptoms of Substance Use Disorder

It can be disconcerting to see a shift in your loved one’s personality. Both trauma itself and self-medicating practices can drastically change how your loved one thinks, feels, and behaves. According to the article “Substance Use Disorder” from the National Alliance on Mental Illness (NAMI), the signs and symptoms of SUD can include:

  • Sudden changes in mood and behavior
  • Withdrawal from family and friends
  • Engaging in more risky behaviors
  • Increased consumption of substances
  • A seeming inability to function without the substance
  • Increased tolerance of substances
  • Experiencing withdrawal symptoms when they stop consuming substances

Knowing the signs and symptoms of SUD can help you better understand the changes in your loved one’s behavior. Meanwhile, the changes to your loved one’s behavior are often not only a result of changes to the brain from substance use, as SUD often co-occurs with mental health disorders as well.

Co-Occurring SUD and Mental Health Disorders

As noted in an article from the National Institute on Drug Abuse (NIDA), substance use and mental illness often co-occur. For example, difficulties with mental health disorders like depression, anxiety, and schizophrenia have a high co-occurrence with SUD. Further, many people may attempt to self-medicate their mental health symptoms with alcohol and other drugs. However, the use of substances can exacerbate mental health symptoms as well as increase the risk for SUD.

Moreover, as noted in an article from Public Health Review, there is a bidirectional relationship between trauma and SUD, which highlights the co-occurrence of post-traumatic stress disorder (PTSD). In addition, major depressive disorder (MDD) and other mood disorders like bipolar disorder (BP) are the most common co-occurring mental health disorders. Therefore, the co-occurrence of SUD and mental health disorders are not always a direct cause of each other but rather share a relationship in which they impede on each other.

Furthermore, co-occurring SUD and mental health disorders increase the risk of poor health outcomes. As Public Health Review notes, 77% to 93% of SUD clients used tobacco products, and 50% of those clients died from tobacco-related conditions.

According to NIDA and Public Health Review, some of the health risks for SUD and mental health disorders include:

  • Overdose
  • Lung disease
  • Heart disease
  • Stroke
  • High blood pressure
  • Hypertension
  • Increased risk for mental health disorders
  • Cancer
  • Dental problems
  • Damaged nerves cells
    • Brain
    • Spinal cord
    • Peripheral nervous system
  • Increased risk of infection
    • HIV/AIDS
    • Hepatitis B and C
    • Other sexually transmitted infections (STIs)
    • Heart infection
    • Skin infection

It is clear that self-harming behaviors can be detrimental to your long-term physical and psychological well-being. Moreover, approaching your loved one about their self-harming behaviors is an overwhelming task, but it is the first step toward healing for them and the whole family. When it comes to self-harming behaviors like SUD, you cannot bury your head in the sand and hope the issue goes away. While it may feel easier to hope things will get better, leaving self-harming behaviors unaddressed not only harms your loved one but the whole family as well.

How SUD Impacts Families

According to an article from Social Work in Public Health, SUD impacts the whole family as the family is often the primary source of attachment, nurturing, and socialization in your life. Moreover, the relationships you form in your family act as a communication conduit that connects you to each other. Thus, when those relationships are put under strain by SUD, the well-being of the whole family is put in jeopardy.

Furthermore, it may be difficult to imagine that your loved one’s self-harming behaviors could be just as harmful to you and your well-being too. Therefore, it is important to understand that SUD impacts each family member in unique ways that may not always clearly illustrate SUD as the source of distress. As noted in an article from the Journal of Food and Drug Analysis, some of the adverse effects SUD can have on you and the rest of your family include:

  • Relationship distress
    • Increased tension between family members
    • More frequent conflicts between family members
      • Typically related to the SUD and the issues it causes
  • Emotional distress
    • You and other family members may experience a wide range of emotions
      • Anger
      • Frustration
      • Fear
      • Worry
      • Anxiety
      • Depression
      • Guilt
      • Shame
      • Embarrassment
  • Financial difficulties
    • Irresponsible use of money
      • Spending money on substances rather than basic needs
    • Losing jobs
    • Frequent reliance on public assistance
  • Legal issues
    • Driving under the influence
    • Possession of illegal substances
    • Engaging in other illegal risky behavior
    • Incarceration
  • Issues with children
    • Substance use during pregnancy can result in
      • Congenital disorders
      • Developmental delays
      • Cognitive delays
    • Children are at an increased risk of:
      • Abuse and or neglect
      • Physical issues
      • Difficulties with conduct or oppositional disorders
      • Behavioral and impulse control issues
      • Difficulties with emotional regulation
      • Low academic performance
      • SUD and mental health disorders during adulthood
  • Parental issues
    • Parents with SUD may neglect the physical and emotional needs of their children
      • Less sensitivity
      • Lack emotional availability
    • Parenting an adolescent or adult child with SUD is emotionally taxing
      • Feeling helpless
      • Anger and frustration
      • Depressed
      • Guilt
  • Family instability
    • Increase instances of abuse and or violence between family members
    • Family unity can be disrupted and or severed
      • Separation
      • Divorce
      • Removal of children from the home

The adverse effects of SUD highlight the far-reaching impact your loved one’s self-harming behaviors can have on the well-being of the whole family. However, as noted in Social Work in Public Health, the impact of SUD can be particularly detrimental to the children in your family.

Parenting With SUD

According to Social Work in Public Health, growing up around self-harming behaviors disrupts the entire family system:

  • Healthy attachment relationships between children and adults deteriorate
  • Family rituals and routines disappear
  • Roles within the family become distorted
  • Communication between parents and children breaks down
  • Social life is disrupted
  • Children may develop stressors around financial instability

Additionally, growing up in a household with SUD often creates physically and psychologically unhealthy environments. For instance, children in substance-using environments are surrounded by:

  • Secrecy
  • Loss
  • Conflict
  • Fear
  • Physical abuse
  • Verbal abuse
  • Neglect
  • Emotional instability
  • Role reversal

Therefore, the level of instability SUD causes children can have long-term consequences that follow them into adulthood. With a deeper understanding of the possible roots of self-harming behaviors, you can start taking steps toward reaching out to your loved one. However, you may be wondering how to start a conversation with your loved one to address their specific experiences and needs.

Supporting a Loved One With SUD

As noted in the article “Reaching Out to a Loved One with Substance Use Disorder” by Claire Nana, it is important to remember that connection is a key feature of support. When it comes to support systems, everyone needs connection when they are facing something difficult. In times of both distress and joy, you turn to the people in your life for support, as every part of life presents both hardships and life lessons. Listed below are some of the points of connection in support to keep in mind before, during, and after you talk with your loved one:

  • Approach them without judgment
  • Reassure them that you are here for them
  • Clearly state your commitment to them on their journey
    • Acknowledge that relapse is not a failure but a part of the journey
    • Let them know you will not abandon them when they have setbacks
  • Come from a place of curiosity
    • You may find it difficult to understand your loved one’s addiction, but staying curious opens the door to
      • Communication
      • Empathy
      • Connection
  • Make sure your loved one knows you are here to support them even if you do not understand their self-harming behavior

As SAMHSA notes, starting a conversation with your loved one is the first step toward getting them help. Moreover, your ability to offer support to a loved one could be the key to the treatment, resources, and services they need to start their recovery journey.

Some tips on how to start a conversation with your loved one about their self-harming behaviors include:

  • Finding the right time and place to talk
    •  Private setting with few distractions
  • Expressing your concerns
    • Ask them about how they are feeling
  • Being direct about your concerns
    • State clearly your reasons for feeling concerned
  • Listening and acknowledging how they are feeling
    • Open listening
    • Engage in active listening
    • Listen without judgment
  • Offering support
    • Reassure them that treatment is available
    • Support them in locating resources
    • Help them connect with treatment services
  • Having patience
    • Remember, recovery does not happen overnight
    • Keep reaching out to your loved one
      • Let them know you are here to listen
      • Offer to help

Thus, the opportunity for recovery for your loved one starts with a willingness to connect with each other.

Addressing Self-Harming Behaviors at The Guest House

While you may not know or understand your loved ones self-harming behaviors, your support can help them connect with treatment services that can understand their specific needs. At The Guest House, we believe an important part of the recovery journey is uncovering the underlying causes of self-defeating behaviors. When your loved one can deepen their self-awareness of what led them down this path, we can truly start the healing process. In addition, we also recognize and deeply believe in the power of connection and community.

Reaching out to your loved one with love, openness, and communication can be a foundational piece of their recovery. Truth be told, self-harming behaviors may leave your loved one feeling isolated and alone in their pain. Moreover, your loved one may find themselves in unhealthy relationships that have impeded their well-being.

Thus, receiving nonjudgmental support from you highlights the power of healthy connection and gives your loved one a healthier foundation to tackle their self-harming behaviors. Moreover, with our commitment to community, your loved one can have a safe and comfortable space to rediscover themselves. While we know the path to recovery has its ups and downs, your willingness to reach out to your loved one can be the beginning of their long-term recovery.

Reaching out to a loved one about their self-harming behaviors can be an important step toward long-term recovery. When self-harming behaviors are left unaddressed, it can increase physical and psychological distress. Moreover, the distress of self-harming behaviors can disrupt healthy communication, strain relationships, and cause financial difficulties, among others. In particular, children are at a higher risk for maltreatment, mental health disorders, and substance use disorder. Therefore, being a source of healthy support for your loved one can help them and the whole family heal. At The Guest House, we believe in a holistic approach to care that provides a safe, nonjudgmental space where healing can truly start. Call the The Guest House at (855) 483-7800 to learn more.