Trigger warning. This blog talks, in depth, about self-injury/self-harm and suicide.

Our world lies in the grip of a deadly pandemic, COVID-19, which has ravaged countries all over the globe. But, for some people, they have been fighting their own battles, in silence, and often for a long time.  This pandemic may not kill like COVID or influenza does, but it still has the potential to bring chaos, and wreck lives. It touches: 

• All ages

• All races and religions

• All social classes, from those in poverty to the very rich

• All genders

It isn’t something that can be ignored yet, somehow, it is both, ignored, and treated, like something that is wrong. For this reason, it is a hidden and painful pandemic for those affected.  Only by shining a light on this subject can it be recognised and understood. As it’s actually a far bigger topic than a lot of people realise, I’m writing this blog in two parts. This first blog, I hope, will give you an idea of what self-harm is, and why it is so urgent people understand it, as well as why a person self-injures. To explain that, I am sharing my own story. In the second blog you can learn how to recognise it in somebody you care about, the best way to help a loved one you think, or know, is self-injuring, and some alternatives to self-injury.

To begin with learning to recognise self-injury, help in the best way, and find alternatives, there is a need to first understand self-harm, and its varying levels, from socially acceptable to socially unacceptable. Self-harm does not always equal self-injury. The simplest definition of self-harm is obvious - doing harm to yourself.  In this sense, every smoker self-harms. Everybody who drinks to excess self-harms. Everybody who exercises to a level that is obsessive, and can cause injuries, or hamper recoveries from injury, self-harms. Everybody who suffers from eating disorders, whether they are restricting, bingeing, overeating, purging, or using laxatives, is self-harming.  With the possible exception of some of the various forms of eating disorder, all of the above are considered socially acceptable, even encouraged or approved of.  

But self-injury is the socially unacceptable face of self-harm. It is hushed up or ignored because it isn’t understood. So, below are a few basic facts about self-injury for you to get a sense of why it needs to be understood.

• Self-injury is not an attempt at suicide. It is a coping mechanism to deal with intense stress, anxiety, depression or pain.

• Self-injury is rarely for attention. In fact it is often hidden so nobody knows.

• Self-injury does not always mean cutting. It is also things like pulling hair, head-banging, scratching, hitting or slapping yourself, or something else. Or even goading someone else to hit you. This is not an exhaustive list. If someone is causing hurt to their own body they are self-injuring.

• Self-injury amongst adolescents carries a population rate of about 17% at any given time. In adults the rate is approximately 5 to 10%. Do you know 20 people? There’s a distinct possibility that there is at least one of them who self-injures.

• Self-injury can begin as young as 5 years of age, with a rate of about 1.3% of children aged 5-10 who self-injure. This can increase in children with a diagnosed anxiety disorder, or under chronic mental distress. Our children can also have these problems. Intervening early can make all the difference in becoming an adult who self-injures, and one who does not.

• Whilst people tend to think young, white females as the ‘type’ of person who self-injures, 35-50% of all cases are male, and this is thought to be underreported owing to the fact men self-injure using different methods, or are less likely to seek help for it.

• Research tends to show that race or financial status does not really affect the population percentage who self-injure, but sexual orientation does. More gay or bisexual men self-injure than their heterosexual peers, and in women, the group most at risk are bisexual, with anything up to 47 per cent of bisexual women engaging in self-injury. In addition, trans people are more likely to have self-injured, with a shocking 72 per cent of trans people having self-injured at least once.

• Children and adolescents who are bullied are more likely to self-injure

• Whilst the act of self-injury itself is not a suicide attempt, it has strong links to depression, hopelessness, and dissociation, so the likelihood of a person making a suicide attempt is over three times higher.

• With eating disorders previously mentioned, it is relevant to add, that over 50% of people who self-injure also have an eating disorder of some type.

Once you break the figures down like this it isn’t difficult to see why this author categorises self-injury as a pandemic. But you probably wonder why people would choose to do this. I can’t tell you why everyone does. Only why I do. But possibly it would give you a sense of why someone you know might be hurting themselves. 

I’m nearly 41. I am a mum of two kids, and I am bipolar, though I wasn’t diagnosed until 2016. I self-harm, I hurt myself though my eating and, in the past, through over exercising. But I also self-injure.  And, I never realised that my depression and self-harm went back to my teenage years. Like some teens I had bouts of underlying depression. It was never severe enough, or obvious enough, to be recognised by my family, or even myself, but as young as fourteen or fifteen I can remember having those feelings that, after many years, I now recognise as bipolar mood swings. I had low moods, as well as times where I was much higher, though again never enough to be picked up. But sometimes I felt angry, and when I felt angry I didn’t always channel it very well. There were multiple occasions where I chose to punch hard objects, objects that would hurt and bruise my knuckles. 

As I got older I took up martial arts. Like a lot of autistic people, I can get very obsessive about the special interests I have, and at one point was training 9 or 10 hours a week in the dojo, as well as working out at home around a full-time job. It didn’t matter if I was hurt, I would still train. I guess in this sense, I wasn’t trying to hurt myself, I was just obsessed with doing something I loved. But again, when I was angry, I chose to hurt myself. I would hit punch bags, with no wraps or gloves on, until my knuckles were bruised or split.  For me, hurting myself was my way of dealing with feelings of being angry that I didn’t know how to express. So instead of letting it outwards, I would turn it on myself.  It became a theme for later on, hurting myself because I couldn’t express how I felt or how big the feeling really was.

In 2009 my daughter was born. It was an awful pregnancy and a horrific birth experience, that we were lucky to both come out of without dying, or having severe health problems. The second I looked at her I was hit with a lightning bolt of pure love. I know how lucky I am to have had that instant connection, when some people struggle initially with bonding with their baby. Being a mum suddenly became my whole reason to live. It still is. I’ve tried to commit suicide more than once, but equally my children have saved me from myself more times than I can count.  But, despite this, I suffered post-natal depression. I was put on medication but chose to take myself off it after 9 months, believing I was fine. My second daughter came along in 2011. Again, I had a bad pregnancy, only this time, along with health problems, I was suffering anxiety from undiagnosed PTSD.  After she was born it took a little longer for the lightning bolt, about three months, though I cared about her, and loved her, from the beginning. I had a sterilisation as I was advised against any more children after another difficult birth. I was suffering horribly from post-natal depression. My whole family, all my friends, and my health visitor could see it, but I was in complete denial, refusing any help. Once she was a year old I finally crashed, when I realised I couldn’t have any more babies. I was eventually signed off work, very unwell, reviewed for sectioning once, and often under the mental health crisis team. I was totally numb. I felt disconnected from the whole world, moving in a fog, wading through treacle.

We just happened at the time to have a large fish tank on the floor in the computer room, with a chipped edge. Walking through the room to the kitchen one day, a couple of months before I finally was signed off work, I hit it and cut my leg. It was suddenly like something cut through my numbness. It hurt, but at least I was feeling something. It took a few weeks before I tried again. I was tired of the numb feeling, so I took a safety pin and scratched it across my wrist. Instantly I felt that same jolt that brought me out of my numb state into the world. It never lasted long through, and before long I was doing it more and more regularly, and more badly. Instead of a safety pin it became a razor blade, and instead of a scratch a cut. Like the anger, I had no way of expressing how I was feeling, or just how immense the feeling was. So I either hurt myself to turn it all inwards, or to connect with the world around me that I didn’t feel a part of. 

Eventually it became a crutch I relied heavily on, and used to deal with more and more difficult emotions. It was not just anger and dissociation. Even now I find it difficult to express myself. In times of stress, I often internalise just how much the stress is building. I often ‘store’ all my stress in my back, chest, and shoulders. As stress piles on stress my muscles all tighten up, they become tight and painful. The pressure inside my chest grows, where I feel like I am taking a breath in but can’t breathe out, and it feels like somebody is blowing up a balloon inside my body. For some reason the air is all hot and red. When I self-harm there is a sharp moment – it’s the one that brings me back to the world when I am numb.  The sharpness makes me gasp, and it allows all that stored up breath in my chest to escape. The next breath I draw in is cool, and blue, and soothing.  I know some of you may be reading this, feeling like I am speaking complete gibberish, but would also wager some are reading this and hearing their own feelings. A two-way conversation between both types of readers is the only thing that can help society understand self-injury, and help people who self-injure.

Self-harm or self-injury helps me deal with pain. Now I know some of you think this is nonsense. But physical pain is easier to deal with than emotional pain.  Emotional pain cuts you as well, just deep inside and not on the surface. When I self-injure I am bringing that pain to the surface, trying to store it there instead of deep down inside me.  And I have a complex relationship with my scars. I hate my scars, they are ugly, and every time I look at them I am reminded of my failures, my guilt, and my shame. Every time I self-injure I am left feeling ashamed and a failure. Sometimes this sends me into a circular spiral of it happening, over and over again, in a catch 22 situation. My scars remind me of the shame, and of the feeling that I have let everyone I love down. But equally they remind me of my pain, which makes it real. It makes it valid. Because my scars mean people can see I’ve been in pain and I’m not making it up. They make it real and show how much I’m fighting. 

Luckily for me I’ve had a horrible ten-year battle with this pain. I’m sure that sounds a little strange considering I’ve told you I’ve had crippling depression, I’ve been drawn to the point of attempting suicide, and I’ve been hospitalised more than once. And I’ve also had to give up the career I loved as a nurse.  But it means I have had a journey, where I’ve learned new coping skills through therapy, I’ve been put under the care of a mental health team, where I have access to a psych nurse, a psychiatrist and a psychologist. I’ve finally been diagnosed with bipolar and autism, which has allowed me to understand why I struggle the way I do. My family have learned about self-injury, especially my husband, who has had to learn the best ways to support me, and lastly, I have learned to open up and express myself a little better.

Are things sorted? Hell no. I still hurt myself at times, and I think that even if a time comes when I’ve not self-harmed in years, I won’t ever be an ex self-harmer. Just a recovering one. Because I think the need and urges will be there any time I’m in a place where I would have done it before. And this is the exact reason I wrote this blog. Because some of you out there are where I was. Some of you are where I am. And some of you reading, this are either unaware your loved one, your friend, your colleague, is self-harming, or you have found out and are just trying to help them with it as best as you can. If the words of this blog touch just one reader, it’s been worth writing.

~TBB