Is Self-Harm an Addiction?

As stigmas are being broken down, our understanding of mental health is growing. Commonly misunderstood behaviors are starting to be explored as a way to help those who are struggling.

One area that is being explored more is self-harm. There’s still a lot to learn, but those struggling with this have more resources than ever to help them understand their struggle and get help.

As you’ll see, self-harm shares many characteristics and symptoms of substance addiction. These include compulsions, desire for relief, and potential relapsing. So, is self-harm an addiction? 

Defining Addiction

Addiction is a treatable, chronic disease that is often coupled with underlying mental health conditions. Signs of addiction include urges that feel beyond control and heavy, oftentimes painful, cravings.

For a long time, it was thought that addiction was solely a physical dependency (i.e. the need for a substance for the brain to function). However, it’s now understood that addiction can be a psychological dependence as well.

Behavioral Addictions

Behavioral addictions are a relatively recent addition to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and the ICD-11 (International Classification of Disease). These are addictions that do not involve a substance, such as shopping addiction and video game addictions.

We now understand that addictions can develop from behaviors that flood the brain with dopamine. Anything that can stimulate this dopamine release can develop into an addiction if there’s a change from habits to obligatory behaviors.

The actions, patterns, and behaviors follow the same patterns as substance addiction.

Non-Suicidal Self-Injury

The definition of non-suicidal self-injury (NSSI) delineates a difference between self-injury and suicidal behaviors. It’s helpful to have this distinction because not everyone who harms themselves has suicidal ideation.

The most familiar form of NSSI is cutting, but behaviors like hitting, pinching, and burning are also under this category. It’s also more common amongst women than men and it tends to occur during teenage years or early adulthood.

It’s important to note that not everyone who self-harms will have a hard time stopping. 

It’s Often a Symptom of a Mental Health Disorder

NSSI is often a symptom of an underlying mental health disorder. Some of the disorders that provoke self-harm include:

• Depression disorder
• Anxiety disorder
• Bipolar disorder
• Borderline personality disorder
• Body dysmorphic disorder

Why Do People Do It?

Thanks to a rise in recent studies, three areas have been found regarding why people self-injure. 

The first is to cope with overwhelming emotions like anger or loneliness. It’s used as a way to dampen those feelings and to dissociate. This is the most common reason for people who perform NSSI. 

The second reason found for self-punishment is self-loathing. This can include guilt from other behaviors, a low view of self, or body dysmorphic disorder.

Third is the desire to gain control over a situation or person. A desire to influence others or show an outward sign of distress isn’t the most common reason for NSSI, but is relevant nonetheless.

Self-Harm as an Addiction

Addiction develops when substance use floods the brain with higher than regular dopamine levels. 

It might feel really good the first time, but the brain begins to adapt to the additional dopamine and will no longer produce the correct amount for daily function.

That’s why addiction involves compulsive behaviors despite negative consequences; individuals feel like they need the substance or behavior in order to function regularly. 

This pattern is strikingly similar to those who compulsively engage in self-harm.

People Most Often Self-Harm As A Relief

Like a substance abuse disorder (SUD), people often use self-injury as a way to cope with a mental health or behavioral disorder.

There is some evidence to suggest that self-harm can trigger the brain’s reward center and opioid system responses. These are the same brain functions we see affected by SUDs and increase the likelihood of addiction.

It Often Follows The Same Addiction Cycle

With most SUDs, we can see a cycle of addiction that includes triggers, cravings, and relapses. This same cycle can be seen in those who suffer from compulsive self-harm.

Unless the cycle of addiction is broken, individuals will return to the behavior for relief.

We Still Need to Learn More

While our understanding of NSSI is ever-increasing, there is so much we need to learn. 

Currently, the DSM-5 does not classify NSSI as an addiction. In fact, it’s defined as a condition for future study. 

A growing body of work shows the similarities between NSSI and SUDs, but it’s yet to be widely accepted. Some of these studies even suggest so much commonality between the two that they can be treated similarly.

While we’re still searching for understanding, one thing is known: compulsive NSSI is treatable.

Treating Self-Harm

Treatment should be tailored to the individual’s needs. Not everyone self-injures for the same reasons and that needs to be taken into consideration. 

NSSI is usually a symptom of a mental health disorder. Therefore, treatment involves any underlying cause for the behavior. Common treatments for this condition include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Acceptance and Commitment Therapy (ACT)

Each of these teaches healthy coping mechanisms and helps patients deal with difficult emotions or negative self-image. 

Get Better at Sequoia

At Sequoia Behavioral Health, we offer addiction and mental health treatments. Our holistic approach to your treatment heals not only symptoms, but any underlying conditions. 

We’ll focus on the root cause of your self-harm and teach better coping skills so your journey to recovery can thrive outside the treatment  facility.

Begin your journey toward getting better at Sequoia Behavioral Health. Reach out today for a consultation.