Is Self Harm an Addiction?

Self-harm, or non-suicidal self-harm, involves voluntarily and explicitly harming one’s body without the intent to end one’s life. Anywhere from 15 to 20 percent of adolescents and young adults experience non-suicidal self-harm, as opposed to about 6 percent of adults. Non-suicidal self-harm is highest in people who report self-criticism and self-directed negative emotions. But is self harm an addiction?

Is Self Harm an Addiction?

When most people think of self-harm, they usually don’t think of it as the kind of behavior that can become “addictive.” Cutting yourself, burning yourself, starving yourself, or otherwise inflicting damage on your body usually implies pain, not pleasure.

But addiction can take many forms, and the criteria for cases of non-suicidal self-harm have long coincided with many of the same criteria applied to behavioral addiction (sex, gambling, etc.) and substance use disorders.

Whether or not self-harm is an addiction is still up for debate. Existing research implies that the case could be made for self-harm to be treated as a form of addiction, meaning patients with a history of non-suicidal self-harm (and suicidal behavior) need a treatment plan that is structured similarly to those used to treat substance use disorders and other cases of addiction. But understanding why self-harm addictive can be, and what it even means to be addicted is important.

What Defines an Addiction?

The root of an addiction is compulsion. Someone who is addicted cannot stop doing what it is they are doing, despite clear detrimental effects.

In an extreme example, someone addicted to alcohol may alienate their loved ones, suffer setbacks at work, inch closer to financial destitution, and even suffer physical illness because of their drug use before they can successfully stop drinking. In many cases, their addiction can lead to death.

Reinforcements

Another common criterion is that an addiction involves positive reinforcement as well as negative reinforcement. Drinking alcohol feels good and can trigger feelings of relaxation and euphoria.

As a depressant drug, alcohol is similar in effect and structure to some anti-anxiety medications and can thus soothe feelings of overarching worry or unease. But trying to quit drinking after some time can lead to powerful cravings and withdrawal symptoms. Your body can punish you – quite severely – for going cold turkey.

Despite the long-term consequences and drinking and its negative effects on the mind and body both after each drink and over time, alcohol is a drug that positively reinforces its reuse, as well as negatively reinforcing itself through painful withdrawal symptoms.

Considering Compulsion Through OCD

On the other hand, consider a compulsion under the definition of obsessive-compulsive disorder. In OCD, compulsive behaviors arise as a soothing mechanism for unwanted and intrusive obsessions, ranging from thoughts of violence to anxiety-inducing worries about germs. In this case, the compulsion is fueled by negative reinforcement.

Washing your hands eight times in a row several times a day doesn’t necessarily produce any pleasure on its own but can be soothing in the context of the germ-related obsessions you struggle with as a result of your OCD. This is not considered to be a useful parallel to drug addiction.

Understanding Non-Suicidal Self-Harm

Non-suicidal self-harm is any instance of self-harm suffered without interest in ending one’s own life. Non-suicidal self-harm, or non-suicidal self-injury, is not noted to occur in response to a positive effect (i.e., it is not rewarding in and of itself), but it is almost always performed in response to negative affect (self-hate, self-shame, feelings of guilt, or depression).

There are many forms of non-suicidal self-harm. They can include:

• Cutting
• Hitting self
• Burning
• Carving
• Hair pulling
• Severe scratching
• Picking wounds/scabs
• Swallowing dangerous substances and/or objects
• Biting
• Pinching
• Needling
• Skin scraping (with a rough object or surface)
• Self-stabbing
• Intentionally falling downstairs
• Jumping from a tall height (to cause injury, not death)
• And more.

Non-suicidal self-harm is usually experienced in conjunction with a mental health condition. Roughly a third of people experiencing tendencies of non-suicidal self-harm are diagnosed with major depressive disorder. A little less than a third have a history of drug use and dependence.

Other common co-occurring conditions include generalized anxiety disorder, dysthymia (low-intensity persistent depression), eating disorders, and panic disorder.

Common in Cases of Depression or Anxiety

Non-suicidal self-harm is common in cases of depression or anxiety, and it can come in many shapes and forms. But is it addictive? If we examine the criteria mentioned earlier, it could be argued that non-suicidal self-harm isn’t an addiction, in the same sense as an alcohol problem or a nicotine addiction. But that doesn’t mean there isn’t any merit to the idea of treating self-harm in a similar way.

Non-suicidal self-harm can be performed as a response to negative emotions, such as self-hatred or guilt, or even worry. But they are rarely performed in response to a craving or to seek an addictive high.

Yes, pain can result in the release of endorphins, which can feel good. But neither the endorphin release nor the craving for self-harm is as strong in cases of self-harm as it is in cases of drug addiction, or behavioral addictions such as sex addiction or gambling addictions.

Negative Emotions

The fact that people who perform self-harm feel better afterward has more to do with the release from a buildup of negative emotions than the result of positive emotions created by the pain.

Despite lacking a positive reinforcement (i.e., an addictive high), there is still an argument to be made that non-suicidal self-harm shares enough similarities with addictive tendencies that a similar treatment plan may help reduce instances of self-harm, and stop the destructive cycle.

More Research Needed

Much of the research surrounding non-suicidal self-harm has been performed in the last two decades. More time and more research will give medical professionals a better understanding of how self-harm works, why it is so common, and how it can be treated effectively.

Even if the parallels drawn between self-harm and drug addiction aren’t perfect, there may be merit in recontextualizing self-harm as a compulsive condition requiring specialized treatment, rather than just a symptom of anxiety or depression.

Seeking Help for Self-Harm

If you or someone you know is struggling with self-harm and/or suicidal behavior, it is important to seek immediate help. Even non-suicidal self-harm often correlates with a strong increase in suicidal tendencies and can lead to death, whether intentional or accidental.

Self-harm is also more common in psychiatric populations, meaning you or your loved one may be diagnosed with another mental health condition in need of professional attention. Psychiatric therapy, medication, and a long-term treatment plan can not only save your life but can help you lead a more fulfilling life.