What You Should Know About the Link Between Anxiety and Self-Harm

While many people are much more aware of anxiety now than in the past, some details and symptoms still aren’t as commonly discussed.

One lesser-known symptom of anxiety is the urge to self-harm. Not all or even most people who experience anxiety will have these urges, and there are people who self-harm who do not struggle with anxiety. Yet, when anxiety and self-harm co-occur, it may be crucial to a person’s well-being and safety to identify the issue in order to connect with help.

Can Anxiety Cause Self-Harm?

It’s very possible for anxiety to spark urges to self-harm. Self-harm is frequently associated with a sense of release from overwhelming emotions or situations in those who engage in the behavior. Since anxiety is characterized by a sense of feeling overwhelmed or worried about not being able to handle life situations, self-harm acts can bring relief from anxious feelings. While anxiety does not always lead to self-harm, studies have shown people who engage in self-harm are more likely to experience anxiety and vice-versa.

Types of Anxiety That May Lead to Self-Harm

Certain types of anxiety may be more likely to lead to self-harm than others:

• Social anxiety: This type of anxiety is characterized by an intense fear or worry of being judged by others. Studies have shown that this type of anxiety has a high likelihood of leading to self-harm behaviors.
• Generalized anxiety: General anxiety is a constant sense of worry or stress in the long-term that doesn’t seem to have one specific cause. This type of anxiety has also been shown to have a higher chance of leading to self-harm behaviors.

While obsessive-compulsive disorder (OCD) was once listed as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5 lists it as an obsessive-compulsive disorder. Although OCD is now technically in a different category than anxiety, is may frequently co-occur with anxiety and has been known to cause self-harm.

One type of OCD, known as harm OCD, can cause intense fear of hurting oneself or others. While this anxiety about harming oneself may be severe and vivid, those with harm OCD are thought to be no more likely to act on their thoughts of self-harm than someone without harm OCD.

Why Is Anxiety Connected to Self-Harm?

Anxiety is frequently accompanied by overwhelming feelings of worry, racing thoughts, and sometimes panic attacks. This can make people with anxiety feel they’ve completely lost control of their minds and bodies. They may turn to self-harm in order to focus their mind outside of their racing thoughts or worries, or they may use it as a way to regain feeling if they’ve begun to feel numb from long-term anxiety.

Alternatively, self-harm is sometimes used out of anger. People with anxiety may feel frustrated or mad at themselves for not being able to keep their anxious thoughts under control or that they can’t “fix” themselves. In this case, self-harm may not be done for the purpose of relief, but as self-inflicted punishment. Self-harm used in anger can be especially damaging, as it isn’t a coping mechanism, but a sign of deeper emotional struggle.

Self-harming thoughts often lead to self-harming behaviors in an effort to either feel relief, feel pain, or punish oneself.

Angela Avery, MA, LLPC, NCC, a therapist in Clarkston, Michigan, notices that self-harm may tend to occur with social anxiety. She explains,

“In my clinical practice with teenagers, I often see self-harming behaviors co-occur with social anxiety. Those who experience social anxiety are afraid that they will be judged by others and often that belief is validated because they lack social skills and social confidence to create friendships or engage with others.

When you feel like no one is your friend, and you are too afraid to speak to anyone, you tend to feel poorly about yourself. Low self-worth then leads to self-critical, irrational thoughts presuming we are “bad” and “stupid” and “no one likes us.” Self-harming thoughts often lead to self-harming behaviors in an effort to either feel relief, feel pain, or punish oneself.

I tend to view harming behaviors as coping strategies of choice for people who view themselves with a severely critical eye. Add in a sprinkling of social anxiety or limited social skills and we have a combination for continued harm.”

It’s important to note that anxiety can lead to multiple forms of self-harm that aren’t always what people typically think of. The stereotyping around self-harm as a form of “attention seeking” or something people do when they’re into a certain type of music has deeply damaged our society’s ability to recognize self-harming behaviors in some cases.

Anxiety and Personality Disorders As a Cause of Self-Harm

In addition to anxiety, some some studies show that certain personality disorders may have a higher likelihood of leading to self-harm. Some of these disorders are closely linked to anxiety and may co-occur, and some can lead to self-harming behaviors independent of anxious thoughts or feelings.

Some disorders that have been linked to self-harm include:

• Borderline personality
• Schizophrenia
• Dependent personality
• Avoidant personality

At the end of the day, regardless of the cause, people who are engage in destructive self-harming behavior should not try to overcome these patterns alone. They’re a maladaptive coping mechanism, and while they can be painful and scary, there is hope. With the help of a licensed mental health professional and plenty of love and encouragement from friends and family, people can learn to manage their anxiety and overcome their self-harm behaviors.

References:

1. Bhandari, S. (2018, February 21). Mental health and self-injury. Retrieved from https://www.webmd.com/anxiety-panic/guide/self-injuring-hurting#1
2. Bolton, J., Chartrand, H., Sareen, K., & Toews, M. (2011, September 21). Suicide attempts versus nonsuicidal self‐injury among individuals with anxiety disorders in a nationally representative sample. Depression and Anxiety, 29(3), 172-179. doi: 10.1002/da.20882
3. Klonsky, E. D., Oltmanns, T., Turkheimer, E. (2003, August 1). Deliberate self-harm in a nonclinical population: Prevalence and psychological correlates. The American Journal of Psychiatry, 160(8), 1501-1508. Retrieved from https://doi.org/10.1176/appi.ajp.160.8.1501
4. Living with harm OCD: What’s going on? (n.d.). Retrieved from https://www.intrusivethoughts.org/ocd-symptoms/harm-ocd
5. O’Connor, R., Rasmussen, S., & Hawton, K. (2009). Predicting depression, anxiety and self-harm in adolescents: The role of perfectionism and acute life stress. Behaviour Research and Therapy, 84(1), 52-59. doi: 10.1016/j.brat.2009.09.008
6. Pierce, L. (2018, April 21). OCD, Self Injury, and Suicidal Thoughts. Retrieved from https://www.verywellmind.com/ocd-self-injury-and-suicidal-thoughts-2510599
7. Self-harm. (2018, May 25). Retrieved from https://www.nhs.uk/conditions/self-harm

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