Self-injury is not officially classed as a mental health disorder the way that eating disorders and drug or alcohol addictions are. Instead, it's usually viewed as a symptom of another mental health problem such as depression or borderline personality disorder. That's not to say that everyone who self-harms is mentally ill - for some people, it may just be a coping mechanism, perhaps one they learned from family or friends who self-injure.

Secret Shame's Diagnoses Associated with Self-Injury page is a good place to start if you want to learn about different mental health disorders and their links with self-injury.

For information on the kinds of help available for mental health problems, please see our Treatment page.

Contents
Depression & bipolar disorder
Borderline personality disorder
Anxiety
Obsessive compulsive disorder
Post-traumatic stress disorder
Dissociation
Other disorders
Mental health websites

 
Depression & Bipolar Disorder

We often talk of being "depressed" when we feel sad or unhappy, but depression is actually an illness which can be very debilitating. Symptoms can include constantly feeling low, being unable to enjoy anything, difficulty concentrating, problems sleeping and loss of appetite. People who are depressed may self-harm for many reasons, including as a form of self-punishment or as a way of dealing with unbearable feelings.

Bipolar disorder (also known as manic depression) is an illness where sufferers experience the lows of depression but also extreme highs - episodes where they feel much more excited, energetic, talkative, impulsive and/or agitated than usual. These episodes are known as mania or hypomania. People with bipolar disorder may also self-injure during manic episodes as a way of calming themselves down.

To find out more about depression and bipolar, see our Depression page.

 
Borderline Personality Disorder (BPD)

Broadly speaking, people with BPD have personality traits which contribute to their unstable emotions, relationships, self-image and impulsive behaviour. Symptoms of BPD can include self-injury, other self-destructive behaviours (e.g. substance abuse, overspending, bingeing), fear of abandonment, disrupted relationships, having no real sense of "who you are", mood swings, chronic feelings of emptiness, inappropriate anger and paranoia or dissociation. It's the only disorder to specifically mention self-injury as a symptom, and is therefore a very common (but controversial) diagnosis for people who self-harm.

For more information on BPD, see our Borderline personality disorder page.

 
Anxiety

Anxiety can take many forms - panic attacks, phobias, obsessive and compulsive behaviour, the nightmares and flashbacks of post-traumatic stress disorder, or just a constant feeling of being nervous and on edge. People who suffer from anxiety disorders may self-injure as a way of calming themselves down. When someone injures themselves, their brain produces chemicals called endorphins which have a soothing effect and can bring fast relief from tension. This relief is only temporary, and many self-injurers find they have to hurt themselves more and more often or more and more severely to achieve the same effect.

To find out more about anxiety disorders, see our Anxiety page or the information on OCD and PTSD below.

 
Obsessive Compulsive Disorder (OCD)

OCD is a condition in which people experience repetitive and upsetting thoughts or images (obsessions), and feel compelled to carry out certain behaviours (compulsions). As mentioned above, self-injury can bring relief from the anxiety associated with OCD. It can also be a compulsive behaviour, a symptom of OCD itself.

Understanding OCD
This booklet is for anyone who wants to understand more about OCD. It provides an outline of possible treatments, looks at what support is available and at the ways that people can learn to help themselves.

OCD and Self-Injury
Information on when self-injury can be considered a symptom of OCD.

OCD Action
A UK charity for people with OCD, with an extremely informative website. It includes information on compulsive skin picking and trichotillomania.

 
Post-Traumatic Stress Disorder (PTSD)

It is fairly common for self-harmers to have experienced some form of abuse or trauma in childhood or adolescence. PTSD is an anxiety disorder which can arise from such trauma. Symptoms can include nightmares, flashbacks, avoiding anything which reminds you of the trauma, and being easily aroused.

Understanding PTSD
Information on PTSD, including the types of help available.

PTSD and Self-Injury
Includes information on "Complex Post-Traumatic Stress Disorder" - for which one of the proposed criteria is self-injury.

David Baldwin's Trauma Information Pages
An incredible amount of information on trauma and its effects, including post-traumatic stress syndromes.

 
Dissociation

Put simply, dissociation is "a sort of turning off of consciousness".¹ There are many different kinds of dissociation, which can include amnesia (forgetting things that have happened to you or personal details), a feeling that your body or the world around you is unreal, being unsure of who you are, or having different "personalities" that come out at different times. Dissociation is often a defence mechanism which helps people survive traumatic experiences. People who dissociate may self-injure without realising they're doing it, or as a way of bringing themselves back to reality.
 
Dissociative Disorders and Self-Injury
Brief explanations of the various dissociative disorders and the links with self-injury.

Understanding Dissociative Disorders
More detailed information, including sources of help available.

First Person Plural
UK organisation for abuse and trauma survivors who suffer from dissociative disorders.

1. From Diagnoses associated with self-injury on the Secret Shame website, accessed 7 August 2005.

 
Other Disorders

Understanding Autistic Spectrum Disorders
Information on autism and Asperger syndrome.

How to Cope with Sleep Problems
Information and advice for people suffering from insomnia.

Understanding Schizophrenia
Information on schizophrenia including causes, treatments and practical advice.

Understanding Schizoaffective Disorder
Information on schizoaffective disorder - an illness with symptoms similar to both manic depression (bipolar disorder) and schizophrenia.

Trichotillomania.co.uk
Support and help in overcoming trichotillomania (pulling out hair).


Mental Health Websites

Mind
The leading mental health charity in England and Wales, Mind works to create a better life for everyone with experience of mental distress. Their website includes many excellent online booklets on different aspects of mental health.

Mental Health Foundation
The biggest website on mental health (and mental illness) in the UK, which exists to help people survive, recover from and prevent mental health problems.