The Difference Between Self-Harm and Suicidality

Published on 10/28/2020

Trigger Warning. As indicative of the title, the following post will discuss self-harm as well as suicidality. There is no shame in clicking off now; this is a topic not everyone is ready to read or discuss.

Self-harm is a difficult thing to discuss. Firstly, because I never really know if there is meant to be a hyphen in between. A quick google search seems to suggest the hyphen, so I’ll keep it in for now. The google search also brings up a lot of prevention websites, which is great to see, but also something I know many wouldn’t turn to. There also isn’t much actual discussion on self-harm, to help us understand it.

When I started self-harming, I didn’t even realise what I was doing to myself. I didn’t connect the dots between hurting myself and being depressed or self-harming. It was something I did to relieve the overpowering emotional pain and to punish myself. Even though I didn’t understand what I was doing, already at the age of fifteen, I knew this was something shameful, that I had to keep hidden. It created a cycle, hurting myself, then hating myself for it, and then hurting myself again. I kept it covered, and on the outside, I seemed fine, so is the danger of high functioning depression. It continued on and off for seven years, and part of that was hurting myself through purging, excessive exercise and food restriction. I hated myself so much, and self-harm felt like the solution, it felt like the only way to stay alive.

I’ve avoided discussing my self-harm even though I discuss mental illness online, as the idea of everyone knowing still scares me. I still feel weaker for it, prime for judgement. But I know how badly I needed to read something like this when I was struggling, and so I’ll write it in the hopes that someone can feel understood.

The Different Forms of Self Harm

We often make the mistake of only picturing the traditional cuts on the wrist when considering self-harm, given that this was the only way it was portrayed in the media. But self-harm can occur in numerous different forms, such as:

  • Cutting
  • Pinching & scratching
  • Starvation
  • Purging
  • Alcohol or drug abuse
  • Burning
  • Punching objects or the wall to induce pain

And there are probably countless more, people in a dark place can get cruelly creative. But another form of self-harm to consider is the self-harm of self-sabotage. Of making decisions and carrying out actions, you know will hurt you, and distance others. I’ve seen this in myself through refusing to let people care for me, and punishing those who did. I had a cycle of being romantically interested in people I knew were less interested in me so that after the deed was done, I’d be alone. Then I would be able to tell myself that was all I was worth that I was unloveable. Others do it by betraying those who care for them, in the hope it will leave them isolated and able to continue their streak of sabotage.

Why do people self-harm?

To people who don’t do it, self-harm can seem crazy and stupid. As humans, we evolved to focus on our survival, but then some people intentionally inflict pain upon themselves? But in reality, it’s not such an insane thought, haven’t we all let our fingers linger slightly too close to a flame?

Self-harm isn’t just a bid for attention. If you take nothing else from this article, please take this. Even if someone wants their self-harm to be noticed, it isn’t just about attention; they are not attention-seeking. Someone who goes to the lengths of hurting themselves to be noticed is clearly struggling and deserves compassion and to be helped. They deserve for their pain to be acknowledged as well.

People self-harm for a variety of reasons. But we need to look at the cause of self-harm in two separate ways, firstly the lifestyle cause, and then the emotional benefit they receive from it. As there is the reason they start, and the reason they continue.

Why start?

  1. The pressure at school or work.
  2. Money, family, relationship stressors.
  3. Low self-esteem.
  4. Depression, anxiety or other mental illnesses.
  5. Bereavement or grief.
  6. Bullying.

Sometimes there also isn't a concrete reason.

Why continue/what do they gain from it?

  1. To feel alive, to see that they’re real.
  2. Addictive nature.
  3. To punish yourself.
  4. To numb your emotional pain.
  5. To create a physical example of your emotional pain.
  6. For the visual sight of blood to ground you.
  7. To feel something.

The list could go on, as it is highly subjective and often isn’t just one reason. Many people that self-harm don’t even understand why they do it, simply that they do. Whatever the reason for someone’s self-harm, it should be respected and tackled as the serious issue it is.

It is harmful to consider self-harm as ‘just a teenager problem’, as many adults struggle with it too and this diminishes their experience. We need to remove the shame surrounding self-harm, as this isolates individuals and worsens their experience.

Does self-harm mean you are depressed?

Self-harm does not necessarily equate to depression; it should be considered as a separate struggle that can also be a part of depression. It consists of a deliberate act of self-injury or behaviour that intends to harm yourself. The most common form of self-harm is overdosing, followed by cutting, which shows that it isn’t always about depression; it could be addiction or another struggle.

Symptoms of depression include a loss of enjoyment and interest in things that you previously liked, a continuously lowered mood and fatigue. Someone may self-harm and not experience these things; they may be hurting themselves due to low self-esteem, to punish or numbness. It’s different, and we shouldn’t assume what it means to self-harm.

Even if self-harm is indicative of a mental illness, it might not be depression; it could be a different mental health issue, such as anxiety or a personality disorder.

The difference between self-harm and suicidal

I’d like to start by saying, I can imagine how scary self-harm is to those unfamiliar with it. And it should be, it is certainly not something to take lightly. But something important to keep in mind, for you and the individual doing it, is that self-harm does not necessarily equate to being suicidal. To many, it is like a coping mechanism to avoid the latter. It becomes a soothing addiction, like smoking or drinking to others. It still is not healthy and justified, but it does not mean they wish to end their life, simply that they are unhappy and troubled. I have had points of being suicidal and more prolonged periods of simply self-harming with no intention to die. They’re a different type of pain and a different state of mind. So if you believe or know someone is self-harming, do not panic and think this means they’re trying to kill themselves. It could be the case, but either way approach this calmly to ensure you can be effective in reaching out.

Self-harm should be taken seriously. It can cause long-lasting physical, emotional and mental damage. It further isolates an individual and becomes harder to stop. Self-harm can also later lead to suicidality. If you think someone if self-harming, read this post on how to approach the subject with them. Make sure to also check in with yourself, as this is a difficult thing to deal with.

This was probably a difficult piece to work through, so congratulations on making it to the end. Don’t leave here feeling low; leave here enlightened. Whether you are/have self-harmed, know someone who is, or have not been affected by this yet, you now are a step closer to opening the conversation. Self-harm is a challenging topic, but by discussing it, we begin to shed this taboo coat and allow suffering individuals the room to feel they are heard and understood. If you wish to discuss the topic further, never hesitate to get in touch. If you are struggling with self-harm thoughts or behaviour, remember you are not alone in this pain.




Welcome to Symptoms of Living! A place where I like to relieve myself of the barrage of thoughts and ideas filling my mind. Here I'll take a look at various topics, from books to BPD, series to self-harm, there's nothing that we can't, and shouldn't, talk about.

Having struggled with mental illness since the age of 15, one of the hardest parts was how alone I felt in it. While mental illness is beginning to be discussed more openly, and featured in the media, I still think there is room for improvement. So whether it is mental illness or merely mental health, a bad day or a bad year, let's make this a place to approach it and strip it back. Everyone has their own symptoms of living, and you certainly won't be the only one with it.

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