In westernized societies, self-harm is on the rise. Untreated mental health disorders such as depression, bipolar, and eating disorders can lead to unhealthy coping skills and a need for emotional release. In the United States, in one year, 1 in 5 females and 1 in 7 males will engage in self-harm behaviors .
60% of those who do participate in self-harm behaviors typically have a history of abuse and trauma, and most often experience sexual abuse. 90% of those who do self-harm started in their early tween and teenage years .
Self-injury is not considered a mental diagnosis, and no diagnosis can be found in the Diagnostic and Statistical Manual of Mental Disorders-V.
It is typically a symptom of further underlying issues and is a learned coping mechanism.
Typically those who engage in self-harm do so by cutting, burning, skin or wound picking, punching or hitting oneself, insert objects into their skin, purposely bruising or breaking one’s bones, and hair pulling .
When an individual decides to use self-injury, they do so to cope with internal emotions, numb oneself from feeling any emotion, look at it as a form of punishment, to belong socially, gain attention, or to feel or think about something different than what their current emotions and thoughts are.
What Self-Harm Does
Often self-harm behaviors are seen in those with eating disorders, especially bulimia nervosa. In a study that looked at inpatient eating disorder patients, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, and 60% had suicidal behavior . The researchers in the study found that self-harm and suicidality were connected.
Self-harm can be associated with a conscious, intentional and repeated self-harm act without suicidal intent .
Somatic symptoms within individuals who have eating disorders increase the self-harm behaviors as well as sex differences, compulsive behaviors, substance use and abuse.
Bulimia is a severe eating disorder, which is typically where an individual will binge on foods in a rapid fashion, at least three times per week or more.
Episodes of binging are followed by purging, which is self-induced, laxative or diuretic abuse, or over-exercising to rid the body of the food ingested. Low self-esteem, thoughts of becoming or being fat, and shame are typically emotions and feelings that accompany the behavior patterns.
Bulimia and Self-Harm
Many individuals who struggle with bulimia also have self-harm behaviors, substance abuse, and issues with impulsivity with risky actions, such as sexual behaviors, drinking or shoplifting, driving reckless, etc. .
- 1.0% of women and .01% of men will meet the criteria for bulimia at any given time 
- In 2007 an American study looked at almost 10,000 adults about various mental health issues, including eating disorders. The results showed that 1.5% of women and .05% of men had bulimia during their life .
If a person is using an eating disorder to cope with a past or current situation, and those behaviors begin to fail in helping manage, self-harm may be used as a new way to deal.
Typically when one behavior is being addressed, the other tends to increase in responses and symptomatology. Both behaviors are self-destructive and can act as an unhealthy way for a person to block out, or release intense feelings of shame, anger, guilt, sadness, etc. .
Self-harm and bulimia can also be a type of punishment for many as a way to express self-hatred toward oneself and body .
It can stem from past trauma or abuse, poor self-image or self-loathing. It can also be around punishing oneself for not being able to stick with an eating disordered routine or to provide relief from the restriction or patterns of the disorder.
Self-harm can be described as any behavior that causes harm or injury to someone as a way to deal with painful emotions . The United Kingdom has the highest rate of self-injury, second to the United States. It is estimated that 400 in 100,000 individuals self-harm within the UK .
Research states that self-injury occurs most frequently in adolescents and college age individuals. Teens reported self-injury is as high as 15% while college age is as high as 35% .
Signs and Symptoms
Signs and symptoms of someone who is struggling with self-harm are noticing frequent unexplained injuries to include cuts and burns. Observing the person struggles with low self-esteem, and has difficulty handling feelings or being able to express them verbally. Often they will have trouble with relationships and may be socially isolated.
Other signs include wearing long clothing, even when the weather does not call for it. They may struggle with work or school due to comorbid eating disorder symptoms.
Eating disorder signs and symptoms can include consuming large amounts of food in secret, but noticing food is missing. Other signs and symptoms are going to the bathroom after meals or snacks.
Detecting a puffy throat, face, and red or bloodshot eyes due to purging. Those with eating disorders may become socially isolated due to low self-esteem and poor body-image.
In both disorders, you may notice irritability, mood swings, tiredness or fatigue, and likes to be alone more often than not. Being able to seek professional help is essential when working to treat bulimia and self-harm.
It is about learning new coping skills, being able to push off urges when they strike, and building a support system of individuals who can support you through the recovery process.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
 Gluck, S. (n.d.). Self Injury, Self Harm Statistics and Facts – Self Injury – Abuse. Retrieved August 19, 2017, from https://www.healthyplace.com/abuse/self-injury/self-injury-self-harm-statistics-and-facts/
 Koutek, J., Kocourkova, J., & Dudova, I. (2016). Suicidal behavior and self-harm in girls with eating disorders. Retrieved August 19, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833374/
 Overview and Statistics. (n.d.). Retrieved August 19, 2017, from https://www.nationaleatingdisorders.org/bulimia-nervosa
 Emergency Help. (n.d.). Retrieved August 24, 2017, from https://www.selfharm.co.uk/get/facts/self-harm-and-eating-disorders
 Self-harm. (2016, March 01). Retrieved August 24, 2017, from https://www.mentalhealth.org.uk/a-to-z/s/self-harm
 Self-injury (Cutting, Self-Harm or Self-Mutilation). (2016, August 17). Retrieved August 24, 2017, from http://www.mentalhealthamerica.net/self-injury
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on November 13, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 13, 2017.
Published on EatingDisorderHope.com