Self-harm, the distressing way to escape emotional pain

The life of the third-year university student in Hanoi changed drastically when she had to stop her studies. Sleeping only three to four hours each night, she felt mentally disconnected from her newborn child, unable to provide care or affection.

She was overwhelmed by physical exhaustion and mental frustration each time the baby cried. For months after delivery she stayed at home, and became obsessed with being a "perfect" mother, convinced her worth depended on it.

"I felt like caring for my child was my only purpose, and I had to do it perfectly," she told Dr. Tran Thi Hong Thu, deputy director of the Mai Huong Daytime Psychiatric Hospital in Hanoi, when she went for therapy in September.

When her baby did not gain weight or fell ill, or even vomited, Hong spiraled into self-blame, feeling incapable of caring for her child. A recent visit to her in-laws' exacerbated her distress after they and their neighbors criticized the baby’s slow development and her cooking skills. Another aggravating factor was her husband’s constant criticism.

The stress of childcare and haunted by the constantly imagined sound of her baby crying, she resorted to self-harm. "I cried, scratched, hit, and slapped myself to feel better," she admits.

Phuong Nhi’s mother found razor blades and matches on her desk but did not realize the 14-year-old had been harming herself until she saw scars on her body. "I was too careless; I regret not treating my daughter better," her mother tearfully told Dr Thu.

The family first noticed a change in Nhi’s behavior a year earlier when her grades started slipping. Constantly scolded and deprived of free time, she was forced to study until midnight under strict supervision. In response, she began self-harming, hiding her injuries with long sleeves. By the time she was admitted to the hospital, her wrists had 14 cuts, some fresh, others already healing.

She described her life as "incredibly suffocating, doing nothing except burying myself in books, unable to find any meaning in life." Mentally unstable, she used razor blades to cut her arms or pressed hot matches onto her skin to relieve emotional pain. "It did not hurt; it gave me a sense of calm."

Both Hong and Nhi were diagnosed with depression and self-harm disorder and are now undergoing therapy and medication.

A depressing woman. Illustration by Pexels

Self-harm disorder is a condition where individuals intentionally cause physical and emotional harm to themselves to achieve a sense of relief and reduce their suffering and stress. Dr Thu explained that self-harm is often linked to anxiety or depression. Common behaviors include cutting, scratching, burning, or hitting oneself.

Young people who lack the emotional experience to cope with their feelings are the most susceptible, and often turn to self-harm as a way to escape or release emotions. Without proper care and treatment, self-harm carries significant risks and complications.

The prognosis for self-injury varies depending on the individual’s emotional and psychological state. Identifying the factors that drive someone to self-harm and addressing possible pre-existing personality disorders are crucial in its treatment.

Although self-harm is not typically intended as a suicidal act, its repetitive nature can worsen existing mental health issues and increase the risk of suicide. Ongoing emotional instability, stress, and anger can lead to difficulties in daily life and strained relationships.

The disorder can also, later in life, cause psychological issues such as borderline personality disorder, depression and anxiety. Many turn to substance abuse to cope, increasing the risk of criminal behavior. The best way to address self-harm is to share one’s emotions with loved ones and seek support from those around you.

Dr. Thu said since this is a common psychological disorder, particularly among adolescents and young people, changing the educational approach and paying closer attention to children’s emotions and thoughts are essential for effectively preventing and treating the condition.