Self-harm is the co-occurring elephant in the room. It is happening (at a rate higher than you think) and yet no one wants to talk about it. It is often ruled as an exclusionary criteria during the admissions process at rehab so clients lie about it and it goes on unabated. But March is self-harm awareness month and we’re going to shine a light on this struggle that affects nearly 1 in every 5 young people.
Many people who seek treatment for substance abuse also have a history of self-harm. The two are deeply connected. But here’s the good news: help exists, and with the right kind of treatment, healing is possible.
Why Do Self-Harm & Addiction Coexist?
Taken at a glance, it would be easy to assume that self-harm and addiction exist on opposite ends of the behavioral health spectrum. But the reality is that they share a lot of common ground. Both revolve around external behaviors to cope with overwhelming internal emotional pain and both offer temporary relief—even if they come with long-term consequences. Much like addiction, self-harm can become a compulsive behavior. Over time, the brain craves more—more intensity, more frequency—to achieve the same relief, making both behaviors progressively worse.
The stigma around self-harm makes it difficult for people to feel comfortable asking for help. The secrecy only deepens feelings of shame and loneliness, which fuels the behaviors even more. Self-harm and substance use both trigger the release of endorphins and dopamine, providing a temporary feeling of relief or euphoria. Over time, this reinforces the behavior, making it difficult to stop without addressing the underlying neurobiological drivers. Many individuals who struggle with both self-harm and addiction have experienced trauma, such as physical or sexual abuse, neglect, or significant loss. Trauma-informed care is essential in addressing both of these issues in treatment.
The Different Forms of Self-Harm
Self-harm isn’t always as visible as people assume. It goes beyond cutting and can take many forms, including burning, hitting or biting, scratching, hair pulling, interfering with wound healing, extreme risk-taking behaviors, and using substance abuse as a form of self-harm. These behaviors all serve as maladaptive coping mechanisms that require comprehensive intervention.
What Does Effective Treatment Look Like?
Trauma-Informed Therapy
Many people who self-harm have experienced trauma, whether it’s from childhood, relationships, or life events. Trauma-informed therapy (like EMDR or somatic experiencing) helps people process these experiences safely, without resorting to self-harm or substance use.
Dialectical Behavior Therapy (DBT)
DBT is one of the most effective approaches for treating both addiction and self-harm. It teaches emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness—helping people learn healthier ways to cope and build stronger relationships.
Medical & Psychiatric Support
Since self-harm and addiction often stem from underlying mental health conditions, psychiatric care is a critical piece of treatment. Medications for depression, anxiety, or mood disorders can help stabilize emotions and reduce the urge to self-harm. This, combined with therapy, offers a comprehensive approach to healing.
Group Therapy & Peer Support
Being around others who get it is a game-changer. In residential treatment, group therapy creates a space where people can share their experiences, gain support, and learn from one another. Feeling seen and understood can be incredibly healing. Peer support also helps individuals build accountability and reinforce positive coping strategies.
Building New Coping Skills
From art therapy to yoga to adventure-based therapies, residential treatment helps people discover new ways to express and process emotions. Learning these skills is crucial for preventing relapse and building a fulfilling life in recovery.
What Families Need to Know
This isn’t about attention-seeking. Self-harm is often misunderstood as a plea for attention, but it’s actually a way of coping with deep emotional pain. Recovery is a process. There’s no quick fix, but with the right support, healing happens. You play a role in recovery. Educating yourself, offering support, and setting healthy boundaries can make a huge difference. Avoid judgment and criticism. Shaming a loved one for their self-harm or substance use can push them further into secrecy and despair.
Taking the First Step Toward Healing
You don’t have to keep living in the cycle of self-destruction. Recovery is possible, and it starts with reaching out. If you’re considering treatment, take that first step today. Healing is hard, but staying stuck is harder. You deserve better—and real help is waiting.
