Young Adults’ Experiences of Depression in the U.S.

Depression and self-harming

Self-harm is defined as intentionally directly injuring one’s body surface, usually without intention* of suicide. Self-harm occurs relatively commonly, with some studies showing that up to 13-23% of people have engaged in this behavior in their lifetime. Self-harm is most common in adolescents and young adults, but can occur in people from other age groups. Those who engage in these activities may have depression, other mental health disorders such as anxiety, or no clinical diagnosis. Some of the young adults we interviewed in this study described self-harm activities as part of their experience of depression. 

Why people self-harm

There were several reasons why people said they self-harm. Of the people we interviewed, one group of young adults started injuring themselves as a way to manage intense emotions. Ryan describes: “I started feeling hopeless again and a lot more depressed than I had in my entire life. And I became very self-destructive. I started doing things like hitting myself and I really didn’t realize why I was doing it.” Crystal, who experienced abuse as a childhood, began to associate pain with emotions that she could not name.
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Another group of young adults described engaging in self-harm because pain was something they could feel in the midst of the “flat emotions” that often go along with depression.
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Other young adults described turning to self-harm to deal with a specific intense emotion or negative core belief. Devin describes feeling “like he was not good enough for his parents”. Here, Sierra Rose describes learning about cutting from an acquaintance and trying it as a way to deal with the anger she was feeling.
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(For more information about relationships, see ‘Depression and relationships’).

The addictive nature of self-harming behavior

Because self-harm can provide a temporary reprieve from disagreeable emotions it can often lead to cravings to engage in more self-harm and difficulty stopping*1. Sierra Rose describes that her “cutting is just as addictive as alcohol” and she has relapses. Similarly, Ryan describes that despite telling himself “I don’t want to do this...it just got worse”.

Self-harm as a sign of the seriousness of depression

For many people in our study self harming was a sign of the seriousness of their depression. Teddy describes “I kind of slipped back into my depression it got really, really bad to the point where I started cutting.” Sometimes self harm prompted a person to seek help or others to seek out help for that person. Many people said a family member or friend noticed signs of self-harming such as the cuts on their skin and became concerned. People we interviewed also thought that sometimes parents blamed themselves for the self-harm. Kate describes that once she realized this was hurting her father she “decided at that point she wanted to stop”. Other people described however that their parents thought “it was a phase” or did not know how to respond to this behavior.
Treatment for self-harm

Certain kinds of therapy and medication can help self-harm*2. Crystal identified the origins of her self-harm behavior through therapy: “to replace the abuse that I had before, I abused myself”. Mara felt her self-harm was rooted in something deeper than the desire to express her emotions, and said medication helped her in addition to “going to regular therapy and having someone to talk to”.

For more about treatment for depression, see ‘Therapy and counseling’ or ‘Depression, medication and treatment choices’.

References
*Jacobson, Colleen M., and Madelyn Gould. "The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature." Archives of Suicide Research 11.2 (2007): 129-147. 

*1Victor, Sarah Elizabeth, Catherine Rose Glenn, and Elisha David Klonsky. "Is non-suicidal self-injury an “addiction”? A comparison of craving in substance use and non-suicidal self-injury." Psychiatry research 197.1 (2012): 73-77. 

*2 Hawton, K., et al. "Psychosocial and pharmacological treatments for deliberate self harm." Cochrane Database of Systematic Reviews 3 (1999). 

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