Self-Harm and Mental Health: Is It Dissociation or Something More?

Q: Self-Harm and Mental Health: Is It Dissociation or Something More?

Hello, Huiwu： Self-harm is often associated with depression, high stress, and difficulty in coping with irritability. <br>In your description, you mentioned symptoms such as depression, anxiety, and dissociation, along with a background that has experienced considerable stress. <

What is happening to me? Is it dissociation? Thought disorder? Am I just overthinking?

Since last November, I have been experiencing self-harm behaviors that have become increasingly intense and deeper.
Self-harm provides me with a sense of calm and a feeling of clarity, and I find it difficult to stop.
I engage in self-harm about four to five times a week.
Additionally, I often have impulses to engage in dangerous behaviors at night, such as breaking things or harming others.

I have researched related information online and was surprised to find that I exhibit symptoms consistent with autonomic nervous system dysregulation and psychotic disorders.
I frequently feel anxious in crowded situations or under stress, experiencing difficulty breathing.
However, I often feel mentally foggy and my thoughts drift away.
At night, I tend to ruminate, especially on negative thoughts.
Sometimes, while walking, I feel a sense of unreality.

My family situation is that of a single-parent household, and my family has high expectations of me.
I often experience emotional instability, and even minor mistakes can lead to harsh criticism, which deeply hurts me and causes significant emotional pain.
I would like to ask the doctor what might be happening to me.

Chen Huiwu, 10~19 year old female. Ask Date: 2024/03/22

Dr. Liang Sunyuan reply Psychiatry

Hello, Huiwu: Self-harm is often associated with depression, high stress, and difficulty in coping with irritability.
In your description, you mentioned symptoms such as depression, anxiety, and dissociation, along with a background that has experienced considerable stress.
Your personal traits make you sensitive to criticism.
You may recognize that writing this letter could be the beginning of change.
It is advisable to seek professional help and discuss treatment options in person.
Additionally, I recommend developing healthy lifestyle habits, such as maintaining a regular routine, having a balanced diet, exercising regularly, and making friends.
By taking a multifaceted approach, you can gradually become the person you aspire to be.

Reply Date: 2024/03/22

More Info

It sounds like you are experiencing a complex interplay of emotions and behaviors that are deeply affecting your mental health. Self-harm, as you described, is often a coping mechanism for emotional distress. It can provide a temporary sense of relief or clarity, but it is crucial to understand that it is not a healthy or sustainable way to manage overwhelming feelings. The fact that you are engaging in self-harm multiple times a week indicates that you are in a state of significant emotional turmoil.

Your mention of feeling detached or dissociated, especially in stressful situations or when surrounded by people, is also concerning. Dissociation can manifest as a feeling of being disconnected from oneself or one’s surroundings, and it often occurs as a response to trauma or extreme stress. Given your background of high expectations and emotional instability within your family, it is understandable that you might be feeling overwhelmed.

The symptoms you describe, including anxiety, difficulty breathing, and negative thoughts, suggest that you may be dealing with anxiety disorders or even depressive symptoms. The pressure you feel from your family, combined with your own expectations, can create a cycle of stress that exacerbates these feelings. It’s important to recognize that these experiences are valid and that seeking help is a strong and positive step.

Here are a few recommendations based on your situation:
1. Seek Professional Help: It is crucial to consult with a mental health professional who can provide a safe space for you to express your feelings and experiences. A therapist can help you explore the underlying issues contributing to your self-harm and develop healthier coping strategies. Cognitive Behavioral Therapy (CBT) is often effective for addressing negative thought patterns and behaviors.

2. Establish a Support System: While it may feel challenging, try to reach out to trusted friends or family members who can provide emotional support. Sharing your feelings with someone who understands can alleviate some of the burdens you carry.

3. Develop Coping Strategies: Work with a therapist to identify healthier coping mechanisms. This could include mindfulness practices, journaling, or engaging in creative outlets like art or music, which can serve as a form of expression and release.

4. Educate Yourself: Understanding more about mental health, self-harm, and anxiety can empower you. Knowledge can help demystify your experiences and reduce feelings of isolation.

5. Consider Medication: If your symptoms are severe, a psychiatrist may recommend medication to help manage anxiety or depressive symptoms. This can be an important part of a comprehensive treatment plan.

6. Practice Self-Compassion: Be gentle with yourself. Recognize that you are going through a difficult time, and it’s okay to seek help. Self-criticism can exacerbate feelings of worthlessness and despair.

7. Emergency Support: If you ever feel like you might harm yourself or others, it is essential to seek immediate help. Contact a crisis hotline or go to the nearest emergency room.

In conclusion, your experiences are significant, and it is essential to address them with the help of professionals who can guide you through this challenging time. Remember, you are not alone, and there are people and resources available to support you on your journey to healing.

Similar Q&A

Understanding Self-Harm and Mental Health: Is It a Disorder?

I have been suffering from severe depression, and throughout three years of treatment, my emotions have fluctuated repeatedly. Currently, I feel that my depression is not as severe, yet I also hope that it will never completely go away. When I am anxious, I tend to bite my arms, ...

Dr. Wu Enliang reply Psychiatry
If online interactions are causing significant disruptions in your life, it is indeed a form of illness. It is advisable to continue collaborating with your physician and psychologist to receive the necessary treatment. Dr. Wu En-Liang

Understanding Self-Harm: Seeking Help for Emotional Distress

Hello Doctor, I have been feeling very down lately. When I get angry, I tend to scratch my hands, feet, and face with my nails, hit walls, pull my hair, and binge eat. After these actions, I feel terrible about myself. I also struggle with insomnia and often have nightmares. Ever...

Dr. Wu Enliang reply Psychiatry
Hello: It is recommended to use a mood thermometer (link below, and there is also an app available for download) to assess your emotional state over the past week. If your score is above 10, it is advisable to seek help. If it exceeds 15, it is definitely time to consult a psychi...

Understanding Relapses in Depression and Anxiety: A Personal Journey

A few months ago, I started experiencing emotional decline due to interpersonal and family issues, as well as academic problems, which led to self-harm. I sought help from a mental health specialist and was diagnosed with depression. Consequently, I decided to transfer schools, m...

Dr. Yan Congyou reply Psychiatry
Dear Lili, Based on your description, it appears to be a complex situation that requires a definitive diagnosis and a discussion of treatment options such as medication, psychotherapy, or family therapy. I would recommend that you establish a regular and stable follow-up with a ...

Understanding Self-Harm and Emotional Outbursts: The Impact of Family Dynamics

During middle school, when conflicts arose with family or friends, I would self-harm in my room using a utility knife, especially when I was extremely angry. I would cry while self-harming. Later, in high school, I stopped using the utility knife for self-harm, but I began smokin...

Dr. Liu Runqian reply Psychiatry
Based on what you mentioned, your impulse control is poor, and your emotions are often unstable. Many psychiatric diagnoses may present with such symptoms, including depression, bipolar disorder, and certain personality disorders such as borderline personality disorder. The cause...