Last Updated:

May 28th, 2025

Self-Harm and Addiction | Signs and Support Options

What is self-harming?

Self-harming refers to the act of deliberately causing physical pain or injury to oneself as a way of coping with emotional distress. It is not typically an attempt to end one’s life but rather a way to release overwhelming feelings, regain a sense of control or distract from emotional pain.

While it can sometimes be linked to suicidal thoughts, self-harm is distinct from suicidal behaviour because the intention is usually to manage emotions rather than a want to die.

There are different types of self-harming behaviours, and they can vary from person to person. Some of the most common forms include:

  • Cutting or scratching: Using sharp objects to create wounds on the skin, often on the arms, legs or torso.
  • Burning: Applying heat, such as matches, lighters or hot objects, to the skin.
  • Hitting or punching: Physically striking oneself or hitting walls and objects to cause bruising.
  • Hair pulling (Trichotillomania): Repetitively pulling out hair from the scalp, eyelashes or eyebrows.
  • Interfering with wound healing: Reopening or picking at wounds to prolong pain and injury.
  • Substance-related self-harm: Using alcohol or drugs in a way that deliberately causes harm rather than seeking pleasure or escapism.

The key difference between self-harm and suicidal behaviour is intention. Someone who self-harms is typically seeking temporary relief from emotional pain, whereas suicidal behaviour is driven by a desire to end one’s life.

suicidal-behaviour-hand-injuries

Why would someone want to self-harm?

There is no single reason why someone might engage in self-harm, just as there is no specific thought process or behaviour that guarantees a person will self-harm. It’s a deeply personal and complex experience influenced by various factors.

Below, we take a look at some of these potential factors.

To release emotional pain
For some, self-harm provides an outlet for overwhelming emotions. When distress feels too intense or difficult to express, physical pain can serve as a temporary release. However, this relief is often short-lived and can lead to a harmful cycle.
To regain a sense of control
In times of uncertainty, self-harm can feel like a way to regain control. Choosing when and how to cause harm may create an illusion of control, even if the behaviour ultimately leads to more distress.
To numb or distract from emotional pain
Physical pain can serve as a temporary escape from emotional suffering. For some, it may overshadow feelings of grief, trauma or loneliness, offering momentary relief from distressing thoughts.
As a response to self-hatred or guilt
Low self-worth and guilt can contribute to self-harm. A person may feel they deserve pain, using self-harm as a form of punishment, reinforcing negative beliefs about themselves.

Are there links between self-harm and addiction?

There is strong evidence linking self-harm and addiction, with research showing that those who engage in self-harm are at a higher risk of developing substance use disorders. The relationship is particularly noticeable in adolescence when self-harm and substance use often co-occur.

One of the most extensive and long-running studies to examine this link is a 15-year prospective cohort study conducted in Victoria, Australia.

Tracking 1,943 adolescents from the age of 15.9 to 29.1, researchers found that adolescents who engaged in self-harm were more than three times more likely to use substances. By young adulthood, they were also four times more likely to develop multiple substance dependence syndromes. Even after adjusting for anxiety and depression, the connection remained strong, highlighting self-harm as a potential independent risk factor for addiction.

These findings suggest that self-harm in adolescence may serve as a key warning sign for future substance use disorders, underscoring the importance of early intervention.

What are the warning signs of co-occurring self-harm and addiction?

Many self-harming behaviours happen in private, making them difficult to recognise. Even when there are visible marks, they are often explained away as accidental injuries. Addiction can also be hidden, with some people managing to conceal the extent of their substance use. Because both issues can be kept secret, it is not always obvious when someone is struggling.

However, certain emotional, behavioural and physical signs may indicate a deeper problem.

Unexplained injuries and frequent accidents
Repeated cuts, burns or bruises, especially in areas that can be easily hidden, may suggest self-harm. It may be a warning sign if someone frequently has injuries with unclear explanations.
Wearing concealing clothing despite warm weather
Long sleeves or trousers in hot weather can indicate an attempt to hide scars or fresh wounds. A sudden and persistent change in wardrobe may be worth noting.
Emotional instability and erratic behaviour
Sudden mood shifts, irritability or seeming overwhelmed can indicate distress. Self-harm and addiction often develop as coping mechanisms for deeper emotional struggles.
Social withdrawal and avoidance of loved ones
People may distance themselves from friends and family, avoid social interactions or become more secretive about their daily lives.
Increased secrecy and defensiveness
Becoming unusually private, avoiding discussions or reacting angrily to questions may suggest someone is struggling and trying to keep it hidden.

Spotting these signs is not always easy, but if you suspect someone is in distress, letting them know they are not alone and encouraging professional support can be the first steps toward recovery.

How are self-harm and addiction treated at a rehab centre?

 

Rehab centres provide vital support for those facing both addiction and self-harm, but self-harming behaviours often need to be managed before beginning addiction treatment. This ensures that the recovery process isn’t disrupted. Seeking support from a mental health specialist beforehand can help stabilise self-harming tendencies, making addiction treatment more effective.

Once self-harm is under control, the first stage of rehab usually involves detox, allowing the body to clear substances in a safe environment.

From there, therapy becomes the core focus, addressing addiction and its root causes. Many rehab programmes include cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT), which help individuals manage distressing emotions and break harmful cycles. These therapies can be just as beneficial for self-harm recovery as they are for addiction.

woman-asking-help-self-harm

Aftercare is the last step of most rehab programmes and is crucial in maintaining progress and providing continued guidance and a support system after leaving rehab.

What are the next steps?

If you or a loved one are struggling with self-harm and addiction, Addiction Helper can provide the guidance and support you need. Our team is available to offer confidential advice and connect you with the right treatment options. Reach out today and take the first step toward a healthier, safer future. Call us now for help.

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Our compassionate team are ready and available to take your call, and guide you towards lasting the lasting addiction recovery you deserve.

Frequently Asked Questions

How does self-harm lead to addiction?
Self-harm can create a cycle of emotional distress that some try to escape through substance use. Over time, reliance on drugs or alcohol to cope can develop into an addiction.
Can addiction worsen self-harming behaviours?
Yes, addiction can intensify self-harming behaviours by lowering inhibitions and increasing emotional instability. Substances may amplify feelings of guilt or distress, making self-harm more frequent or severe.
Are there treatments for self-harm and addiction?
Yes, therapy-based treatments like CBT and DBT address both self-harm and addiction. Rehab programmes provide structured support, helping individuals develop healthier coping mechanisms for emotional distress and substance dependence.

(Click here to see works cited)

    • Moran P, Coffey C, Romaniuk H, Degenhardt L, Borschmann R, Patton GC. Substance use in adulthood following adolescent self-harm: a population-based cohort study. Acta Psychiatr Scand. 2015 Jan;131(1):61-8. doi: 10.1111/acps.12306. Epub 2014 Jun 23. PMID: 24954250; PMCID: PMC4293154.