7 Psychiatric Conditions Linked to Self-Harm and Suicide

What makes a mental health condition more perilous than others? Consequences of some disorders can include the danger of self-harm or suicide. And it is more common than you might imagine. According to the National Institute of Mental Health, 20% of adults in the U.S. have a psychiatric disorder of some type. This means almost 53 million Americans are struggling with mental health issues that have a wide array of symptoms ranging from mild to severe that may include self-injury. Could you or a loved one be at risk?

How Self-Harm Differs from Suicide

When a person deliberately hurts the surface of their body without intending to cause a lethal injury, it is referred to as self-harm or non-suicidal self-injury (NSSI). Repeatedly cutting, burning, biting, carving, and scratching the skin or hitting oneself are common forms of NSSI. Although these are maladaptive coping mechanisms, such behaviors can temporarily provide a sense of relief from stress, painful memories, and difficult emotions—or even give someone a sense of control when faced with uncertain circumstances. For some people, it may also be a way to express suicidal thoughts in order to avert the possibility of acting on them.

Unfortunately, the symptoms of some mental health disorders can feel intolerable to those suffering from them and suicide might feel like the only way out. In 2019, the CDC reported that suicide was the 10th leading cause of death in the U.S., and for individuals between the ages of 10 and 34, it was the 2nd highest cause of mortality. Research has also found that people who engage in NSSI are at a much higher risk for suicide compared with the general population.

7 Psychiatric Disorders Most at Risk for Self-Harm and/or Suicide

The potential for severe symptoms in some mental health conditions makes those who are struggling with them more vulnerable to engaging in some form of self-harm—or worse. While not an exhaustive list, here are 7 of the most common disorders that have an increased risk for these behaviors:

1. Bipolar Disorder

Approximately half of the people with bipolar disorder engage in NSSI at least once in their life, according to a study published in the Journal of Nervous and Mental Disease. Because symptoms in this condition can be very severe, the lifetime risk for suicidal gestures is believed to be about 20 to 30 times greater for those who have it; 5-6% will intentionally end their life. Females with bipolar disorder tend to make more suicide attempts, but males are more likely to have fatal results. While there are a number of factors that influence suicidality in this condition, research has found that the most prominent one is a depressed mood state—which, in bipolar disorder, can be debilitating.

2. Borderline Personality Disorder

Characterized by impulsivity and instability in many areas of life, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5TR) also includes repeated self-harming behavior as well as suicidal thoughts, threats, and attempts as one of the criteria for a diagnosis of this condition. Repeated incidents of NSSI are common in borderline personality disorder and may be used to help manage the intense emotions they experience, offset feelings of unhappiness, or cope with distress. Self-harm may also occur during dissociative states. Suicidal behavior is prevalent too. While some threats may be attempts to avoid abandonment or for other manipulative purposes, the risk of completed suicide for those with borderline personality is as high as 6%.

3. Depression

The previously referenced research from the Journal of Nervous and Mental Disease also found that 37% of people with unipolar depression (as opposed to bipolar depression) had engaged in NSSI at least once. What’s even more concerning, however, is that some of the symptoms inherent in this disorder—especially hopelessness and an inability to experience joy or pleasure in their life—are known to increase the chances of making a suicide attempt. Overall, people suffering from major depression have a 17-fold greater risk of taking their own life.

4. Early Trauma

Individuals with adverse childhood experiences (ACEs) often develop serious mental health problems as a consequence of having endured emotional, physical, and/or sexual abuse, neglect, domestic violence, parental substance abuse, mental illness, incarceration, or other traumas while growing up. A study published in the International Journal of Environmental Research and Public Health found that individuals with 4 or more ACEs were more likely to repeatedly engage in NSSI and had a 12-times greater risk of committing suicide.

5. Eating Disorders

Self-harming behaviors often accompany this group of psychiatric conditions—especially anorexia and bulimia—which most frequently affect adolescents. A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. According to the DSM-5TR, 25-33% of people with bulimia struggle with suicidal thoughts and attempts, while suicide is the second leading cause of death for those suffering from anorexia.

6. Schizophrenia

Self-harm is not unusual for people who have this severe mental illness. In fact, researchers studying NSSI in those with schizophrenia found that when they had a co-occurring substance use disorder (mostly cannabis), the prevalence of self-harm was 43.6%. Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. Sometimes the decision to do so is the result of delusions or demands that come from their hallucinations. There is a high lifetime risk for suicide in schizophrenia and 5-6% of people with this condition will intentionally end their life.

7. Substance Abuse/Alcohol Use Disorders:

Addictions are often linked to untreated mental health problems, including all the ones listed above. Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms. Even outside the presence of addiction, it is well-established that alcohol and illicit drugs diminish a person’s judgment and impulse control, which can increase the possibility that an act of intentional self-harm will accidentally cause a fatal injury.

Furthermore, disinhibition combined with the intensity of painful emotions can elevate the chance of someone becoming suicidal. Research that examined the suicide risk in people with alcohol and opiate use disorders found that at the time they took their own life, 22% had used alcohol, 20% had used opioids, and 10.2% had used marijuana.

Co-Occurring Mental Health Problems are Common

Many people who struggle with these conditions have more than one type of mental illness, thus increasing the risk for self-harm and suicide. For example, about 50% of those with bipolar disorder also have alcohol use disorder, which can significantly worsen symptoms, especially during a depressed or psychotic state. And many people with borderline personality have co-occurring depression or bipolar disorder, substance abuse, an eating disorder, or other mental health conditions.

These complex problems illustrate the critical importance of getting correctly diagnosed and receiving effective treatment as soon as possible to help stop the consequences of self-harming behaviors and offset the potential for a tragic ending.

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PLEASE NOTE: If you observe evidence of self-harm on a loved one (i.e. otherwise unexplainable scars, cuts, and bruises), talk with them about what is going on in their life—without judging or shaming—and encourage them to accept the need for professional help.

If you notice someone making statements about not wanting to be alive, it is a cry for help and should be taken seriously. Or, if a loved one is giving away their belongings, finalizing business matters, or purchasing a weapon or other lethal means, consider it an urgent situation that needs to be addressed immediately by a mental health professional. Call 911 or take the person to the nearest emergency room if you believe they are in crisis.

If you have concerns for yourself or someone you know, put the National Suicide Prevention Lifeline numbers in your phone directory: 800-273-8255 and 988. It is staffed 24/7 by trained counselors who provide compassionate and knowledgeable support as well as connections to helpful resources.

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Bipolar disorder, depression, alcohol or substance abuse problems and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

***AMEN CLINICS DOES NOT PROVIDE CRISIS SERVICES***