Self Harm - Is It Necessarily Depression?


I have recently - 3 months ago - been diagnosed with a mental health issue (social anxiety disorder) that I have actually been dealing with for around 6 years, but recently, I was so affected by this issue that I felt no option but to find some sense of relief in self harm

I am both extremely symoathetic and empathetic with anyone struggling with depression, and would never want to undermine the struggle of it in any way, so when I ask this question it's not in any way to trivialise depression. However, does this mean that I'm probably dealing with something more than the anxiety, which could be depression? My initial instinct is to say it's just a by-product of the anxiety, but if it was genuinely apparent that depression could be a possibility, I don't want to let it fester

I want to ask your views as I've seen from many posts that a lot of you are keen to share experiences and advice

Many thanks in advance



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11 Replies

  • Anxiety and depression are often closely linked - though the mechanisms for both aren't well understood ... yet.

    I'm not an expert on self harm (far from it) but I get the impression that it isn't necessarily about anxiety or depression - sometimes it can be about anger or some other strong emotion.

    The best thing to do would be to go and see your GP and talk things through with them. Try booking a double appointment so it isn't so much of a rush - write down what you want to say before hand - not necessarily as a speech but the bullet points so you don't forget anything - and if there is someone you trust that could go along with you then that would be a good idea though this may be something that you aren't yet comfortable talking to other people about and that is fine ... but please do talk about your concerns to your GP, or your counsellor if you are seeing a counsellor.

    There are also support groups out there that might be able to help you with understanding what is going on.

  • Now that you mention it, I do think it's possible that it stems from another emotion/ thing entirely.

    Having social anxiety, it's even difficult to phone and book an appointment and then actually go to an appointment with my doctor, so I might have to set a goal to be able to do that. I just last week started to see a counsellor whilst I'm on the waiting list for individual CBT so hopefully I may manage to bring it up with her

    Thank you for your reply & help

  • Hope you do manage to raise things with your counsellor. I know it is really difficult but it is their job to help you. Also, please hold on to the thought that they have a duty of confidentiality to you. Its a professional ethic and although there are circumstances in which they might be able to break that confidence they are extreme conditions eg if they felt there was an immediate threat to life and it really doesn't sound as if you are in that situation.

    On the whole I think it is better to focus on learning strategies for where you are now than to spend a lot of time wondering how you got here. I'm not saying that it isn't important to understand triggers but you have to deal with where you are now. Understanding what happened can help you with recognising triggers and that is useful in helping you to deal with and get back from where you are now.

    From times when I have accidentally cut myself my experience is that there are chemicals that get released when the body suffers a trauma. For me I go into a state of shock where on one level my senses are heightened and I can think straight and focus on getting away from the immediate trauma and other things recede into the background. I don't necessarily notice that I am bleeding but all those responses kick in. I think this phenomenon is something that is key in self-harm - it's like a bit of a natural high but as you say, it isn't a healthy strategy because there are a lot of other risks associated with it. Alcohol is a similar trap like other forms of 'self-medication'. It's dealing with the symptoms rather than find a way of really dealing with the situation.

    It's fine to find ringing the doctor really stressful - I don't have social anxiety but I wouldn't like to say that it isn't a stress-free prospect for me either.

    Hope you start to get over some elements of your social anxiety soon. Glad that posting here has given you a bit of release as well.

  • Headllo

    Generally it could be depression, although other problems will cause this like a bad relationship or enjoying the pain .

    Anxiety possibly can cause it

    So with this I would make an appointment with the GP and discuss why you need to do this Make a list before you go.

    Have an extended appointment, this will give you time to explain why you do this to yourself.

    On most occasions you could be seen by a CPN who will talk over this problem you have, the reasons can be complicated

    All the best


  • Hi

    I would think you perhaps carry a lot of pain with you which may stem from the social anxiety or may relate to the causes of that anxiety, and that self-harm is a way of letting out some of the pain by giving it some kind of understandable meaning, for example - I am hurting because I have cut myself with a razor blade - which may feel better than simply not knowing why you hurt. You don't say when the social anxiety began but if you have been anxious throughout your life then it may be that you cannot recall why you are anxious because the experiences which initially caused you to feel so anxious when relating to others were early in your life. I wonder whether you can recall ever not having social anxiety? Understanding where the feelings come from - ie WHY you are anxious - will not remove the anxiety entirely immediately but will enable you to become more in control of it because it will be understandable in terms of the past, as a result you will be able to think about that and find you can gradually overcome it. You amy ALSO be depressed, it is possible that the anxiety is masking an underlying depression and certainly if you feel the anxiety goes back to childhood then it is likely that while letting go of the anxiety you may become depressed as you come to understand the original causes. Do write more on the website if you feel able to, we may be able to help you to understand why you experience such a high level of anxiety that the idea of seeing the GP makes you so very anxious.


  • I remember distinctively dealing with it for around 6 years, since I was 13 - I'm almost 19 now. It often happens in a situation where I'm so worked up about a social occasion, or simply just having to go to university - even to the shop - that in order to calm down, I need the release of self harm. I've been fortunate enough never to have a panic attack, but when I've self harmed, it feels like I'm so close to that extreme situation, and I find a great release by doing it (I realise this is completely unhealthy behaviour and it needs to stop)

    I don't actually remember how all of my anxiety started. I wrote down a list recently of events or situations that made me feel extremely belittled socially, and I think combined, all of this has just effectively made me hate myself & believe that everyone else will feel the same. The worry with a doctors appointment first comes will calling to make the appointment, which takes a long time to get the courage to do, and then waiting the week or so for the appointment, I cannot stop thinking about it - wondering whether I should cancel, if I can deal with going. When I initially went to the doctors in early September of this year, I was absolutely terrified. So much so that I was shaking & could barely speak whilst explaining the issue to my GP... I was genuinely fighting back tears

    Around 3 or 4 months ago I genuinely felt suicidal, as my life felt completely empty and like nothing would ever be worth living for. However, I just feel like I'm not going to be able to bring this up in counselling as I view even her as another set of judging eyes. Even worse, what if she ended up having to break confidentiality to tell someone I'm suicidal? I wouldn't physically be able to form the sentence

    I realise this was extremely rant-y, my apologies - maybe this gives you some insight into the extreme anxiety?

    Thanks so much for your reply

  • Hi

    Do not apologise for what you call ranting as most of us on this website will have had similar experiences to those you describe.

    Yes, self-harm can often be used to avoid a panic attack as it releases just enough of the anxiety and also brings a sense of control to the situation.

    If you feel unable to bring up the issue of feeling empty with the counsellor perhaps you could write here and then print out the post the night before and take it with you, it is often easier than saying how you feel and is a really good first step.

    You say you began to feel social anxiety when you were 13 - what were you like before, were you confident, or was it just that as you reached your teens you began to be aware of what was missing?

    Keep on writing, the more you explore the issue the greater the sense of support you may come to feel.


  • This is where I'm unsure. I can definitely pin-point a time when I was 13 where I know what I was experiencing was social anxiety, but before that, I know that I was still shy and got nervous about being with people, but I still just sort of got on with it. When I was 13 was when it really started to stop me from living the way I think most teenagers do. I once went to meet a friend at her house before we were going to go to the local park to meet a few classmates and some of their friends who I didn't know. In the process of walking from her house to the park, I pretended I felt ill and went home, as I was too nervous to cope. This type of situation began occurring at 13, before that it was just nervousness that I could at least ignore

    The worst part about it all is I don't feel believed. The counsellor and the mental health adviser at university (where I'm having the counselling whilst I wait on the list for NHS CBT) both commented separately about how I seem as though I may be on anxiety medication, since I don't avoid eye contact for the entire session or I'm not physically trembling. Definitely feel like my situation is being undermined because I'm attempting to make the effort to try to socialise normally... very frustrating

    Gosh, it does feel good to write it all out, doesn't it?

  • Hi

    Teenage years are often a time when difficulties from childhood begin to affect our lives because it is a time of other massive changes. It sounds as if when you were 13 you had a sudden panic attack and that began a pattern which fed back into itself, so that each time you re-experienced the original feelings the situations became associated with them. CBT may help you to think about and understand those links so that you begin to feel more control over the feelings and separate out the past from present. You say you are not showing social fear during sessions and it may be that you learned to be successful at hiding how anxious you are feeling so that perhaps you don't know it yourself. It sounds as if you do not feel secure enough to experience how anxious you actually are, that you are so good at pretending that you don't actually feel the fear. I can identify with that situation. When things are really scary we can defend against feelings such that we actually don't feel them when it is most dangerous to do so. I wonder what your childhood was like. Although understanding where feelings come from originally does not solve them it does make them understandable and that is often the first step in being able to deal with them permanently. You say you were a nervous and shy child and I wonder where you think those feelings come from, whether you were confident within your family or shy and nervous there as well. I wonder whether you felt loved and valued as the person you were?

    I have just read that feel you hate yourself - what do you think you have done that makes you feel so hateful - or perhaps it was things you didn't do. Are you able to write about that?


  • That is very interesting Sue. Would there be anyway to 'find out' what happened in childhood that may be the underlying cause of lifelong depression/anxiety. I have heard about regression therapy but not sure what this entails. I have been socially anxious and nervous for as long as I can remember. I remember always being a shy and introverted child but can't recall being depressed as such at a young age. It was only after I had left home at age 17/18 that I saw the doctor who diagnosed 'malaise' and have struggled ever since. I had a turbulent childhood - emotionally barren, unaffectionate father (who is I suspect is a manic depressive), very critical, never shown any affection but he doted on my younger sister, constantly put down, parents who were constantly fighting, left home at 17 had to fend for myself etc.

    I wonder whether it was just the general toxic home environment as a child or whether it's something genetic that runs in the family. My father's mother seemed like a depressive too. I would really love to exorcise the demons for once and all! Ziggy x

  • I can identify with the idea of turning off the ability to feel anxious. There are times when I feel completely sick and am shaking (like my visit to the doctor's to enquire about help) but then there are others where I'm just numb to it physically, but mentally I'm still in the same chaotic world where I'm thinking 100 thoughts per second and focusing on calming myself down rather than on what's going on around me.

    With childhood, I don't remember enough of specific events to be able to really look into them. It's not a total blur, but I can't really look back on it in major detail, but I can do that with events from say 5 years ago. I don't really understand why, but one idea I had was just that I wasn't so uptight about things and wasn't so hyper-aware of what was going on around me, therefore i didn't take as much of it in.. but that's just a scenario I've thought of myself. I was nervous around extended family, even if I did see them fairly often - aunts, grandparents - it was only my own family (parents & sister) who I could feel comfortable around. I always feared being asked questions by extended family members, I think that always made me unsettled.. the idea of having to give an explanation or not being able to about something.

    I do have 2 parents who always did everything they could for me, so I don't think I can attribute any of this to them. My parents did legally separate when I was 6/7 and then officially divorced this year, and I know that psychologically things like that are said to affect you. I can't point out anything specifically about it that would have sparked this huge problem now, but maybe there's something I'm not seeing. Writing about it now, I do remember being torn between the two parents a lot in the sense that I didn't want to portray that I preferred one, and I was also the 'messenger' between the two of them, so I suppose it's possible that with that sense of duty which I didn't want could have caused some nervous behaviour.

    I just don't like anything about myself. I mean, it isn't just classic teen angst, but just literally wish that I wasn't who I am. The thought processes that I have which are dominated by negativity, and the way that I get attached to things to always be disappointed, just being the completely lame person I am. There's nothing special about me in the slightest, and I am always in the mindset that the world would just be much better off without me. There isn't anything in particular I can say, because it's just my permenant mindset

    If CBT can take at least one strand of negative thinking away from me, it will be worth the anxiety all of the appointments & phone conversations it took to get there

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