If I am trying to stop self-harming and I seek help, will I need to be put in an inpatient setting?

I have bipolar disorder, paranoid personality disorder, posttraumatic stress disorder, anxiety and obsessive-compulsive disorder. I last self-harmed a week ago. When I am stressed, overwhelmed, hurt, or angry, the urge to self-harm is all I can think of. I am trying to seek help.

Kaileen McMickle, MS, LPC
Kaileen McMickle, MS, LPC
Licensed Professional Counselor

Glad you are reaching out here!

There are two types of self-harm: suicidal and non-suicidal.  A lot of people I see and have seen engage in self-harm just to manage emotional dysregulation, but not to end their lives.  Self-injury actually does a great job at helping us to manage really intense emotional states--even from a chemical level in the body.  When you self-harm, it's triggers your body's endorphin production, which is a chemical that makes us feel good.  I'm not saying you should do it, but I understand why you would choose that option because it is pretty powerful.

To answer your question, I've never heard of anyone being admitted into inpatient for trying to stop non-suicidal self-injuring.  Even some people I've worked with that are suicidal and self-harming have remained outpatient given we have an extensive safety plan, including how to reach out for help and coping skill development.  Unless you are at high risk of suicide, you would most likely be outpatient.  

I also work from a harm reduction model, meaning that if you have to self-harm it might as well be as safe as possible.  When people are trying to stop, sometimes the pressure gets in the way and they relapse (very normal and actually expected).  So we prepare for that by discussing measures to take to make sure the method you use is very safe.  Things here include making sure anything piercing the skin is properly disinfected, areas on the body to avoid cutting, and self-harm alternatives that still cause pain but are much safer.  For example, some people hold ice in the palm of their hands, or snap rubber bands on their wrists.  There are many websites that have safer alternatives as well if you just do a quick google search.  

Have patience with yourself here, too.  You've found a way to manage a whole lot of emotions--and it's worked for you--you did that by yourself!  You also want better for yourself and have made the first steps for change and that's really spectacular.  It'll be similar to quitting any habit, so stick in there.  And if you find a counselor that fits for you, even better!  

I wish you so much luck!

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide.   If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.

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