Deliberate self harm is not just about seeking attention

Many people believe that self-harm is often a cry for attention while others say it is the only way victims can express the distress they feel. Most importantly, the condition needs immediate medical attention once discovered, writes Egan Tabaro

In a 1995 interview with BBC TV, Diana, Princess of Wales revealed to the world that she was a self injurer. A biography, Diana: Her True Story, written by Andrew Morton, revealed even more chilling acts of self-harm including throwing herself into a glass cabinet and slashing her wrists with a razor. The book further revealed that once during a heated argument with her then husband Prince Charles, she picked up a knife and cut her chest and thighs with it. Shocking as it was, Princess Diana’s honest public disclosure has gone a long way in bringing global attention to the problem of self injury.

According to Prof Ssegane Musiisi, head of the Psychiatry Department at Makerere’s College of Health Sciences, self-injury or deliberate self-harm is “to carry out an act which will injure your body with the intention of injuring yourself. This act may or may not be a suicidal gesture”. Deliberate self-harm may take on the form of interfering with wounds healing, poisoning, overdosing on medicine, self cutting, pulling out one’s hair, running in front of a moving vehicle etc. Experience has shown that world over, men choose more dangerous methods than women, such as using guns.

Research has shown that deliberate self-harm exists in societies and cultures the world over. In Uganda, Prof Musiisi says, mental health professionals have observed that it occurs more in urban than rural areas. This is attributed to, among other things, urban poverty/unemployment, family turmoil and cultural disconnectedness. Prof Musiisi adds that in Uganda, three groups are at particular risk of suicidal tendencies including deliberate self-harm; internally displaced persons in conflict zones, HIV/Aids patients and those with a mental disorder, especially clinical depression, personality disorders and substance abuse disorders.

A person who engages in deliberate self-harm may have no intention of actual suicide. Although to an observer it may come off as melodramatic attention-seeking, the person doing it may go to great lengths to conceal their injuries, for example, by wearing long sleeves to conceal wounds and scars on their arms. It usually is an unhealthy attempt to cope with overwhelming negative emotions such as intense anger, tension and frustration.

“Usually, the self-harmer feels at the end of their rope and that self harming is more pleasant than how they actually feel inside,” says Prof Musiisi. Treatment typically involves putting the patient under cautious observation until suicidal thoughts are no more. Psychotherapy helps the patient confront and resolve underlying psycho-social problems e.g. alcoholism, marriage and family turmoil etc. Prof Musiisi adds that the patient is taught alternative ways of coping with life’s stressful events. Psychiatric medication such as antidepressants can be administered to treat a mental disorder commonly associated with deliberate self harm.

According to Dr Noeline Nakasujja, a Consultant Psychiatrist at Mulago Hospital, “If a loved one is self-harming, the first thing to do should be to remove the object they are using, then take the victim to any medical/health facility where they will immediately be treated for the harm e.g. if they have overdosed on medication, the drugs have to be removed from the body system. After that, psychiatrist services may be sought.”

Dr Nakasujja adds that aside from the National Mental Referral Hospital, Butabika, nearly all government and private hospitals around the country have a mental health unit and Mulago National Referral Hospital has a fully fledged Psychiatric Ward, where a victim of deliberate self harm can seek professional help from mental health professionals.