Is it worth seeking therapy for this?

Before I get started, I HAVE sought therapy for this ongoing issue in the past. It didn't really work, for reasons I'll describe below. Also, this post deals with mild self-injury, so be cautious if this is triggering for you. This is a long post, so I apologize if I seem to ramble.

I've spent most of my life, apart from childhood, dealing with self-injurious impulses, anxiety, and depression. I don't want to get off-topic by reciting my life story, but here's the brief background: I was about ten years old, maybe a little younger, the first time I hurt myself. I had never even heard of SI before, and I don't really remember why I did it. I just remember being angry at my parents for something inconsequential and cutting my fingertip with a razor letter opener in response.

I was fifteen the first time I had a serious depressive episode. I self-injured superficially (never left scars and didn't want intense or severe pain) and spent a few months living in a numb fog, to the point where I remember telling one of my online friends that I couldn't remember the last time I was genuinely happy (and meant it). I only self-injured for the first few months of this episode, but even after the most severe parts of it let up I found myself dealing with on-and-off depressive episodes for about two years. Even when not in an episode, I had thoughts of suicide almost daily and if I was especially stressed or triggered would go off by myself to either sit alone by myself in a room in the dark (a friend and a family member found me on two different occasions--that was pretty awkward!) or go on a walk outside by myself at night. At times I couldn't allow myself to be in the same room as a knife because I knew I was too emotionally weak at the time to resist impulses to self-injure. I was very sensitive to light and generally wasn't happy most of the time.

Here's the weird thing, and what I'm thinking about seeking help for (again):

I haven't felt that way in four or five years, but I still get self-injurious impulses. I haven't experienced a full-blown chronic depressive episode since I was a teenager (I'm 21 now). Since I started college, though, I've dealt with very strong acute stress responses whenever I'm mentally or emotionally overloaded. They happened so infrequently, though, that for a long time I didn't think it was worth seeking therapy. During one especially stressful semester, I did seek therapy, but whenever I met with the counselor-in-training (she was still doing licensing hours) we didn't have much to talk about because I hadn't experienced a serious self-injurious impulse lately. I didn't get any real advice out of it except for a photocopied chapter on "thought-stopping" from an anxiety self-help book, but I blame myself for that just as much as the counselor.

Here's the problem:

About two months ago (October) I noticed that I was getting triggered to hurt myself more often instead of just at the end of each semester when stress picked up substantially. I started writing down every time I was triggered, starting with each time I could remember from August onward.

I found that I felt a major wave of anxiety/stress and the desire to hurt myself about nine times since August. About once every 10-18 days, every two weeks on average.

These "triggers" I keep talking about feel a little like this: I feel a wave of extremely heavy anxiety--but not quite full-blown panic. I feel extremely hot and uncomfortable over my entire body, and my mind immediately clicks into thinking "Hurt yourself and you'll fix this." If it's an especially severe triggering episode, my chest physically starts to hurt a little bit and/or the physical feelings are accompanied by depressive thoughts. I start to feel like I did something to deserve the way I feel, that I'm not capable of handling myself, like I'm too weak to keep going on with my life, that I'm too tired to try anymore, that I might as well just give in and hurt myself. If I'm forced to be around other people during a trigger, I get noticeably moody and irritable and have lowered inhibitions when it comes to being verbally aggressive or rude. I just feel tired and beaten down by everything, and if I get triggered enough times in a short enough period of days I start to think that it's no longer a matter of if I hurt myself, but when.

I have yet to actually follow through and self-injure like I did when I was younger, but sometimes it is extremely difficult not to. At its absolute worst, I nearly purchased an Exacto blade because it calmed me down just to know that I had one. Looking at them was enough to calm me down, though, and I didn't end up buying one.

And here's the other problem:

The "triggers" I described above only last anywhere from a few minutes to several hours at the very most. Otherwise, I feel completely fine. I function at a higher level than most people, I'm a stronger student, and more poised to get what I want out of life than a lot of my friends. I'd estimate that I only feel triggered, anxious, or depressed, about 7% of the time at the very most. Because of this, I have no idea what to call this problem. It isn't any sort of major depressive or anxiety disorder, to my knowledge, since those involve more chronic and long-lasting episodes, and mine are extremely brief and intense mood swings with (usually) identifiable stress-triggers. I've looked into bipolar disorder, too, but again, I believe that bipolar disorder is marked by more long-term and chronic depressive episodes, even if they cycle more rapidly/often.

I just don't know what to do about this. If I was triggered more often, to the point where life felt intolerable, I'd definitely seek therapy. But since these triggers only happen every two weeks or so, I don't have a clue what the problem could be called/diagnosed/whatever. I've tolerated these episodes for three years now, and I'd like it if they didn't happen any more. I'm just not sure what to do, if this sort of thing is common, or if a therapist would recognize what to do for me.

I hope that made sense. Thanks for any replies.

Hi wax, thanks for sharing. I do think that it is definitely worth seeking therapy for this. I believe that anything that causes us frustration, or any type of inability to function normally at all times, is a reason that you can get therapy. Also, I feel that if you are really struggling with wondering if it is something worth getting therapy for, that it is probably necessary.

It can't help any, can just help loads. :-)

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l stopped SI for 30 years. Well that's not technically correct, l was still dealing with things in an unhelpful way, but my methods were more socially acceptable, alcohol, overwork/perfectionism, food issues, then the cutting came back. So my advice would be to seek out a therapist to explore things with. Life can throw nasty stuff at us throughout our lives and l wish l had had better coping strategies before these events knocked me off my feet.

I don't think there is any harm with even just going to get someone else's thought or the situation and see what they might suggest treatment wise.

SI is a coping mechanism. So I would think that going to a T to help learn alternative coping skills might help. SI can often become an addiction. Good luck.

If you are hurting yourself to bring calm into your life then yes it is absolutely worth seeking a therapist. And the fact that you feel stable most of the other time outside the self-harming periods is good in that, a lot of good therapy can be done while you're feeling stable. If you were in constant crisis mode a therapist would be in a more supporting role and any deep therapy would need to be held off until you're more stable.

I would suggest if you have any deep trauma in your past, that you find a suitably qualified therapist. One who deals with trauma, self injury, abuse etc because your college one may not be and even if they are, if i'm correct, they'll only be available to you during term and not after graduation. It will be better to have someone who isn't affected by these rules.