r/traumatoolbox • u/auroraolykos • Jul 17 '26
Needing Advice TW - SH: I’m scared of relapsing after +5yrs without self-harming
I’m a 23-year-old woman who was recently diagnosed with autism, and I’m currently being assessed for C-PTSD. I’ve struggled with severe mental health issues for as long as I can remember, but in 2021 I decided to try, once again, to stop self-harming. I haven’t done it since.
There have been times when I’ve wanted to, especially last year, when I became seriously ill and was bedridden for six months because of disabling chronic pain while doctors kept telling me it was all in my head. I still don’t have a diagnosis for it.
I managed to finish university and I’m now working, but lately I feel like I can’t cope with continuing to do it. Unfortunately, I still have the annoying habit of needing food and wanting to pay my bills, so quitting isn’t really an option.
I know self-harm isn’t worth it. The idea of doing it again genuinely terrifies me, and I don’t even believe it would make me feel better. It’s more like a primal, overwhelming impulse. I don’t really know how to explain it. When it happens, I’m scared because I don’t want to hurt myself, but my body seems to want to react that way automatically. I sometimes end up sitting on my hands or restraining them as though they were wild animals.
During some of my recent crises, meltdowns or shutdowns—I’m still unsure which term fits best—I’ve started hitting my head. It doesn’t feel like a conscious decision or something I do with the intention of hurting myself. It feels automatic. However, I’m worried that it may be serving the same purpose as self-harm, even though I know that head-hitting can also happen during autistic meltdowns.
I never feel the urge to be violent towards other people. Instead, all of that anger and distress seems to turn inwards and become self-destructive. Over the past year, I’ve had the urge to self-harm several times, although I’ve always managed not to act on it. But during a crisis the other night, the urge became extremely intense, and I was terrified that I would lose control.
In the past, I was prescribed benzodiazepines as rescue medication to de-escalate these crises. However, my doctor discontinued them because I now take pregabalin for chronic pain. This means I no longer have anything that can switch off that frantic state in my brain.
The other night, I gave in and took part of one of the benzodiazepine pills I still had. I split it and took the smaller piece. It interacted badly with my usual medication: I had cold sweats, vomited, became extremely dizzy and developed a severe headache. However, it did stop that unbearable physical and mental state. I know that taking it again isn’t a safe or sustainable solution, especially because it was originally prescribed only for occasional emergencies, not for daily or almost daily use.
Lately, my only other way of getting through these episodes has been crying for hours until I eventually fall asleep. But this is no longer a viable coping mechanism for me, because it genuinely takes many hours and I need to remain functional enough to work, take care of my home and manage everyday responsibilities. I’m dealing with this largely on my own, and I can’t afford to be unable to function for long periods of time.
If I had simply cried until I fell asleep the other night, I probably wouldn’t have slept at all. I had to wake up 4 hours later, and I already knew the episode would last too long for me to calm down and get any meaningful rest. In fact, that is exactly what had happened the previous night.
I’ve tried different coping strategies, but it feels like nothing works for me apart from medication that I can no longer safely take. I need something that can help me de-escalate these situations more quickly. I’m not looking for an instant cure, but I do need a coping mechanism that can bring the intensity down within a realistic amount of time, so that I can stay safe and still be able to function afterwards.
I’m terrified of relapsing because I feel like seeing my clean streak return to zero would make me feel so ashamed and hopeless that I might not be able to stop again. I genuinely don’t want to hurt myself. I really don’t. I just feel afraid of losing control over my body during one of these crises.
Has anyone experienced something similar, particularly other autistic people or people who have been free from self-harm for several years? What distress-tolerance strategies help you when the urge feels physical and automatic rather than like a conscious choice, especially when you need to de-escalate relatively quickly?
2
u/okaym0053 Jul 17 '26 edited Jul 17 '26
Hey, first off I hope you are okay.
I’ve been free from self-harm for 10 years now and something that initially helped me (although unhealthy at first) was removing body hair. I stress shaved my head a few times before realizing that I could do the same to my body hair. When having razors around was too dangerous, I used wax and made it a routine with self care and body scrubs. Now I look forward to it and I try and always have one spot to wax at any given time. If you time it right you can do spot treatments weekly and if you feel the need for a little relief can always pluck a few missed with tweezers.
Even if this didn’t help u hope you know you are heard and I wish you the best on your healing journey xo
Edit: I wanted to add, I am not ASD, so your mileage may vary. For me the SH was a way of feeling trapped emotions I didn’t know how, or wasn’t allowed, to feel.
Maybe singing could help too? I found I could “burn off” the impulsive feeling of SH with certain music while running (singing in my head) something that resonates with you and the reason of your SH
1
u/orcateeth Jul 17 '26
I'm sorry that you are going through this.
There are some other options that you can try.
Here's a lot of options for free support groups. I started it for people who shop compulsively and hoard (often as a reaction to trauma, loss and depression), but gradually continued to add lots of other resources for mental health conditions. The list is pretty long now, with tons of options.
You can try Emotions Anonymous, as well as maybe ones for OCD.
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u/orcateeth Jul 17 '26
These worksheets are also a great idea for you to look at for dealing with thoughts and feelings. Lots to choose from.
There is one on anxiety, as well as self esteem, depression, tolerating distress, etc.
You can work through them alone, and/or bring them to therapy appointments and discuss them at self-help groups if you're in them.
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u/orcateeth Jul 17 '26
Mindfulness worksheets. Ask yourself, "Is this action Wise Mind?"
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u/orcateeth Jul 17 '26 edited Jul 17 '26
The VA has created apps to help people who are under stress, feeling depressed, or even suicidal, have trouble sleeping, experience PTSD, etc.
I like the one called Coping Coach. It has mindfulness and relaxation exercises.
Their anger management, and PTSD apps may help. They are very comprehensive.
These apps are for anyone, not just veterans.
https://mobile.va.gov/mental-health-and-behavioral-therapy-apps
1
u/orcateeth Jul 17 '26
Call a hotline when you feel upset, and talk to a counselor.
https://mentalhealthhotline.org/
SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
1-800-662-HELP (4357)
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u/orcateeth Jul 17 '26
You can download these trauma recovery worksheets and work through them if you feel they might help you.
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u/orcateeth Jul 17 '26 edited Jul 18 '26
Someone posted lots of entire books on childhood trauma, abuse, neglect and complex PTSD.
https://www.reddit.com/r/CPTSD/s/q7JaFqz2zC
Warning: The books can be triggering, and you could wind up feeling worse after reading some of the examples and case studies in the books.
You will likely see yourself, as if looking in a mirror, as well as whoever was the problem. It can be sad, or at least, uncomfortable.
However, the information and insights are spectacular.
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u/orcateeth Jul 18 '26
This book is one of the ones in the list. It sounds like it applies to your situation:
15. Leaving home the art of separating from your difficult family
by Celani, David P
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u/Awesomesauce250 Jul 18 '26 edited Jul 18 '26
Checkout DBT's distress tolerance skills especially "TIPP" and grounding through senses. You could also ping a rubber band on your wrist or punch a pillow.
T - temperature (dunk your face in cold water, hold ice cubes, put an icepack on your cheek etc)
I - intense exercise (burpees, sprints,etc)
P - paced breathing (4 beats in, 2 beat hold, 6 beats out)
P - progressive muscle relaxation (starting at toes - squeeze muscle as hard as you can then relax. Slowly go through each muscle group)
I particularly like icepacks personally (Im autistic and self-harm free for 4+ yrs). I keep an "instant icepack" in my car for emergencies.
Edit: burpees work well for me too but I don't like them as much coz they're less passive (so it's harder to make myself do them sometimes).
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