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    Depression and Risky Behavior

    Why self-destructive behavior may accompany depression and what to do about it.
    WebMD Feature
    Reviewed by Laura J. Martin, MD

    Depression poses many dangers, burdening people with hopelessness and raising their risk of suicide. But in attempts to quell the pain, some turn to alcohol, drugs, and other harmful behaviors that endanger them even further, psychologists say.

    “There is a strong relationship between depression and high-risk behaviors,” says Pamela Cantor, PhD, a psychologist and lecturer at Harvard Medical School.

    “Excessive drinking, drug abuse, unsafe sex, and cutting are all self-injurious behaviors that individuals may use to provide temporary relief from intense emotional pain,” she says -- a pain that some experts have labeled “psychache.”

    It’s a fairly common scenario in therapists’ offices across the country. Cara Gardenswartz, a clinical psychologist in private practice in Beverly Hills, Calif., and a lecturer at UCLA, estimates that roughly 30% of her depressed clients engage in some type of “self-injurious or harmful behavior,” she says.

    Often, there’s more than one problem. “Someone with one self-injurious behavior is more likely to have two or three,” Gardenswartz says.

    At Fordham University in New York, assistant psychology professor and researcher Peggy Andover, PhD, studies young people who engage in “nonsuicidal self-injury.” In other words, when they’re distressed, they cut, burn, carve, or scratch their skin in an attempt to make themselves feel better.

    There’s not much data on how often depressed people will engage in nonsuicidal self-injury, Andover says. But researchers have studied those with self-injury for symptoms of depression. “What we know is that people who engage in nonsuicidal self-injury generally have higher levels of depressive [symptoms],” she says. Furthermore, newer research suggests that depression comes first and the self-injury follows, not vice versa, she says.

    Reasons for Self-Destructive Behavior

    Depression can unearth unbearable feelings that many people try to escape. For example, a depressed man who grew up in a violent and neglectful home may turn to drinking to bury the feelings of rage and poor self-esteem.

    “For all of these high-risk behaviors, there’s a part of them that’s trying to numb themselves ... from really difficult and significant feelings of loss, anger, shame, or anxiety,” Gardenswartz says.

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