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    Depression and Risky Behavior

    Why self-destructive behavior may accompany depression and what to do about it.

    Reasons for Self-Destructive Behavior continued...

    But there are secondary reasons, too: Self-destructive behaviors can communicate one’s misery, experts say.

    “If they’re depressed and feel that nobody cares -- ‘Nobody loves me and I’m not important to anybody’ -- those behaviors can be a way of saying to themselves and others that ‘I deserve nothing. I don’t deserve to be healthy or happy or whole,’” says Mary Carole Curran, PhD, a psychologist in St. Louis. “Or sometimes, they say, ‘Pay attention to me.’ It’s a cry for help.”

    Some turn to harmful coping methods because their families modeled such behavior, Gardenswartz says. For example, if one’s parents dealt with problems through drinking, an adult child might do the same.

    The Costs

    When depressed people resort to self-destructive behaviors, the physical damage is obvious: liver damage from alcoholism, sexually transmitted diseases or HIV from unprotected sex, or infections and scarring from cutting one’s skin.

    Psychologically, the attempts to avoid or soothe painful emotions with self-destructive behaviors usually backfire, experts say.

    “Drinking numbs the brain, drugs obliterate pain for a while by altering perception, sex provides distraction and a temporary feeling of connection which, however, almost always results in greater feelings of isolation and aloneness,” Cantor says. “These behaviors are all maladaptive coping mechanisms.”

    Gardenswartz says she once treated a woman who became drunk repeatedly, sometimes on as many as four bottles of wine per night. The woman said that after men had sexually assaulted her, she would wake up feeling ashamed. But beyond the woman's understanding, the vicious cycle continued.

    Powerful, unconscious forces and past traumas often drive such self-destructive behavior, according to Gardenswartz. For example, some women who engage in high-risk sex may have been molested as children and learned unconsciously to disrespect themselves and their bodies, she says. “Unfortunately, that was the message put into them.”

    “The person has a void inside. They just feel so much pain from the past,” Gardenswartz adds. “They end up harming themselves instead of helping themselves.”

    Besides the physical and emotional costs, high-risk behaviors also make suicide or accidental death more likely.

    “These behaviors are usually a means of avoiding suicide and relieving pain, yet individuals who self-harm have a greater risk of suicide and suicidal behaviors than individuals who do not,” Cantor says. “Thus, these symptoms of distress, if left untreated, may lead to suicidal gestures, attempts, or plans to commit suicide.”

    Or, as Gardenswartz notes, a person might not have suicidal intentions but may die accidentally from a drug overdose or car crash.

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