I'm struggling with self-harm too. Where do I start?
You start by knowing that support exists right now: if you are in crisis or having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline any time, and call 911 if you are in immediate danger. Self-harm and eating disorders often occur together because both can become ways of coping with pain that feels too big for words. Neither one means you are broken or beyond help. Both respond to treatment, and the same skills and support that heal one very often help heal the other.
If you need support right now
Before anything else on this page: you do not have to be in a life-threatening emergency to deserve support. The 988 Suicide and Crisis Lifeline is free, confidential, and available around the clock by call or text to 988, and trained counselors talk with people about self-harm, overwhelming emotions, and hard nights every single day. If you or someone with you is in immediate danger, call 911 or go to the nearest emergency room.
Reaching out is not dramatic and it is not weakness. It is the exact move that begins to change things, and the people on the other end genuinely want to hear from you.
Why self-harm and eating disorders often show up together
Research consistently finds that self-harm is common among people with eating disorders, and the reason makes painful sense: both often function as ways to manage emotions that feel unbearable. When feelings are overwhelming and words are out of reach, distress can get turned toward the body. Restriction, bingeing, purging, and self-harm can all serve as pressure valves, ways to feel something, feel nothing, or punish a self that harsh inner voices insist deserves it.
The two also share roots. Histories of trauma or invalidation, intense shame, harsh self-criticism, and emotions that arrive at full volume are common soil for both, which is why our pages on eating disorders and trauma and dissociation will feel familiar to many people reading this one. Understanding these behaviors as coping that grew out of real pain, not attention-seeking or manipulation, is where good treatment begins.
Telling someone changes the math
Self-harm survives on secrecy the same way eating disorders do. The single most powerful early step is letting one safe person know: a therapist, a doctor, a trusted friend, or an admissions line like ours. You do not need polished words. Something as simple as saying you have been hurting yourself and want help is complete and enough.
If you are already in eating disorder treatment, please tell your team. Clinicians ask about self-harm without judgment because it is common, it matters for your care, and honesty brings more support rather than punishment. And if shame is the wall between you and saying it out loud, know this: the people who treat these struggles have heard it all before, and what they feel toward clients who disclose is respect, not disgust.
How treatment helps both heal
The strongest evidence-based approach for self-harm is dialectical behavior therapy, and DBT is a core part of programming at Empowered Treatment in Austin. DBT teaches concrete, practical skills: surviving intense moments without harming yourself, regulating emotions before they crest, and building a life that generates less unbearable pain in the first place. Those same skills directly support eating disorder recovery, which is why treating both together works so well.
Around that core, our adult IOP includes weekly individual therapy, group support, psychiatric evaluation, and trauma-integrated care when old wounds are driving the pain. Healing is not just possible here, it is the expected outcome of steady support over time. You can read about everything we offer or call (512) 882-4599. And on any night the pain spikes, 988 is there before, during, and after treatment.
Related questions
Does self-harm mean I'm suicidal?
Not necessarily. Many people who self-harm are trying to cope with pain, not end their lives. At the same time, self-harm is a serious sign of distress that deserves professional support, and if thoughts of suicide are ever present, treat that as a crisis moment: call or text 988, or call 911 in an emergency.
Will I get in trouble if I tell my treatment team about self-harm?
No. Disclosing self-harm leads to more support and a better-fitting care plan, not punishment or judgment. Clinicians ask about it routinely because it is common alongside eating disorders. Honesty is what lets treatment actually reach the part of you that is hurting.
Can both of these really get better?
Yes. Research consistently finds that self-harm and eating disorders both respond to evidence-based treatment, especially DBT and trauma-informed care, and clinicians watch people recover from both all the time. The urges fade as new skills take over the job the behaviors were doing. Recovery is not a long shot. It is the well-traveled path.
Your situation deserves a real plan. Let's build it.
Call or text and tell us what's happening. Confidential, judgment-free, and specific to you.