Understanding Self-Harm: Causes, Symptoms, and Support

CW: self-harm. Image of a woman with a bandage on her wrist.
by Daniel

Self-harm is a complex and distressing behavior that involves deliberately hurting oneself. While often misunderstood and stigmatized, it’s important to recognize that self-harm is not a cry for attention but a coping mechanism for those struggling with overwhelming emotions or mental health conditions.  

In this post, we’ll explore what self-harm is, why people feel compelled to hurt themselves, how self-harm can be treated, and how to seek help. 

What is self-harm?

Self-harm, also called nonsuicidal self-injury, is when someone hurts themselves on purpose without wanting to die. It’s a way to cope with emotional pain. This behavior can manifest in various forms, including cutting, burning, scratching, or hitting oneself. While self-harm is not a suicide attempt, it is often a sign of deep emotional distress and can be associated with suicidal thoughts or behaviors.  

Studies have found that self-harm is most common among teenagers and young adults. Approximately 10-20% of young people have engaged in self-harm at some point in their lives. But it can happen to people of any age, gender, or background.

Why do people self-harm?

Understanding why people harm themselves is crucial to addressing the behavior. There is no single reason why someone might engage in self-harm, as the motivations can vary widely from person to person.   

Some common reasons include:  

  • Dealing with emotional pain: Some people engage in this behavior to handle strong emotional pain, anxiety, or distress. Physical pain can serve as a temporary distraction from overwhelming emotions, providing a sense of relief or release.  
  • Expression of feelings: For some, self-harm is a way to express emotions that they find difficult to verbalize. This might include feelings of anger, sadness, frustration, or numbness. In this way, self-harm becomes a physical manifestation of internal turmoil.  
  • Regaining a sense of control: Self-harm can give individuals a sense of control over their pain and their bodies, especially when they feel powerless in other areas of their lives. It may also be a way to assert autonomy against external pressures or demands.  
  • Punishment or self-criticism: Some people engage in self-harm as a form of self-punishment or self-criticism. They may have negative self-perceptions or feel guilty about certain actions or thoughts, leading them to harm themselves to atone or exert control.  
  • Relief from numbness: Some individuals self-harm to feel something when they are emotionally numb or disconnected. The physical pain of self-harm can break through the numbness, providing a temporary sensation of being alive or present. 

if you or someone you love is thinking of or has harmed themselves, we can help. Click the image to book an appointment.

Conditions associated with self-injury

Hurting yourself is often a symptom of underlying mental health conditions that require attention and treatment.  

Some of the most common mental health conditions associated with self-harm include:  

  • Depression: Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities once enjoyed. Individuals with depression may engage in self-harm to cope with overwhelming feelings of despair or to express the pain internally.  
  • Anxiety disorders: Anxiety disorders, such as generalized anxiety disorder (GAD), social anxiety disorder, or panic disorder, can lead to self-harm as individuals struggle to manage intense and persistent feelings of fear, worry, or panic.  
  • Borderline Personality Disorder (BPD): BPD is a mental health condition characterized by unstable moods, self-image, and relationships. Individuals with BPD may engage in self-harm to cope with intense emotions, emptiness, or fears of abandonment.  
  • Eating disorders: Eating disorders, such as anorexia nervosa, bulimia nervosa, or binge-eating disorder, are often associated with self-harm. The self-destructive behaviors inherent in these disorders, such as extreme dieting, purging, or binge eating, can be seen as forms of self-harm in themselves, as well as being linked to other self-injurious behaviors.  
  • Post-Traumatic Stress Disorder (PTSD): PTSD is a condition that can develop after experiencing or witnessing a traumatic event. Individuals with PTSD may engage in self-harm to cope with flashbacks, intrusive thoughts, or detachment from reality.  
  • Substance use disorders: Substance use disorders, including alcohol or drug addiction, can increase the risk of self-harm. Substance use can exacerbate emotional pain or lead to impaired judgment, making self-harming behaviors more likely.

Types of self-harm  

Self-harm can take many forms, each varying in severity and risk. Some of the most common forms of self-harm include:  

Cutting

Cutting involves using sharp objects, such as razors, knives, or scissors, to make cuts on the skin. It is one of the most common forms of self-harm and often occurs on areas of the body that can be easily concealed, such as the arms, legs, or torso.  

Burning

Burning involves using heat, such as a lit match, cigarette, or heated object, to inflict burns on the skin. Like cutting, burning is often done in areas that can be hidden under clothing.  

Scratching or picking at wounds

Some individuals repeatedly scratch or pick at their skin, leading to open wounds, sores, or infections. This behavior can be compulsive and difficult to control. Some individuals intentionally interfere with the healing process of wounds by reopening cuts, picking at scabs, or otherwise preventing healing. This can lead to chronic wounds and infections  

Hitting

Hitting oneself with fists or objects, or banging one’s head against a wall, is another form of self-harm. This behavior can lead to bruises, broken bones, or other serious injuries.  

Hair pulling (Trichotillomania)

Trichotillomania is a condition characterized by the compulsive urge to pull out one’s hair, leading to noticeable hair loss and damage to the scalp or other areas of the body.  

Ingesting harmful substances

Ingesting toxic substances, such as chemicals, drugs, or non-food items, is another form of self-harm. This behavior can be extremely dangerous and may require immediate medical attention.  

How is it treated?

Treating self-harm involves addressing both the behavior itself and the underlying emotional or psychological issues that contribute to it.  

A comprehensive approach to treatment may include the following:  

  • Therapy: Psychotherapy, particularly cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), is often used to help individuals understand and manage the thoughts, emotions, and underlying issues that lead to self-harm. These therapies can teach coping skills, emotion regulation techniques, and healthier ways to express feelings.  
  • Medication: In some cases, medication may be prescribed to treat underlying mental health conditions, such as depression, anxiety, or borderline personality disorder. Antidepressants, mood stabilizers, or anti-anxiety medications may be used to reduce symptoms and decrease the urge to self-harm.  
  • Hospitalization: In severe cases, where there is a high risk of harm or suicide, hospitalization may be necessary to provide a safe environment and intensive treatment. This can include both inpatient and outpatient care, depending on the individual’s needs.  
  • Support networks: Building a strong support network of family, friends, and mental health professionals is crucial for recovery. Support groups, both in-person and online, can provide a sense of community and understanding for those struggling with self-harm.  
  • Developing coping strategies: Learning and practicing alternative coping strategies is a key aspect of treatment. These may include relaxation techniques, mindfulness practices, journaling, physical exercise, or engaging in creative activities.

Help is available  

If you, a friend, or a family member is thinking of or has harmed themselves, it’s important to seek help immediately. There are numerous helplines and support networks available to help, including:  

  • National Suicide Prevention Lifeline: 1-800-273-TALK (8255) – A 24/7 confidential helpline offering support for those in crisis.  
  • Crisis Text Line: Text HOME to 741741 – A free, 24/7 text-based support service for those in crisis.  
  • S.A.F.E. Alternatives: 1-800-DON’T-CUT (1-800-366-8288) – A resource for those seeking help for self-harm.  
  • The Trevor Project: 1-866-488-7386 – A crisis intervention and suicide prevention service for LGBTQ+  
  • And our team of therapists and psychiatrists are ready to help. Contact us today.