Signs & Symptoms of Self-Harm

Learn About Self-Harm

Self-harming behaviors are the deliberate destruction of a person’s body. This type of behavior is normally not an attempt at suicide, but rather an unhealthy way for some people to cope with emotional pain, frustration, and anger. While self-injury may bring a sense of peace and well-being immediately after the act, this is usually followed by intense guilt and shame. Additionally, the painful emotions that initially triggered the self-injury soon return. Since self-injury is generally considered to be an impulsive act, becoming upset or experiencing any strong emotion can trigger the behavior. While many people self-harm only a few times before stopping, others may find that the behavior serves a unique purpose and it becomes a long-term, repetitive behavior. Even though these behaviors are not intended as a suicidal act, self-injury can lead to serious, even fatal consequences.

Most often, people who engage in self-harm target the arms, legs, and front of the torso because these places are easily reached and can be hidden under clothing. People who self-injure may use one or more ways to harm themselves. There are a number of ways people engage in self-injury, including:

• Cutting
• Burning oneself
• Carving words or symbols into the skin
• Breaking bones
• Hitting or punching oneself
• Biting oneself
• Pulling out hair
• Picking at and deliberately interfering with healing wounds
• Piercing the skin with sharp objects (not as a part of a piercing)

While self-harming behaviors are an unhealthy way of coping with intense emotions, with the proper types of therapy and self-care, those who self-injure are able to recover from this behavior and lead normal, productive, and self-injury free lives.

Self-Harm Statistics

Most individuals who engage in self-injurious behavior keep their habit a secret, which means that the statistics for self-injury are likely skewed. In the United States, each year approximately 2 million cases of self-harm are reported. Most people who cut begin to self-injure during the teen years— 90% of people who engage in this behavior begin during these years. Each year, one in five women and one in seven men engage in some form of self-injury.

Causes and Risk Factors for Self-Harm

The most common causes for self-injury may include a combination of the following:

Genetic: Many mental illnesses that can trigger the urge to self-harm are thought to have genetic components. People who are born into families that have a history of mental illness are at a greater risk for developing the disorder themselves.

Physical: Many types of mental illnesses are the result of imbalances in the neurotransmitters involved in emotional regulation. People who have imbalances of neurotransmitters in the brain may self-injure in order to experience emotions, or as a result of the mental illness.

Environmental: People who experienced abuse are at a greater risk for self-injurious behaviors. Self-injury is used as a way to cope with overwhelming emotions and trauma.

Risk Factors:

• Being female
• Being in teens and early 20s
• Having friends who also self-injure
• Unstable personal identity or sexuality
• Mental health disorders
• Drug and alcohol abuse and addiction

Signs and Symptoms of Self-Harm

It can be challenging to know when a loved one or friend is engaging in self-harming behaviors because it is often done in private. The signs and symptoms of self-injury will vary depending upon the methods a person uses and may include:

Behavioral Symptoms:

• Wearing long pants and long-sleeved shirts, even on hot days
• Brushing off injuries as frequent “accidents” or as a result of being clumsy
• Needing to spend a lot of time alone
• Challenges with friendships and romantic relationships
• Keeping sharp objects or implements of self-injury on hand
• Withdrawing from once-enjoyed activities
• Unpredictable, impulsive behaviors

Physical Symptoms:

• Scars
• Fresh scratches or cuts
• Bruises
• Broken bones
• Patches of missing hair

Cognitive Symptoms:

• Ongoing questions about personal identity
• Helplessness
• Hopelessness
• Worthlessness

Psychosocial Symptoms:

• Emotional numbing
• Emotional instability
• Mood swings
• Depression
• Increased anxiety, especially when unable to self-injure
• Guilt
• Shame
• Disgust

Effects of Self-Harm

The long-term effects of self-harm can range from minor irritants to severe injuries and even unintentional death. This is why it is important for those who engage in this type of behavior to seek professional help as soon as possible so that they can learn healthier ways of coping with stressful or painful emotions. The most common long-term effects of self-injury include:

• Broken bones
• Social isolation
• Feelings of shame, disgust, and guilt
• Poor self-esteem and self-image
• Permanent scarring
• Injured tendons, nerves, blood vessels, and muscles
• Permanent weakness or numbness in certain areas
• Limb or appendage loss
• Multi-organ damage
• Infections
• Septicemia
• Suicide
• Accidental death

Self-Harm and Co-Occurring Disorders

Self-harm is sometimes a symptom of a mental health disorder. The most common co-occurring, comorbid mental illnesses a person who self-harms struggles with include the following:

• Obsessive-compulsive disorder (OCD)
• Past history of trauma – especially in childhood
• Post-traumatic stress disorder (PTSD)
• Borderline personality disorder (BPD)
• Personality disorders
• Eating disorders
• Depression and depressive disorders
• Anxiety disorders
• Bipolar disorder
• Substance abuse
• Alcoholism
• Schizophrenia