Self-harm is a sign of distress and problems with coping skills. People may self-harm when they feel intense anger or frustration. Some say it feels like tension release. Others may do it for a sense of control or to feel something other than numb.

Self-harm can cause shame. This shame can then create a new cycle of intense emotions and self-harm.

Brain

Risk Factors

Self-harm is most common in teens and young adults. Other things that may raise the risk are:

Childhood abuse or neglect
Past trauma
Unstable home during childhood
Binge drinking or drug use
Having other mental health problems, such as depression

Symptoms

The type of harm can vary. Some examples are:

Cutting skin with a sharp object
Skin carving or burning
Self-punching or scratching
Needle sticking
Eye pressing
Finger, lips, or arm biting
Pulling out one's hair
Picking at one's skin

People who use self-harm may:

Have scars, often in the same place on the body
Wear long sleeves or pants to hide injuries
Claim to have frequent accidents
Have relationship problems
Have behavioral problems
Talk about feeling hopeless

Diagnosis

People who self-harm often feel ashamed. Some may not want to reach out for help. A friend or relative may call for medical help.

A doctor may notice scars during an exam. They may ask questions about stress, emotions, and wellness. This will help the doctor assess the problem. The questions may also help to see if other mental health issues may be present. A mental health counselor may also help to make the diagnosis.

Treatment

The goal of treatment is to find out what is leading a person to self-harm. This will help to make a treatment plan. Options are:

Mental health therapy, such as cognitive-behavioral therapy (CBT) to learn about harmful thoughts and find ways to cope
Medicines to ease severe symptoms

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Psychological Association
https://www.apa.org

Mental Health America
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Psychiatric Association
https://www.cpa-apc.org

Canadian Psychological Association
https://cpa.ca

References:

Hooley JM, Fox KR, et al. Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives. Neuropsychiatr Dis Treat. 2020;16:101-112.

Nonsuicidal self-injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nonsuicidal-self-injury. Accessed November 19, 2020.

Self-harm in over 8s: Short-term management and prevention of recurrence. Clinical guideline (CG16). National Institute for Health and Clinical Excellence website. Available at: https://www.nice.org.uk/guidance/CG16. Accessed November 19, 2020.

Self-injury in adolescents. American Academy of Child & Adolescent Psychiatry website. Available at: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Self-Injury-In-Adolescents-073.aspx. Accessed November 19, 2020.

Self-harm. National Alliance on Mental Illness. Available at: https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Self-harm. Accessed November 19, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 04/16/2021

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