Signs and Symptoms of Self-Harm

Learn about self-harm and mental illness

Self-harm, also known as cutting, self-mutilation, and self-injury, occurs when a person purposely and repeatedly inflicts pain upon him or herself. The most common forms of self-harm include cutting, burning, punching oneself, banging one’s head against a wall or other hard object, purposely breaking one’s bones, and drinking harmful substances, such as bleach or detergent. Self-harming behaviors can seem confusing; it can be difficult to understand why someone would purposely inflict pain on himself or herself. Most often, people admit to injuring themselves as a means to take away the emotional pain they are feeling. Many people cannot find ways to control or cope with the feelings that they are suffering from, but they are able to control physical pain. By taking control of the physical pain, they are able to briefly alleviate the emotional pain as they focus only on the physical pain that they have caused. People may also participate in self-injurious behaviors as a means of self-soothing or decreasing intense levels of anxiety. Self-harm has also been attributed to aiding a person who is suffering from dissociation as a means of remaining grounded.

One of the most common misconceptions about self-harm is that people who engage in the behaviors are doing so because they want to die by suicide. This is typically not the case. Similarly, some people think that self-injury is a person’s way of seeking attention. While this may be the case for some individuals, the majority of people partaking in this behavior do not want others to know. That said, there have been many instances in which young people have entered treatment for self-harm and have admitted that they tried it simply because their friends were doing it; however there is often an emotional reason they continue this behavior. Regardless of the reasons why people participate in self-mutilation, it should always be taken seriously.

While the presence of self-harming behaviors can be frightening, confusing, and frustrating to all individuals involved, it is important to know that these behaviors can be treated in a variety of different forms of therapeutic interventions. There is hope for change.

Self-harm statistics

As self-harming behaviors usually occur in private, it can be difficult to determine exact statistics on the prevalence rate. Mental Health America estimates that around 2 million people in the United States purposely injure themselves in some way. Typically, self-injury behaviors are more prominent in adolescents and young women, but a growing number of men are intentionally injuring themselves as well. While the average age of onset for self-mutilation experimentation is said to occur between ages 12 and 15, it has been known to occur in striking numbers among children as young as 7 years old.

Causes and risk factors for self-harm

There is not any one single or simple cause that can be identified as the cause that leads a person to begin partaking in self-mutilation behaviors. However, there has been some evidence suggesting that a combination of factors may be linked to its onset. The following are a few examples of causes and risk factors that may play a role in the development of self-injurious behaviors:

Genetic: Some of the disorders of which self-harm can be a symptom of may have a genetic component. Some examples of disorders that self-harm may be a symptoms of include, but are not limited to, borderline personality disorder, bipolar disorder, and depressive disorders.

Physical: Mental illnesses are believed to be due in some aspect to chemical imbalances in the brain. A disruption or imbalance in the part of the brain that is involved in emotional regulation may contribute to one’s predisposition to self-harm.

Environmental: The environment in which a person is surrounded has the potential to play a role in the development of one’s desire to begin partaking in self-harming behaviors. If a person’s home life is chaotic, unpredictable, or scary, that person may find solace in the act of self-mutilation as it gives them something they have control over.

Risk Factors:

• Peer pressure
• Poor emotional regulation
• Poor coping skills
• Inability to express emotions in a healthy, productive manner
• Having suffered from punishment at the hands of parents or other authority figures
• Perceived chaos in one’s surroundings, whether it be true or imagined
• Experiencing trauma
• Coming to terms with one’s sexuality
• Coping with cultural expectations
• Being the victim of bullying
• Death of a close family member or friend
• Poor relationships

Signs and symptoms of self-harm

The signs and symptoms of self-harming behaviors can vary greatly based on the age of the person participating in the behaviors, their chosen form of self-harm, and the length of time in which they have been partaking in the behaviors. Some examples of symptoms that may lead to the suspicion that a person is harming himself or herself can include:

Behavioral symptoms:

• Withdrawing from peers
• Displaying signs of severe distress
• Verbally justifying unexplained bodily injuries as being attributed to an accident when questioned by friends or loved ones

Cognitive symptoms:

• Impulse control difficulties
• Concentration difficulties
• Obsessing and ruminating thoughts about the self
• Dissociation

Physical symptoms:

• Recurring new wounds (such as cuts, scrapes, bruises, abrasions, lacerations, etc.)
• Broken bones (without the person being able to give an adequate explanation as to why the injury occurred)
• Scarring from cuts and burns

Psychosocial symptoms:

• Internalized hostility
• Feelings of worthlessness
• Feelings of hopelessness
• Feelings of helplessness
• Feeling defeated
• Continuing thoughts of and desires to self-harm
• Believing that their self-injurious behaviors will eventually result in the end of the suffering that they have been experiencing
• Loneliness
• Grief
• Guilt

Effects of self-harm

The long-term effects of self-harm can be devastating for the individuals engaging in the behaviors, as well as their loved ones. Some effects that can result from these behaviors can include:

• Family discord
• Social isolation
• Isolation from family members
• Substance addiction
• Delusional thoughts
• Chronic negative mood states
• Consistent, obsessive, and intruding thoughts about the behavior itself

Self-injuring can also produce long-term physical effects in the person who participates in the behaviors. Some examples of these physical effects can include:

• Broken bones that don’t heal properly
• Severe bleeding and anemia
• Infected wounds
• Permanent tissue damages
• Permanent scarring that may not fade due to the presence of scar tissue
• Chronic pain

The most serious effect that self-mutilation can have on people is  death resulting from their injuring going wrong. For example, cutting themselves so deep that they bleed too much, drinking too much of a chemical substance that causes body failure, or breaking one’s neck when attempting to break a different bone.

Self-harm and co-occurring disorders

Self-harming behaviors commonly occur alongside, or sometimes as a direct result of, other mental illnesses. Some examples of such disorders that self-harm can be symptomatic of can include:

• Major depressive disorder
• PTSD and other stress related disorders
• Anxiety disorders
• Dissociative disorders
• Eating disorders
• Bipolar disorders
• Depersonalization disorder
• Borderline personality disorder
• Conduct disorder and oppositional defiant disorder (in adolescents)