Causes, Signs, & Effects of Self-Harm

Are you concerned that you or a loved one may be struggling with self-harm? Learn about the causes, signs, and effects to identify whether professional treatment may be necessary.

Understanding Self-Harm

Learn about self-harm

Self-harm is characterized by an individual’s compulsion to injure him or herself. When an individual intentionally harms or causes pain to his or her body, this constitutes self-injury, which is also sometimes referred to as self-harm or self-mutilation. While self-harm is not a mental health diagnosis, it may indicate the presence of a mental health disorder. Self-harm can result in serious physical injuries or infections related to injuries. Common ways an individual may engage in self-harm is through burning parts of the body, picking at the skin and/or wounds, cutting, hair pulling, drinking poisonous substances, or performing actions that can break the bones.

For the observing outsider, self-injury may appear as a way to seek attention, or it may be appear to be an attempt at suicide, albeit unsuccessful. It is important to understand that self-harm is not a way to get attention or an attempt to commit suicide; instead, it is a misguided means of experiencing temporary relief from the emotional turmoil that he or she may be feeling. Often, individuals who commit self-injury have poor coping skills for emotional pain and life problems, and may see self-harm as a way to control their emotions. In some cases, self-harm becomes a reactive behavior in response to trauma. Needless to say, self-injury is dangerous for the individual’s health and it can lead to serious consequences. Thus, immediate help should be given to an individual suspected of committing self-injury.

This condition may be difficult to stop but with professional help and with support from family and friends, an individual can improve and recover from self-injury. There are evidence-based approaches to treating self-harm and the causes of self-harm. With help and support, positive progress may begin for those who choose comprehensive support.


Self-harm statistics

Because most cases of self-injury and self-harm are enacted privately, there is no clear estimate as to how many individuals are affected. Most individuals go to great efforts to hide this condition. Based on research, about one in five adolescent females and one in seven adolescent males have tried and committed self-injury at least once in their lifetime. This constitutes about 10% of adolescents. Even though most cases are first treated in teens, about 40% of individuals who engage in self-harm during adolescence will continue this behavior into adulthood.

Causes & Risk Factors

Learn what is known about the causes of self-harm

The following are among the risk factors that can increase the risk that an individual will engage in self-harm:

Genetic: Self-injury often co-occurs with other mental health conditions, many of which are linked to genetics and family history. Heritable mental health disorders that can increase a person’s risk for self-injury include bipolar I disorder, bipolar II disorder, and depressive disorders.

Environmental: Environmental factors may contribute to the development of self-harm. Commonly affected are individuals who have poor coping skills to emotional stress, trauma and negative experiences. Often these individuals seek relief by harming themselves. Stress from home, school and/or work may lead to constant feelings of being overwhelmed which can develop to urges of self-injury. A history of trauma, physical abuse, and abandonment during childhood lead to higher risk of self-injury. In other cases, individuals see self-harm as a way to alleviate emotional stress or very uncomfortable memories.

Risk Factors:

  • Neglect from parents during childhood
  • Physical or sexual abuse during childhood
  • Being female (males are less likely to report this mental health disorder)
  • Low confidence and low self-esteem
  • Lack of emotional support system
  • Impulsiveness
  • Traumatic experiences and repetitive trauma
  • Family history of mental health disorders
  • Individuals with history of mental illness

Signs and Symptoms

Signs and symptoms of self-harm

Individuals with self-harm behaviors may choose to injure themselves in different ways. Depending on the level of harm each individual commits, self-injury can lead to severe physical injury. The following are common symptoms among individuals who engage in self-injury:

Behavioral Symptoms:

  • Isolation from friends, family, and other preferred people
  • Frequent absence from school, work, and other social gatherings
  • Bald spots and thinning hair due to pulling
  • Hiding bruises and injuries by wearing long sleeved shirts and pants, even during hot weather
  • Negative feelings, thoughts, and beliefs
  • Unrealistic explanations to where injuries originate
  • Lack and loss of interest in normally enjoyable activities

Physical symptoms:

  • Wounds that often do not heal (due to picking of wounds)
  • Scars
  • Cuts and burns
  • Constant bruises that are not caused by anemia and other health conditions
  • Scratches and scrapes on the skin
  • Bald spots or thinning hair
  • Broken bones or unusual sprains

Cognitive symptoms:

  • Impulsive thoughts and actions, and the inability to control them
  • Negative thoughts that often escalate to severe negativity
  • Inability to concentrate well
  • Feelings of “derealization,” or difficulty in determining reality from non-reality
  • Having the desire to harm one’s self
  • “Out of body” experiences (“depersonalization”)
  • Painful and disturbing memories

Psychosocial symptoms:

  • Severe depression
  • Feeling anxious
  • Sudden and intense mood swings
  • Feeling helpless or hopeless
  • Detachment or lack of emotions
  • A strong feeling of guilt or shame
  • Easily irritated and distracted
  • Emotional instability


Effects of self-harm

If not given immediate help, individuals who struggle with self-injury can go through serious repercussions and can sometimes even lead to death. Among the consequences are:

  • Anemia
  • Internal bleeding
  • Tissue damage
  • Organ failure
  • Broken bones that may or may not heal
  • Wound infections
  • Nerve damage
  • Body weakness and numbness on some body parts
  • Death or suicide
  • Infections in wounds, including potentially life-threatening infections like MRSA

Other consequences aside from physical harm can include:

  • Low self confidence and self-esteem
  • Poor performance at school or work
  • Failure in academics or job loss
  • Drugs and alcohol use and abuse
  • Strong feeling of guilt and shame
  • Lack of interest to socialize and interact
  • Illnesses that can be caused by infections from injuries
  • Conflict in personal relationships
  • Risking the development of other mental health disorders

Co-Occurring Disorders

Self-harm and co-occurring disorders

Self-injury incidents often are caused by and can co-occur with other mental health disorders. Among the conditions that can occur alongside self-injury are:

  • Anxiety disorder
  • Attention hyperactivity/deficit disorder (ADHD)
  • Bipolar disorder
  • Borderline personality disorder
  • Depressive disorders
  • Obsessive-compulsive disorder (OCD)
  • Posttraumatic stress disorder (PTSD)
  • Schizoaffective disorder
  • Schizophrenia
  • Substance use disorder
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