Signs & Symptoms of Self-Harm

Learn about self-harm

Self-harm refers to the intentional infliction of pain or damage upon yourself. This behavior is also sometimes referred to as self-injury, self-mutilation, self-abuse, or non-suicidal self-injury (NSSI).  

Self-harm can take many forms. Common examples of self-harming behaviors include pinching, cutting, or burning your skin; pulling out your hair; hitting your head on a wall or other hard surface; intentionally breaking or trying to break your bones; or drinking caustic liquids.  

Although the behaviors listed in this section can be dangerous, and in some cases even unintentionally fatal, it is important to note that self-harm is not a form of attempted suicide. However, studies have indicated that people who engage in self-harm for an extended period of time may have an increased risk for suicide. 

Some people intentionally injure themselves in response to overwhelming stress or pressure. Others do so as a means of punishing themselves for perceived shortcomings or failures, or in a misguided attempt to exert control in what feels like an out-of–control world. Still others may engage in self-harm as a means of giving physical presence to emotional or psychological pain. 

Self-harm is often, but not always, a symptom of a mental health disorder. Some people who engage in this behavior do so because they are suffering from depression, anxiety disorders, eating disorders, or other forms of mental illness. However, others who engage in self-harm do not meet the clinical criteria for a mental health diagnosis.  

Regardless of what causes a person to engage in self-harm, this is a clearly dangerous behavior that may require professional care. The good news is that, with the right help, adolescents and adults can regain control of their thoughts and actions and overcome the urge to harm themselves.

Statistics about self-harm

The American Psychological Association (APA) has reported the following statistics about self-harming behaviors among adolescents and adults in the United States: 

• The rate of self-harm among adolescents is about 17%. 
• About 15% of college students have engaged in self-harm at least once during their college years. 
• Among adults, the rate of self-harm is about 5%. 
• Experts estimate that 35%-50% of self-harm cases involve males. 
• About 47% of bisexual females have engaged in self-harm.

Causes and risk factors for self-harm

No single cause or set of circumstances is present in every case of self-harm. The likelihood that a person will engage in self-harm may be influenced by a variety of internal and external factors, including the following: 

• Gender (most studies indicate that self-harm is more common among girls and women than among boys and men) 
• Family history of mental illness 
• Personal struggles with certain mental health disorders 
• Substance abuse and addiction 
• Personal history of trauma 
• Childhood adversity 
• Experiencing overwhelming amounts of stress or pressure 
• Low self-esteem or poor self-image 

Symptoms of self-harm   

Self-harm can take many forms and may be accompanied by a variety of associated thought patterns, actions, and physical effects. With the exception of the self-harm itself, there is no other symptom that is present among all who struggle with this behavior.  

However, the following are among the more common signs and symptoms that may indicate that a person is experiencing the compulsion to engage in self-harm: 

Behavioral symptoms: 

• Wearing long sleeves and long pants, even in hot weather (in an attempt to hide evidence of self-injury) 
• Withdrawing from family and friends 
• Spending significant amounts of time alone 
• Lying or being secretive regarding whereabouts and activities 
• Ending participation in hobbies or pursuits that were previously of great importance 
• Acting with uncharacteristic recklessness 

Physical symptoms: 

• Abnormal sleep patterns (including either insomnia or hypersomnia) 
• Significant change in appetite 
• Dramatically increased or decreased energy levels 

Mental symptoms: 

• Problems with focus or concentration 
• Dramatic mood swings 
• Pervasive sense of shame or guilt 
• Unexplained outbursts of anger or irritability 
• Diminished sense of self-esteem or self-worth

Effects of self-harm

A person who needs but does not get effective care for self-harm may be at risk for a variety of negative effects. These outcomes may result from the self-harming behaviors themselves, as well as from the disorders, symptoms, or emotions that led to the problem in the first place:  

• Strained or ruined relationships with family, friends, peers, or colleagues 
• Substandard performance in school  
• Job loss, unemployment, and resultant financial problems 
• Physical injuries due to self-harming behaviors 
• Social withdrawal and isolation 
• Onset or worsening of other symptoms of mental illness 
• Poor self-esteem 
• Loss of self-confidence 
• Overwhelming sense of hopelessness 
• Suicidal ideation 
• Suicide attempts 

Please note that the effects listed above can be avoided. When you get professional help to overcome the compulsion to harm yourself, you significantly lower your risk for these outcomes. While you are receiving care, you can also begin to heal from any damage that you have already experienced. With the right type and level of assistance, you can learn how to respond to stresses, pressures, and other triggers in a healthier manner, without succumbing to the urge to harm yourself.

Common co-occurring disorders among people who engage in self-harm 

As noted earlier on this page, not everyone who engages in self-harm is suffering from a mental health disorder. However, this behavior is often a symptom of a mental or behavioral health concern. Adolescents and adults who have been engaging in self-harm may be at increased risk for the following: 

• Eating disorders 
• Schizophrenia 
• Borderline personality disorder 
• Anxiety disorders 
• Depressive disorders 
• Bipolar disorder 
• Posttraumatic stress disorder (PTSD) 
• Substance abuse and addiction