Self-Harm & Self-Injury Causes & Effects

Learn about self-harm

Self-harm, also known as self-injury, self-inflicted violence, and non-suicidal self-injury, is the deliberate act of causing physical harm to oneself. While cutting can often appear to be a sign of attempted suicide, most children and teens who engage in self-injury are not actively suicidal. Unfortunately, there is always a risk of death involved in self-injurious behaviors as the person may cut too deeply or hurt themselves beyond the point of which their body is capable of repairing the damage.

It can be very hard to understand why a person would hurt him or herself, as most people attempt to avoid unnecessary pain. Self-injury can serve a number of purposes for children and teens. Some may self-mutilate to take risks, rebel, reject the values of their parents, state their individuality, or to be accepted by peers. Others may hurt themselves out of desperation, anger, or to showcase their inner feelings of helplessness and worthlessness. Teens and children who self-injure often have trouble talking about their feelings and use self-harm as a means to release the emotional tension, physical discomfort, pain, and low self-esteem they feel. Some children and teens who engage in self-harm may feel an immediate sense of relief after their injury while others may feel hurt, hate, anger, and fear. Often, self-injury is done in secrecy to avoid the shame of sharing this deeply hurtful act with others.

While self-harm is often called “cutting,” there are a number of ways in which a person can deliberately hurt him or herself:

• Carving
• Scratching
• Branding
• Marking
• Burning
• Abrasions
• Picking skin
• Pulling hair
• Cutting
• Biting
• Head banging
• Bruising
• Hitting
• Ingesting poisonous materials such as bleach

As self-harming behaviors can become unintentionally fatal, any parent or guardian concerned for their child or teen should seek treatment immediately to prevent any complications and promote more positive outcomes.

Self-harm statistics

There appears to be an epidemic of self-injury among teens today. Preteens and adolescents between the ages of 12 and 19 are engaging in self-injury in ever-increasing numbers. Research indicates that over 10% of teens have experimented with self-injury. In the United States estimates suggest that one in every 200 girls between the ages of 13 and 19 years old regularly engage in self-injurious behaviors. Treatment centers report that visits by teens who self-injure have doubled over the past three years.

Causes and risk factors for self-harm

Researchers in the field believe that self-injurious behaviors are not the result of one single factor but rather a number of causes and risk factors working together. The most common causes for self-injury may include a combination of the following:

Genetic: A number of mental illnesses that can trigger self-harming impulses, such as borderline personality disorder and depressive disorders, are thought to have genetic components.

Physical: Many mental health disorders are thought to be the result of imbalances in certain neurotransmitters in the brain involved in emotional regulation and feelings of pleasure. These people may self-harm as a means to feel less empty, to control their emotions, or as the result of a mental illness.

Environmental: Children and teens who have been abused – physically, sexually, verbally, or emotionally – are at a greater risk for developing self-injurious behaviors as a means to cope. During the abuse, these people were unable to express emotions and feelings in a healthy manner and learned to use self-injury to cope with the overwhelming emotions of the trauma.

Risk Factors:

• Being female
• Being in one’s teens or early 20s
• Having friends who engage in self-injury
• Unstable personal identity
• Unstable sexuality
• Drug and alcohol abuse and addiction

Signs and symptoms of self-harm

As self-injury is often done in private, it can be challenging to know when a loved one or friend is engaging in self-harming behaviors. The signs and symptoms of self-injury will vary depending upon the methods a person uses, co-occurring disorders, and drug or alcohol use. Signs and symptoms of self-injury include:

Behavioral symptoms:

• Dressing inappropriately for the weather, such as wearing long pants and long-sleeved shirts in the summer
• Brushing off injuries as frequent “accidents” or as the result of being clumsy
• The need to spend increasing amounts of time alone
• Challenges with friendships and romantic relationships
• Keeping sharp objects or implements of self-injury available at all times, even while at school
• Gradual withdrawal from once-enjoyed activities
• Unpredictable, impulsive, risky behaviors
• Bloody clothing, towels, or bedding

Physical symptoms:

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

Cognitive symptoms:

• Ongoing questions about personal identity
• Thoughts of helplessness, hopelessness, or worthlessness

Psychosocial symptoms:

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

Effects of self-harm

While self-injury is not considered to be a suicidal act, the chronic effects of self-harm range from trivial irritants, to severe injuries, to unintentional death. This spectrum of consequences is why it is of vital importance that those who self-harm seek the help of mental health professionals for treatment. Long-term self-harm effects will depend upon the ways in which a person harms him or herself, the presence of alcohol or drug use, and co-occurring mental health disorders. The most common consequences of untreated self-harm include:

• Broken bones
• Social isolation and poor interpersonal relationships
• Increasing 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 of the body
• Loss of limb or appendage
• Multi-organ damage and/or failure
• Infections at the site of self-injury
• Septicemia
• Suicidal thoughts and behaviors
• Accidental, inadvertent death

Self-harm and co-occurring disorders

Self-injurious behavior is often the result of an undiagnosed or untreated mental illness. The most common mental health disorders that have self-harm as a symptoms include:

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