What is Self-Harm? Symptoms, Causes & Treatment

Learn about why people self-harm, healthy coping skills to manage self-harm thoughts, and how to prevent self-harm safely and effectively.

Trigger warning: Suicide; Self-harm. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

Self-harm is a sensitive and often misunderstood topic, often surrounded by stigma and silence. Many people who struggle with self-harm behavior feel isolated and ashamed, which can prevent them from reaching out for help. Here is a deeper explanation of the reasons behind self-harming behavior, its links to mental health struggles, and the emotional pain that often drives such actions. Understanding self-harm is the first step toward providing support, and with the right care and resources, people can learn to manage their emotions and begin the journey of recovery and healing.

What is self harm? 

Self-harm, also referred to as self-injury or self-inflicted injury, involves intentionally inflicting harm on oneself as a way to cope with emotional distress. It may manifest as cutting, burning, hitting oneself, or engaging in other forms of self-inflicted harm; however, it’s important to note that self-harm is distinct from suicidal behavior. While both involve harming oneself, self-harm is typically not done with the intent to end one’s life; instead, it is often a response to overwhelming emotional pain or distress. Despite this, there is an undeniable link between nonsuicidal self-injury and suicidal thoughts, as the emotional turmoil can lead to deeper feelings of hopelessness.

The link between self-harm and suicidal thoughts

While self-harm is not always an attempt to end one’s life, it is closely linked to suicidal thoughts and behavior, sometimes leading to it. People who self-harm may have underlying feelings of despair and hopelessness, which can escalate into thoughts of suicide. Although self-harm is a type of coping mechanism, it can be dangerous, and in some cases, people may unintentionally harm themselves severely. It’s important to differentiate between the two behaviors, with self-harm typically involving inflicting harm to cope with emotional distress and suicide involving the intent to end one’s life. However, both behaviors share the commonality of emotional pain and require attention and intervention as soon as possible.

How is self-harm a coping mechanism? 

One of the primary reasons people engage in self-harming behavior is to cope with emotional pain, as people who self-harm often feel overwhelmed by emotions such as sadness, anger, guilt, or numbness. For some, the act of self-harm provides temporary relief or a sense of control over feelings that feel unmanageable. People who struggle with mental health disorders are also at a higher risk of self-harming behavior, as the emotional distress that comes with them can drive a person to engage in self-injury as a way to temporarily escape the intensity of their pain.

Mental health disorders and self-harm

Self-harm is often linked to various mental health disorders, such as depression, anxiety, bipolar disorder, and borderline personality disorder. These disorders can create intense emotional distress, which can push people to self-harm as a way of coping with feelings that they may not be able to manage otherwise. Here is a further description of the most common mental health disorders seen with self-harming behavior.

1. Depression

Depression is a mental health condition that causes people to experience deep sadness, hopelessness, and emotional numbness, making it difficult to cope with everyday life. These overwhelming feelings can sometimes lead to self-harm, as someone may seek a temporary release or distraction from their intense emotions. While self-harm may offer brief relief, it ultimately does not address the underlying depression and can lead to further emotional and physical harm, making it a destructive coping mechanism. For these reasons, it’s important to seek healthier forms of support and treatment to manage depression and its effects on everyday life. 

2. Bipolar disorder

Those with bipolar disorder experience extreme mood swings, ranging from intense periods of mania or hypomania to episodes of deep depression. During depressive episodes, someone may struggle with overwhelming feelings of sadness, hopelessness, and emotional pain. In some cases, self-harm can become a way to cope with the emotional turmoil, offering temporary relief from the intense emotional pain and whiplash. However, while self-harm may seem like a way to manage the pain in the moment, it is a harmful coping mechanism that can lead to further physical and emotional harm.

3. Borderline personality disorder

People with borderline personality disorder (BPD) often struggle with intense and fluctuating emotions, as well as a profound fear of abandonment. These painful emotions can lead to impulsive behaviors, such as self-harm, which may be used as a way to cope with feelings of emptiness or pain. For some, self-harm provides a temporary sense of control or serves as a way to express their emotions when other outlets feel unavailable. While this behavior might offer short-term relief, it ultimately deepens the emotional pain and can contribute to further distress.

4. Eating disorders

Eating disorders, such as anorexia or bulimia, are another form of self-harm in and of themselves, as people experience intense feelings of shame, guilt, and a distorted perception of their bodies. In an attempt to cope with these thoughts or to maintain a sense of control, some may resort to self-harming behavior. This behavior can serve as a way to manage overwhelming feelings or to punish themselves for perceived shortcomings. However, this pattern of self-harm behavior can further reinforce harmful patterns of thinking and behavior, worsening the emotional and physical toll of the eating disorder and contributing further to low self-esteem. Seeking professional help is crucial for addressing both the eating disorder and the underlying emotional struggles in healthier, more effective ways.

The impact of self-harm on physical health

Self-harming behavior can take a significant physical toll on a person’s body, with consequences ranging from minor physical pain, such as cuts, burns, or bruises, to more severe and life-threatening wounds, depending on the method used. Repeated acts of self-harm can leave permanent scars, and in some cases, excessive harm may lead to severe injuries or even death if left untreated. 

Additionally, frequent self-harming can lead to long-term physical complications, such as infections from open wounds, nerve damage, and tissue scarring, which may affect mobility or function in certain areas of the body. If the self-harming behavior involves cutting or burning the skin, damage to the skin and underlying tissues can also make it more difficult for wounds to heal properly, increasing the risk of chronic pain. Over time, the physical effects of self-harm may result in a diminished sense of physical well-being, reinforcing the emotional and psychological toll of the behavior.

How to cope with self-harm

Here are some strategies for coping with self-harm:

1. Seek professional help

One of the first steps in addressing self-harm is to seek professional help. Therapy provides a safe space to explore emotions, understand the underlying causes of distress, and can help target any mental health disorders that a person might have. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are commonly used to help people break the cycle of self-harm by identifying and reframing their negative thoughts and emotions and developing healthier coping strategies. Support groups and, in some cases, medication for mental health disorders like depression or anxiety can also be beneficial. Professional help is key to providing the tools and support needed for recovery.

2. Practice coping skills 

Developing new coping skills is also important for managing emotional distress and preventing self-harm. Mindfulness exercises, such as deep breathing or meditation, can help people stay present and reduce overwhelming emotions. Relaxation techniques, including progressive muscle relaxation or guided imagery, can alleviate stress and promote a sense of calm. Furthermore, physical activities, like exercise or yoga, are also effective for releasing built-up tension and improving mood, while journaling offers a safe space to express difficult emotions and reflect on personal struggles. By incorporating these healthier coping strategies into daily life, people can create positive ways to manage their emotions instead of harmful ones and break the cycle of self-harm.

3. Develop a safety plan

For those experiencing immediate urges to self-harm, creating a safety plan with the help of a mental health professional can be a crucial step in their recovery. These plans typically involve identifying personal triggers that lead to the urge to self-harm and developing strategies to manage those triggers. They often include having a list of emergency contacts or supportive people to reach out to during moments of crisis, as well as coping strategies like grounding exercises or engaging in a calming activity to redirect attention. A safety plan provides structure and support, helping people feel more equipped to handle overwhelming emotions and reduce the risk of self-harm in critical moments.

How to prevent self-harm from developing further

While self-harm is often a sign of deeper emotional distress and doesn’t always indicate suicidal intent, it can increase the risk of suicide. For people who self-harm, feelings of despair and hopelessness may eventually become so overwhelming that they lead to thoughts of ending their lives. Recognizing the signs of self-harm and understanding the potential for suicidal thoughts is critical for suicide prevention. Providing immediate support and intervention is essential to prevent the situation from escalating. As mentioned above, mental health professionals can guide people through these emotions, addressing underlying issues such as mental health disorders, substance use, and trauma while offering resources and strategies to help break the cycle of self-harm and reduce the risk of suicide.

How Charlie Health can help

If you or a loved one are struggling with a mental health disorder, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions, including self-harm. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.