Reasons Why People Self-Harm, According to Therapists

We review five common reasons why people self-harm, plus how to recognize when it may be a sign of mental illness.

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Deliberate self-harm, or non-suicidal self-injury (NSSI), is when a person intentionally causes themselves physical harm. Self-harm can also involve thoughts and behaviors that cause psychological pain, such as negative self-talk, self-sabotaging behaviors, and harmful thought patterns. While the definition of self-harm is pretty straightforward, the reasons why people engage in self-harming behaviors are a bit more nuanced. 

“People self-harm, or hurt themselves on purpose, for different reasons,” says Alysson Thewes, MSW, LCSW, a Charlie Health Primary Therapist. She adds that when people feel extremely overwhelmed or upset, they may cope by harming themselves through behaviors like cutting, burning, hair pulling, or hitting themselves. Below, we review leading self-harm causes, risk factors, and associated mental health conditions so that you can better understand why people experience the urge to self-harm. 

Why do people self-harm?

People self-harm for very personal reasons, but there are several common causes. According to Mental Health America, people may self-harm for the following reasons: 

1. To cope with difficult feelings

Self-harm can be a way to cope with intense feelings like anger, fear, frustration, overwhelm, and sadness. When someone doesn’t have the emotional regulation skills to handle difficult situations and emotions, they may be more likely to turn to unhealthy coping mechanisms like self-harm. 

2. To feel something

On the other hand, people who are emotionally numb may self-harm in order to feel something. “It can be because the pain feels good,” says Thewes. The pain can also serve as a way to reconnect with emotions that feel otherwise inaccessible—a physical jolt that momentarily breaks through the numbness and creates a sense of emotional presence, even if fleeting.

3. To gain control

Deliberate self-harm can also be a way to gain a sense of control in life. Between work, school, relationships, and finding your purpose in life, the pressure to succeed can feel overwhelming. For some people, self-harm allows them to feel in control of at least one aspect of life. 

4. To punish themself

Self-harm can also be a form of self-punishment. If you have negative beliefs about yourself or are struggling with feelings like shame, guilt, worthlessness, and self-loathing, you may turn to self-harm as a way to punish yourself for perceived mistakes. 

5. To ask for help

Though the stigma around self-harm has people believe it can be attention-seeking behavior, it is actually a way that someone is letting others know that they may need support and are in emotional, physical, or psychological pain.

Is self-harm a sign of a mental health condition? 

Self-harm is not a diagnosable mental health condition, but research consistently shows it can be a sign or symptom of one. If you or someone you know engages in self-harming behaviors, it may be associated with an underlying mental health condition like:

• Anxiety
• Bipolar disorder
• Borderline personality disorder (BPD)
• Depression 
• Eating disorders 
• Obsessive-compulsive disorder  (OCD)
• Post-traumatic stress disorder (PTSD)
• Substance use disorders 

It’s important to note that self-harm is not the same as suicidal thoughts and behaviors. Unlike self-harm, suicidal behavior involves an intent to end your life — such as expressing suicidal thoughts and feelings, making a suicide plan, and attempting suicide. But while there’s a clear difference between the two, there’s also a strong association. Engaging in self-harming behaviors may lead to accidental medical complications or death. One study even suggested that self-harm may serve as a “gateway behavior” for suicide. 

What are the risk factors for self-harm? 

Anyone can engage in self-harming behaviors, but there are several risk factors that may increase your chances of self-harm. 

Age and gender

Research shows that self-harm is more common among females ages 16–19 years. Many people who self-harm first begin around 12-14 years old, and it’s particularly prevalent among college students. 

Gender identity and sexual orientation

Young people who identify as LGBTQIA+ report higher rates of self-harming behaviors compared to straight and cisgender youth. Some of the top reasons why LGBTQIA+ youth self-harm is to relieve stress, deal with frustration, and cope with uncomfortable feelings like anxiety and depression.

History of trauma

According to some research, bullying, childhood abuse, parental divorce, and other types of traumatic events are leading risk factors for self-harm in young people.

Limited support system

People who feel lonely or have limited social support may be more likely to engage in unhealthy behaviors such as self-harm. The previously mentioned study also found that a lack of friends and poor family relationships can also contribute to an increased risk of self-harm. 

Unhealthy substance use or substance abuse

You may be more likely to self-harm if you binge drink or use illegal drugs since these substances limit self-control.

Is self-harm addictive?

Self-harm is considered a type of behavioral addiction. When someone engages in self-harm, they experience physical pain that can help relieve their emotional distress. It may provide some temporary emotional relief, but it’s not a sustainable solution for coping with emotional pain. 

While it’s possible to self-harm once and then never again, many people find themselves in a toxic cycle of self-harming behavior. For some people, the act of self-harm can cause feelings like shame and guilt — which may lead to further self-harm to cope with those intense negative feelings. This cycle can become addictive because self-harm may offer a temporary sense of emotional release or control, providing momentary relief from overwhelming thoughts or numbness.

How to recognize self-harm triggers

One of the first steps in stopping the cycle of self-harm is to recognize why it’s happening in the first place. If you’re not sure why you self-harm, here are some questions to help you recognize triggering thoughts and situations:  

• How do I feel before I get the urge to self-harm? 
• What happened before the last time I self-harmed? 
• Do any of my habits or routines contribute to that feeling?
• Are there certain people, places, or things that make me want to self-harm?

It’s not always easy to tell when someone else is self-harming, but there are several signs that suggest someone may be engaging in self-harming behavior. Recognizing the signs can help you identify when someone is struggling so you can support them in getting the care they need. 

• Changes in mood
• Unexplained cuts, bruises, or scars
• Wearing concealing clothing, even in warm weather
• Social withdrawal and isolation
• Secrecy 
• Deliberate self-injury like cutting, burning, or scratching

How Charlie Health can help

If you or a loved one have a history of self-harm, Charlie Health is here to help. Charlie Health’s behavioral health programs, including its virtual Intensive Outpatient Program (IOP), provide more than once-weekly mental health treatment for dealing with serious mental health conditions, including bipolar disorder, borderline personality disorder, and suicidal thoughts and behaviors. Our expert clinicians incorporate evidence-based therapies into individual therapy, family therapy, and group sessions. With treatment, learning why you self-harm and how to stop it is possible. Fill out the form below or give us a call to start healing today.