Self-harm, also called nonsuicidal self-injury, is not technically a mental health disorder. Rather, it is considered a negative coping mechanism. It often indicates an underlying disorder such as depression, anxiety, or an eating disorder.
If someone you know intentionally hurts themselves, you may find it hard to understand why they’re doing this. Here is an overview of self-harm behaviors and reasons why people engage in nonsuicidal self-injury (NSSI).
Common Self-Harm Behaviors
Self-injury behaviors may include:
- Inserting objects under the skin
- Pulling out hair
- Skin picking
Many of these behaviors leave scars, bruises, or other physical damage. If you notice unexplained injuries in a loved one, it could be a sign of self-harm. Here are some other signs to look out for:
- Wearing long sleeves and/or long pants, even in warm weather
- Frequently carrying sharp objects or keeping sharp objects in their home/room
- Making excuses for frequent injuries
- Difficulty coping with negative emotions
- Low-self esteem
- Poor impulse control
Reasons for Nonsuicidal Self-Injury
People may engage in self-injury for a variety of reasons:
- As a coping mechanism for intense negative emotions
- To relieve emotional numbness
- To release the body’s natural pain-killers and lift mood (self-injury stimulates endorphins)
- To punish themselves for perceived failures or flaws
- As a form of nonverbal communication when they have trouble discussing their feelings
A common myth about self-harm is that people who do it are seeking attention or trying to manipulate their loved ones. In reality, people who self-harm often go to great lengths to conceal their injuries and will often lie about the true nature of their scars or bruises.
Self-Harm and Suicide
Another common misconception is that self-harm indicates suicidal intent. Self-harm scars may be mistaken for a suicide attempt. Most people who self-harm do not intend to take their own life, although they may experience suicidal thoughts in addition to self-harm behaviors. Nonsuicidal self-injury can also be a risk factor for suicidal ideation, so people who engage in these behaviors should be screened for suicide risk.
Who Is At Risk for Nonsuicidal Self-Injury?
There are certain risk factors that make it more likely for someone to self-harm, including:
- Trauma such as bullying, neglect, or physical, emotional, or sexual abuse
- Mental health conditions like depression, anxiety, and post-traumatic stress disorder
- Alcohol or drug use
- Negative body image
- Having friends who self-harm
Self-Injury Among Adolescents
Anyone can self-harm, regardless of their age or gender, but teenagers are at increased risk. In one study, the national average of teens who self-harm was estimated at 1 in 4 girls and 1 in 10 boys. In every state that participated in the study, a higher percentage of girls reported self-harm behaviors.
How to Help a Teenager Who Self-Harms
Parents, teachers, coaches, and other adults should be aware of the signs of self-harm and know what to do if a child is engaging in self-injury.
For teachers, coaches, and other professionals working with children:
The first thing you should do is talk to the child about your concerns. Let them know that you are there as a support person and they can talk to you about anything that’s troubling them. Whether they admit to self-harm or not, you should share your concerns with another adult who can help them. Talk to the school nurse and guidance counselor, as well as their parents.
For parents or guardians:
As a parent, you’re understandably alarmed by your child’s self-injury behaviors. It’s important to remain calm when speaking about the issue. Try to ask objective, non-judgmental questions about your teen’s reasons for self-harming. This will give you an idea of what could be contributing to the behavior.
Talk to your child’s doctor or a mental health professional to see if there is an underlying mental health condition. Even if a mental health disorder isn’t present, your child could benefit from counseling to teach them positive coping strategies and reduce self-harming behaviors.
Treatment for Self-Harm
Self-harm is most often treated with counseling. Some therapies that might be helpful include psychodynamic therapy, cognitive behavioral therapy (CBT), and dialectical behavior therapy (DBT). Treatment goals will focus on identifying the cause of the self-harm behavior and finding positive alternatives. A doctor or psychiatrist might also prescribe medication if there is a mental health disorder present.
If you or someone you know is self-harming, it’s important to seek professional help. Effective intervention can teach positive coping skills and reduce self-injury behaviors. At The Light Program, we have therapists trained in a variety of techniques. Find a location near you to begin working with a counselor today.