Self-Harm: A Comprehensive Guide
Medically reviewed by Andre Stone | MD, University of Pittsburgh School of Medicine on August 26th, 2026.
Published on April 9th, 2026. Updated on August 28th, 2026.
Key Takeaways
Self-harm involves intentionally hurting yourself to cope with difficult emotions or situations
It affects millions of people, especially teenagers and young adults, regardless of gender or background
Common forms include cutting, burning, hitting, or other physical injuries to oneself
Self-harm is often a way to manage overwhelming feelings, not necessarily an attempt at suicide
Professional help and healthy coping strategies can effectively address self-harm behaviors
Overview
Self-harm means deliberately hurting yourself. This article focuses mainly on non-suicidal self-injury, in which the person does not intend to end their life, although suicidal intent can sometimes be unclear or change over time. People who self-harm typically do so to cope with intense emotional pain, stress, anger, or feelings of emptiness. This behavior can provide temporary relief from overwhelming emotions but often leads to guilt and shame afterward.
Self-harm affects people of all ages, though it most commonly begins during the teenage years. Studies suggest that self-harm is relatively common among adolescents and young adults, but estimates vary depending on the population, definition, and time period studied. It occurs across all racial, ethnic, and socioeconomic backgrounds. While both males and females self-harm, the methods and frequency can vary between genders.
The behavior often starts as a way to feel control or to express emotions that feel too difficult to put into words. Many people who self-harm report feeling relief, calm, or a sense of release after the behavior. However, these feelings are temporary, and the underlying emotional issues remain unaddressed without proper support and treatment.
Symptoms & Signs
Self-harm behaviors can vary widely from person to person. Some people may engage in these behaviors occasionally during times of stress, while others may develop patterns that occur regularly. The signs and symptoms may not always be obvious, as many people who self-harm go to great lengths to hide their behaviors.
Primary Symptoms
Unexplained cuts, scratches, bruises, or burn marks, especially on wrists, arms, thighs, or chest
Keeping sharp objects like razors, knives, or broken glass easily accessible
Wearing long sleeves or pants even in warm weather to cover injuries
Frequent "accidents" that result in injuries or explanations that don't match the wounds
Emotional signs like increased isolation, mood swings, or expressing feelings of worthlessness
When to Seek Care
Warning signs that indicate immediate professional help is needed include thoughts of suicide, severe depression, using increasingly dangerous methods of self-harm, or when the behavior becomes more frequent or severe. If self-harm is accompanied by substance abuse or eating disorders, prompt medical attention is especially important.
When to Seek Immediate Care
Call emergency services now if there is immediate danger, a suicide plan or intent, an overdose, or a serious injury. For any suicidal thoughts, contact a crisis service or healthcare professional promptly for help deciding what support is needed.
Causes & Risk Factors
Self-harm typically develops as a coping mechanism in response to emotional distress. The behavior often begins during adolescence when emotional regulation skills are still developing and life stressors may feel overwhelming. A healthcare professional may also consider physical health problems when symptoms or medical history suggest they could be affecting mood or well-being.
The reasons people begin self-harming are complex and individual. Some people use it to feel something when they feel emotionally numb, while others use it to distract from emotional pain. For some, it provides a sense of control over their body when other aspects of life feel chaotic or uncontrollable.
Age
Risk Factors and Associated Conditions
Self-harm most commonly begins during the teenage years, though it can begin at any age. Risk factors and associated conditions may include family history, social isolation, perfectionism, difficulty expressing emotions, high stress, depression, anxiety, eating disorders, PTSD, and substance use disorders.
Genetics
Family history of self-harm, suicide, or mental health conditions increases risk
Lifestyle
Social isolation, perfectionism, difficulty expressing emotions, or high stress levels
Other Conditions
Depression, anxiety, eating disorders, PTSD, or substance abuse disorders
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Diagnosis and Assessment
Diagnosis
There is no single test to diagnose self-harm behaviors. Instead, healthcare providers rely on honest conversations, physical examinations, and assessment of emotional and mental health. The process typically involves building trust with the patient to encourage open communication about their experiences and behaviors.
Medical History & Physical Examination
During an assessment, healthcare providers will ask about emotional well-being, stress levels, coping strategies, and any history of self-harm or suicidal thoughts. They may also inquire about family history of mental health conditions and recent life changes or stressors. The physical examination may reveal signs of self-injury, though providers are careful to approach this sensitively and without judgment.
Diagnostic Testing
Mental health screening questionnaires to assess depression, anxiety, and other emotional concerns
Risk assessment tools to evaluate the severity of self-harm behaviors and suicide risk
Medical evaluation when symptoms or medical history suggest that a physical health condition or medication may be affecting mood
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Treatment Options
The goal of treating self-harm is to help individuals develop healthier ways to cope with difficult emotions and address the underlying issues that contribute to the behavior. Treatment is most effective when it addresses both the self-harm behaviors and any co-occurring mental health conditions.
Conservative Treatments
Cognitive-behavioral therapy (CBT) to identify triggers and develop alternative coping strategies
Dialectical behavior therapy (DBT) which specifically teaches emotional regulation and distress tolerance skills
Family therapy to improve communication and support systems within the home environment
Support groups where individuals can connect with others who understand their experiences
Advanced Treatments
Intensive outpatient programs when self-harm behaviors are severe or frequent
Residential treatment programs for individuals who need 24-hour support and structure
Medication to address underlying depression, anxiety, or other mental health conditions that contribute to self-harm
Living with the Condition
Learning to manage self-harm urges and developing healthy coping strategies takes time and practice. Building a strong support network and working with healthcare providers can make a significant difference in recovery. Many people find that combining professional treatment with peer support and self-care practices provides the best foundation for healing.
Daily Management Strategies
Create a safety plan that includes removing or securing items used for self-harm, identifying warning signs of urges, and having a list of healthy alternatives ready. Practice relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness meditation. Keep a journal to track emotions and identify patterns or triggers. Maintain regular routines for sleep, meals, and physical activity to support overall emotional stability.
Exercise & Movement
Regular physical activity can help manage stress and improve mood naturally. Safe activities include walking, swimming, dancing, or team sports that provide social connection. Avoid high-risk activities during times of emotional distress. Some people find that safe, moderate movement helps them manage stress while an urge passes. Exercise should not be used to cause pain, injury, or exhaustion; seek support if an urge feels difficult to manage safely.
Prevention
Building emotional resilience and healthy coping skills from an early age can help prevent the development of self-harm behaviors. Open communication about emotions and stress management should be encouraged in families, schools, and communities.
Learn and practice healthy stress management techniques before crisis situations arise
Build strong, supportive relationships with family members, friends, or mentors who can provide emotional support
Develop emotional vocabulary and communication skills to express difficult feelings in words rather than through harmful actions
Address mental health concerns early, and seek medical care for physical health problems that may be affecting emotional well-being
Frequently Asked Questions
Non-suicidal self-injury and suicide attempts are defined by different intentions, but a person’s intent may be mixed, unclear, or change over time. People who self-harm typically do not intend to die but are trying to cope with emotional pain. However, people who self-harm may be at higher risk for suicide, so it's important to take all self-harm seriously and seek professional help.
Talking openly about self-harm in a supportive, non-judgmental way does not increase the risk of self-harm behaviors. In fact, honest conversations can help people feel less alone and more likely to seek help. Avoiding the topic or responding with anger or punishment typically makes the situation worse.
While self-harm is not technically an addiction, it can become a habitual way of coping with stress and difficult emotions. The temporary relief it provides can make it feel necessary, creating a cycle that's hard to break without developing alternative coping strategies and addressing underlying issues.
Listen without judgment, express care and concern, and encourage them to seek professional help. Avoid making promises to keep their self-harm secret, as they may need professional support. Learn about self-harm and evidence-based treatment approaches to better understand the available support options.
Yes, recovery from self-harm often involves setbacks and is rarely a straight line. Having occasional urges or even engaging in self-harm again doesn't mean treatment isn't working or that recovery is impossible. It's important to view setbacks as part of the learning process and continue working toward healthier coping strategies.
Still have questions?
Consult with a healthcare professional for personalized advice.