Self-harm is a dangerous and often misunderstood behavior. Sometimes also referred to as self-injury, self-mutilation, and nonsuicidal self-injury (NSSI), self-harm involves the intentional infliction of pain or harm on one’s own body.
As the term NSSI indicates, self-harming behaviors are not suicide attempts. Of course, some people who engage in self-harm may also struggle with suicidal ideation. And certain self-harming behaviors may, unfortunately, lead to accidental death. But there is a distinct difference between self-harm and suicide.
It is also important to understand that self-harm is not a mental health disorder, though it can be a symptom of several mental illnesses. People who engage in self-harm may do so for several reasons, including the following:
- They are attempting to punish themselves for something they did or didn’t do.
- They feel that they have little to no control over their life, and they are using self-harm as a means of establishing some sense of control.
- They are trying to give a physical presence to emotional pain.
- They are responding to recurring, intrusive thoughts related to untreated trauma.
- They have been bullied, harassed, ostracized, or mistreated by their peers.
No matter why a person begins to engage in self-harm, they may need professional treatment to end this behavior. Thankfully, when a person receives the appropriate type and level of care, they can regain control over their thoughts and actions. With proper treatment, a person can stop engaging in self-harm and start living a healthier and more hopeful life.
Signs & Symptoms of Self-Harm
The signs and symptoms of self-harm can vary considerably from one person to the next. People who engage in self-harm may do so in a variety of ways, including the following:
- Burning their skin with lighters, candles, cigarettes, or other objects
- Repeatedly cutting themselves, often in the abdomen, upper thighs, or arms
- Pulling their hair out
- Inserting needles or other sharp objects under their skin
- Picking at scabs and sores to prevent them from healing
- Punching themselves or hitting their head against solid objects
- Hitting their limbs against hard objects with the intention of bruising their skin or breaking bones
- Forcing themselves to exercise well past the point of exhaustion
People who intentionally harm themselves often go to great lengths to hide these behaviors and the effects the behaviors have had on their bodies. Although the following are not examples of self-harm, they can be signs and symptoms that a person has been engaging in self-harm:
- Wearing long sleeves and long pants, even in hot weather
- Wearing baggy, shapeless clothing
- Refusing to change clothes in front of someone else
- Suffering from frequent unexplained injuries
- Having bruises, cuts, and other injuries that never seem to heal properly
- Exhibiting dramatic mood swings
- Acting with uncharacteristic impulsivity or instability
- Losing interest in hobbies or other important activities
- Failing to meet expectations at home or in school
- Pulling away from family and friends
- Spending excessive amounts of time alone
- Speaking of themselves with disdain or even self-hatred
Self-harm can have a significant impact on a person’s body and mind. Anyone who has been experiencing the signs and symptoms of self-harm may be in crisis and should consult with a qualified healthcare provider immediately. With proper treatment, a person can overcome the urge to harm themselves and achieve improved mental health.
Since people who intentionally harm themselves often work hard to keep this behavior a secret from family members, friends, and even medical professionals, it can be difficult to get an accurate statistical snapshot of the prevalence of self-harm. However, considerable research has enabled experts to make data-supported estimates about how many people engage in self-harm.
The American Psychological Association has reported the following statistics about self-harm:
- The rate of self-injury among adults age 18 and older is about 5%.
- Among college students, the rate of self-harm is about 15%.
- Among college students who have engaged in NSSI, about 33% told researchers they hurt themselves severely enough to require medical attention. However, only about 5% of this population sought professional care for their self-inflicted injuries.
- About 17% of adolescents have engaged in self-harm at least once.
- The rate of self-injury among children ages 5-10 is about 1.3%.
- Males account for 35%-50% of self-injury cases.
- As many as 55% of people who self-injure are struggling with an eating disorder.
What Causes Self-Harm?
A person’s risk for self-harm can be influenced by a variety of internal and external factors.
For example, self-harm is sometimes, but not always, related to a mental health disorder. Disorders that are associated with an increased risk of self-harm include the following:
- Anxiety disorders
- Depressive disorders
- Eating disorders
- Substance use disorders (addictions)
- Bipolar disorder
The following characteristics, personality traits, and circumstances may also increase the likelihood that a person will engage in self-harm:
- Poor self-esteem
- Exposure to overwhelming stress or pressure
- Poor stress management skills
- Lack of sufficient social support
- History of untreated trauma
- Being bullied or harassed
- Age (self-harm is most common among adolescents)
- Being a member of the LGBTQIA+ community
In addition to helping a person overcome the urge to harm themselves, effective treatment can also address the mental health disorder or other underlying cause that may have contributed to the behavior in the first place.
Effects of Untreated Self-Harm
Without proper professional care, people who continue to engage in self-harm can expose themselves to significant physical, psychological, and social damage. The following are examples of the many potential negative effects of untreated self-harm:
- Infections, broken bones, and other serious physical health concerns
- Worsened health problems due to a reluctance to seek medical assistance
- Permanent damage to organs or other body parts
- Onset or worsening of mental health disorders
- Substance abuse and addiction
- Conflicts with family members and other loved ones
- Inability to form and maintain healthy friendships and romantic relationships
- Withdrawal and isolation
- Reduced performance in school or at work
- Academic setbacks
- Job loss and long-term unemployment
- Increased shame, guilt, and self-loathing
- Accidental death
The potential effects of untreated self-harm do not follow a predictable pattern. Even one instance of self-harm can cause irreversible damage or even death. This is one of the many reasons why people who are struggling with self-harm and related mental health concerns need immediate help.
When a person is receiving treatment for self-harm, they will be under the care and supervision of a team of experts. These dedicated professionals can keep the person safe while they work to address the challenges that may have prompted them to engage in self-harm.
During treatment, a person can begin to heal from any damage they might have experienced while also learning how to manage their symptoms and avoid future harm.
Levels of Care for Self-Harm
When a person is seeking treatment for self-harm and related mental health concerns, it is important to determine which level or levels of care are right for them. At CenterPointe Hospital, we offer self-harm treatment for adults and adolescents at the following levels:
- Inpatient treatment: The general goal of inpatient treatment is to help patients achieve the level of stabilization that will allow them to safely return home or step down to a lower level of care. People who receive inpatient treatment for self-harm benefit from round-the-clock care and supervision. They follow structured, personalized schedules that may include a variety of therapies and support services. Typical length of stay at this level is seven to 10 days.
- Residential treatment: Residential treatment at CenterPointe Hospital also features structured daily schedules, personalized care, several types of therapy and support services, and round-the-clock care. At the residential level, patients typically remain in treatment for 14-28 days.
- Partial hospitalization program (PHP): Our PHP features full days of treatment without a residential component. Clients may step down to our PHP after completing inpatient or residential care, or they may begin treatment at the PHP level. PHP clients may attend treatment five to seven days per week. Each treatment day typically includes four to five hours of care. Typical length of stay at the PHP level is five to seven days.
- Intensive outpatient program (IOP): Our IOP includes three hours of treatment per day, three days a week. As with our PHP, adults and adolescents may step down to one of our IOPs from a higher level of care, or they may enter treatment for self-harm directly at this level. Typical length of stay in one of our IOPs is four to six weeks.
Types of Treatment for Self-Harm
Treatment for self-harm at our hospital is a highly personalized experience. We thoroughly assess each new patient, then develop a customized plan that reflects the full scope of their needs.
Depending on several factors, including the information we gather during the assessment and the level of care the patient is participating in, their treatment for self-harm may include elements such as the following:
- Basic medical services
- Medication management
- Individual therapy
- Process groups
- Psychoeducational groups
- Experiential groups
- Family therapy
- Family support groups
- Trauma-informed therapy
- 12-Step education and support
- SMART Recovery
- Nutrition education
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Motivational interviewing
Before a patient begins any new therapy or support service, a member of their treatment team will explain the procedures and benefits and answer any questions the patient might have. We want all patients to play active roles in their treatment to the greatest degree they are able. Ensuring that each person has the information they need is a vital component of this effort.
This content was written on behalf of and reviewed by the clinical staff at CenterPointe Hospital.