Causes & Symptoms of Self-Injury

Self-harming behaviors occur when someone purposely and intentionally inflicts some form of pain onto him or herself. Such behaviors can include cutting, burning, or biting oneself, pulling out one’s hair, banging one’s head against a hard object, or punching oneself. While not necessarily as common, some people will injure themselves by purposely drinking harmful substances like bleach, detergent, or other household chemicals, or by purposely breaking their own bones.

One common misconception about self-harm is that people are participating in such acts as a means of ending their own lives. Typically, this is not the case. The majority of individuals who purposely injure themselves do so as a means of dealing with an inner sense of emotional turmoil that is so powerful that they cannot find any other way to cope with it. By inflicting physical pain onto themselves, these people are able to control the pain they are feeling, giving them back the sense of control that they lost through their emotional pain.

Other individuals will use self-mutilation in order to ground themselves in reality. For example, people who suffer from dissociative episodes or feelings of depersonalization and derealization often use self-harm as a way to forcefully make themselves return to the world around them. The physical pain provides them with something tangible to focus on.

Regardless of the reason or reasons why an individual begins harming him or herself, it is a behavior that requires immediate treatment because even if the person does not start the behavior with the intention of committing suicide, the line between self-injury and making an actual suicide attempt can be crossed at any time.

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The act of self-harm is something that is most commonly done in private, which makes it difficult to compile any exact statistics on the true prevalence of how often these behaviors occur or how many people are participating in them. However, results from different studies have shown that approximately 10% of teenagers between the ages of 12 and 19 have experimented with self-mutilation. Additional estimates state that 1 in every 200 girls between the ages of 13 and 19 engage in self-harming behaviors on a regular basis.

Causes and Risk Factors of Self-Harm

Professionals in the field agree that the contributing factors that can ultimately lead a person to start harming him or herself are a compilation of genetic, physical, and environmental factors, as described in the following:

Genetic: Self-injury is often symptomatic of the presence of a mental health disorder, and these types of disorders are known to have a strong genetic component. For example, disorders such as bipolar disorder, anxiety disorders, and depressive disorders are all known to run in families and all may lead to the onset of self-harming behaviors. Therefore, individuals who have family members who struggle with mental illnesses are likely to be at a higher risk for beginning to participate in self-mutilating behaviors.

Physical: The brain consists of neurotransmitters that are responsible for appropriately regulating emotions. When these neurotransmitters suffer an imbalance, an individual becomes more susceptible to developing a mental disorder, which can then lead to the onset of self-injurious behaviors.

Environmental: The environment in which children and adolescents spend a great deal of time can have a momentous impact on whether or not they will begin to self-harm. Individuals who grow up in chaotic or violent homes may turn to self-harm as a way of gaining a sense of control over themselves because they are unable to control anything else in their lives. Similarly, individuals who have been made victims of abuse may begin self-injuring as a means of numbing themselves from the residual pain of their experiences.

Risk Factors:

  • Being female
  • Being in the age group of adolescents, teens, and young adults
  • Personal history of depression or other mental illness
  • Family history of mental illness
  • Having friends or family members who self-harm
  • Lacking appropriate coping skills
  • Experiencing trauma
  • Lacking the ability to regulate one’s emotions
  • Lacking strong, healthy interpersonal relationships
  • Experiencing the death or loss of a loved one

Signs and Symptoms of Self-Harm

The signs and symptoms that may be exhibited by an individual who is self-injuring can vary greatly from person to person. Due to the fact that the majority of people who partake in these behaviors go to great lengths to keep their behaviors a secret, the signs may not be as evident as one would hope. However, there are some warning signs to look out for that may indicate that a problem exists and requires further inquiry. Examples of such signs may include:

Behavioral symptoms:

  • No longer participating in activities that were once highly enjoyed
  • Wearing long-sleeved shirts or long pants, even when the weather is hot
  • Isolating oneself from family and friends / spending significant amounts of time alone
  • When confronted with the presence of noticeable injuries, brushing them off as being “accidents”

Physical symptoms:

  • Patches of missing hair
  • Frequent bruises
  • Frequent scrapes or cuts
  • Presence of scars
  • Frequent, unexplained broken bones

Cognitive symptoms:

  • Having difficulty controlling impulses
  • Chronic, uncontrollable thoughts of wanting to self-harm
  • Dissociating
  • Having extreme difficulty concentrating and focusing
  • Ruminating thoughts about one’s personal identity

Psychosocial symptoms:

  • Feelings of helplessness
  • Feelings of hopelessness
  • Feelings of worthlessness
  • Feeling guilty and ashamed
  • Feeling disgusted by oneself
  • Emotional numbing
  • Emotional instability
  • Ever-increasing feelings of anxiety, especially when unable to self-harm
If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.

Effects of Self-Harm

When a person is participating in self-harming behaviors and does not receive treatment to help address the underlying reasons for why the behavior exists, the long-term effects can be detrimental. Examples of such effects may include:

  • Increased frequency of the self-injurious behaviors
  • Increased feelings of shame, disgust, and guilt
  • Developing an addiction to drugs and/or alcohol
  • Complete isolation from family and friends
  • Familial discord
  • Academic failure
  • Consistent and intrusive thoughts about the behavior itself
  • Accidental death

Additionally, depending on the method by which one uses to self-harm, there can be long-term physical consequences as well, including:

  • Infected wounds
  • Severe bleeding
  • Anemia
  • Permanent scarring
  • Permanent tissue damage
  • Permanent numbness in certain parts of the body
  • Permanent weakness in certain parts of the body
  • Improper healing of broken bones
  • Damage to organs
  • Multi-organ failure

Co-Occurring Disorders

It is not uncommon for individuals who self-injure to be suffering from a mental illness, as the behavior itself can by symptomatic of a variety of different mental health disorders. The disorders most commonly associated with self-mutilation include:

  • Depressive disorders
  • Bipolar disorder
  • Obsessive-compulsive disorder
  • Panic disorder
  • Other anxiety disorders
  • Post-traumatic stress disorder
  • Borderline personality disorder
  • Schizophrenia
  • Eating disorders
  • Substance abuse disorders
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