Self-harm, also known as nonsuicidal self-injury disorder, is when a person physically injures themselves on purpose. People usually self-harm to cope with emotional pain, anger, sadness and/or stress, and is most common in people with strong tendencies for self-criticism or other self-directed negative emotions. For people who self-harm, it can bring immediate relief from their intense emotions, but is often followed by guilt and shame in addition to the return of the initial emotional pain.

According to the National Institute of Health:

• Onset typically occurs around ages 13-14
• 6% of adults report a history of self-harm
• Rates of self-harm are highest among people who report feelings of emotional distress, such as depression, anxiety and emotion dysregulation
• Rates of self-harm are equal in women and men
• Self-harm rates are higher in LGBTQIA+ populations

Self-harm can be caused by cutting one’s skin with a sharp object, such as a razor blade or knife, burning, using objects to hit the body, punching a wall or scratching or rubbing the skin until injury is induced. The most common areas for self-harm are on the arms, wrists, abdomen and thighs.

The Mayo Clinic lists indications and symptoms of self-harm as:

• Scars, often in patterns
• Fresh cuts, scratches, bruises or other wounds
• Keeping sharp objects or other items used for self-injury on hand
• Wearing long sleeves or long pants to hide self-injury, even in hot weather
• Frequent reports of accidental injury
• Difficulties in relationships with others
• Behaviors and emotions that change quickly and are impulsive, intense and unexpected
• Talk of helplessness, hopelessness or worthlessness

Any thoughts of self-harm are an indication to seek professional help. Open wounding from self-injury that isn’t treated can become infected and/or cause nerve damage. Self-harm can also cause permanent scarring and lead to severe injury, accidental death or increased likelihood of suicide.

Treatment for Self-Harm

Once physical wounding is treated, if required, self-harm is treated through emotional and psychological interventions that address the root cause of self-harm. These may include:

• Psychotherapy: Psychotherapy involves talking with a mental health professional and can include individual, group and/or family therapy. This process helps identify and change emotions, thoughts and behaviors that may contribute to self-harm. There are many psychotherapy modalities, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and more.
• Medication: Medications may be effective in treating any underlying mental health disorders, such as depression, bipolar disorder, anxiety or others and are often used in conjunction with psychotherapy. There are several different types of antidepressants, and it may take time to figure out the most effective one. Some antidepressants have side effects, which often improve with time. If they don’t, talk to your healthcare provider about trying a different medication or pursuing a different treatment option.
• Holistic therapies: Holistic therapies and complementary medicine include yoga, mindfulness and meditation practices, equine therapy, massage and more. These can be used in tandem with any other treatment methods.

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