Self-Injurious Behavior
Deliberately hurting oneself, often to cope with distress
Quick Facts
- Type: Behavioral / mental health concern
- Often a sign of: Emotional distress
- Important: Not the same as a suicide attempt
- Help: Support is available and effective
Overview
Self-injurious behavior means deliberately causing harm to one's own body. In adolescents and adults, it often takes the form of non-suicidal self-injury, such as cutting, scratching, or burning the skin, usually as a way of coping with intense emotional pain. In some children with developmental conditions, self-injury can include behaviors like head-banging or biting, often linked to communication difficulties, frustration, or sensory needs.
Self-injury is a serious sign that a person is struggling, but it is important to know that help works and recovery is possible. Although non-suicidal self-injury is different from a suicide attempt, the two can be linked, so any self-injury deserves a caring, prompt response. If you or someone you know is in immediate danger or has thoughts of suicide, contact emergency services or a crisis line right away.
Signs
Signs that someone may be hurting themselves can include:
- Unexplained cuts, burns, scratches, or bruises, often on the arms, thighs, or stomach
- Wearing long sleeves or pants even in warm weather to cover marks
- Keeping sharp objects on hand without clear reason
- Spending long periods alone, especially in the bathroom or bedroom
- Frequent statements of worthlessness, hopelessness, or being overwhelmed
- In children with developmental conditions, head-banging, biting, hitting, or skin-picking, often when distressed or overstimulated
People often hide self-injury, so a caring, nonjudgmental approach is important if you have concerns.
Causes
Self-injury usually serves a purpose for the person, even when it is harmful. Underlying causes can include:
- Coping with emotions: A way to release or manage overwhelming feelings such as sadness, anger, numbness, or anxiety.
- Mental health conditions: It can occur with depression, anxiety, trauma, and other conditions.
- Developmental conditions: In autism or intellectual disability, self-injury may relate to communication difficulty, frustration, pain, or sensory needs.
- Difficult experiences: Trauma, abuse, loss, or significant stress.
Understanding the reason behind the behavior is key to providing the right help.
Risk Factors
- Depression, anxiety, or a history of trauma
- A history of self-injury
- Difficulty identifying or expressing emotions
- Developmental conditions such as autism or intellectual disability
- Significant life stress, bullying, or loss
- Social isolation or limited support
Evaluation
Self-injury is assessed by a doctor or mental health professional through a caring, supportive evaluation that aims to understand the person and keep them safe:
- Sensitive conversation: Understanding when, how, and why the behavior occurs.
- Safety assessment: Checking for any thoughts of suicide and ensuring immediate safety.
- Mental health assessment: Looking for depression, anxiety, trauma, or other conditions.
- Developmental assessment: In children with developmental conditions, identifying triggers, communication needs, and sensory factors.
The aim is not to judge but to understand and to connect the person with effective support.
Treatment
Treatment focuses on safety, understanding the reasons behind the behavior, and building healthier ways to cope:
- Therapy: Approaches that teach emotion regulation and coping skills, and address underlying mental health conditions and trauma.
- Treating related conditions: Managing depression, anxiety, or other conditions, sometimes including medication.
- Support for families: Helping families respond calmly, supportively, and safely.
- For developmental conditions: Identifying triggers, improving communication, and meeting sensory needs to reduce self-injury.
With support, people can learn safer coping strategies and recover. Crisis lines and mental health services provide help, and reaching out is a sign of strength.
Support & Prevention
Caring relationships and early support help prevent and reduce self-injury:
- Keep communication open, calm, and nonjudgmental
- Take any self-injury seriously and seek professional help
- Help build healthy coping skills and stress relief
- Reduce access to means of harm when there is risk
- Know local crisis and emergency resources
When to Get Help
If a person has seriously injured themselves, is in danger, or has thoughts of suicide, seek emergency help immediately by contacting emergency services or a crisis line.
For ongoing self-injury without an immediate emergency, arrange care with a doctor or mental health professional as soon as possible. Reaching out early, with compassion and without judgment, can connect a person to effective help and is an important step toward recovery.
Frequently Asked Questions
Is self-injury a suicide attempt?
Non-suicidal self-injury is different from a suicide attempt, as it is often a way to cope with emotional pain rather than to end one's life. However, the two can be connected, so any self-injury should be taken seriously. If there is any thought of suicide or immediate danger, contact emergency services right away.
Why do people hurt themselves?
People often self-injure to cope with overwhelming emotions, to feel a sense of control, or to manage numbness or distress. It can be linked to depression, anxiety, or trauma. In some children with developmental conditions, it relates to frustration, communication difficulty, or sensory needs.
How should I respond if I think someone is self-harming?
Respond with calm, caring concern and without judgment. Let them know you care and want to help, listen more than you advise, and encourage them to get professional support. If they are in danger or have thoughts of suicide, seek emergency help immediately.
Can self-injury be treated?
Yes. Therapy that builds emotion-regulation and coping skills, along with treatment for any underlying conditions, helps people stop self-injuring and find healthier ways to cope. For developmental causes, addressing triggers and communication needs reduces the behavior.
Where can someone find help right away?
In an emergency or if there are thoughts of suicide, contact local emergency services or a suicide and crisis line. For ongoing support, a doctor or mental health professional can provide treatment and connect the person with resources.
References
- National Institute of Mental Health (NIMH). Self-harm.
- American Academy of Child and Adolescent Psychiatry (AACAP).
- MedlinePlus, U.S. National Library of Medicine. Self-harm.
- Substance Abuse and Mental Health Services Administration (SAMHSA).