Signs & Symptoms of Self-Harm

Learn about self-harm

When someone deliberately inflicts pain onto him or herself, it is referred to as self-harm. Also known as self-injury or self-mutilation, these behaviors can include, but are not limited to, cutting, burning, biting, scratching, picking at skin, pulling out one’s hair, or purposely breaking one’s bones. For many, it can be difficult to comprehend why anyone would want to intentionally impose pain onto oneself, but for these individuals, the behavior serves a very precise purpose. It is likely that these individuals are suffering from some form of emotional distress or disturbances over which they feel that they cannot gain a sense of control. The act of inflicting harm onto themselves allows them to define a physical cause for their pain, while also providing them with the control they need over the negative emotions they are experiencing. However, this false sense of control will dissipate quickly, leading these individuals to partake in a cyclical pattern of devastating self-injurious behaviors. For this reason, amongst others, it is imperative that the presence of such self-harming behaviors be properly addressed through treatment so that the underlying reason for why the behaviors began can be confronted and tools for how to cope with negative emotions can be developed.

Causes and risk factors for self-harm

Professionals in the field of mental health have concluded that there are a number of contributing factors that work together to elicit the onset of self-injurious behaviors. These factors are described briefly in the following:

Genetic: In the vast majority of cases, the presence of self-harming behaviors is indicative that a mental health condition exists. This means that, while the self-injuring itself is not heritable, the mental illnesses of which it can be symptomatic can be inherited from one’s family members. Especially for people who have biological relatives who are suffering from illnesses like bipolar disorder, depression, or anxiety, there is an increased risk that they will inherit the lack of impulse control that can eventually lead one to engage in these destructive behavior patterns.

Physical: The brain is made up of neurotransmitters, which are chemicals that are responsible for appropriately regulating an individual’s emotions. When these chemicals become imbalanced, an elevated susceptibility to developing a mental illness can result, of which self-harm may be a symptom.

Environmental: Certain environmental factors can play a monumental role in the onset of self-harming behaviors. When individuals are exposed to environments in which there exists much stress or chaos over which they have no control, they are at a heightened risk for beginning to self-injure. This is due in part to the fact that the act of self-mutilation is something that they can feel a sense of control over. Additionally, people who have been the victims of any type of abuse may turn to self-harm as a means of coping because, in those instances, they are in control of the pain that they feel, as opposed to having someone else inflict the pain onto them. Furthermore, this type of behavior can ensue when individuals experience various types of emotional distress yet do not have an adequate support system.

Risk Factors:

• Personal history of mental illness
• Family history of mental illness
• Being the victim of abuse and/or neglect
• Experiencing trauma
• Lacking impulse control
• Lacking effective coping skills
• Losing a loved one
• Having friends who engage in similar behaviors and encourage such acts
• Having an inadequate support system

Signs and symptoms of self-harm

Because self-injury is typically a behavior that is done in private, it can be difficult to determine whether or not someone is actually partaking in such acts. However, there are some warning signs that may be present that could indicate that an individual is engaging in self-harming behaviors. Examples of these signs may include the following:

Behavioral symptoms:

• Wearing clothes that are inappropriate for the weather (e.g. wearing pants and long-sleeved shirts despite it being warm outside)
• Frequent absences from work or school
• No longer participating in activities that were once enjoyed
• Isolating oneself from family and friends
• Picking scabs
• Making excuses for repeated injuries

Physical symptoms:

• Scratches
• Scrapes
• Bruises
• Cuts
• Burn marks
• Broken bones
• Patches of missing hair

Cognitive symptoms:

• Derealization
• Depersonalization
• Inability to control impulses
• Memory impairments
• Concentration difficulties
• Ongoing, pervasive thoughts about wanting to self-harm

Psychosocial symptoms:

• Feelings of guilt and shame
• Feelings of hopelessness
• Feelings of helplessness
• Feelings of worthlessness
• Feelings of loneliness
• Excessive levels of anxiety
• Increased feelings of depression
• Emotional instability
• Emotional numbness

Effects of self-harm

Participating in self-harming behaviors will inevitably render individuals susceptible to experiencing a number of adverse consequences. Depending on the method that one uses in order to inflict harm onto him or herself, there are a vast array of physical effects that can result. Examples of such physical effects may include the following:

• Permanent tissue damage
• Onset of permanent weakness in certain parts of the body
• Onset of permanent numbness in certain parts of the body
• Anemia
• Developing infections
• Scarring
• Nerve damage
• Hemorrhaging
• Bones that fail to heal properly
• Vital organ damage
• Accidental and untimely death

In addition to the negative physical ramifications that can result from self-injury, the following long-term effects can also occur:

• Social withdrawal and isolation
• Pervasive feelings of guilt, shame, and/or disgust with oneself
• Development of an addiction to drugs and/or alcohol
• Familial discord
• Disturbed interpersonal relationships
• Persistently decreasing sense of self-esteem and self-worth
• Decline in occupational functioning, leading to job loss
• Decline in academic functioning, leading to academic failure

Self-harm and co-occurring disorders

Individuals who engage in the act of self-harm are likely suffering from a mental health condition that has elicited the emotional distress that leads to the onset of such detrimental behaviors. The disorders of which self-harm is commonly cited as being symptom include the following:

• Depressive disorders
• Bipolar disorder
• Generalized anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Social anxiety disorder
• Posttraumatic stress disorder (PTSD)
• Eating disorders
• Schizoaffective disorder
• Schizophrenia