Understanding Self-Harm
What is self-harm?
Self-harm is when a person inflicts pain to/on their body purposefully. Self-harm is also called non-suicidal self-injury. Self-harm can take many different forms. Self-harm is not a suicide attempt; it is a way for a person to cope with strong emotions they are feeling. Self-harm may appear as: cutting an area of the body, burning an area of the body, biting an area of the body, pulling their hair, hitting or punching themselves, hitting their body on another object, pinching an area of the body, stabbing an area of the body with a sharp object, forcing themselves to throw up, scratching or rubbing an area of the body, ripping their skin, using a sharp object to carve a word or object into the skin, and more.
Signs and Symptoms
A person who is struggling with self-harm may exhibit the following:
scars on the body from bites, burns, cuts, or bruises (often in patterns)
keeping sharp/self-harming items close to/on their person
wearing multiple bracelets to cover their arms
wearing long sleeves or pants even in warm weather
excessive rubbing of an area
having friends who self-harm
experiencing difficult life circumstances
being secretive
avoiding scenarios where the person would have to expose the part of their body where they self-harmed
experiencing any other mental health struggles in their life
How to Talk to Teens about Self-Harm
When talking to a teen about self-harm, it’s important to be gentle in your words and actions. It may be difficult for the teen to talk about self-harm. The adult can ask the youth questions to try to understand the youth’s experience and emotions surrounding the self-harm. The adult can let the youth know that they are there for them and they still love them amidst whatever the youth is experiencing. Youth can experience a lot of shame surrounding self-harm, so it is helpful for the adult to affirm their love and care for the teen.
If a teen is struggling with self-harm, it’s important to ask the youth if they’ve cleaned their wounds. If a teen does not take proper care of their wounds, it can lead to infection. If the wound is severe (where a cut is very deep or a burn is extreme), it may be needed to seek medical care.
If an adult thinks they see warning signs of self-harm, they should not assume a youth is self-harming before a conversation is had. Do not assume just because the youth is self-harming that they are struggling with depression. Many other mental health conditions can cause strong emotions which can lead a teen to self-harm.
It’s also important for adults to try to control their emotions for the moment, to be fully present with the youth. If the teen is not already in therapy, it is highly advised and recommended for the teen to be put in therapy. If an adult is having a difficult time coping with the emotions of their teen struggling with self-harm, it is highly recommended they seek out therapy for themselves.
What Is Self-Harm?
Self-harm, also known as non-suicidal self-injury (NSSI), refers to the intentional infliction of pain or injury on one’s own body, without the conscious intention of ending one’s life. It is a coping mechanism—often an attempt to manage overwhelming emotions, mental distress, or psychological pain.
Self-harm can take many forms, including but not limited to:
Cutting or scratching the skin
Burning
Biting
Pulling out hair (trichotillomania)
Hitting or punching oneself
Head-banging or hitting one’s body on objects
Pinching
Carving words or symbols into the skin
Rubbing or scratching harshly
Purging behaviors (e.g. forcing oneself to vomit)
Using sharp objects to inflict marks
Although self-harm is not in itself a suicide attempt, it is a serious sign of distress and is associated with increased risk for suicidal thoughts or behaviors if left unaddressed.
Prevalence & Trends: What Do the Numbers Say?
Understanding the scope of self-harm helps frame its urgency and relevance.
Global Trends
A recent global study (2021 data) estimated age-standardized mortality rates for self-harm at 12.8 per 100,000 for males and 5.4 per 100,000 for females.
The burden of self-harm (measured in disability-adjusted life years, DALYs) peaked in the 20–24 age group globally.
While globally the prevalence of self-harm among adolescents has shown a modest downward trend over recent decades, disparities remain across regions and genders.
Among Adolescents & Youth
Lifetime prevalence estimates for non-suicidal self-injury among adolescents/young adults fall in the 15 % to 20 % range. PMC+2PMC+2
A systematic review focusing on adolescents (ages ~11 to 18) found an average prevalence of ~16 %, with women reporting higher rates (≈19.4 %) than men (≈12.9 %). PMC
In the U.S., rates of self-harm vary widely by study, but many fall within the 7.5 % to 46.5 % range for youth, depending on sampling methods and definitions. PMC
Emergency department (ED) data show that in a recent year, there were ~224,341 self-harm–related visits among adolescents and young adults in the U.S. CDC
Girls and young women have a significantly higher rate of ED visits for self-harm (~514 per 100,000) compared to boys and young men (~200.5 per 100,000). CDC
Suicide rates (which sometimes overlap with self-harm) in U.S. youth aged 10–24 rose from 6.8 per 100,000 in 2007 to ~11.0 per 100,000 by 2021 — a 62 % increase. CDC+2Yale School of Medicine+2
For high school–aged youth (14–18), suicide was the third leading cause of death in 2021, with ~1,952 deaths and a rate of ~9.0 per 100,000. CDC
These numbers suggest that self-harm is a significant public health concern, especially among youth, and is likely underreported (many cases never reach medical attention).
Warning Signs & Symptoms
Someone engaging in self-harm may display behaviors or physical evidence including:
Scars, cuts, burns, bruises—often in repetitive or patterned arrangements
Keeping sharp objects, razors, or “tools” for self-injury on or near them
Wearing long sleeves, pants, or covering clothing even in warm weather
Frequent use of bracelets, wristbands, or concealment accessories
Excessive rubbing, scratching, or touching of a particular area
Avoiding exposure of certain areas of the body (e.g., arms)
Isolation, secrecy, sudden changes in behavior or mood
Co-occurring mental health conditions (depression, anxiety, trauma, borderline traits)
Talking indirectly about emotional pain, hopelessness, or “needing to feel something”
Because self-harm is often done in private, spotting changes in behavior, emotional regulation, mood swings, or withdrawal may be as important as noticing physical marks.
How to Talk to Teens About Self-Harm
Talking to a teen you suspect is self-harming demands sensitivity, patience, and a nonjudgmental approach. Here are recommendations:
Choose a calm, private moment. Avoid confronting them when emotions are high.
Use open, nonjudgmental language. For example, “I’ve noticed you seem to be in a lot of pain. I’m worried about you. Can you help me understand what’s been going on?”
Focus on listening, not fixing. Let them express emotions in their own words without interrupting.
Affirm care and support. Reassure them that you’re there for them, you care, and that their feelings matter.
Ask about wound care. Gently ask whether they’ve cleaned any cuts or injuries and offer to help with medical attention if needed.
Avoid assumptions. Don’t assume self-harm always means depression or suicidal intent—emotional distress arises from many possible sources.
Stay emotionally present. Manage your own reactions so that fear, anger, or shock don’t shut down the conversation.
Encourage professional help. If they’re not already seeing a therapist, suggest a mental health professional (counselor, psychologist, psychiatrist) who is experienced with self-injury and teen mental health.
Care for yourself. Supporting someone who self-harms can be emotionally heavy. Consider your own counseling or support system.
If injuries are severe (very deep cuts, burns, signs of infection) or there is any expression of suicidal intent or plan, seek medical / psychiatric help immediately.
Why Do People Self-Harm? Contributing Factors & Risks
Self-harm is a complex behavior with multiple contributing factors. Common ones include:
Emotional regulation: People may self-harm to relieve overwhelming emotions, tension, or numbness.
Interpersonal difficulties or trauma: Histories of abuse, neglect, bullying, or relationship problems often correlate with self-harm.
Mental health conditions: Depression, anxiety disorders, post-traumatic stress disorder (PTSD), borderline personality traits, eating disorders, and substance misuse can co-occur with self-harm.
Feeling of control: In chaotic circumstances, self-harm may provide a sense of control over internal pain.
Identity stress or marginalization: Youth who are LGBTQ+, gender nonconforming, or from marginalized groups may face elevated stressors, discrimination, or rejection, increasing vulnerability.
Social contagion / peer influence: Exposure to self-harm behavior (in peers, online, social media) can contribute to imitation behaviors.
Neurobiological factors: Dysregulation in stress systems, pain perception, or impulsivity may play a role.
It’s also important to note that not everyone who self-harms has suicidal intentions; however, self-injury increases risk for suicidal thoughts and attempts over time if left untreated.
When to Seek Help & What Interventions Work
Immediate Indicators for Professional Help
Seek immediate help if:
The self-inflicted injury is deep, bleeding heavily, or shows signs of infection
The person expresses suicidal thoughts, plans, or intent
There is significant impairment in daily life (school, work, relationships)
The behavior escalates in frequency or severity
Evidence-Based Interventions
Cognitive Behavioral Therapy (CBT): Helps identify triggers, teach emotion regulation skills, and develop alternative coping strategies.
Dialectical Behavior Therapy (DBT): Particularly effective for individuals with intense emotional dysregulation; includes skills training, distress tolerance, and emotion regulation.
Trauma-informed therapies: For those with histories of abuse or trauma (e.g., EMDR, Trauma-Focused CBT).
Family therapy / interpersonal therapy: Involving family or caregivers can improve communication, monitoring, and support.
Medication: While there is no medication for self-harm per se, co-occurring conditions (e.g., major depression, anxiety) may be treated with medications as part of a broader plan.
Safety planning & coping toolkits: Developing a personalized plan that includes distraction techniques, crisis contacts, and self-soothing strategies.
Digital supports & apps: Some apps and online resources help manage self-harm urges and crises—but they should not replace professional care.
Resources & Helplines (U.S. and West Virginia–specific)
If you or someone you know is struggling with self-harm, the following organizations can help:
988 Suicide & Crisis Lifeline
Call or text 988 (available 24/7 in the U.S.)
Website: https://988lifeline.orgSAMHSA (Substance Abuse and Mental Health Services Administration)
Phone: 1-800-662-HELP (4357)
Website: https://www.samhsa.govNational Alliance on Mental Illness (NAMI)
Phone: 1-800-950-6264
Website: https://www.nami.orgCrisis Text Line
Text “HOME” to 741741
Website: https://www.crisistextline.orgAmerican Psychological Association (APA)
Phone: 1-800-374-2721
Website: https://www.apa.orgHelp4WV (West Virginia–specific)
Phone: 1-844-435-7498
Website: https://www.help4wv.comCenters for Disease Control and Prevention (CDC)
Website: https://www.cdc.gov (for data and prevention info)Mental Health America (MHA)
Phone: 1-800-969-6642
Website: https://www.mhanational.orgHealthyPlace
Website: https://www.healthyplace.com
If someone is in immediate danger or you’re unsure what to do, call 911 or go to the nearest emergency department.