Self-harm

Self-harm means hurting your own body on purpose. For most people, it is a way to cope with feelings that seem too big to bear. It is a sign of deep distress, not a bid for attention and not a flaw in character.^1,2

Self-harm is more common than many people think, especially among teens and young adults. With the right support, people learn other ways to cope and stop hurting themselves. This page explains what self-harm is, why people do it, how it relates to suicide, and what helps. It does not describe ways people hurt themselves.

What is self-harm?

Self-harm, also called self-injury, is hurting your own body on purpose. Injuries can be minor or serious. They can leave scars or cause lasting health problems.¹

Self-harm is a behavior, not a mental illness on its own. But it often happens along with conditions such as depression, anxiety, eating disorders, posttraumatic stress disorder (PTSD) or borderline personality disorder.^1,2

Doctors sometimes use the term non-suicidal self-injury (NSSI). It means self-injury without the wish to die. Others use "self-harm" in a broader way that includes suicide attempts. This page focuses on self-injury without suicidal intent. Much of the advice applies either way.

Who self-harms?

People of any age self-harm. It usually starts in the teen or early adult years.¹ A large review pulled together studies of people who were not in treatment. It estimated that about 17% of teens, 13% of young adults and 5.5% of adults had self-harmed at some point.³

Self-harm is more common in people who:¹

• Went through abuse or trauma in childhood
• Live with depression, an eating disorder, PTSD or certain personality disorders
• Misuse alcohol or drugs
• Have friends who self-harm
• Have low self-esteem

Older adults self-harm too. A review of 40 studies of people age 60 and older found that self-harm was often linked to losing control over health or independence, growing loneliness, and feeling that aging had made them a burden.¹⁰ In some studies, nearly 3 in 10 had seen their primary care doctor in the week before. Older adults who self-harm have a higher risk of suicide than younger people who self-harm.¹⁰ Any self-harm in later life needs prompt care. See Suicide risk in later life.

Why do people self-harm?

Self-harm usually serves a purpose for the person, even when it causes harm. A review of studies on the reasons people give found that most do it to manage their own feelings. Between 63% and 78% said it helped them cope with or calm strong emotions. Fewer, about 33% to 56%, said it was also a way to show others how much they were hurting.⁴

People describe many reasons, such as:¹

• To feel something when they feel numb or empty
• To get relief from anger, tension or hopelessness
• To block out painful memories
• To punish themselves
• To feel more in control
• To show that they need help

The relief is short. Shame and guilt often follow, and those feelings can lead to more self-harm. This can become a cycle.²

Calling self-harm "attention seeking" misses the point. Even when part of the purpose is to show distress, that is a sign the person needs help and does not yet have a better way to ask for it.

How does self-harm relate to suicide?

Most self-injury is not a suicide attempt. People who self-harm usually do not intend to die.¹ But people who self-harm have a higher risk of suicide attempts later, especially if they do not get help.¹

A review of 172 long-term studies looked at what predicts later suicide attempts. A history of non-suicidal self-injury was one of the stronger predictors, though no single factor could predict well for any one person.⁵ Among people treated at a hospital for self-harm, about 16 in 100 hurt themselves again within a year.⁶

What this means in daily life:

• Take every episode seriously, even if the injury seems minor.
• Ask directly about suicidal thoughts. See Helping someone who may be thinking about suicide.
• Each episode may have different reasons. UK guidelines advise treating each one in its own right.⁷

What helps

The badges show how strong the research is. See how we rate evidence.

Good care is respectful. UK guidelines say staff should treat people who self-harm with respect, dignity and compassion, and avoid punishing or judging them. They also advise making a safety plan together and arranging follow-up soon after an episode.⁷

For more on handling strong feelings, see Emotion regulation.

If you self-harm

You are not alone, and you are not a bad person. Self-harm is a way of coping that made sense at some point. You can learn other ways that hurt less.

• Tell one person. Choose someone you trust: a friend, family member, school counselor, doctor or faith leader.
• Get injuries checked. Shame can make people hide wounds. Medical staff should treat you with respect.⁷ If you are not sure how serious an injury is, get it checked.
• Make a plan for urges. Write down what triggers your urges, what helps you wait them out, and who you can contact. Urges usually rise and then fade.
• Look for therapy. DBT and CBT-based therapies help many people. See how to find a therapist.
• Be patient with yourself. Setbacks can happen. Each time you use another way to cope, you are building a new habit.

If you ever think about ending your life, call or text 988 right away.¹²

How to talk with someone who self-harms

Finding out that someone you love self-harms can be frightening. How you respond can make it easier or harder for them to get help.

If you are a parent: Encourage your child or teen to talk with a trusted adult. If they will not, talk to one yourself.¹ A mental health professional can find and treat the problems behind the self-harm.¹¹ See For parents of teens.

Look after yourself too. Supporting someone who self-harms can be stressful. Talk with someone you trust, and get support for yourself.

When it is an emergency

When to get help

Any self-harm is a reason to talk with a doctor or mental health professional. It is more urgent if:

• There are thoughts of suicide
• Self-harm is happening more often or causing worse injuries
• Alcohol or drugs are involved
• The person is an older adult, or has recently had a big loss or health change

Our private self-check can help you put your feelings into words before a visit. For crisis lines, see Get help now.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.