Self-harm: signs, causes and treatment

Learn how to spot the signs of self-harm and understand how it can be treated.

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his page was clinically reviewed by Dr Donna Grant (MBBS, MCRPsych, BSc Hons), Consultant Psychiatrist at Priory Hospital Chelmsford, in April 2024.

What is self-harm?

Self-harming, also known as self-injury, is a relatively common behaviour where someone may hurt themselves to feel temporary relief from their pain. It's often concealed from friends and family members, so it can be difficult to spot.

Self-harming may start in childhood and increase in frequency and severity in adolescence, as the pressures of growing up, coupled with bodily and hormonal changes in puberty, take their toll.

Drastic changes in a person’s situation, such as end of a relationship, an increase in work related stress, or any other significant personal trauma can contribute to the intense emotions which lead to the urge to self-harm.

Why do people self-harm?

Self-harming can provide temporary relief from feelings such as anxiety, depression, stress or self-loathing.

The pain that's inflicted can release endorphins and a rush of adrenaline, which often become pleasurable to the sufferer and causes them to temporarily forget other negative feelings they may be experiencing. However, this is often short-lived, and the internal anguish often remains afterwards.

Self-harm is frequently associated with adolescents, and in fact, recent figures show that it's affecting younger people more than ever before. The stresses of puberty, school life and the influence of social media can be challenging for some adolescents and can sometimes result in anxiety and depression. When depression and anxiety increase, some turn to self-harming, and many parents say they don't know how to help their child in the best way. It's important to understand that self-harming is not an attention-seeking behaviour and is actually a coping mechanism. 

Signs of self-harm

Dr Paul McLaren, General Adult Psychiatrist and Medical Director at Priory Hospital Hayes Grove, explains that self-harm is a common sign of psychological dysfunction. It has seeped into popular culture and spans the generations, from childhood to old age. 80% of self-harm episodes involve stabbing or cutting the skin with a sharp object. Self-cutting and overdosing are the most common forms, but other self-injurious behaviour includes:

  • Punching hard objects
  • Picking at skin
  • Hair pulling
  • Swallowing foreign bodies
  • Intentional poisoning with medication
  • Burning parts of the body

More complex behaviours such as piercing or tattooing, while socially sanctioned, can have similar psychological drivers in some people. Munchausen’s syndrome and factitious disorder also share some of the psychopathology of self-harm.

As self-injury is often associated with minors, there are some additional signs that parents can look out for if they think their child is hurting themselves. These six signs of self-harm for parents may come in useful for any parent, guardian, or even friend who is concerned about someone.

While the physical impact of self-harming can be more apparent, the psychological difficulties you might experience if you self-harm can be extreme.

Feelings of anxiety, frustration and depression regarding your current situation, or as a result of personal trauma, ultimately become so overwhelming that damaging your body provides temporary relief. Psychological symptoms of self-harming include:

  • Anxiety
  • Depression
  • Frustration
  • Confusion
  • Insomnia
  • Social isolation

What causes self-harm?

Due to self-harm affecting people of all ages, it's believed that the overwhelming emotional issues that can affect you at any stage of life are a major factor behind self-harming, as a means of coping and releasing built-up tension or frustration.

Self-harm is a symptom of mental distress and in a high proportion of people, it's evidence of underlying psychiatric disorders or emotional distress. A wide range of psychological processes can lead to self-harm. For example, in adolescence, emotional distress is common and self-harm can emerge as a maladaptive coping strategy.

Common underlying diagnoses are:

  • Anxiety
  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Maladaptive personality traits, such as emotionally unstable personality disorder (EUPD)

People who self-harm may also struggle with emotional difficulties that have external influencing factors. Other causes of self-harm could be:

  • Social and relationship problems - social issues can affect anyone at any age. Bullying in school or the workplace, having relationship problems with partners, friends and family, as well as coping with gender or cultural expectations, can all cause a build-up of anxiety, stress or depression which can ultimately lead to an urge to self-harm
  • Trauma or abuse - physical or sexual abuse, suffered either as a child or adult, can lead to confusing feelings of self-blame and low self-esteem, while severe trauma such as the death of immediate family members and close friends, or having a miscarriage can trigger symptoms of depression

Preventing self-harm

If you've recognised that you have a problem and are ready to begin your journey to becoming well again, there are some steps you can take to help you stop self-harming:

  • Confide in someone and accept that you need help. Once you feel ready to talk, it can be a huge relief to let go of the secret that you may have been trying to hide. Asking for help is an important first step in recovery
  • Recognise your personal triggers. As self-harm is often a way of coping with difficult and intense emotional pain, it's important to recognise in yourself which feelings drive your desire to self-harm, whether these are feelings of sadness, shame, guilt, anger or loneliness
  • Try alternative, less damaging ways to release tension. Squeezing ice cubes, taking a cold shower, eating a hot chilli, or drawing on yourself with red pen may all be alternatives to self-harm. Be creative and find what helps you
  • Learn new ways to cope. When a trigger has been recognised, it's important to find alternative methods of dealing with it. These can include engaging in creative activities such as painting, writing and music, exercising, bathing and talking to someone, whether this is a friend or relative, therapist or on a relevant online forum
  • Make a 'self-soothe' kit. This could be a box, bag, or tin of objects/activities that are meaningful to you and focus on sensory experiences that soothe you. For example, it could contain objects that feel nice or unusual, smell good or remind you of positive things. These may be pictures, music play lists, puzzles or colouring in. Collect items together that you can go to in an emergency

Self-harm guidance for parents

If you suspect your child is self-harming, there are some signs of self-harm to look out for. If you notice any of these signs, you can speak to your child or consult with a GP to find out the next appropriate steps to take. Parents of a young person who self-harms can often be confused and frightened. You may struggle to understand why your child is doing it, and wonder whether there's anything you could have done to stop it.

Don't panic.

In most cases, while self-harm indicates distress, it's not a suicide attempt. Try to listen to what your child is saying and understand what's going on. Don't jump to conclusions. Don't be afraid to ask for help or to take your child for help. It's something that can be addressed together.

We understand that self-harm and the overwhelming emotions that lead to this behaviour can severely affect your mental health and ability to function in daily life. Early diagnosis and treatment can help you or a loved one learn ways of coping with underlying feelings of stress, anxiety or depression, so you can regain control over your life without feeling the urge to injure yourself.

"If a young person is suddenly wearing long sleeves. for example. for sport when they used to wear short sleeves, or tracksuit bottoms instead of shorts, they may be trying to hide marks."

Read the practical tips for parents worried about self-harming here.

Child and Adolescent Psychiatrist, Dr Hayley van Zwanenberg on why some adolescents self harm, how to spot the signs and 10 practical tips for parents to help avoid and manage self harm.

How is self-harm treated?

The type and length of self-harm treatment will depend on your individual circumstances and the severity and complexity of your condition. Some people are treated as outpatients, which means they come to Priory for hourly sessions with their psychiatrist, psychologist or therapist.

Others need a more structured treatment approach, which can include staying at one of our Priory hospitals for the duration of their treatment, where they take part in the psychological group programme as well as regular sessions with their consultant.

Self-harm support includes the development of positive coping mechanisms, the reduction of any underlying stress that you may have, learning healthy communication skills and helping to regulate your emotions. Self-harm therapy may involve group work, individual work, family therapy, and talking therapies, alongside prescribed medication if you have co-existing mental health conditions such as depression.

Clinical praise for Priory's innovative self-harm protocols

After developing safe intervention for ligaturing assessment score (SILAS), Priory patients and staff have been able to treat and manage self-harm more effectively.

"Since we started this initiative, the need for restraint following this form of self-harm has significantly reduced and consequently patient and staff injuries have also reduced."

Read more about new self-harm protocols here.

Our specialist counsellors, psychologists and psychiatrists can provide an all-encompassing treatment programme to help ease the symptoms of self-harm. These treatment programmes may include cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT) and psychodynamic therapy.

Repeated self-harm can become like an addiction. DBT may be appropriate for people who have recurrent episodes of self-harm and need a psychological intervention. DBT is a form of CBT that focuses on impulse control and managing emotions. It aims to equip you with different skills and tools to use when you’re having strong urges to self-harm, helping you to regulate distress and manage difficult emotions. The four elements of DBT are mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness skills. A harm-minimisation approach may be useful for young people who self-harm recurrently; this can help to manage scarring and help people who feel compelled to self-harm stay as safe as possible. DBT provides structured support, with a combination of group and individual sessions. With adequate and functional skills, you'll be able to tolerate distress and seek helpful tools to moderate your stress reactions.

Self-harm treatment near me

We have self-harm treatment centres located throughout the country, meaning you can access the support you need in a location that’s convenient for you. To find your nearest self-harm treatment centre, please use the search form below.


Mental health treatment summary

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