Self-Harm Warning Signs

Overview

Self-harm means hurting your own body on purpose. It is also called self-injury. Common forms include cutting, burning, hitting, or scratching yourself. People usually self-harm to cope with very painful emotions, like sadness, anger, or numbness. It is not typically a suicide attempt, but it is a sign that someone is struggling and needs support.

Yes, it is surprisingly common. Studies suggest that around 10% of young people may self-harm at some point. Many people hide it, so the true number is likely higher.

Self-harm can affect anyone, regardless of age, gender, or background. It is most often seen in adolescents and young adults. People with mental health conditions like depression, anxiety, or borderline personality disorder are at higher risk. It is also more common in LGBTQ+ youth, people who have experienced trauma, and those who feel isolated.

Symptoms

Common symptoms

• Unexplained cuts, burns, or bruises, often on the arms, legs, or stomach.
• Wearing long sleeves or trousers even in hot weather to cover injuries.
• Keeping sharp objects (like razors, knives, or broken glass) nearby.
• Spending a lot of time alone or withdrawing from friends and family.
• Changes in mood, such as increased irritability, sadness, or feeling numb.
• Talking about feeling worthless, hopeless, or having a lot of guilt.
• Finding blood stains on clothing or tissues, or noticing missing sharp items.

Symptoms in children

• Many of the same signs as adults, but children may also show more sudden behavior changes.
• They might have trouble explaining their feelings or say they 'feel bad' without details.
• You might notice them hiding their arms or legs, or being secretive about their body.
• Younger children might not understand why they self-harm and may do it impulsively when upset.

Symptoms in older adults

• Self-harm can occur in older adults, often alongside depression or chronic pain.
• Signs may be mistaken for accidents or age-related skin changes, so look for patterns.
• They may express feelings of being a burden or having no purpose.
• Isolation is a big red flag—if an older adult suddenly stops social contact, check in.

Causes

Main causes

• Overwhelming emotions: using physical pain to distract from emotional pain, anger, or numbness.
• A sense of control: when life feels chaotic, self-harm can feel like the one thing they can control.
• Self-punishment: feeling guilty or full of self-hatred and harming as a way to punish themselves.
• Feeling real: some people feel detached or ‘numb’ and hurt themselves to feel something physical.
• Communication: when they cannot put their pain into words, self-harm may express what they are going through.

Risk factors

• A history of abuse, neglect, or traumatic experiences, especially in childhood.
• Having depression, anxiety, an eating disorder, or borderline personality disorder.
• Misusing alcohol or drugs.
• Being bullied or feeling socially isolated.
• Belonging to a group that experiences discrimination, such as LGBTQ+ young people.
• Having a friend or family member who self-harms (some people may copy the behavior).
• Facing big life stresses like family breakdown, exams, or losing a loved one.

When to see a doctor

See a doctor urgently if:

• You find recent or worsening injuries that need medical attention (infection, deep cuts).
• You or someone you know has taken any substance with the intention to cause harm.
• There is a sudden increase in the frequency or severity of self-harm.
• Suicidal thoughts become strong or a plan is mentioned.

Book a routine appointment if:

• You have started self-harming and want to understand why and how to stop.
• You are worried about a pattern of hiding injuries or feeling the urge to harm.
• You want to talk to a GP or mental health professional about safer coping strategies.
• You are a parent or friend who notices warning signs and wants advice on how to support.

Diagnosis

Self-harm is not a diagnosis itself—it is a behavior. A doctor or mental health professional will talk with you about what you do, how often, and what triggers it. They will also ask about your mood, thoughts, and any other symptoms to see if there is an underlying condition that needs treatment.

Tests that may be done

• A physical exam to check wounds, infections, or scars.
• Sometimes blood tests if there is a concern about infection, anaemia, or the impact of an overdose.
• No test can diagnose self-harm; the conversation is the most important part.

What to expect at your appointment

You will meet a professional who is there to help, not to judge. They will ask sensitive but caring questions. You can bring a friend or family member if you like. Everything you say is confidential unless they believe you are at serious risk of harm to yourself or others. The goal is to understand what you’re going through and find the best path forward together.

Treatment

Recovery is possible. The aim of treatment is to address the emotions behind the self-harm and to learn safer, healthier ways to cope. Treatment is tailored to you—there is no one-size-fits-all. It often involves talking therapies, sometimes alongside support for family or caregivers. If an underlying mental health condition exists, treating that condition is an important part of the plan.

Self-care at home

• Distraction techniques: when the urge hits, try holding ice cubes, taking a cold shower, scribbling on paper, or listening to loud music.
• Calming activities: deep breathing, meditation, or gentle yoga can help settle your nervous system.
• Creative outlets: writing, drawing, or playing an instrument can express feelings safely.
• Reach out: phone a trusted friend, a helpline, or write a message instead of acting on urges.
• Make a safety plan: list triggers, coping strategies, and emergency contacts so you know what to do when feelings get intense.

Medical treatments

Psychological therapies are the main treatment. Common approaches include cognitive behavioural therapy (CBT) to change unhelpful thought patterns, dialectical behaviour therapy (DBT) which teaches skills for managing emotions and relationships, and counselling. Some people are offered therapy that involves the whole family, especially younger patients. If there is a condition like depression or anxiety, a doctor might discuss medication alongside therapy. Any medication decision is made carefully, considering your overall health and needs.

Living with this condition

Learning to live without self-harm is a journey. It means building new habits and being kind to yourself. Some days will be harder than others. A clear, written safety plan (often made with a therapist) can guide you during tough moments. Over time, you replace self-harm with skills that truly soothe and strengthen you.

Lifestyle tips

• Stick to regular sleep and meal patterns—hunger and tiredness can worsen emotions.
• Find small things that bring joy or comfort, like a warm drink, a walk, or petting an animal.
• Avoid alcohol and drugs, as they lower inhibition and make it harder to resist urges.
• Connect with supportive people regularly, even when you don't feel like talking.

Diet and exercise

A balanced diet and gentle exercise can improve your overall mood and energy. Exercise releases natural ‘feel-good’ chemicals in the brain. Even a short walk or some stretching can reduce tension. But be careful not to use exercise as a way to punish yourself—it should be something you enjoy.

Mental health and emotional wellbeing

Self-harm often brings feelings of shame and secrecy, which can make you pull away from people. This isolation can make the problem worse. Over time, untreated self-harm can lead to more severe depression or self-loathing. But many people break this cycle. With the right support, you can regain your confidence and find healthier ways to face your feelings.

Prevention

It is not always possible to prevent self-harm, especially if someone is already in deep distress. But building emotional resilience from a young age can help. This includes teaching children how to name and manage feelings, fostering open communication at home and school, and reducing stigma around mental health. Safe, supportive environments make it easier for people to ask for help before they turn to self-harm.

Complications

If left untreated

• Wounds can become infected, leaving permanent scars or causing serious illness.
• Without help, some people harm themselves more severely over time, sometimes accidentally ending their life.
• Shame and secrecy increase, leading to deeper isolation and worsening mental health.
• It can strain relationships with family and friends who don't understand.

Long-term outlook

The outlook for someone who self-harms is very hopeful. Many people recover completely and never self-harm again. It is a sign of distress, not a sign of weakness or a permanent state. With patience, the right treatment, and a strong support network, you can learn to manage emotions without hurting yourself. Recovery does not mean never having urges; it means knowing how to cope when they come.

Find support

International organisations

• Befrienders Worldwide ↗
• International Association for Suicide Prevention - Resources ↗

Local organisations

• Mind (UK mental health charity) ↗ · United Kingdom
• Samaritans (UK emotional support) ↗ · United Kingdom and Ireland

Helplines

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