Key Takeaways
- Self-harm, or non-suicidal self-injury (NSSI), is a coping behavior — not a mental illness on its own.
- Common signs include unexplained cuts or burns, covered skin in warm weather, and withdrawal from friends and family.
- Professional treatment — not willpower alone — is usually what helps someone stop for good.
Finding out that someone you love is hurting themselves on purpose is frightening. You may feel shocked, guilty, or unsure what to say next. If you are trying to figure out how to help someone who self-harms, you are already doing the most important thing: paying attention.
At Lifeskills Behavioral Health in Florida, our clinical team works with individuals and families through exactly this kind of crisis, and they know recovery is possible with the right support because they see it happen every day.
What Is Self-Harm?
Self-harm, also called non-suicidal self-injury (NSSI), is deliberate injury to your own body without the intent to die, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). It includes behaviors like cutting, burning, scratching, hitting, and hair pulling. It is usually a way to manage overwhelming emotions rather than a sign of active suicidal intent, though the two can be connected.
Signs + Symptoms of Self-Harm
Self-harming behaviors are often well hidden, which is part of why a loved one’s self-harm can go unnoticed for a long time.
Watch for:
- Unexplained cuts, scratches, burns, or bruises, often on arms, legs, or the torso
- Wearing long sleeves or pants even in hot weather
- Bloodstained clothing, tissues, or bedding
- Sharp objects, like razors or safety pins, kept in unusual places
- Sudden withdrawal from friends, family, or activities they used to enjoy
- Increased irritability, secrecy, or emotional numbness
Hidden Signs of Self-Harm
Some signs of self-harm are quieter, making them harder to spot. A person may avoid swimming, gym class, or physical touch to hide injuries. They may spend unusually long periods alone in the bathroom or bedroom, or offer vague explanations for injuries, such as blaming a pet or an accident. Frequent excuses like these, paired with mood changes, are often the clearest hidden signs of self-harm.
Why Do People Self-Harm
Self-harm is rarely about seeking attention. It is more often tied to emotional distress that feels too big to manage in the moment.
Reasons someone might self-harm include:
- Relieving intense emotional pain or numbness
- Regaining a sense of control during chaos
- Punishing themselves out of shame or guilt
- Expressing feelings that feel impossible to put into words
- Coping with symptoms of depression, anxiety, trauma, or borderline personality disorder
Self-harm is not, by itself, a mental illness. It is more accurately described as a maladaptive coping mechanism, one that often develops alongside conditions such as depression, anxiety, PTSD, or borderline personality disorder, a condition the National Institute of Mental Health (NIMH) notes is linked to a higher likelihood of self-harming behavior.
Myths + Facts About Self-Harm
- Myth: Self-harm is just about seeking attention. Fact: Most people who self-harm go to great lengths to hide it.
- Myth: Self-harm always means someone is suicidal. Fact: According to the National Library of Medicine, people who self-harm are usually not attempting suicide, though they are at higher risk of a suicide attempt if they don’t get help.
- Myth: Only teenage girls self-harm. Fact: Self-harm affects people of any age or gender.
How to Help Someone Who Self-Harms
It can be hard to know how to respond when we find out someone we care about is hurting themself. In an attempt to help, well-meaning loved ones can make the situation worse, not better. That’s why it’s important to understand what to say and what comments to avoid.
What to Say
Self-harm often carries deep guilt and shame, and that shame can fuel more self-harming behavior. Lead with calm, nonjudgmental curiosity instead. Try phrases like, “I care about you, and I’m here to listen,” or “You don’t have to go through this alone.” Ask how they would like to be supported instead of assuming what they need. Encouraging them to talk to a counselor, doctor, or trusted adult signals that help exists — and that seeking it is not a failure.
What Not to Say
Avoid “Just stop” or “Why would you do this to yourself?” These questions imply the behavior is a simple choice, when it usually is not. Skip accusations of attention-seeking, and never issue ultimatums or threats. Pressure and shame tend to push someone further into secrecy rather than toward help.
Self-Harm + Suicide Risk
Self-harm and suicide are related but different. Non-suicidal self-injury is not, by definition, a suicide attempt. Still, peer-reviewed research on adolescent NSSI shows it is a meaningful risk factor for future suicidal thoughts and attempts, particularly when the underlying emotional dysregulation goes untreated over time.
If a loved one ever expresses a wish to die or a specific plan to harm themselves, treat it as an emergency and contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
When to Seek Professional Treatment
Encourage a loved one to seek professional treatment for self-harming behaviors when the behavior is frequent, escalating in severity, or paired with signs of depression, anxiety, or trauma. Treatment is also appropriate if self-harm interferes with school, work, or relationships, or if the person expresses hopelessness. A licensed clinician can help identify what is driving the behavior and build healthier coping mechanisms through evidence-based care, such as residential or outpatient treatment.
Related reading: Is Picking Your Skin a Form of Self-Harm?
Specialized Care at Lifeskills Behavioral Health
At Lifeskills Behavioral Health, our master’s-level clinicians specialize in treating complex mental health disorders, including self-harming behaviors, along with co-occurring trauma, anxiety, and depression. Through evidence-based, person-centered treatment, clients learn to manage urges, identify triggers, and develop practical coping strategies that support lasting stability.
“Can’t say enough about my experience at Lifeskills,” shares one grateful alum. “Never could have done this without you … and will forever be grateful!”
Contact our admissions team today to learn more about our specialized treatment programs and how we help individuals and families build the skills needed for long-term healing. With the proper support, recovery is possible.
Frequently Asked Questions
What are the signs of self-harm?
Common signs include unexplained cuts, burns, or bruises, frequently wearing long sleeves in warm weather, bloodstained clothing, and withdrawal from friends or family. Mood changes, secrecy, and hiding sharp objects are also common warning signs worth paying attention to.
What are the hidden signs of self-harm?
Hidden signs include avoiding situations that expose skin, like swimming, spending long periods alone, and vague or inconsistent explanations for injuries. These subtler patterns often appear alongside mood or behavior changes rather than obvious physical evidence.
What should you say to someone who is self-harming?
Speak calmly and without judgment. Try, “I’m here for you,” or ask how they would like support. Gently encourage professional help, and avoid interrogating them about details. The goal is connection, not confrontation.
Why do people self-harm?
Most people self-harm to cope with overwhelming emotions, regain a sense of control, or manage shame and emotional numbness. It often accompanies depression, anxiety, trauma, or borderline personality disorder rather than occurring on its own.
What should you not say to someone who is self-harming?
Avoid phrases like “Just stop” or accusations of attention seeking. Skip threats, ultimatums, or shaming language. These responses tend to increase secrecy and shame instead of encouraging someone to reach out for help.
Is self-harm always a sign that someone is or may become suicidal?
No. Self-harm is usually non-suicidal self-injury, done without intent to die. However, it is associated with a higher risk of suicidal thoughts and attempts over time, especially without treatment, so it should never be ignored.
When should you encourage a loved one to seek professional treatment for self-harming behaviors?
Seek professional treatment when self-harm is frequent, worsening, or tied to depression, anxiety, or hopelessness. Treatment is also appropriate when the behavior disrupts school, work, or relationships, or when a loved one asks for help.
References
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- National Institutes of Health (NIH)
- National Institute of Mental Health (NIMH)
- Frontiers in Psychiatry / PubMed
This article references research and guidance from trusted behavioral health and medical organizations, including NIMH, NIH, and SAMHSA.
