How to Spot the Warning Signs of Self-Harm

How to Spot the Warning Signs of Self-Harm


In October 2019, Instagram expanded its ban on graphic images of self-harm to include memes, drawings, comics, or graphics from films or TV. The move comes on the heels of research in New Media and Society, which found that nearly one-third of teens and young adults said they engaged in some form of self-injury after seeing self-harm [posts on Instagram.

In the study, which involved 729 young adults aged 18-29, 43% said they had seen at least one post on Instagram about self-harm. And 60% of those who saw such a post said it triggered thoughts about what it might feel like.

Self-harm is when a person intentionally causes injury to their own body. Cutting and burning may be the first things that come to mind, but some people may bang their heads against the wall; punch themselves; scratch, pick or pinch the skin; insert objects under the skin; drink bleach or other poisonous substances, or pull their hair. Typically, this type of behavior is not intended to be suicidal, but rather, it is used as a way to cope with emotional pain.

More commonly seen in adolescents, teens, and young adults, self-injury is on the rise, according to research in The Lancet Psychiatry. And it puts young people at an increased risk of suicide. Up to 40% of people who deliberately injure themselves think about suicide and estimates show that as many as 85% have attempted suicide at least once.

Researchers suggest the rise in self-harm may be tied to the increased prevalence of anxiety and depression in girls and young women, who are more likely to self-injure than males. No matter what’s driving this disturbing trend, it’s important to know the warning signs.

Warning Signs of Self-Harm

People who engage in self-abuse usually do it in secret and try to hide the signs from family and friends. Scars, burns, and other evidence of this behavior can be hidden under long sleeves and long pants. If you’re worried that a loved one may be practicing self-injury, look for these signs:

  • Multiple scars: Scars that are linear or in neat patterns, such as railroad tracks, or that spell out words are indicative of cutting.
  • Frequent injuries: Everyone gets an occasional cut, scrape, or bruise, but when injuries happen with alarming regularity it could be a sign of a problem.
  • Unlikely excuses for injuries: When someone routinely comes up with unusual excuses for how injuries occurred—blaming the neighbor’s cat, for example—it’s worth investigating.
  • Covering up with clothing: Take note if someone is always wearing long sleeves and long pants, even in warm weather, at the beach, or at the pool. Wearing lots of bracelets may be another way someone hides cuts, burns, or other marks on the arms.
  • Having sharp objects: Carrying razor blades, an X-Acto knife, or a box cutter in a purse or backpack when there is no logical explanation for doing so may be cause for concern.

In addition to these telltale signs, it’s important to take note of any changes in moods, behavior, school performance, or relationships. Increasing impulsiveness, anxiousness, blue moods, a drop in grades, or social withdrawal can make someone more vulnerable to self-harm

What’s Behind Self-Harm?

Many people who self-harm have experienced physical or verbal abuse, bullying, childhood neglect, or sexual assault. They do it as a way to control their emotional pain, stress, and anxiety. When someone is feeling overwhelmed by their emotions, cutting and other forms of self-harm can actually blunt that pain. In fact, some experts view it as a form of self-medication, similar to the way some people use alcohol or drugs to deal with emotional issues.

A growing body of scientific studies has found that self-injury is often associated with other psychiatric issues, especially anxiety and depression. Up to 89% of people who intentionally harm themselves also struggle with anxiety and up to 79% suffer from depression, according to a review of existing research in Child and Adolescent Psychiatry and Mental Health. Other common conditions seen in people who self-harm include post-traumatic stress disorder (PTSD), borderline personality disorders, substance abuse, eating disorders, and dissociative disorders.

Because self-harm is often a symptom or coping mechanism for a deeper problem, it’s imperative to get to the root of the problem and address the underlying issue.

How to Get Help for a Loved One

If you suspect your tween or teen is cutting or engaging in some other form of self-harm, don’t get angry at them or punish them for their behavior. They need help. One of the best ways to handle the situation is to simply open the door to communication. Let them know you’re concerned about them, willing to listen, and ready to assist them in getting the help they need.

At Amen Clinics, we have treated many young people and adults who engage in self-harming behaviors. We use brain SPECT imaging as part of a comprehensive evaluation to uncover underlying issues of anxiety, depression, PTSD, and other conditions. This information helps our physicians identify all issues that need to be addressed so we can personalize treatment using the least toxic, most effective solutions.

Our care specialists can be reached at 888-288-9834 or you can schedule a visit online.



  1. You forgot to mention autism. Autistic people experience worse racism – defining them as a separate race of life unworthy of life and anything life has to offer to make it worth living – than any other ethnic group in America’s history. The unemployment rate among able bodied and able minded autistic people, including those with very high IQ’s is 80% and the suicide rate is 9 times that of the general population. PTSD is common for these people.

    Comment by Robert Vincelette — January 29, 2020 @ 3:34 AM

  2. Self-harm behavior carries into older adulthood and/or re-manifests itself. One may not realize that systemic itching could be caused from anxiety or that skin-picking (as in scratching leading to digging then picking and re-picking scabbed picks) is actually self-harm until a Dermatologist diagnoses “Picker’s Nodules.” Treatment by a Psychologist specializing in Trauma is an excellent choice to work toward alternatives to picking and understanding the cause of the behavior.

    Comment by Sharon Hutchinson — January 29, 2020 @ 5:09 AM

  3. Is there any research regarding adult causing scabs and continual picking, so the scabs do not heal on their arms?

    Comment by LZ — January 29, 2020 @ 8:25 AM

  4. You’ve ably addressed self harm as seen with cutting. However, severe nail biting and cuticle pulling to point of bleeding is another way of self abuse. People often stop all other activity and focus just on the nail biting. Picking and peeling skin of feet to point of blood as well. Peering at self in mirror for long periods of time doing pimple squeezing, using pins to open up etc too. Could you address this in a future blog?

    Comment by Kaitlyn — January 29, 2020 @ 9:09 AM

  5. I started nail biting when I was very young and would tear ate the skin around it to where I didn’t have much of any cuticles.
    I’m almost 49 and still struggle with it. Later on where severe abuse was going on, I would bite myself during the sexual attacks. Then, my mind seemed so twist that it was hard to think. So I started hitting my head any way possible. Finally, started cutting. I have manager over to to just nail biti g and picking cuticles beyond belief. However, do to multiple events on the past year; I’m doing all the above and pushing people away. No one wants to help so I just do t want to reach out any more. I’m lonely and tired. The only thing keeping me alive is paying off medical bills so my mom doesn’t get burdened with them.

    Comment by Joanna — January 29, 2020 @ 11:08 AM

  6. Joanna,
    I am praying for you right now!

    Comment by Lisa — January 29, 2020 @ 12:54 PM

  7. I am praying for you, too.

    Comment by Janet — January 29, 2020 @ 3:52 PM

  8. my heart goes out to you and I hope you get the help and relief you deserve!

    Comment by cathy — January 29, 2020 @ 4:40 PM

  9. Joanna
    There are several therapy techniques that could help you. One of the is EMDR which is a trauma recovery process. It helps disconnect the negative emotions from trauma experience its impact on impact on self image. Another technique is EEG Neurofeedback which trains the brain to learn to be calm. After the over arousal and hypervigilance have been addressed, then Alpha -Theta training can allow the person to disconnect from feelings of terror, fear, anger etc. every time memory of the trauma comes up.

    Comment by Hanno W. Kirk, PhD, LICSW — January 30, 2020 @ 1:16 PM

  10. Thank you for this helpful comment Hanno, here are helpful links about those services offered at Amen Clinics:
    EMDR: (scroll halfway down the page, and there’s a helpful video as well)

    Comment by Amen Clinics — January 30, 2020 @ 1:23 PM

  11. Thank you for your comment Robert. I completely agree as having a 12 year old daughter diagnosed as High Functioning Autism. She was discovered this last fall as cutting. It has been a harrowing journey to say the least. She experiences severe anxiety and it has been very difficult dealing with the school system and community. They only focus on her high intellect ignoring her emotional/social pain which has impaired her functioning. I have also experienced this with other members of my family. My 18 yr old nephew has struggled also. They need constant support in order to succeed. Thank you for bringing this subject to light.

    Comment by Darragh — February 5, 2020 @ 5:48 AM

  12. Joanna I am 56 and still struggling with mental illness. DO NOT give up on yourself! Keep demanding quality care (doctor, therapist, groups). They are not all the same, shop around. Also educate yourself. It is empowering. I feel your pain as a person with mental health illness prevalent in my family. Can’t do much about genes. Try to practice self love and compassion. In my thoughts.

    Comment by Dee — February 5, 2020 @ 6:00 AM

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