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When tension, emptiness, frustration, anger, or self-loathing become unmanageable, some people harm themselves as an outlet for their emotional distress. Self-harm is the act of intentionally injuring oneself to inflict pain that is not intended to be suicidal. Clinically, this is referred to as nonsuicidal self-injury disorder (NSSID), but it may also be known as self-injury, self-mutilation, or self-abuse.

People who engage in self-harm often experience feelings of shame and guilt afterward, which unleashes even more emotional distress, which then leads to another round of self-injury. It’s a vicious cycle that can interfere with your everyday routine, steal your happiness, and negatively impact your overall quality of life.


Nonsuicidal self-injury is most common among adolescents and young adults and some research indicates it is becoming more prevalent. In a 2012 study in Child and Adolescent Psychiatry and Mental Health, 17% of adolescents reported engaging in self-harm at least once. Among college students, 15% reported at least one incident of non-suicidal self-injury, according to a 2011 study in the Journal of College Health. Self-harm is not as common in children or adults. In kids ages 5-10, about 1.3% self-injure. Among adults, it’s estimated that about 5% practice some form of self-harm.

Self-harm is more common in females, who make up as much as 65% of all those who injure themselves. However, some experts suggest that self-injury may be underreported in boys and men.

People who have experienced any of the following may be at increased risk of self-harm:

  • Bullying
  • Sexual abuse
  • Childhood abuse
  • Abandonment
  • Emotional trauma


Some of the most common forms of self-injury include:

  • Cutting: Considered the most common form of self-mutilation, cutting involves using any sharp object to break the skin. People often create parallel lines or tracks on the hands, arms, or thighs, or they may spell out words on their skin. Cutting is more commonly seen in females.
  • Burning: Using cigarettes, matches, or any other hot objects to burn the skin.
  • Head banging: Hitting your head against a wall, desk, or other hard object.
  • Punching: Hitting yourself, the wall, or other objects. This is more commonly seen in males.
  • Scratching or pinching: A person may scratch until they bleed or pinch the skin until it leaves a mark or causes bleeding.
  • Skin picking: Picking at scabs or wounds to prevent healing, or tearing or ripping the skin.
  • Insertion: Pushing things, such as glass, into the skin.
  • Poisoning: Consuming harmful substances, such as drinking bleach or swallowing batteries.
  • Pulling hair: Known as trichotillomania, people pull out their own hair and sometimes consume it.


If you’re worried that a loved one may be practicing self-injury, look for these warning signs:

  • Scars (often in patterns or spelling out words)
  • Frequent cuts, bruises, scratches, or other signs of injury
  • Unusual stories about accidental injuries
  • A preference for wearing long-sleeve clothing and long pants at all times
  • Problems with school performance
  • Trouble with friendships and romantic relationships
  • Keeping sharp objects on hand
  • Impulsive and unpredictable behavior
  • Withdrawal from social activities


Research shows that self-injury is often seen with other mental health conditions. It is common for people who self-harm to also have the following conditions:

  • Anxiety: Approximately 72%-89% of people who self-harm also have anxiety
  • Depression: About 72%-79% of people who self-harm also suffer from depression
  • Post-traumatic stress disorder (PTSD): Research suggests that 25%-28% of people who self-harm also struggle with PTSD
  • Borderline personality disorder (BPD): Anywhere from 20%-52% of people who self-harm also have BPD.
  • Substance abuse: About 9% of people who self-harm experience a problem with substance abuse.
  • Suicidal thoughts: Although NSSID is considered nonsuicidal in nature, up to 40% of people who self-harm think about suicide, and approximately 50%-85% have made at least one suicide attempt in their lifetime. Because of this, it is absolutely critical to seek help for any form of self-harming behavior.

Likewise, a high rate of people with the following disorders also engage in self-harm:

  • Borderline personality disorder: Approximately 70%-75% of people with BPD practice self-injury. BPD is the only mental health disorder in which self-injury is one of the diagnostic criteria.
  • Eating disorders: About 27%-61% of people diagnosed with the binge-purge subtype of anorexia nervosa, 26%-55% of those with bulimia nervosa, and 13%-42% of those with the restrictive subtype of anorexia also have a history of self-harm.
  • Dissociative disorders: Approximately 69% of those with dissociative disorders exhibit self-harm.
  • Alcohol abuse: Some research suggests that 25%-33% of people with alcohol dependence also have a history of self-injury.


Brain imaging studies reveal abnormal activity in the brains of people who self-injure. A 2018 study from researchers at The Ohio University found that the brains of girls who engage in self-harm show abnormalities similar to those seen in people with borderline personality disorder. These included decreased volume and abnormal function in areas of the brain involved in regulating emotions. Decreased brain volume is also commonly seen in people who have experienced emotional trauma, abuse, or neglect.


At Amen Clinics, we use brain SPECT imaging as part of a comprehensive evaluation to diagnose and treat people struggling with self-harm and co-occurring mental health conditions. In addition, we assess any the biological, psychological, social, and spiritual factors that may be contributing to your issues.

When it comes to treatment for self-injury, one size does not fit all! What works for one person may not work for another—or could even make your symptoms worse! Based on your complete assessment, we can create a personalized treatment plan for you. At Amen Clinics, we believe in using the least toxic, most effective therapies and strategies to optimize your brain function so we can help you get a handle on your emotional distress and find a path toward a happier life.

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