Harming oneself might seem unthinkable, but it is one of the most common mental health issues. One way in which people do this is by cutting themselves.
Some older research among college students found that 15.3% had engaged in self-harm, such as cutting, at least once.
Another, more recent study suggests the occurrence of nonsuicidal self-harm in hospitalized teenagers in the United States is 35% and 10% in the rest of the teenage population.
Self-harm can cause permanent scars. Cutting and other forms of self-harm can also cause accidental injuries, such as when a person accidentally cuts too deeply.
People who cut or hurt themselves in other ways may need treatment for their mental health issues rather than shunning or shame. Also, finding a healthier release for their emotions can help them recover.
Read on to learn why people cut themselves, including the psychology behind this and advice about how to stop.
Cutting, like any other coping mechanism, can be an outlet for emotional pain.
Most people who cut report that they do so when their emotional distress feels unbearable. They do not cut themselves because they want to die or get attention.
The physical pain of cutting provides an outlet for a person’s emotional pain, making the latter feel more tolerable.
People who cut may report that they feel better immediately after cutting, though they may feel regret hours later or in the following days.
Cutting can feel like an addiction. A person may feel an overwhelming urge to harm themselves, particularly during times of emotional pain.
For some individuals, they feel temporary relief when they cut themselves and may then resolve to never do it again. However, the longer they go without cutting, the more the tension mounts, and the greater their desire to self-harm becomes.
Some factors that may indicate that a person might be at risk of self-harm include:
- They are experiencing depression, anxiety, or seem very unhappy.
- They have recently experienced a traumatic event, such as a breakup or sexual assault.
- They have trouble talking about or managing their emotions.
- They have a history of self-harm.
Some warning signs that a person may already be self-harming include:
- They have lots of unexplained injuries.
- They wear long sleeves, even during the summer or when they are hot.
- They are secretive or retreat during times of stress.
- They need to go to the emergency room or see a doctor because of unusual injuries. This could mean they have cut deeper or injured themselves more than they intended.
People from all demographic groups engage in self-harm. However, research suggests it is more common among females and sexual minorities, such as gay, lesbian, or asexual individuals.
Mental health diagnoses are more common among these groups, in general, which may help to partially explain why they are more likely to cut or engage in other types of self-harm.
A 2017 systematic reviewemphasizes that the behavior is more common among adolescents and young adults, often starting between the ages of 12 and 14 years old.
Drug use and access to the tools necessary to self-harm may increase the risk.
People with mental health and intellectual disabilities may also be more vulnerable to self-harm. For example, children with autism may bang their heads in frustration or anger.
A 2012 analysis found some common elements among hospitalized teens who self-harm:
- Teens who hurt themselves had lower scores on an “attraction to life” inventory.
- The majority (63.5%) met diagnostic criteria for borderline personality disorder. The remainder met the criteria for other personality disorders associated with trouble regulating emotions.
- More than half (53.8 percent) had high levels of depression.
This data suggest that trouble regulating emotions and controlling impulses may increase the risk of self-harm in people who experience depression, especially if they feel disinterested in life.
Self-harming is highly treatable. Medications can help control the emotions that trigger the impulse to self-harm.
Some people achieve good results with antidepressants. Most, however, need therapy. Therapy offers a healthy outlet for intense emotions and can help a person establish better skills for coping.
A 2014 systematic review emphasizes that researchers have not thoroughly studied various therapeutic techniques for treating cutting.
The review suggests the following treatments may help:
- dialectical behavior therapy
- emotion regulation group therapy
- manual cognitive therapy
- dynamic deconstructive psychotherapy
- atypical antipsychotics
- selective serotonin reuptake inhibitors with or without cognitive-behavioral therapy
People who self-harm may need immediate treatment for their injuries. When a person has scars or severe burn marks, they may seek cosmetic surgery and other treatments to reduce the appearance of these injuries and avoid probing questions.
It might seem like self-harm is a choice, but for people struggling with cutting, the impulse can be overwhelming.
Shaming, blaming, or making the person feel guilty may not help. Because these strategies can intensify painful emotions, they may even make the cutting worse.
People may instead want to try the following methods:
- Ask the person about their feelings.
- Listen to them without judgment.
- Offer to help the person find treatment.
- Suggest there are other ways to deal with overwhelming emotions.
Parents who are worried about a child or young person should find ways to create a safe environment without being punitive or needlessly controlling.
Being excessively punitive can backfire, making a child’s emotions feel even more unmanageable.
Family therapy may help the whole family develop better strategies for managing self-harm.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
People who self-harm may also be at a higher risk of suicide, and the risk factors for both are very similar.
Many people with both suicidal thoughts and a history of self-harm report unbearable and unmanageable emotions.
Helping a person who cuts or self-harms may save their life or prevent serious injuries.
Cutting is not a choice but a sign of extreme distress. Treatment can help, while shame, anger, and judgment will not.