Non-suicidal self-harm is common, particularly among youth and young adults, and new research says it may have become more common during the pandemic. Self-harm, or self-injury, refers to intentionally hurting oneself, such as cutting. It is a harmful way of coping with emotional distress and people often try to hide the behavior and feel shame or guilt. Effective treatment, often including psychotherapy, is available to help people with healthy ways to cope.

One recent study found that among college students with major depression, more than one-third had a history of non-suicidal self-injury.¹ Another, which looked at data over the past several years, found a significant increase in self-harm behaviors in adolescents during the pandemic.² The researchers found the number of adolescents admitted to the hospital with self-injury behaviors increased, the average age was younger, and the duration of the disorder was longer. The study also found that overuse of mobile phones, as identified by parents, was significantly associated with adolescents' self-injury behaviors. The youth’s relationship with their parents and the experience of stressful learning situations (as indicated by the students) during the pandemic were also associated with self-injury behaviors.

Self-harm is not classified as a separate mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it is included in the section on conditions for further study. As proposed, self-harm is when an individual has, “on 5 or more days, engaged in intentional self-inflicted damage to the surface of his or her body of a sort likely to induce bleeding, bruising, or pain.” The individual expects the behavior to lead to relief from a negative feeling; resolve an interpersonal difficulty; and/or bring a positive feeling. It is not associated with suicidal intent and the expectation is that the injury will only cause minor physical harm. The behavior causes significant distress or interferes with functioning and is not socially sanctioned (such as body piercing, tattooing, part of a religious or cultural ritual).

The average age of starting self-harm is about 13 and some research has found that females are more likely to self-harm than males. One large international study found the most common reason for self-harm was relief from thoughts or feelings, about half reported only one or two episodes, and slightly more than half sought help, most commonly from a friend.

Self-harm often occurs along with other mental health conditions. Having a recent diagnosis of a mental disorder may be a particular risk factor, according to a study of individuals aged 10 to 64 enrolled in Medicaid and accessing mental health clinic services. ^{In particular, the study identified diagnoses of depression, personality disorder or substance use disorder as risk factors. Women and people 17 to 25 years old were also at greater risk of self-harm.}

Being a victim of cyberbullying has also been found to contribute to the risk of self-injury. A recent study notes that dispositional mindfulness may buffer the potential impact of cyberbullying on self-injury. The study authors suggest that intervention and prevention strategies should include “helping youth reduce emotion reactivity to break the cyberbullying victimization to non-suicidal self-injury cycle and to enhance youths’ mindfulness to buffer against the ill effects of cyberbullying victimization.”

The authors of a 2018 meta-analysis of self-harm research highlight the need for preventive efforts: ‘Preventative interventions that help adolescents deal with negative feelings should be instituted at the onset of puberty. Because friends are frequently asked for support, interventions also should be developed for peer groups.”⁵

If you or a loved one is experiencing distress or are concerned about self-injury, reach out to your health care professional or a mental health professional. Help is available.

Crisis Textline: Text HOME to 741741