How to Respond if Someone Is Self-Harming

If you notice that someone you care about is self-harming, it can be upsetting and concerning. You might want to help, but don’t know what to say or do.

In this article, we’ll cover signs of self-harm, steps for helping someone who self-harms, and how to care for yourself during this time.

What is Self-Harm?

Self-harm means that a person is hurting themselves on purpose. They might do this because it offers them a brief sensation of relief from the emotions they are feeling, or because they feel numb and the pain makes them feel something. Some people engage in self-harm because they are having suicidal thoughts. But others engage in self-harming behaviors have no intent to die.

Some people also think that cutting is the only form of self-harm. But people do engage in self-harm in other ways, such as burning their skin, pulling their hair, or kicking themselves. 

Participating in activities where there is a risk of injury, such as playing contact sports, or socially normative behaviors like getting tattoos or piercings, is not self-harm unless the person is intentionally seeking harm. 

Recognizing the Signs of Self-Harm

Most people who self-harm want to keep it a secret, so it can be difficult to know if someone you care about is engaging in self-harming behavior. However, there may be some specific self-harm warning signs.

Physical Indicators

Signs that someone might be self-harming include:

• Unexplained cuts, bruises, or burns.
• Wearing pants or long sleeves, even in hot weather.
• Finding unusual, sharp objects or other implements.
• Scars in similar places, suggesting repeated self-harming behavior.

Emotional and Behavioral Changes

You might notice that someone who is self-harming shows changes in their emotions and behavior. This may include:

• Mood changes, like withdrawal and isolation. 
• Expressions of hopelessness or self-criticism.
• Changes in relationships or activities.
• Avoiding places where their body may be seen, such as swimming.

How to Respond with Compassion if Someone Is Self-Harming

Recognizing possible stigma and listening actively can help show compassion if you notice that your loved one is self-harming. 

Initial Conversations

If you think that someone is self-harming, it’s important to approach them with care and without judgment. When responding to self-harm, it’s natural to feel upset, angry, or worried. But people who self-harm may feel ashamed of their actions, so it is important to approach them with calmness and thoughtfulness.

Open the conversation with an “I…” statement that allows them to share how they are feeling if they are ready. For example, “I noticed that you haven’t been yourself lately, and I am worried that you might be self-harming. I wanted to ask how you are doing?” You might be met with denial or guarded language. If this is the case, calmly let them know that you are there for them if they ever need to talk about something.

Being aware of mental health stigma can also help you approach your loved one in a non-judgmental way. For example, some people believe that individuals self-harm because they are looking for attention.

Avoiding this way of thinking can help your loved one feel seen and supported. It’s also important not to demand that your loved one stop the self-harming behavior. They might be resistant to doing so because it offers them some form of relief. It takes time, professional mental health support, and effective coping methods to manage self-harm behavior. 

Providing Emotional Support

As a loved one, your job isn’t to fix the person’s problems for them. It’s to provide emotional support so that they can care for themselves. Active listening is a good way to offer this mental health support. This involves repeating the person’s words back to them in your own words, checking that you understand what they are saying.

You can also focus on validating the person’s feelings without validating the behavior. For example, you might say that you understand that self-harming offers them a feeling of relief, but gently suggest that there might be safer ways to achieve this. Framing getting help as a sign of strength and a way to learn about helpful tools might encourage your loved one to seek help without putting pressure on them. 

Immediate Safety Concerns

In some cases, self-harm can lead to more severe injuries that need immediate medical help.

Assessing the Severity

It’s important to note that there is a difference between self-harming and suicidal behaviors. Self-harm tends to occur frequently and is less severe.

Most people who self-injure do not have suicidal thoughts when self-injuring and do it because it gives them a brief sensation of relief. With suicidal behaviors, there is an intent to die, and injuries are more severe. If someone is in immediate danger due to suicidal thoughts or actions, call 911.

Sometimes, self-harming can result in more severe injuries or lead to suicidal thoughts or behaviors. If your loved one has bleeding that won't stop, loss of consciousness, or is very lethargic, call 911. It's a medical emergency. If you suspect or know that they have taken excessive amounts of drugs or alcohol, then this is also a good indicator to seek immediate medical help.

Crisis Resources

If you decide that immediate help is needed, there are a few ways to do so:

• Call 911 (or your local emergency number) if the person is in immediate physical danger.
• For a mental health crisis where the person is physically safe and able to communicate by phone, call or text the Suicide and Crisis Lifeline at 988. Trained counselors can provide crisis intervention to help de-escalate the situation.
• If in-person mental health support is needed, a mobile crisis team can be called. They can provide assessment, de-escalate, and recommend resources. Call 988 to inquire about this. 

Encouraging Professional Help

Encouraging someone who self-harms to seek help can be tough. They may feel shame about their actions, fear judgment, or worry about losing their way to cope. Being nonjudgmental and normalizing seeking help can help them decide to get self-injury support. 

Types of Treatment Available

There are several types of treatments available for self-harming, some of which work better for some people than others. Therapy is often the first choice for treatment. It targets the root behavior and helps people learn safer coping methods. Types of therapy that can help with self-harming behaviors include:

• Cognitive-behavioral therapy (CBT): A type of therapy focused on the connection between thoughts, behaviors, and emotions. CBT can help with identifying and changing negative thoughts, as well as introducing coping methods.
• Dialectical behavioral therapy (DBT): DBT helps with managing intense emotions. It teaches skills for managing emotions and handling distress, as well as better connecting with others. 
• Mindfulness-based therapies: Mindfulness-based therapies can help you live in the present moment. This can reduce negative thoughts and relieve anxiety.
• Trauma-focused therapy: For some people, past trauma can be a contributing factor to self-harming behavior. Trauma-focused therapy can help them process these experiences.

Medication may also be used in combination with therapy. There isn't a specific medication for self-harming behavior. However, your doctor might prescribe medications to help treat any underlying mental health concerns, such as depression or anxiety.

In some cases, a healthcare provider might also recommend inpatient treatment. Inpatient treatment is usually recommended when self-harming behavior is frequent or severe. This can help provide a safe, stable environment to start recovery. 

Supporting Someone Long-Term

Supporting someone long-term can bring up difficult emotions. Understanding what the recovery process looks like and taking care of yourself can help you navigate this. 

Being a Consistent Ally

Your long-term support can be helpful, but it’s important to be aware of how you are feeling and maintain balance. Regular check-ins and listening without trying to fix the problem can be helpful. It’s also important to set healthy boundaries.

This includes letting your loved one know when you are available—and when you aren’t. This doesn’t mean that you aren’t there for them. Instead, it means that you are setting healthy boundaries so that you are able to be there for them without burning out.

Checking in with yourself is also an important part of supporting someone else. If you’re feeling tired, take the time to practice some self-care. If you start noticing signs of burnout, like exhaustion, increased anxiety, or irritability, then you may need to seek support for yourself. 

Learning About Recovery

Having knowledge about what recovery looks like can make helping someone who self-harms easier. It’s important to know that recovery is a process. Sometimes, your loved one might seem to be doing really well, and other days it might seem like they are taking a step back. This is normal. Healing isn’t linear.

As a support person, you can help your loved one by being there for them during the healing process. Self-care activities can help on a bad day. Simple things like going for a walk or sharing a meal together can make a difference.

Celebrating their successes is also important. For example, if you notice that your loved one is using one of their coping strategies, gently let them know that you’ve noticed it and are proud of them. Recovering from self-harming behavior is tough, but your compassion and care can help support your loved one through the experience.

References

Cleveland Clinic. (2023, October 6). Self-harm (nonsuicidal self-injury disorder). In Health Library. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12201-self-harm

Crisis Text Line. (n.d.). Help for self-harm. Crisis Text Line. Retrieved [Insert Retrieval Date], from https://www.crisistextline.org/topics/self-harm/

Mayo Clinic Staff. (2024, November 21). Self-injury/cutting: Diagnosis & treatment. Mayo Clinic. Retrieved September 1, 2025, from https://www.mayoclinic.org/diseases-conditions/self-injury/diagnosis-treatment/drc-20350956

National Center for PTSD. (n.d.). Self-harm. U.S. Department of Veterans Affairs. Retrieved September 1, 2025, from https://www.ptsd.va.gov/understand/related/self_harm.asp

Samaritans. (n.d.). How can I support someone who has self-harmed? Samaritans. Retrieved September 1, 2025, from https://www.samaritans.org/how-we-can-help/if-youre-worried-about-someone-else/how-can-i-support-someone-who-has-self-harmed/