Over 600,000. 

That’s the number of people who visited emergency departments across the United States in 2022 due to self-inflicted injuries, according to the Centers for Disease Control and Prevention (CDC). 

Self-injury is commonly defined as the deliberate infliction of physical harm on oneself without the intent to die as a result. Some of the most common forms include cutting, skin picking, biting, and hair pulling.

As America’s youth mental health crisis worsens, resources and information relating to suicide awareness have become widespread across the internet. While the stigma and negative connotations surrounding mental health have somewhat faded, the internet has become both a refuge and a risk for those in need. Because of the internet, terms like “depression” and “self-harm” have been integrated into everyday online language, and the weight and meaning of these terms have begun to blur. As a result, conversations about why people choose to hurt themselves are often left unheard. 

The psychology behind self-harm

About 17% of people worldwide have engaged in self-injurious behaviors at least once in their lives, according to a 2018 study published in the National Library of Medicine. Numbers and statistics can provide a scope of how many people are affected by self-harm. Yet, they do nothing to reveal the complexities of why a person chooses to hurt themselves, and whether or not those thoughts are affiliated with suicide. 

“Sometimes people will say self-harm and suicide in the same sentence, but that’s not right. Suicide is harm to oneself, so even though it sounds exactly the same, it’s not, not even close. It’s really important to put that out,” said Chris Mosunic, a clinical psychologist. “Suicidality and self-harm are totally different concepts, but that’s not to say that self-harm couldn’t be a part of someone’s symptoms when they’re suicidal.”

When examining what motivates or pushes a person to harm themselves, there are two factors to consider, according to Mosunic: intrapersonal and interpersonal motivations. 

Intrapersonal motivations come from inside the mind and can stem from feelings of anxiety, guilt, or shame. People who are driven to hurt themselves due to intrapersonal motivations often do so as a sort of “punishment” to themselves. 

“From a personal viewpoint, I’d say it’s just super strong emotions that cause you to feel violent, or as if there’s no outlet for your emotion; nothing seems like it’s enough when you’re trying to let out that emotion and express it,” said Rose Amani*, a teenager who previously struggled with self-harm. “It might help that emotion be expressed, even though it does end up causing more shame or negative feelings afterward.”

In addition, many who are diagnosed with Bipolar Disorder tend to be at a higher risk of self-harm; those who experience dissociation or derealization tend to turn to self-harm as a way to end feelings of numbness and depersonalization. 

Another factor that may influence a person to harm themselves is interpersonal motivation, or factors related to a person’s social life in general. 

“Sometimes self-harm is done to manipulate other people. For instance, in relationships, it might be to get control back or to basically get somebody’s attention,” Mosunic said. 

Other interpersonal motivations include communicating distress, seeking help, influencing others, or bonding with peers; it’s important to note that, regardless of motivation, self-harm is self-harm. Motivations and experiences vary from person to person, and one person’s struggles do not invalidate those of another. As conversations about self-harm move online, however, the ways these behaviors are shared and compared can quickly become damaging and unhealthy.

Self-harm on the internet

Social media and online communities play a prominent role in how younger generations perceive, understand, and cope with self-harm. While the internet has done wonders in spreading awareness and providing access to resources that can help those in need, it can also normalize harmful behaviors and reduce the complex emotions that drive self-injury to more surface-level expressions.

One of the largest concerns relating to discussions about self-harm online is the way it can be glamorized or romanticized. An article by Awa Ndour and Lucy Foulkes, psychologists from the University of Oxford, explores this idea, noting that romanticization can have both positive and negative effects. 

“The internet’s a double-edged sword when it comes to self-harm, because, on the one hand, you’re able to see that you’re not alone. When people find out via social media that they’re not the only ones harming themselves, there’s a feeling of less stigma,” Mosunic said. 

On the other hand, people who previously had no engagement with the idea of self-harm can be exposed to it through the internet.

“While I do feel like the internet is destigmatizing self-harm in some ways, I feel that it can also have the opposite effect, as there are harmful communities for it,” Amani said. “There are social media platforms where people show it in a glorifying kind of way, or they’re trying to promote it, and I feel like that’s causing negative effects for a lot of the younger generation who may not understand it.”

Social media platforms like Instagram, TikTok, and X, formerly known as Twitter, can play a significant role in the spread of self-harm material on the internet. Oftentimes, the comment sections on these platforms provide an opportunity for discussion regarding self-harm that isn’t always positive. Comment sections can offer support, but they can also promote or normalize harmful behaviors. 

“More often than not, if I see a video where someone has scars, or if they’re talking about self-harm, the comments are usually ridiculing or bringing the person down for their self-harm instead of focusing on what the video’s actually about,” Amani said. 

According to a report by Cornell University, many of the adverse effects that come with content relating to self-harm are driven by how they’re presented, and the way people interact in comment sections can significantly impact the way a person perceives self-harm. 

Comments typically range from supportive advice to either encouragement of harmful behaviors, ridicule, or instructions on how and where to self-harm so that people don’t notice. Some users also tend to leave self-deprecating remarks. Although they don’t necessarily encourage self-injurious behaviors, they can contribute to a sense of hopelessness that discourages people from seeking help. 

Similar to comment sections, online forums like Reddit and Tumblr often serve as spaces for discussion about self-harm. Many people turn to these communities seeking advice, understanding, or a sense of connection with others who share similar experiences. 

In 2009, a team of researchers from the United Kingdom created an experimental self-harm support forum called SharpTalk to examine and experiment with online engagement between health professionals and young people who self-harm. 

After the study concluded, many participants noted that they preferred talking to strangers online through the forum rather than family and friends, as they felt less judged and were more open. Many users also shared that they felt that they’d learned more from online discussion forums than from information sites. 

However, one of the most prominent ethical concerns relating to the study was the anonymous aspect of the forum. While anonymity encouraged openness, it also raised concerns about whether or not intervention would be possible in the event of a suicide threat. In addition, without proper moderation, anonymous forums can become spaces where harmful advice goes unchecked.

“Unfortunately, online forums are mostly going to be hurtful, because what it takes to do an online forum that’s helpful is super, super hard, and expensive,” Mosunic said. “You have to regulate them with a professional because people come in with no treatment, and quite often, they’re full of completely unregulated emotion and start doing inappropriate things. You have to monitor 24/7 with a human being to ensure that stuff doesn’t happen.” 

Because proper regulation is difficult and costly, many forums unintentionally end up supporting or pressuring self-harm rather than providing meaningful help.

“There are probably different kinds of communities where people are actively trying to help each other, or ones where discussion is just adding to the fire, but I think if it’s talked about in a mature manner where people can understand why it’s happening and actively work towards recovery, they can be good,” Amani said. 

Online communities and forums can provide a sense of connection, but don’t replace professional guidance. Licensed mental health professionals, school counselors, structured programs, and supportive peers offer proper intervention and resources that online spaces often cannot, helping ensure safety and effective care for those struggling with self-harm.

Support systems and getting help

Reaching out for help is the first — and often one of the most difficult — steps in rehabilitation, whether through a licensed professional, a school counselor, or trusted family and friends. Because self-harm can become a dangerous addiction, Mosunic emphasizes that the most effective way to combat it is by going into therapy. 

“Breaking out of any addiction that helps you emotionally is super hard, if not impossible, to do without therapy,” Mosunic said. “Anything that makes you feel better really quickly can become an addiction, and the best way to break out of that addiction is by going into therapy, preferably with someone who knows how to handle addiction and these kinds of symptoms.”

However, not everyone has access to professional help, which is where school counseling systems can play an integral role. 

“The Wellness Center can have a huge influence on students by providing them with the support and tools they may need on any given basis,” said Sogand Taherian, a therapist at Carlmont’s Wellness Center. “Counselors are often aware of higher-risk students and can take initiative in ensuring these students have the best level of care throughout their school day.”

Taherian adds that psychoeducation on self-harm can help students understand the underlying reasons behind their behaviors. She notes that small adjustments can help students manage their emotions and reduce urges to self-harm, like incorporating regular breaks or moments for reflection in class.

Still, reaching out for help can seem incredibly daunting.

“I feel like younger individuals often have a hard time reaching out about these issues because they’re afraid of what could happen,” Amani said. “Maybe they have a difficult home life and want to talk to a counselor about it, but they may stay quiet and continue to struggle because counselors are required to contact home about these types of things.”

For those who may be hesitant to approach professionals, having someone you trust can make a significant difference, whether it’s a close friend, teacher, or family member. However, these connections should complement professional help rather than replace it altogether. 

“With teens, peer support isn’t so great,” Mosunic said. “You shouldn’t be worrying about other human beings and how to help them in a way that’s professional and takes training.”

Even so, reaching out can make a real difference, regardless of whether you speak to a friend or a trusted adult. 

“I think the first step to getting out of it is going to be very difficult, and you just have to acknowledge that,” Amani said. “Don’t be quiet about it, and definitely talk to trusted individuals about it. If there’s anything in your life that’s contributing to it — like a tool you use — get rid of it. Keeping it around is only going to make it harder to stop.”

*In accordance with Carlmont Media’s anonymous sourcing policy, the name of this source has been changed to protect their privacy.