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Last updated: May 17, 2025

Navigating the Diagnosis of Self-Harm in Mental Health

Self-harm is a term used to describe a range of behaviors where individuals intentionally cause harm to themselves. Understanding how mental health professionals diagnose self-harm can help individuals recognize the signs and seek appropriate help. In this blog, we will explore the criteria used to assess self-harm's severity and the underlying issues that may contribute to these behaviors.

What is Self-Harm?

Self-harm can take many forms, including:

  • Cutting
  • Burning
  • Hitting oneself
  • Engaging in risky behaviors

It's essential to note that self-harm is not always about wanting to end one’s life; many people self-harm as a way to cope with emotional pain or distress.

How Do Professionals Diagnose Self-Harm?

Mental health professionals have specific criteria and steps they follow to diagnose self-harm effectively:

  1. Initial Assessment: This includes a conversation between the individual and the mental health professional. They will discuss the person's feelings, thoughts, and any behaviors related to self-harm.
  2. Behavioral Analysis: The professional will look at the frequency, intensity, and methods of self-harm. They may ask questions like:
  • How often do you self-harm?
  • What triggers your self-harming behavior?
  1. Psychological Evaluation: This step involves assessing for underlying mental health conditions, such as depression, anxiety, or borderline personality disorder, which often co-occur with self-harm.
  2. Risk Assessment: Professionals evaluate the risk level associated with the self-harm behaviors. They consider factors like:
  • The severity of injuries caused by self-harm
  • Any history of suicidal thoughts or attempts
  • The presence of support systems in place

Criteria Used for Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines criteria that mental health professionals use to diagnose self-harm behaviors:

  • Recurrent self-harming behavior: This can include cutting, burning, or other forms of self-injury, performed repeatedly over time.
  • Emotional distress: The individual often experiences significant emotional distress before or after engaging in self-harm.
  • Lack of intent to die: It's important to differentiate self-harm from suicidal behavior. Many individuals who self-harm do not intend to end their lives but use self-injury as a coping mechanism.

Real-Life Examples of Self-Harm Diagnosis

  • Example 1: Sarah, a 22-year-old college student, often cuts her arms when she feels overwhelmed by stress. During her assessment, the therapist finds that she is experiencing severe anxiety and low self-esteem, both of which contribute to her self-harming behavior.
  • Example 2: Mark, a 30-year-old man, engages in self-harm by burning himself. Upon assessment, it is revealed he has been battling depression for years, and self-harm is his way of coping with feelings of numbness.

Types of Self-Harm

Self-harm can be categorized into various types based on the method used:

  • Cutting: Using sharp objects to create cuts on the skin.
  • Burning: Inflicting burns on the skin using hot objects or chemicals.
  • Self-hitting: Punching or hitting oneself to create pain.
  • Substance abuse: Engaging in excessive drug or alcohol use as a form of self-punishment.

Recognizing these behaviors and understanding the diagnosis process can empower individuals to seek help. If you or someone you know is struggling with self-harm, reaching out to a mental health professional is a vital step towards recovery.

Dr. Neeshu Rathore

Dr. Neeshu Rathore

Clinical Psychologist, Associate Professor, and PhD Guide. Mental Health Advocate and Founder of PsyWellPath.