Cutting is when a person deliberately hurts themselves by scratching or cutting their body with a sharp object. The reasons someone might do this are complicated.

People who cut themselves might be trying to cope with frustration, anger, or emotional turmoil. It might be an attempt to relieve pressure. But any such relief is short-lived and may be followed by feelings of shame or guilt.

There are people who cut once or twice and never do it again. For others, it becomes a habitual, unhealthy coping mechanism.

Cutting is a form self-injury not typically associated with suicide. But it can lead to severe, even fatal, injury.

Continue reading to learn more about the signs that someone may be cutting and what you can do to help.

There are no easy answers as to why a person turns to cutting, though there are some general causes. A person who self-harms may:

  • have difficulty understanding or expressing emotions
  • not know how to cope with trauma, pressure, or psychological pain in a healthy manner
  • have unresolved feelings of rejection, loneliness, self-hatred, anger, or confusion
  • want to “feel alive”

People who self-injure may be desperate to break the tension or rid themselves of negative feelings. It could be an attempt to feel in control or to distract from something unpleasant. It can even be a means of self-punishment for perceived shortcomings.

It’s certainly not always the case, but self-injuring behavior can be associated with other conditions such as:

In time, the act of cutting can become similar to an addiction.

Some risk factors for cutting are:

  • Age. People of all ages self-injure, but it tends to occur more in teenagers and young adults. Adolescence is a time of life when emotions and conflicts, and how to deal with them, can be confusing.
  • Sex. Both males and females cut themselves, but it’s believed that girls do so more often than boys.
  • Trauma. People who self-harm may have been abused, neglected, or raised in an unstable environment.
  • Identity. Teens who cut may be questioning who they are or confused about their sexuality.
  • Social circle. People who have friends who self-injure may be inclined to do the same. Peer pressure may play a role, especially during the teen years. On the other hand, social isolation and loneliness can also be a factor.
  • Mental health disorders. Self-injury sometimes goes along with other mental health issues such as depression, anxiety disorders, eating disorders, and post-traumatic stress disorder (PTSD).
  • Drug or alcohol misuse. Those who tend to cut themselves are more likely to do so if they’re under the influence of alcohol or drugs.

There are exceptions, but people who cut generally go through a lot of trouble to hide that fact. People who self-harm may:

  • frequently criticize themselves
  • have troubled relationships
  • question their personal identity or sexuality
  • live with emotional instability
  • have an impulsive nature
  • have feelings of guilt, hopelessness, or worthlessness

Upsetting events can trigger the impulse to cut. If someone is cutting, they might:

  • frequently have fresh cuts, particularly on the arms and legs
  • have scars from previous cuts
  • keep sharp objects like razor blades and knives on hand
  • cover up their skin even when the weather is hot
  • make excuses about cuts and scars that just don’t ring true

A person who cuts may also engage in other self-harm behaviors such as:

  • scratching or picking at wounds
  • burning themselves with cigarettes, candles, matches, or lighters
  • pulling out their hair

If you discover that a loved one is cutting, reach out to them.

Children and teens: friend to friend

If you find out your friend is cutting, remember that you aren’t responsible for their behavior or for fixing it. But you might be able to help. What your friend needs right now is understanding, so let them know you’re there for them.

It's important that you talk to them without any judgement. Suggest that they talk to their parents about cutting. If they aren’t comfortable with that, suggest they speak with a school counselor or other adult they trust.

If you’re very worried and don’t know what to do, tell your own parents or a trusted adult.

Parent to child

If your child is cutting, they need compassion and guidance. And they need to know that you love them no matter what. Punishing them or purposely embarrassing them will be counterproductive.

Make an appointment to see your pediatrician or family doctor right away. Have your child examined to make sure there are no serious wounds or infections. Ask for a referral to a qualified mental health professional.

You can also do some research on your own to learn more about self-injury, strategies for overcoming it, and how to avoid relapse.

Once a therapist sets a treatment plan, support your child in following it. Consider joining a support group for parents of people who self-injure.

Adults: friend to friend

If you have a friend who is self-injuring, urge them to see their doctor or mental health specialist.

They have enough on their plate, so try not to pile on with disapproval or ultimatums. Don’t imply that they’re hurting people who love them because guilt doesn’t work and often can make things worse.

They won’t change until they’re ready to do so. Until then, continue spending time with them and ask how they’re doing. Let them know that you’re ready to listen if they want to talk and you’ll support them in their recovery when they do seek help.

Cutting isn’t usually an attempt at suicide, but an accidental injury can quickly become life-threatening. If someone you know is bleeding heavily or appears to be in immediate danger, call 911.

Suicide prevention

  • If you think someone is at immediate risk of self-harm or hurting another person:
  • •  Call 911 or your local emergency number.
  • •  Stay with the person until help arrives.
  • •  Remove any guns, knives, medications, or other things that may cause harm.
  • •  Listen, but don’t judge, argue, threaten, or yell.
  • If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Cutting can exacerbate negative emotions. It can also lead to worsening mental and physical problems such as:

  • increased feelings of guilt and shame
  • becoming addicted to cutting
  • infection of the wounds
  • permanent scarring
  • severe injury requiring medical treatment
  • accidental fatal injury
  • increased risk of suicide

Self-harm can turn into a vicious cycle seemingly without end — but it doesn’t have to be that way. Help is available. Self-harming behaviors can be successfully treated.

The first step is to speak to a doctor. A mental health evaluation will determine if there are contributing conditions such as depression, anxiety, or personality disorders.

There’s no drug treatment specifically for self-harming behaviors. But if there is a coexisting mental health disorder, medication may be appropriate. The treatment plan will take all this into consideration.

The main treatment is talk therapy (psychotherapy). The goals are as follows:

  • Identify triggers.
  • Learn methods of managing emotions and tolerating stress.
  • Learn how to replace unhealthy behaviors with positive ones.
  • Work on relationship skills.
  • Develop problem-solving skills.
  • Boost self-image.
  • Deal with traumatic events in your past.

Along with individual therapy, the doctor may recommend group or family therapy. For those who have severely injured themselves or have had suicidal thoughts, short-term hospitalization may be helpful.

Here are some ways people can support their own treatment:

  • Stick to the treatment plan.
  • Ask for help when you need it.
  • Avoid alcohol.
  • Don’t take any drugs that haven’t been prescribed by your doctor.
  • Exercise every day to help boost your mood.
  • Eat well and don’t skimp on sleep.
  • Keep in touch with friends and family.
  • Make time for social activities and hobbies.

If someone you know is cutting, there’s help available. Ask your family doctor, therapist, or local hospital for information about support groups in your area. Other resources include: