ADHD and Self-harm

ADHD, which stands for attention deficit hyperactivity disorder, is considered a neurodevelopmental disorder. Scientists connect its causes with the disruption of the functioning of certain parts of the brain. It mainly concerns the prefrontal cortex and striatum, which are responsible for the cognitive control of behavior. It leads to the issues of ADHD people with hyperactivity, impulsivity, inattention, and emotional dysregulation. [1]

However, among symptoms that often come with ADHD, self-harm is the one that requires a lot of attention from specialists. Statistics show higher risks of non-suicidal self-injury, suicidal ideation, suicide attempts, and dying by suicide for people with ADHD. For example, one study revealed that the tendency to commit suicide is 30% higher among them. [2] Such numbers demonstrate a serious challenge the patients with this disorder deal with. Hence, if you or your loved ones have ADHD symptoms, you should contact our therapists from URP Behavioral Health for professional help.

Is Self-Harm a Sign of ADHD?

If approaching the topic strictly, the simple answer is no. Self-harm isn’t a sign of ADHD as such. Not all people with ADHD suffer from self-harming urges. However, there is a strong connection between the mental disorder and self-harm. Almost half of ADHD adults admit they experienced suicidal thoughts. Such statistics allow specialists to claim that ADHD and self-harm are strongly associated, though self-harm isn’t a sign of this mental condition. [2]

The Link Between Self-Harm and ADHD

The above numbers prove the link between self-injuring behavior and the disorder. It isn’t rigidly determined, but this connection can’t be denied. Understanding these connections is essential for developing effective prevention and intervention strategies tailored to those at risk. As we see further, every ADHD symptom, especially impulsivity and emotional dysregulation, can make self-harming manifestations more likely.

Can ADHD Cause Self-Harm?

Psychiatrists clearly have established that the mental condition isn’t the reason for self-injuring tendencies. At the same time, ADHD characteristics put people in a danger zone of higher risks of engaging in self-injuring activity. It concerns both non-suicidal self-harm patterns and suicidal behaviors. The tendency of ADHD to coexist with conditions like depression, anxiety, and substance use disorders makes these risks even more threatening.

Symptoms of ADHD and Self-Harm

Although the disorder doesn’t cause self-injury behavior directly, it often contributes to it. It’s because of ADHD specifics. It has such symptoms that intensify self-harm tendencies. Some of them make more impact on ADHD people, like impulsivity and emotional dysregulation, others are less. Add to this possible social pressure towards them because of their communication awkwardness. Therefore, it’s no wonder that almost every second person with the disorder struggles with a self-harm mindset. [2]

Let’s look at how ADHD symptoms affect and strengthen self-injuring patterns:

• As a hallmark of ADHD, it pushes individuals to rash acts in response to distress. It can be self-harm actions and even suicidal attempts, among other things. Impulsivity also hinders people with the disorder from thinking rationally and considering the long-term consequences. All these factors enhance the chance of self-harm.
• Emotional dysregulation. It’s another core ADHD symptom responsible for increasing the likelihood of self-injuring tendencies. It occurs because patients with the disorder hardly manage intense emotions. It can make them engage in self-injury as a coping mechanism.
• Social factors. As mentioned above, these factors can be ignored. However, they play a significant role in elevating the risk of self-harm. It’s especially crucial for adolescents who may encounter bullying or rejection because of their mental issues. They may consider self-injuring behavior in attempts to handle intense distress caused by feelings of isolation and low self-esteem. [3]
• Comorbid mental health issues. When ADHD combines with other disorders, which is a common occurrence, it leads to a more severe condition of a person. For instance, it might be anxiety or depression disorders. A combination of ADHD and these mental issues symptoms worsen the risk of self-harm. [4]

Treatments for Self-Harm and ADHD

Self-injuring tendencies of people with ADHD make their treatment much harder. It’s because specialists have to deal with self-harm and the disorder symptoms simultaneously. This leads to the necessity to combine treatment approaches for both these conditions sophisticatedly. Some of these medical methods overlap, while others are specific for ADHD and self-injury.

Standard treatment approaches are the following for ADHD people with self-harm tendencies:

• Cognitive behavioral therapy (CBT). This approach is effective for treating both the disorder and non-suicidal self-injury (NSSI). It’s based on the idea of restructuring and reframing unhealthy thought patterns and behaviors. CBT also provides tools to manage strong emotions.
• Dialectical Behavior Therapy (DBT). It‘s a variation of CBT that aims to improve communication skills, mindfulness, stress resistance, and emotion regulation. These competencies are very helpful in overcoming self-harm intentions and controlling ADHD symptoms.
• Avoidance techniques. There are several types of them. Some are intended to keep a person busy, distracting them from self-injuring thoughts. These can include sports, strolls, meetings with friends, writing, and any other emotion-expression approach. Another effective way to prevent self-harm attempts is to remove potentially dangerous objects. A card with emergency contacts at hand is helpful as well.
• There are no specific drugs to treat self-injury. They’re used commonly against comorbid disorders like depression, anxiety, or ADHD. For the latter, it can be stimulants like methylphenidate or amphetamines as the first-line treatment. If they are not effective enough or undesirable because of side effects, therapists might prescribe non-stimulant options such as atomoxetine. [5][6]

There is a strong correlation between ADHD and self-harm in adults and adolescents. Research clearly shows that many people with the disorder experience self-injuring tendencies. Nevertheless, ADHD doesn’t cause them even though they have a firm link. It may be easily comprehended that the main symptoms, like impulsivity and emotional dysregulation, can contribute to NSSI and suicidal attempts. Because of that, treatment centers struggle to address ADHD and self-harm at the same time. It can be a combination of medicine and psychotherapy approaches. If you seek professional help for yourself or your loved ones, don’t hesitate to contact our specialists from URP Behavioral Health.

References:

1. The National Institute of Mental Health. Attention-Deficit/Hyperactivity Disorder (ADHD). https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd. Feb 2025
2. Joanna Solomon and Sara Rzepa. Examining the Relationship Between ADHD and Self-Harm in Adults. https://mhs.com/blog/examining-the-relationship-between-adhd-and-self-harm-in-adults/.
3. Kate Burke. Teenagers with ADHD more likely to self-harm, research shows. https://www.unsw.edu.au/newsroom/news/2024/06/Teenagers-with-ADHD-more-likely-to-self-harm-research-shows1
4. Mairin R Taylor, Joseph M Boden, Julia J Rucklidge. The relationship between ADHD symptomatology and self-harm, suicidal ideation, and suicidal behaviours in adults: a pilot study. May 8, 2014
5. Discovery Mood & Anxiety Program. Treatment for Self-Harm. https://discoverymood.com/blog/treatment-self-harm/
6. Victoria A Nazarova, Aleksandr V Sokolov, Vladimir N Chubarev, Vadim V Tarasov, Helgi B Schiöth. Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials. https://pmc.ncbi.nlm.nih.gov/articles/PMC9713849/. Nov 17, 2022