Nonsuicidal Self-Injury (Self-Injury)

Nonsuicidal self-injury, commonly referred to as self-injury, is the intentional act of harming one’s own body, such as cutting or burning oneself. It is typically not a suicide attempt but rather a harmful way to cope with emotional pain, sadness, anger, and stress.

Symptoms

Symptoms of self-injury may include scars in patterns, fresh cuts, scratches, bruises, bite marks, or other wounds. Individuals may engage in excessive rubbing to create a burn, keep sharp objects or items used for self-injury on hand, and wear concealing clothing even in hot weather to hide self-harm. Other signs include frequent reports of accidental injury, difficulties in relationships, impulsive and intense emotions, and talk of helplessness, hopelessness, or worthlessness.

Forms of Self-Injury

Self-injury is usually done in private and often follows a controlled pattern, leaving identifiable marks on the skin. Common forms of self-injury include cutting, burning, carving words or symbols, self-hitting, piercing, and inserting objects under the skin. The targets of self-injury are most commonly the arms, legs, chest, and belly, although any area of the body may be affected.

When to Seek Help

If you or someone you know is engaging in self-injury or experiencing thoughts of self-harm, it is essential to reach out for help. Any form of self-injury indicates the presence of underlying stressors that need attention. Talking to a trusted individual, such as a friend, family member, healthcare provider, or school counselor, can be the first step toward successful treatment. It’s crucial to remember that seeking help from supportive and non-judgmental individuals is essential in overcoming self-injury.

When to Get Emergency Help

If self-injury results in severe injury or if there are concerns about life-threatening harm or suicide, call 911 or your local emergency number immediately. Additionally, consider contacting your mental health provider, a suicide hotline, a school counselor or nurse, a close friend or family member, or a spiritual leader for immediate support.

Causes and Risk Factors

The causes of self-injury are complex and can vary from person to person. It is often a result of poor coping skills and difficulties managing emotions, such as feelings of worthlessness, loneliness, anger, guilt, and rejection. Self-injury may be an attempt to manage distress, gain a sense of control, express internal feelings, or communicate stress or depression to the outside world. Risk factors for self-injury include having friends who self-injure, experiencing past neglect or abuse, struggling with mental health issues, and using alcohol or drugs.

Complications and Suicide Risk

Self-injury can lead to feelings of shame, guilt, low self-esteem, and permanent scars or harm to the body. If not properly treated, underlying issues may worsen. Although self-injury is not typically a suicide attempt, it can increase the risk of suicide due to the emotional problems that trigger self-harm. The pattern of damaging the body during times of distress can also make suicide more likely.

Prevention

Preventing self-injury involves strategies at both individual and community levels. Identifying individuals at risk and offering help, encouraging supportive social networks, raising awareness, promoting help-seeking behaviors, and discussing media influence are essential steps in reducing the risk of self-injury.

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Diagnosis

Although some people may ask for help, sometimes family or friends discover the self-injury. Or a health care provider doing a routine medical exam may notice signs, such as scars or fresh injuries.

Treatment

The first step is to tell someone about your self-injuring behavior so you can get help. Treatment is based on your specific issues and any related mental health conditions you might have, such as depression. Because self-injury can become a major part of your life, it’s best to get treatment from a mental health professional who is experienced in treating self-injury.

Psychotherapy

Known as talk therapy or psychological counseling, psychotherapy can help you:

  • Identify and manage underlying issues that trigger self-injury.
  • Learn skills to better manage distress.
  • Learn better ways to manage intense emotions.
  • Learn how to boost your self-image.
  • Develop skills to improve your relationships and social skills.
  • Develop healthy problem-solving skills.

Lifestyle and Home Remedies

In addition to professional treatment, here are some important self-care tips:

  • Follow your treatment plan. Keep therapy appointments. Practice and use coping skills learned in therapy. Take any prescribed medicine as directed.
  • Recognize the situations or feelings that might trigger your desire to self-injure. Make a plan for other ways to soothe or distract yourself or to get support, so you’re ready the next time you feel the urge to self-injure.
  • Ask for help. Keep your mental health provider’s phone number handy. Tell your provider about all incidents related to self-injury. Choose a trusted family member or friend as the person you’ll immediately contact if you have an urge to self-injure or if self-injury happens.
  • Take care of yourself. Learn how to include physical activity and relaxation exercises as a regular part of your daily routine. Eat healthy. Ask your health care provider for advice if you have sleep problems, which can have a big impact on behavior.
  • Avoid alcohol and recreational drugs. They affect your ability to make good decisions and can put you at risk of self-injury.
  • Take care of your wounds if you injure yourself or seek medical treatment if needed. Call a trusted family member or friend for help and support. Don’t share items used for self-injury. That raises the risk of infectious diseases.

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