Overview

Nonsuicidal self-injury, commonly known as self-injury, refers to the deliberate act of causing harm to one’s own body, such as cutting or burning, as a way to cope with emotional pain, sadness, anger, and stress. It’s essential to note that self-injury is usually not a suicide attempt, but rather an unhealthy means of dealing with intense emotions.

Symptoms

Recognizing the signs of self-injury can be crucial in seeking help. Common symptoms include:

  • Scars, often forming patterns
  • Fresh cuts, scratches, bruises, bite marks, or other wounds
  • Creating burns through excessive rubbing
  • Keeping sharp objects for self-injury
  • Wearing concealing clothing, even in hot weather, to hide self-injury
  • Reports of frequent accidental injuries
  • Difficulty in maintaining relationships with others
  • Impulsive, intense, and unexpected behavioral and emotional changes
  • Expressions of helplessness, hopelessness, or worthlessness

Forms of Self-Injury

Self-injury is often done privately and follows specific patterns, resulting in recognizable skin marks. Various forms of self-harm include:

  • Using sharp objects to cut, scratch, or stab
  • Burning with matches, cigarettes, or heated objects
  • Carving words or symbols on the skin
  • Self-hitting, punching, biting, or head banging
  • Piercing the skin with sharp objects
  • Inserting objects under the skin

While the most common targets are the arms, legs, chest, and belly, self-injury can occur in any body area, and some individuals use multiple methods.

Seeking Help

If you are engaging in self-injury or having thoughts of harming yourself, it’s essential to reach out for help. Any form of self-injury indicates underlying stressors that require attention. Talk to someone you trust, such as a friend, family member, healthcare provider, or counselor, who can offer support and guide you towards appropriate treatment options. Remember, seeking help is a crucial step towards healing, and there are caring individuals who will support you without judgment.

Helping a Friend or Family Member

If you suspect that a friend or family member is self-injuring, it’s essential to take their situation seriously and offer support. Here are some ways to help:

  • If the person is a child, talk to their pediatrician or healthcare provider for an initial evaluation or referral to a mental health professional.
  • If the person is a preteen or teenager, suggest that they talk to parents, a teacher, a school counselor, or another trusted adult.
  • If the person is an adult, gently express your concern and encourage them to seek medical and mental health treatment.

Emergency Help

If you or someone else has severely injured themselves or is in immediate danger, call 911 or your local emergency number immediately. Additionally, consider these options if you’re having suicidal thoughts:

  • Call your mental health provider if you have one.
  • Contact a suicide hotline, such as the 988 Suicide & Crisis Lifeline, available 24/7, or use the Lifeline Chat for free and confidential support.
  • Seek help from your school nurse or counselor, teacher, or healthcare provider.
  • Reach out to a close friend or family member.
  • Contact a spiritual leader or someone else in your faith community.

Causes and Risk Factors

The causes of self-injury are complex and multifaceted. Generally, self-injury may result from:

  • Poor coping skills, leading to an inability to manage stress and emotional pain effectively.
  • Difficulty in managing emotions, including feelings of worthlessness, loneliness, panic, anger, guilt, rejection, and self-hatred.
  • Self-injury as a means to manage distress, provide a sense of control, or express internal feelings externally.

Various risk factors, such as a history of abuse, mental health issues, substance use, and social isolation, may increase the likelihood of engaging in self-injury.

Complications and Prevention

Self-injury can lead to various complications, including worsening feelings of shame, infection, permanent scars, and exacerbation of underlying issues if left untreated. While it’s challenging to prevent self-injury entirely, early intervention and supportive environments can help reduce the risk. Strategies involve:

  • Identifying at-risk individuals and offering help in developing healthy coping skills.
  • Encouraging the formation of supportive social networks to improve communication and relationships.
  • Raising awareness about self-injury and its warning signs.
  • Encouraging open communication and seeking help when concerned about someone’s well-being.
  • Teaching critical thinking skills to reduce harmful media influences.

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Diagnosis

Diagnosing self-injury is based on a physical and psychological evaluation, as there are no specific tests for this condition. Family or friends may sometimes discover the self-injury, or it may be noticed during a routine medical exam. If self-injury is suspected, a mental health professional experienced in treating self-injury may conduct an evaluation. This evaluation involves discussions about your life, thoughts, feelings, and behaviors. Additionally, other mental health conditions linked to self-injury, such as depression or personality disorders, may also be evaluated.

Treatment

Seeking help and telling someone about your self-injuring behavior is the first step in the treatment process. Treatment for self-injury is based on your specific issues and any related mental health conditions you may have. It’s crucial to seek treatment from a mental health professional with experience in treating self-injury, as it can become a significant part of your life.

If self-injury is associated with a mental health condition like depression or borderline personality disorder, the treatment plan will address both the condition and the self-injury behavior.

Treating self-injury can be a challenging and time-consuming process that requires your dedication to recovery.

Psychotherapy

Psychotherapy, also known as talk therapy or psychological counseling, can be beneficial in managing self-injury. It helps you identify and manage underlying issues that trigger self-injury and learn skills to cope with distress and intense emotions. Several types of individual psychotherapy may be helpful, such as:

  • Cognitive Behavioral Therapy (CBT): Identifies and replaces unhealthy beliefs and behaviors with more effective ones and teaches coping skills.
  • Dialectical Behavior Therapy: Teaches behavioral skills to manage distress, emotions, and improve relationships.
  • Mindfulness-Based Therapies: Help you live in the present and cope with difficult emotions and negative thoughts.

In addition to individual therapy, family therapy or group therapy may also be recommended.

Medicines

There are no specific medicines to treat self-injury directly. However, if you have a mental health condition like depression or anxiety disorder, your healthcare provider may prescribe antidepressants or other medications to treat the underlying condition, which may help reduce the urge to self-injure.

Inpatient Care

In severe cases of self-injury or repeated episodes, hospitalization for psychiatric care may be recommended. This can provide a safe environment and intensive treatment during a crisis. Mental health day-treatment programs focusing on behavioral coping skills may also be an option.

Lifestyle and Home Remedies

Alongside professional treatment, self-care is crucial. Here are some important self-care tips:

  • Follow your treatment plan, attend therapy sessions, and take prescribed medication as directed.
  • Recognize situations or feelings that trigger self-injury and create a plan for alternative coping strategies or seeking support.
  • Ask for help from your mental health provider or a trusted family member or friend when you feel the urge to self-injure.
  • Take care of yourself through physical activity, relaxation exercises, healthy eating, and addressing sleep problems.
  • Avoid alcohol and recreational drugs, as they can impair decision-making and increase the risk of self-injury.
  • If you injure yourself, take care of your wounds or seek medical treatment as needed.

Coping and Support

If you are coping with self-injury or supporting a friend or family member, consider the following tips:

  • Connect with others for support, such as trusted family members, friends, support groups, or healthcare and mental health providers.
  • Avoid websites that support or glamorize self-injury and seek out sites that support recovery efforts.
  • Learn to express emotions in positive ways, engage in activities you enjoy, and practice relaxation techniques.
  • If supporting a loved one, learn more about self-injury, avoid judgment or criticism, and encourage treatment adherence.
  • Create a safe home environment by limiting access to items used for self-injury.
  • Share coping strategies and serve as a positive role model for healthy coping.
  • Take care of yourself and seek support from counselors, therapists, or local support groups if needed.

Preparing for Your Appointment

If you suspect self-injury, be prepared to provide accurate and honest information about your situation during your appointment. It may be helpful to bring a trusted family member or friend along for support and to help remember information.

Consider making a list of symptoms, triggers for self-injury, the duration and methods of self-injury, major stresses or life changes, and any medications or supplements you are taking. Prepare questions to ask your mental health provider about available treatments, potential side effects, coping strategies, and recognizing worsening conditions.

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