Definition

What is self-injury?

Nonsuicidal self-injury, often simply called self-injury, is the act of deliberately harming the surface of your own body, such as cutting or burning yourself. It’s typically not meant as a suicide attempt. Rather, this type of self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration.

While self-injury may bring a momentary sense of calm and a release of tension, it’s usually followed by guilt and shame and the return of painful emotions. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more serious and even fatal self-aggressive actions.

Getting appropriate treatment can help you learn healthier ways to cope.

Self-injury usually occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin. Examples of self-harm include:

  • Cutting (cuts or severe scratches with a sharp object)
  • Scratching
  • Burning (with lit matches, cigarettes or hot, sharp objects like knives)
  • Carving words or symbols on the skin
  • Hitting or punching
  • Piercing the skin with sharp objects
  • Pulling out hair
  • Persistently picking at or interfering with wound healing

Most frequently, the arms, legs and front of the torso are the targets of self-injury, but any area of the body may be used for self-injury. People who self-injure may use more than one method to harm themselves.

Becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. But for others, self-injury can become a long-term, repetitive behavior.

Although rare, some young people may self-injure in public or in groups to bond or to show others that they have experienced pain.

How common is self-injury?

Self injury statistics show that this disturbing phenomenon is a real and present danger to vulnerable people worldwide, especially in developed countries, such as the U.S. and those in western Europe. Females comprise 60 percent of those who engage in self injurious behavior. About 50 percent of those who engage in self mutilation begin around age 14 and carry on into their 20s. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of self-injury?

The common symptoms of self-injury are:

  • Scars
  • Fresh cuts, scratches, bruises or other wounds
  • Excessive rubbing of an area to create a burn
  • Keeping sharp objects on hand
  • Wearing long sleeves or long pants, even in hot weather
  • Difficulties in interpersonal relationships
  • Persistent questions about personal identity, such as “Who am I?” “What am I doing here?”
  • Behavioral and emotional instability, impulsivity and unpredictability
  • Statements of helplessness, hopelessness or worthlessness

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you’re injuring yourself, even in a minor way, or if you have thoughts of harming yourself, reach out for help. Any form of self-injury is a sign of bigger issues that need to be addressed.

Talk to someone you trust — such as a friend, loved one, health care provider, spiritual leader or a school official — who can help you take the first steps to successful treatment. While you may feel ashamed and embarrassed about your behavior, you can find supportive, caring and nonjudgmental help.

If you have a friend or loved one who is self-injuring, you may be shocked and scared. Take all talk of self-injury seriously. Although you might feel that you’d be betraying a confidence, self-injury is too big a problem to ignore or to deal with alone. Here are some ways to help.

  • Your child. You can start by consulting your pediatrician or other health care professional who can provide an initial evaluation or a referral to a mental health specialist. Don’t yell at your child or make threats or accusations, but do express concern.
  • Teenage friend. Suggest that your friend talk to parents, a teacher, a school counselor or another trusted adult.
  • Gently encourage the person to seek medical and mental health treatment.

When to get emergency help

If you’ve injured yourself severely or believe your injury may be life-threatening, or if you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you’re having suicidal thoughts:

  • Call your mental health specialist.
  • Call a suicide hotline number.
  • Seek help from your primary doctor or other health care provider.
  • Reach out to a close friend or loved one.
  • Contact a spiritual leader or someone else in your faith community.

Causes

What causes self-injury?

In most cases, people who self-harm do it to help them cope with overwhelming emotional issues, which may be caused by:

  • Social problems – such as being bullied, having difficulties at work or school, having difficult relationships with friends or family, coming to terms with their sexuality if they think they might be gay or bisexual, or coping with cultural expectations, such as an arranged marriage
  • Trauma – such as physical or sexual abuse, the death of a close family member or friend, or having a miscarriage
  • Psychological causes – such as having repeated thoughts or voices telling them to self-harm, disassociating (losing touch with who they are and with their surroundings), or borderline personality disorder

These issues can lead to a build-up of intense feelings of anger, guilt, hopelessness and self-hatred. The person may not know who to turn to for help and self-harming may become a way to release these pent-up feelings.

Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age. Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police.

Although some people who self-harm are at a high risk of suicide, many people who self-harm don’t want to end their lives. In fact, the self-harm may help them cope with emotional distress, so they don’t feel the need to kill themselves.

Risk factors

What increases my risk for self-injury?

There are many risk factors for self-injury, such as:

  • Most people who self-injure are teenagers and young adults, although those in other age groups also self-injure. Self-injury often starts in the early teen years, when emotions are more volatile and teens face increasing peer pressure, loneliness, and conflicts with parents or other authority figures.
  • Having friends who self-injure. People who have friends who intentionally harm themselves are more likely to begin self-injuring.
  • Life issues. Some people who injure themselves were neglected or abused (sexually, physically or emotionally) or experienced other traumatic events. They may have grown up and still remain in an unstable family environment, or they may be young people questioning their personal identity or sexuality. Some people who self-injure are socially isolated.
  • Mental health issues. People who self-injure are more likely to be highly self-critical and be poor problem-solvers. In addition, self-injury is commonly associated with certain mental disorders, such as borderline personality disorder, depression, anxiety disorders, post-traumatic stress disorder and eating disorders.
  • Excessive alcohol or drug use. People who harm themselves often do so while under the influence of alcohol or recreational drugs.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is self-injury diagnosed?

Although some people may ask for help, sometimes self-injury is discovered by family members or friends. Or a doctor doing a routine medical exam may notice signs, such as scars or fresh injuries.

There’s no diagnostic test for self-injury. Diagnosis is based on a physical and mental evaluation. A diagnosis may require evaluation by a mental health provider with experience in treating self-injury.

A mental health provider may also evaluate you for other mental illnesses that may be linked to self-injury, such as depression or personality disorders. If that’s the case, evaluation may include additional tools, such as questionnaires or psychological tests.

How is self-injury treated?

There’s no one best way to treat self-injuring behavior, but the first step is to tell someone so you can get help. Treatment is based on your specific issues and any related mental health conditions you might have, such as depression.

Treating self-injury behavior can take time, hard work and your own desire to recover. Because self-injury can become a major part of your life, you may need treatment from a mental health professional experienced in self-injury issues.

If the self-injury behavior is associated with a mental health disorder, such as depression or borderline personality disorder, the treatment plan focuses on that disorder, as well as the self-injury behavior.

Psychotherapy

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

  • Identify and manage underlying issues that trigger self-injuring behavior
  • Learn skills to better manage distress
  • Learn how to regulate your emotions
  • Learn how to boost your self-image
  • Develop skills to improve your relationships and social skills
  • Develop healthy problem-solving skills

Several types of individual psychotherapy may be helpful, such as:

  • Cognitive behavioral therapy (CBT), which helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
  • Dialectical behavior therapy, a type of CBT that teaches behavioral skills to help you tolerate distress, manage or regulate your emotions, and improve your relationships with others
  • Psychodynamic psychotherapy, which focuses on identifying past experiences, hidden memories or interpersonal issues at the root of your emotional difficulties through self-examination, guided by a therapist
  • Mindfulness-based therapies, which help you live in the present, appropriately perceive the thoughts and actions of those around you to reduce your anxiety and depression, and improve your general well-being

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

Medications

There are no medications to specifically treat self-injuring behavior. However, if you’re diagnosed with a mental health condition, such as depression or an anxiety disorder, your doctor may recommend antidepressants or other medications to treat the underlying disorder that’s associated with self-injury. Treatment for these disorders may help you feel less compelled to hurt yourself.

Psychiatric hospitalization

If you injure yourself severely or repeatedly, your doctor may recommend that you be admitted to a hospital for psychiatric care. Hospitalization, often short term, can provide a safe environment and more intensive treatment until you get through a crisis. Day treatment programs also may be an option.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage self-injury?

The following lifestyles and home remedies might help you cope with self-injury:

  • Stick to your treatment plan. Keep therapy appointments and take prescribed medications 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 doctor or mental health care provider’s phone number handy, and tell him or her about all incidents related to self-injury. Appoint a trusted family member or friend as the person you’ll immediately contact if you have an urge to self-injure or if self-injuring behavior recurs.
  • 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 doctor for advice if you have sleep problems, which can significantly affect your behavior.
  • Avoid alcohol and recreational drugs. They affect your ability to make good decisions and can put you at risk of self-injury.
  • Take appropriate care of your wounds if you injure yourself or seek medical treatment if needed. Call a relative or friend for help and support. Don’t share instruments used for self-injury — that raises the risk of infectious disease.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 13, 2017 | Last Modified: December 13, 2017

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