Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, 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. And with self-injury comes the possibility of more serious and even fatal self-aggressive actions.
Because self-injury is often done impulsively, it can be considered an impulse-control behavior problem. Self-injury may be linked to a variety of mental disorders, such as depression, eating disorders and borderline personality disorder.
Signs and symptoms may include:
Forms of self-injury
Most frequently, the arms, legs and front of the torso are the targets of self-injury because these areas can be easily reached and easily hidden under clothing. 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.
Because self-injury is often an impulsive act, becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. However, 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.
When to see a doctor
When a friend or loved one self-injures
There's no one single or simple cause that leads someone to self-injure. In general, self-injury is usually the result of an inability to cope in healthy ways with psychological pain related to issues of personal identity and having difficulty "finding one's place" in family and society. The person has a hard time regulating, expressing or understanding emotions. The mix of emotions that triggers self-injury is complex. For instance, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred or confused sexuality.
Through self-injury, the person may be trying to:
Certain factors may increase the risk of self-injury, including:
Self-injury can cause a variety of complications, including:
If you, your friend or a loved one is having suicidal thoughts or is in emotional distress, get help right away. Take all talk of suicide seriously. Here are some options:
If you think your friend or loved one is in immediate danger of attempting suicide or has made a suicide attempt, make sure someone stays with him or her. Call for emergency help or take the person to the hospital, if you can safely do so. If possible, take away any tools used for self-injury.
Preparing for your appointment
Your first appointment may be with your family doctor, another primary care doctor, a school nurse or a counselor. But because self-injury often requires specialized mental health care, you may be referred to a mental health provider for evaluation and treatment.
What you can do
Prepare a list of questions to make the most of your time with your doctor. Some basic questions to ask your doctor include:
Don't hesitate to ask questions any time you don't understand something.
What to expect from your doctor
Tests and diagnosis
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 specific 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.
Treatments and drugs
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 and it's often accompanied by mental disorders, you may need treatment from a mental health professional experienced in self-injury issues.
There are several treatment options for self-injuring behavior.
Several types of individual psychotherapy may be helpful, such as:
In addition to individual therapy sessions, family therapy or group therapy also may be recommended.
Lifestyle and home remedies
You can do some things for yourself that will build on your treatment plan. In addition to professional treatment, follow these self-care tips:
Coping and support
If you or a loved one needs help in coping, consider the tips below. If there's a focus on thoughts of suicide, you or your loved one can call the National Suicide Prevention Lifeline 24-hour crisis line at 800-273-8255 (800-273-TALK).
Coping tips if you self-injure
Coping tips if your loved one self-injures
There is no sure way to prevent your loved one's self-injuring behavior. But reducing the risk of self-injury may include strategies that involve both individuals and communities — for example, parents, schools, medical professionals, supervisors, co-workers and coaches:
Last Updated: 2012-12-06
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