Self-injury is the act of deliberately harming your own body, such as cutting or burning yourself. It's 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 inflicting serious and even fatal injuries.
Because self-injury is often done on impulse, it may be considered an impulse-control behavior problem. Self-injury may accompany a variety of mental illnesses, such as depression, eating disorders and borderline personality disorder.
Because self-injury is often kept secret, it may be difficult to spot signs and symptoms. Self-injury symptoms may include:
Forms of self-injury
People who self-injure may use more than one method of harming themselves. Self-injury is often an impulsive act. You may become upset, or triggered, and develop an urge to hurt yourself.
Many people only self-injure a few times and then stop. However, for others, self-injury can become a repetitive behavior, occurring multiple times, rather than just once or twice. 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.
When to see a doctor
If you're hurting yourself
While you may feel ashamed and embarrassed about your behavior, you can find supportive, caring and nonjudgmental help. Getting appropriate treatment can help you learn healthier ways to cope — ways that won't leave your body permanently scarred. Try to work up the courage to talk to someone you trust, whether it's a friend, loved one, health care provider or a school official. Someone you trust can help you take the first steps to successful treatment.
When a friend or loved one self-injures
If your loved one is an adult, gently encourage him or her to seek medical treatment. If it's your child, you can start by consulting your pediatrician or family doctor, 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 — doing so may increase the risk that your child will self-injure.
If you discover that your teenaged friend is self-injuring, let him or her know that you care and let your friend know that he or she has options. Suggest that your friend talk to his or her parents, a teacher, a school counselor or another trusted adult. If your friend doesn't seek help, you may need to let someone know what's going on. Although you might feel that you'd be betraying your friend, self-injury is too big a problem for your friend to deal with alone. Ask your parent, a teacher or your school counselor for help.
There's no one single or simple cause that leads someone to self-injure. The mix of emotions that triggers self-injury is complex. In general, self-injury is usually the result of an inability to cope in healthy ways with deep psychological pain. For instance, you may have a hard time regulating, expressing or understanding your emotions. Physical injury distracts you from these painful emotions or helps you feel a sense of control over an otherwise uncontrollable situation.
When you feel emotionally empty, self-injury is a way to feel something, anything, even if it's physical pain. It also offers an external way to express internal feelings. You may also turn to self-injury as a way to punish yourself for perceived faults. Sometimes self-injury may be an attempt to seek attention or to manipulate others.
Certain factors may increase the risk of self-injury, including:
Self-injury can cause a variety of complications, including:
In addition, people who self-injure are also more likely to get into car accidents.
Preparing for your appointment
Your first appointment to start treating your self-injury may be with a school nurse or counselor, your family doctor, or a general practitioner. 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
What to expect from your doctor
Tests and diagnosis
Unless you're ready to stop self-injuring and you tell someone about your behavior, it can be difficult for a doctor or therapist to diagnose self-injury. Sometimes self-injury is discovered accidentally. For instance, a doctor doing a routine medical examination may notice signs, such as scars or fresh injuries.
In any case, there's no specific diagnostic test for self-injury. Diagnosis is based on a physical and mental evaluation. During an initial evaluation for self-injury, a health care provider may ask you such questions as:
A definitive 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 accompany self-injury, such as depression or personality disorders.
Treatments and drugs
There's no one best way to treat self-injury. Treatment is tailored to your specific issues and any related mental health conditions you might have, such as depression. Treating self-injury can take time, hard work and your own desire to recover. Because self-injury can become such a major part of your life and it's often accompanied by serious mental disorders, treatment with a mental health professional experienced in self-injury issues may be necessary.
Treatment options for self-injury include:
Several types of psychotherapy in particular may be helpful, including:
In addition to individual therapy sessions, family therapy or group therapy also may be recommended.
Lifestyle and home remedies
While you generally shouldn't try to treat self-injury on your own, you can do some things for yourself that will build on your treatment plan. In addition to professional treatment, follow these self-care tips for self-injury:
Coping and support
If you or a loved one is suicidal or in emotional distress, you can call the National Suicide Prevention Lifeline 24-hour crisis line at 800-273-TALK (800-273-8255).
Coping tips if you self-injure
Coping tips if your loved one self-injures
There is no sure way to prevent self-injury. Prevention strategies may need to involve both individuals and communities, including parents, schools, medical professionals and coaches, for instance.
Ways to reduce the risk of self-injury may include:
Last Updated: 2010-08-03
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