Signs and symptoms may include:
- Scars, such as from burns or cuts
- Fresh cuts, scratches, bruises or other wounds
- Broken bones
- Keeping sharp objects on hand
- Wearing long sleeves or long pants, even in hot weather
- Claiming to have frequent accidents or mishaps
- Spending a great deal of time alone
- Pervasive 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
Forms of self-injury
One of the most common forms of self-injury is cutting, which involves making cuts or severe scratches on different parts of your body with a sharp object. Other forms of self-harm include:
- Burning (with lit matches, cigarettes or hot sharp objects like knives)
- Carving words or symbols on the skin
- Breaking bones
- Hitting or punching
- Piercing the skin with sharp objects
- Head banging
- 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 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
Getting appropriate treatment can help you learn healthier ways to cope.
- Reach out for help. 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, religious 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.
- Emergency help. If you've injured yourself severely or believe your injury may be life-threatening, call 911 or your local emergency services provider.
When a friend or loved one self-injures
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 options for help.
Dec. 06, 2012
- 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, but do express concern.
- Teenage friend. Suggest that your friend talk to parents, a teacher, a school counselor or another trusted adult.
- Adult. Gently encourage the person to seek medical and psychological treatment.
- Shedler J. The efficacy of psychodynamic psychotherapy. American Psychologist. 2010;65:98.
- Self-harm in young adults. National Alliance on Mental Illness. http://www.nami.org/Content/ContentGroups/Helpline1/SelfInjury_Fact_Sheet_FINAL.pdf. Accessed Oct. 11, 2010.
- What is self-injury, self-harm, self-abuse? The Official Newsletter of NAMI Springfield. 2012;2:1.
- Cutting. TeensHealth from Nemours. http://kidshealth.org/teen/your_mind/mental_health/cutting.html. Accessed Oct. 11, 2012.
- Facts for families: Self-injury in adolescents. American Academy of Child & Adolescent Psychiatry. http://aacap.org/page.ww?name=Self-Injury+in+Adolescents§ion=Facts+for+Families. Accessed Oct. 11, 2012.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed Sept. 14, 2012.
- A family guide: What families need to know about adolescent depression. http://www.nami.org/Template.cfm?Section=Child_and_Adolescent_Action_Center&template=/ContentManagement/ContentDisplay.cfm&ContentID=24806. Accessed Sept. 14, 2012.
- When you fear someone may take their life. American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?page_id=f2f25092-7e90-9bd4-c4658f1d2b5d19a0. Accessed Sept. 14, 2012.
- Mental health and teens: Watch for danger signs. Healthychildren.org. http://www.healthychildren.org/English/Pages/default.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed Oct. 11, 2012.
- Hofmann SG, et al. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology. 2010;78:1.
- Self-injury. NAMI On Campus. http://www.nami.org/Content/NavigationMenu/Find_Support/NAMI_on_Campus1/Mental_Illness_Fact_Sheets/Self-injury.pdf. Accessed Oct. 12, 2012.
- Barrocas AL, et al. Rates of nonsuicidal self-injury in youth: Age, sex, and behavioral methods in a community sample. Pediatrics. 2012;130:39.
- Lewis SP, et al. The scope of nonsuicidal self-injury on YouTube. Pediatrics. http://pediatrics.aappublications.org. Accessed Oct. 11, 2012.
- Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. (Nov. 1, 2012).
- Alarcon RD (expert opinion). Mayo Clinic, Rochester, Minn. (Nov. 4, 2012).
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