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
  • Biting
  • 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.

  • 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.
Dec. 06, 2012