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:
Scars, such as from burns or cuts
Fresh cuts, scratches, bruises or other wounds
Keeping sharp objects on hand
Spending a great deal of time alone
Wearing long sleeves or long pants, even in hot weather
Claiming to have frequent accidents or mishaps
Forms of self-injury One of the most common forms of self-injury is cutting, which involves making cuts or scratches on your body with a sharp object. Forms of self-harm, include:
Carving words or symbols on the skin
Hitting or punching
Piercing the skin with sharp objects
Pulling out hair
Interfering with wound healing
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 Emergency situations If you have injured yourself severely or believe your injury may be life-threatening, call 911 or your local emergency services provider. If a loved one has injured himself or herself severely, take him or her to the hospital or call for emergency help. If possible, take away any instruments used for self-injury.
If you're hurting yourself If you are 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. Self-injury poses the risk of serious injury, infection or disfigurement, or even death. And self-injury has some addictive qualities, making it hard to overcome on your own.
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 you have a friend or loved one who's self-injuring, you may not know what to do. You may be shocked and scared. Learning more about self-injury can help you understand why it occurs and help you develop a compassionate but firm approach to helping your loved one stop this harmful behavior.
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:
Age. Most people who self-injure are teenagers. Self-injury often starts in the early teen years, when emotions are more volatile and children 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 sexually, physically or emotionally abused as children or adults. They may also have experienced neglect in childhood.
Mental health issues. Among those at highest risk are people who experience many negative emotions and are highly self-critical. People who self-injure are more likely to be impulsive and to have poor problem-solving skills. In addition, self-injury is commonly associated with certain mental illnesses, including borderline personality disorder, depression, anxiety disorders, substance abuse disorders, post-traumatic stress disorder and eating disorders.
Alcohol or substance use. People who harm themselves often do so while under the influence of alcohol or illegal drugs.
Self-injury can cause a variety of complications, including:
Worsening feelings of shame, guilt and low self-esteem.
Infection, either from your wounds or from sharing implements.
Life-threatening problems, such as blood loss if major blood vessels or arteries are cut.
Accidental or deliberate suicide. You may unintentionally injure yourself fatally, especially if you injure yourself while under the influence of alcohol or illegal drugs. You're also at higher risk of deliberately taking your own life.
Permanent scars or disfigurement.
In addition, people who self-injure are also more likely to get into car accidents.
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