Nonsuicidal self-injury, often simply called self-injury, is the act of deliberately harming the surface of your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, this type of 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. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more serious and even fatal self-aggressive actions.
Getting appropriate treatment can help you learn healthier ways to cope.
Signs and symptoms of self-injury may include:
Forms of self-injury usually occurs in private and is done in a controlled or ritualistic manner
that often leaves a pattern on the skin.
Examples of self-harm include:
Most frequently, the arms, legs and front of the torso are the targets of self-injury, 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.
Becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. But 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.
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. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more serious and even fatal self-aggressive actions.
Getting appropriate treatment can help you learn healthier ways to cope.
Signs and symptoms of self-injury may include:
- Scars
- Fresh cuts, scratches, bruises or other wounds
- Excessive rubbing of an area to create a burn
- Keeping sharp objects on hand
- Wearing long sleeves or long pants, even in hot weather
- 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 usually occurs in private and is done in a controlled or ritualistic manner
that often leaves a pattern on the skin.
Examples of self-harm include:
- Cutting (cuts or severe scratches with a sharp object)
- Scratching
- Burning (with lit matches, cigarettes or hot, sharp objects like knives)
- Carving words or symbols on the skin
- Hitting or punching
- Piercing the skin with sharp objects
- 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, 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.
Becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. But 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...
-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, spiritual 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.
-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, spiritual 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.
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.
If you've injured yourself severely or believe your injury may be life-threatening, or if you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
Also consider these options if you're having suicidal thoughts:
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.
If you've injured yourself severely or believe your injury may be life-threatening, or if you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
Also consider these options if you're having suicidal thoughts:
- Call your mental health specialist.
- Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at
- 1-800-273-TALK (1-800-273-8255).
- Seek help from your primary doctor or other health care provider.
- Reach out to a close friend or loved one.
- Contact a spiritual leader or someone else in your faith community.
Through self-injury, the person may be trying to:
- Manage or reduce severe distress or anxiety and provide a sense of relief
- Provide a distraction from painful emotions through physical pain
- Feel a sense of control over his or her body, feelings or life situations
- Feel something — anything — even if it's physical pain, when feeling emotionally empty
- Express internal feelings in an external way
- Communicate depression or distressful feelings to the outside world
- Be punished for perceived faults
There are effective treatments for self-harm that can allow a person to feel in control again.
Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms.
The first step in getting help is talking to a trusted friend or family member,
or medical professional who is familiar with the subject, ideally a psychiatrist.
A psychiatrist will ask that person questions about their health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. The more information that person can give, the better the treatment plan will be.
Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. For someone with depression, for instance, an antidepressant may lessen harmful urges.
A doctor will also recommend therapy to help a person learn new behaviors, if self-injury has become a habit. Several different kinds of therapy can help, depending on the diagnosis.
Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms.
The first step in getting help is talking to a trusted friend or family member,
or medical professional who is familiar with the subject, ideally a psychiatrist.
A psychiatrist will ask that person questions about their health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. The more information that person can give, the better the treatment plan will be.
Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. For someone with depression, for instance, an antidepressant may lessen harmful urges.
A doctor will also recommend therapy to help a person learn new behaviors, if self-injury has become a habit. Several different kinds of therapy can help, depending on the diagnosis.
