Table of ContentsView AllTable of ContentsSymptomsCausesRisk FactorsDiagnosisTreatmentsCoping
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Table of Contents
Symptoms
Causes
Risk Factors
Diagnosis
Treatments
Coping
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Self-harm involves self-inflicted, non-suicidal bodily harm that is severe enough to either cause tissue damage or to leave marks that last several hours. Cutting is the most common form of self-injury but burning, head banging, and scratching are also common. Other forms of self-harm include biting, skin picking, hair pulling, hitting the body with objects, or hitting objects with the body.
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Self-harm is not always easy to detect because people often try to hide it. Some signs that a person might be self-injuring include:
Warning SignsPeople who self-injure become very adept at hiding scars or explaining them away. Look for signs such as a preference for wearing concealing clothing at all times (e.g., long sleeves in hot weather), an avoidance of situations where more revealing clothing might be expected (e.g., unexplained refusal to go to a party), or unusually frequent complaints of accidental injury (e.g., a cat owner who frequently has scratches on her arms).
Warning Signs
People who self-injure become very adept at hiding scars or explaining them away. Look for signs such as a preference for wearing concealing clothing at all times (e.g., long sleeves in hot weather), an avoidance of situations where more revealing clothing might be expected (e.g., unexplained refusal to go to a party), or unusually frequent complaints of accidental injury (e.g., a cat owner who frequently has scratches on her arms).
Methods of self-injury can include:
People sometimes only engage in one form of self-injury, but it is not uncommon for multiple methods to be used. The arms are one of the areas that people self-harm most frequently, but other areas of the body including the legs and torso are also common targets.
Self-harm is a complex condition that has no simple explanation. Althoughsuicidal feelingsmay accompany self-injury, it does not necessarily indicate a suicide attempt.
If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.
If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
Most often self-harm is simply a mechanism for coping with emotional distress. People who select this emotional outlet may use it to express feelings, deal with feelings of unreality or numbness, stop flashbacks, punish themselves, or relieve tension.
Self-harm isnot recognized as a mental illness, but theDiagnostic and Statistical Manual of Mental Disorders(DSM-5) lists non-suicidal self-injury as a proposed condition under the category of conditions in need of further study.
Self-injury is also associated with certain conditions including:
Risk factors for self-injury include:
Self-injury indicates a lack of coping skills for dealing with severe emotional distress. People who self-harm may struggle to understand and manage their emotions. They also may not have the necessary skills to cope with stress and trauma in healthy ways.
Although self-injury such as cutting is recognized as a common problem among the teenage population, it is not limited to adolescents. People of all sexes, nationalities, socio-economic groups, and ages can self-injure.
While suicide is not the intent of self-injury, self-harm has a strong association with suicide attempts. In one study of adolescents, 46% who had engaged in non-suicidal self-injury went on to attempt suicide before the age of 21.
A doctor or therapist will then evaluate the person’s health history including:
The next step is to determine if the individual has a coexisting psychiatric condition and to evaluate if the person isat risk for suicide. Once these assessments have been made, the doctor can make recommendations for treatment.
Medications such asantidepressants,mood stabilizers, andanxiolyticsmay alleviate the underlying feelings that the patient is attempting to cope with through self-injury.
In addition to treating any coexisting psychiatric conditions,cognitive-behavior therapy (CBT)can be an effective treatment for non-suicidal self-injury. This type of therapy addresses underlying negative thought patterns as well as the harmful behaviors themselves.
Another important aspect of treatment is learning better coping mechanisms to replace the self-harm behaviors. Once the person is stable, therapeutic work should be done to help cope with the underlying problems that are causing their distress.
Some experts say thathospitalizationor forced stopping of the self-injury is not a helpful treatment. It may make the doctor and involved friends and family feel more comfortable, but does nothing to help the underlying problems.
Further, the person is generally neither psychotic nor actively suicidal and will benefit more from working with a doctor who is compassionate to the reasons that they are hurting themselves. A desire to cooperate and get well is a major factor in recovery.
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If someone you know is engaging in cutting or some other form of self-injury, there are things that you can do to offer support and assistance.
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In addition to the risk of accidental life-threatening injuries, self-harm behaviors such as cutting also present a risk of scarring and infection. If you are engaging in self-injury, no matter how minor or infrequent, you should talk to your doctor. Such actions are a sign of a larger problem that needs to be addressed, so the sooner you get help, the better the outcome.
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1 SourceVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mars B, Heron J, Moran P, Klonsky ED, O’Connor RC, Tilling K, et al.Predictors of future suicide attempts among adolescents with suicidal thoughts or non-suicidal self-harm: A population-based birth cohort study.The Lancet Psychiatry.2019;6(4):327-337. doi:10.1016/S2215-0366(19)30030-6Additional ReadingZetterqvist, M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature.Child Adolesc Psychiatry Ment Health. 2015;9:31. doi:10.1186/s13034-015-0062-7
1 Source
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mars B, Heron J, Moran P, Klonsky ED, O’Connor RC, Tilling K, et al.Predictors of future suicide attempts among adolescents with suicidal thoughts or non-suicidal self-harm: A population-based birth cohort study.The Lancet Psychiatry.2019;6(4):327-337. doi:10.1016/S2215-0366(19)30030-6Additional ReadingZetterqvist, M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature.Child Adolesc Psychiatry Ment Health. 2015;9:31. doi:10.1186/s13034-015-0062-7
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mars B, Heron J, Moran P, Klonsky ED, O’Connor RC, Tilling K, et al.Predictors of future suicide attempts among adolescents with suicidal thoughts or non-suicidal self-harm: A population-based birth cohort study.The Lancet Psychiatry.2019;6(4):327-337. doi:10.1016/S2215-0366(19)30030-6
Zetterqvist, M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature.Child Adolesc Psychiatry Ment Health. 2015;9:31. doi:10.1186/s13034-015-0062-7
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