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Self-injury/cutting

Medically reviewed by Drugs.com. Last updated on Apr 6, 2023.

Overview

Nonsuicidal self-injury, often simply called self-injury, is the act of harming your own body on purpose, such as by cutting or burning yourself. It's usually not meant as a suicide attempt. This type of self-injury is a harmful way to cope with emotional pain, sadness, anger and stress.

While self-injury may bring a brief sense of calm and a release of physical and emotional tension, it's usually followed by guilt and shame and the return of painful emotions. Life-threatening injuries are usually not intended, but it's possible that more-serious and even fatal self-harm could happen.

Getting the proper treatment can help you learn healthier ways to cope.

Symptoms

Symptoms of self-injury may include:

Forms of self-injury

Self-injury mostly happens in private. Usually, it's done in a controlled manner or the same way each time, which often leaves a pattern on the skin. Examples of self-harm include:

Most frequently, the arms, legs, chest and belly are the targets of self-injury. But any area of the body may be a target, sometimes using more than one method.

Becoming upset can trigger urges to self-injure. Many people self-injure only a few times and then stop. But for others, self-injury can become a longer term, repeated behavior.

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 stressors that need attention.

Talk to someone you trust — such as a friend, family member, health care provider, spiritual leader, or a school counselor, nurse or teacher. They 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 help from people who aren't going to judge you.

When a friend or family member self-injures

If you have a friend or family member 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 ways to help.

When to get emergency help

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 right away.

Also consider these options if you're having suicidal thoughts:

Causes

There's no one single or simple cause that leads someone to self-injure. In general, self-injury may result from:

Self-injury may be an attempt to:

Risk factors

Teenagers and young adults are most likely to self-injure, but those in other age groups do it, too. Self-injury often starts in the preteen or early teen years, when emotional changes happen fast, often and unexpectedly. During this time, teens also face increasing peer pressure, loneliness, and conflicts with parents or other authority figures.

Certain factors may increase the risk of self-injury, including:

Complications

Self-injury can cause complications, such as:

Suicide risk

Self-injury is not usually a suicide attempt, but it can increase the risk of suicide because of the emotional problems that trigger self-injury. And the pattern of damaging the body in times of distress can make suicide more likely.

Prevention

There is no sure way to prevent someone's self-injuring behavior. But reducing the risk of self-injury includes strategies that involve both individuals and communities. Parents, family members, teachers, school nurses, coaches or friends can help.

Diagnosis

Although some people may ask for help, sometimes family or friends discover the self-injury. Or a health care provider doing a routine medical exam may notice signs, such as scars or fresh injuries.

There's no specific test to diagnose self-injury. Diagnosis is based on a physical and psychological evaluation. You may be referred to a mental health professional with experience in treating self-injury for evaluation. This professional talks to you about your life, thoughts, feelings and behaviors.

A mental health professional also may evaluate you for other mental health conditions that could be linked to self-injury, such as depression or personality disorders.

Treatment

The first step is to tell someone about your self-injuring behavior so you can get help. Treatment is based on your specific issues and any related mental health conditions you might have, such as depression. Because self-injury can become a major part of your life, it's best to get treatment from a mental health professional who is experienced in treating self-injury.

If the self-injury behavior is linked with a mental health condition, such as depression or borderline personality disorder, the treatment plan focuses on that condition, as well as the self-injury behavior.

Treating self-injury behavior can take time, hard work and your own desire to recover.

Here's more information about treatment options.

Psychotherapy

Known as talk therapy or psychological counseling, psychotherapy can help you:

Several types of individual psychotherapy may be helpful, such as:

In addition to individual therapy sessions, your provider may recommend family therapy or group therapy.

Medicines

There are no medicines to specifically treat self-injuring behavior. However, if you're diagnosed with a mental health condition, such as depression or an anxiety disorder, your health care provider may recommend antidepressants or other medicines to treat the underlying condition that's linked with self-injury. Treatment for these conditions may help reduce the urge to hurt yourself.

Inpatient care

If you injure yourself severely or repeatedly, your health care provider may recommend that you be admitted to a hospital for psychiatric care. Being cared for in a hospital, often short term, can provide a safe environment and more-intensive treatment until you get through a crisis. Mental health day-treatment programs that focus on learning behavioral coping skills to manage distress also may be an option.

Lifestyle and home remedies

In addition to professional treatment, here are some important self-care tips:

Coping and support

If you or a friend or family member needs help in coping, consider the tips below. If there's a focus on thoughts of suicide, take action and get help right away.

Coping tips if you self-injure include:

Coping tips if a friend or loved one self-injures include:

Preparing for an appointment

Your first appointment may be with your primary care provider, a school nurse or a counselor. But because self-injury often requires specialized mental health care, you may be referred to a mental health professional for more evaluation and treatment.

Be ready to provide accurate, thorough and honest information about your situation and your self-injuring behavior. You may want to take a trusted family member or friend along, if possible, for support and to help you remember information.

What you can do

To help prepare for your appointment, make a list of:

Questions to ask may include:

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your mental health provider is likely to ask you a number of questions, such as:

Your mental health provider may ask more questions based on your responses, symptoms and needs. Preparing for questions will help you make the most of your time with the provider.

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