Learning About Non-Suicidal Self-Injury in Your Child

What is non-suicidal self-injury?

Non-suicidal self-injury means that a person injures themself on purpose. For example, they may cut, scratch, or bite their skin until it bleeds. Self-injury is serious. So it's important to seek help from a health professional. People who self-injure don't do it to die. But some may also be thinking about suicide.

How is it diagnosed?

To assess, the doctor may ask how often the injuries happen and if they bleed, bruise, or cause pain. And the doctor may ask how self-injuring makes your child feel. The doctor also may ask questions to find out if your child has other health conditions, like depression.

What puts your child at risk?

You can look for things that make self-injury more likely. Children may be at risk if they:

• Have self-injured before.
• Feel hopeless.
• Have certain health conditions such as a personality disorder, depression, post-traumatic stress disorder (PTSD), or an eating disorder.
• Don't have healthy ways to manage emotions like anger or sadness.
• Feel numb or empty. They may turn to self-injury to feel something.
• Are stressed or anxious about problems at school or at home.
• Have low self-esteem.
• Have a history of trauma.
• Have a history of abuse.
• Have a friend who self-injures.
• Are LGBTQ+. Issues like bullying and discrimination can contribute to an increased risk.

What are the signs?

Your child might be self-injuring if they:

• Have injuries that are unusual. For instance, your child may have multiple cuts or deep scratches on the arms, legs, or stomach.
• Have odd blood stains on their clothes.
• Wear bandages on their arms. Your child may do this to hide injuries.
• Wear long sleeves when it's hot, especially if this is a change in how your child usually dresses.
• Avoid activities that need less clothing (swimming, gym class), especially if these are things your child usually loves to do.
• Wear lots of bracelets, wristbands, or other jewelry on large areas of their arms. Your child may use these to hide injuries.

If you think your child is self-injuring, talk to a doctor or a mental health professional.

How is it treated?

Self-injury is treated with counseling. Dialectical behavioral therapy (DBT) and cognitive-behavioral therapy (CBT) are common types of counseling for self-injury. Medicines are sometimes used with counseling. Ask your doctor about the different types of treatment. Then you can decide together about what might work best.

How can you care for your child?

If your child self-injures, here are some ways you can help.

• Find a counselor or therapist for your child.

  Look for a counselor that your child feels safe with and trusts. You can ask your child's doctor for a referral.

• Make a plan to keep your child safe.

  A health professional such as your child's doctor or counselor can help you.

• Manage how you react to your child.

  If you are feeling emotional, it's okay to take some time to yourself. It's best to approach your child when you're feeling calm.

• Avoid trying to fix your child.

  Your usual parenting skills likely aren't the right tools to help your child. And you can't make your child stop self-injuring. Time and counseling can help your child get better.

• Build a support system.

  You may want to find a counselor for yourself. And look for a self-injury support group. Ask for help from trusted friends, family, and community members.

• Take parenting classes.

  These can help you learn how to model healthy coping skills. For example, you can learn how to talk about emotions. And skills like deep breathing and yoga may help you learn how to manage your emotions.

If it's an emergency, call 911.

Where to get help 24 hours a day, 7 days a week

If your child talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.