Learning About Non-Suicidal Self-Injury

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. You may be asked how self-injuring makes you feel. The doctor also may ask questions to find out if you have other health conditions, like depression.

What puts you at risk?

There are things that may put you at risk of self-injury. For example, you may be at risk if you:

• Have self-injured before.
• Feel hopeless.
• Have certain health conditions such as depression, post-traumatic stress disorder (PTSD), a personality disorder, or an eating disorder.
• Don't have healthy ways to manage emotions like anger or sadness.
• Feel numb or empty. You may turn to self-injury to feel something.
• Are really stressed or anxious about problems at work 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 discrimination and abuse can contribute to an increased risk.

What are the signs?

Signs that a person might be self-injuring include:

• Injuries that seem unusual. For instance, there may be multiple cuts or deep scratches on the arms, legs, or stomach.
• Odd blood stains on their clothes.
• Bandages on their arms. The person may wear these to hide injuries.
• Long sleeves when it's hot.
• Not doing activities that require less clothing (swimming, gym class).
• Lots of bracelets, wristbands, or other jewelry on large areas of their arms. These may be worn to hide injuries.

If you or someone you know 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 yourself?

Here are some ways you can care for yourself if you self-injure.

• Find a counselor.

  Look for someone who makes you feel safe and welcome. You can ask your doctor for a referral.

• Make a plan to keep yourself safe.

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

• Build a support system.

  Look for a self-injury support group. Ask for help from trusted friends, family, and community members.

• Practice healthy ways to manage your emotions.

  Use these skills when you have big feelings, anxiety, and stress. A counselor can help you find what works for you. For example, together you may learn that yoga, deep breathing, or certain music calms you.

If it's an emergency, call 911.

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

If you or someone you know 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.