Signs and Symptoms of Self-Injury

Signs and symptoms may include:

• Scars, such as from burns or cuts
• Fresh cuts, scratches, bruises or other wounds
• Broken bones
• Keeping sharp objects on hand
• Wearing long sleeves or long pants, even in hot weather
• Claiming to have frequent accidents or mishaps
• Spending a great deal of time alone
• Pervasive 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-injuryOne of the most common forms of self-injury is cutting, which involves making cuts or severe scratches on different parts of your body with a sharp object. Other forms of self-harm include:

• Burning (with lit matches, cigarettes or hot sharp objects like knives)
• Carving words or symbols on the skin
• Breaking bones
• Hitting or punching
• Piercing the skin with sharp objects
• Head banging
• Biting
• 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 because these areas can be easily reached and easily hidden under clothing. 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.

Because self-injury is often an impulsive act, becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. However, 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 doctorGetting appropriate treatment can help you learn healthier ways to cope.

• Reach out for 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, religious 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.
• Emergency help. If you've injured yourself severely or believe your injury may be life-threatening, call 911 or your local emergency services provider.

When a friend or loved one self-injuresIf 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. Here are some options for help.

Your child. You can start by consulting your pediatrician or family doctor who can provide an initial evaluation or a referral to a mental health specialist. Don't yell at your child or make threats or accusations, but do express concern.

Teenage friend. Suggest that your friend talk to parents, a teacher, a school counselor or another trusted adult. Adult. Gently encourage the person to seek medical and psychological treatment.