Non-suicidal self-injury, often simply called self-injury, is the act of deliberately harming your own body, such as cutting or burning yourself.  It’s typically not meant as a suicide attempt. Rather, this type of self-injury is a harmful way to cope with emotional pain, intense anger, and frustration. 
 
While self-injury may bring a momentary sense of calm and a release of tension, it’s usually followed by guilt and shame and the return of painful emotions.  Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more serious and even fatal self-aggressive actions. 
 
Getting appropriate treatment can help you learn healthier ways to cope. 
 
Signs and Symptoms of Self-Injury: Signs and symptoms of self-injury may include:
·Scars, often in patterns
·Fresh cuts, scratches, bruises, bite marks, or other wounds
·Excessive rubbing of an area to create a burn
·Wearing long sleeves or long pants, even in hot weather
·Frequent reports of accidental injury
·Behavioral and emotional instability, impulsivity, and unpredictability
·Statements of helplessness, hopelessness, or worthlessness
 
Forms of Self-Injury:
Self-injury usually occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin.  Examples of self-harm include:
·Cutting (cuts or severe scratches with a sharp object)
·Scratching
·Burning (with lit matches, cigarettes, or heated, sharp objects such as knives)
·Carving woods or symbols on the skin
·Self-hitting, punching, or head banging
·Piercing the skin with sharp objects
·Inserting objects under the skin
 
Most frequently, the arms, legs, and front of the torso are the targets of self-injury, 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.
 
Becoming upset can trigger an urge to self-injure.  Many people self-injure only a few times and then stop.  But for others, self-injury can become a long-term, repetitive 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 issues that need to be addressed.  Talk to someone you trust—such as a friend, loved one, doctor, spiritual leader, or a school counselor, nurse, or teacher—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 non-judgmental help.
 
When a Friend or Loved One Self-Injures
If 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 ways to help:
 
Your child. You can start by consulting your pediatrician or other health care provider who can provide an initial evaluation or a referral to a mental health professional.  Express your concern, but don’t yell at your child or make threats or accusations.
 
Pre-teen or teenage friend. Suggest that your friend talk to his/her parents, a teacher, a school counselor, or another trusted adult. 
 
Adult. Gently express your concern and encourage the person to seek medical and mental health treatment. 
 
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 immediately.
 
Also consider these options if you’re having suicidal thoughts:
 
·Call your mental health professional if you’re seeing one.
·Call the National Suicide Prevention Lifeline at 988. 
·Seek help from your school nurse or school counselor, teacher, doctor, or other health care provider.
·Reach out to a close friend or loved one.
·Contact a spiritual leader or someone else in your faith community. 
 
Causes
There’s no one single or simple cause that leads someone to self-injure.  Through self-injury, the person may be trying to:
·Manage or reduce severe distress or anxiety and provide a sense of relief
·Provide a distraction from painful emotions through physical pain
·Feel a sense of control over your body, feelings, or life situations
·Feel something—anything—even if it’s physical pain, when feeling emotionally empty
·Express internal feelings in an external way
·Communicate depression or distressful feelings to the outside world
·Be punished for perceived faults
 
Prevention
There is no sure way to prevent a person’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. 
·Identify someone at risk and offer help.  Someone at risk can be taught resilience and healthy coping skills that can be used during periods of distress.
·Encourage expansion of social networks.  Many people who self-injure feel lonely and disconnected.  Helping someone form connections to people who don’t self-injure can improve relationship and communication skills.
·Raise awareness.  Learn about the warning signs of self-injury and what to do when you suspect it.
·Encourage peers to seek help.  Peers tend to be loyal to friends.  Encourage children, teens, and young adults to avoid secrecy and to reach out for help if they have a concern about a friend or loved one. 
·Talk about media influence.  News media, music, and other highly visible outlets that feature self-injury may nudge vulnerable children and young adults to experiment.  Teaching children critical thinking skills about the influences around them might reduce the harmful impact.