Symptoms

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
• Keeping sharp objects on hand
• Wearing long sleeves or long pants, even in hot weather
• Frequent reports of accidental injury
• Difficulties in interpersonal relationships
• 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 words 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 nonjudgmental 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.
• Preteen or teenage friend. Suggest that your friend talk to 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 a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use their webchat on suicidepreventionlifeline.org/chat.
• Seek help from your school nurse or 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.