Self-injury is a non-suicidal injury which includes deliberately harming your own body such as cutting or burning yourself. It is an unhealthy way of coping with emotional pain, frustration and intense anger.
Self-injury brings a momentary sense of calm and relief from tension, but it is usually followed by regret and shame and also the return of painful emotions.
In what ways can a person cause self-injury?
Self-injury is usually done in private and is done in a ritualistic and controlled manner that leaves a pattern on the skin. It can include:
- Cutting (with sharp objects)
- Burning (with matchstick, cigarettes or any other hot object like knife)
- Hitting or punching
- Carving symbols or words on skin
- Pulling out hair
- Piercing the skin with sharp objects
- Persistently disturbing a wound to avoid proper healing
Usually, self-injury is done on arms, legs or front part of the abdomen. However, the person may harm any area of the body.
What are the causes?
There is no one simple or direct cause that leads a person to cause self-injury.
It can include:
- Inability to cope with psychological pain
- Failure to express or understand emotions
- Mix of too many emotions may trigger self-injury like worthlessness, loneliness, anger, guilt, self-hatred or confused sexuality
What are the risk factors?
Factors which increase the risk of self-injury are:
- Age: Self-injury is commonly seen among young adults and teenagers.
- Having friends who do self-injury: People who have friends who do self-injury are more likely to indulge in the same.
- Traumatic life events: People who were neglected or abused.
- Unstable family environment: People who have grown or still live in a volatile family environment.
- Mental disorders: Self-injury is associated with specific psychiatric disorders like depression, anxiety, post-traumatic stress disorder and eating disorders.
- Excessive alcohol or drug use: People who have the habit of drinking excessive alcohol or drugs.
What are the symptoms of self-injury?
Sign and symptoms can include:
- Fresh cuts, bruises, scratches or wounds
- Keeping sharp objects on hand
- Problems in personal relationships
- Behaviour and emotional instability
- Impulsivity and unpredictability
- Frequent questions about identity like” Who am I?” “What am I doing?”
- Helplessness and hopelessness
- Trying to cover body parts by wearing long sleeves clothes
Is there a risk of suicide?
Self-harm is not an attempt at suicide. However, worsening of underlying emotional problems can increase the risk of suicide.
How is self-injury diagnosed?
There are no diagnostic tests which can detect self-injury disorder. Diagnosis is usually made by a psychologist or a psychiatrist after a physical and mental evaluation. They may also evaluate other mental illnesses that may be linked to self-injury.
What is the treatment for self-injury?
Self-injury can become a habit for the person. So, the patient should have his desire to get treated for self-injury. A mental health professional or a psychiatrist can be able to treat a self-injury patient efficiently.
Psychological counselling or psychotherapy can help a person to:
- Identify underlying mental disorders that trigger self-injury
- Learn skills to manage stress
- Learn how to handle emotions
- Develop skills to improve relationships and social life
- Learn skills to boost self-image
- Develop better problem-solving skills
Several types of psychotherapies used in treating this disorder like cognitive behavioural therapy, mindfulness-based treatment, family therapy, etc.
There are no specific medicines to treat self-injury disorder or behaviour. Drugs are prescribed to address the underlying mental issues like depression, anxiety or phobias that are associated with self-injury.
If the patient harms themselves severely/repeatedly, the doctor may advise hospitalisation under psychiatric care. It may provide a safe environment and more intensive treatment for the patient.
There is no definitive way to prevent someone from self-injury. However, the risk of self-injury can be reduced by strategies that involve both the individual and community like parents, schools, supervisors, medical professionals, coaches and co-workers. It includes:
- Encouraging socialisation: Patients with self-injury are usually lonely and disconnected. So, meeting and talking to people may help them improve their interpersonal skills.
- Helping people at risk: Teaching them healthy coping skills to handle stressful condition in a better way.
- Spreading awareness: People especially who work with children should be educated about how to identify the signs of self-injury and take action if they suspect it.
- Encouraging peers to seek help from adults: Teenagers tend to be loyal to their friends even when they come to know that a friend is suffering from some problem. Programs that encourage teenagers and young adults to reach out for help may help in preventing secrecy.
Complications of self-injury
Complications can include:
- Permanent scars or disfigurement
- Infection from wounds
- Worsening of feelings of guilt, shame and worthlessness
- Severe injuries
Emergency medical help should be sought if you suspect suicide attempt by anyone showing signs of self-harm.
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- Cutting and self-harm. http://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm. Accessed on 14th Sept 2016.
- Self-harm. http://www.nhs.uk/conditions/Self-injury/Pages/Introduction.aspx. Accessed on 14th Sept 2016.
- Self-harm. http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Self-harm. Accessed on 15th Sept 2016.
- Self-injury. http://www.cmha.ca/mental-health/understanding-mental-illness/self-injury/. Accessed on 15th Sept 2016.