What is non-suicidal self-harm?

Non-suicidal self-injury

Non-suicidal self-injury means that a person injures themself on purpose. Self-injury can include cutting, scratching, and biting the skin until it bleeds. Some people may burn their skin with something hot or punch their bodies. Or they may hit their heads against something hard, such as a wall.

There are many reasons people self-injure. For example, some may do it because they have a hard time with managing emotions like anger or sadness. Or they may do it to relieve stress or anxiety. It's common for a person to hide their injuries.

People who self-injure don’t do it to die. But sometimes they may also be thinking about suicide.

What are the signs of non-suicidal self-injury in children?

A sign of non-suicidal self-injury is injuries that seem unusual. These include multiple cuts or deep scratches on a child's arms, legs, or stomach. Another sign is odd blood stains on clothing. A child may cover injuries with long sleeves and bandages. A child may also avoid activities that need less clothing, like swimming.

How is non-suicidal self-injury 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 is non-suicidal self-injury diagnosed in children?

To assess, the doctor may ask how often the injuries happen and if they bleed, bruise, or cause pain. And the doctor may ask how self-injuring makes your child feel. The doctor also may ask questions to find out if your child has other health conditions, like depression.

How can you care for yourself if you self-injure?

First, find a counselor that you trust. Then work together to make a plan to keep you safe. A counselor can help you find healthy ways to manage emotions. For example, you may learn that deep breathing calms you. Try joining a support group. Consider asking for support from trusted friends and family members.

What puts your child at risk for non-suicidal self-injury?

You can look for things that make self-injury more likely. Children may be at risk if they:

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

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.

Teens: Supporting a friend who self-injures

It's tough to have a friend who self-injures, or hurts themself on purpose. You may feel worried about your friend. And you may be wondering what to do. You can't stop your friend from self-injuring, but you can be there for them.

Here are some ways to support your friend.

  • Encourage your friend to seek help.

    Your friend can talk to an adult they trust, such as a counselor, a parent, or a faith leader. If this is too hard for your friend, you can offer to talk to someone for them.

  • Don't promise to keep it a secret.

    Self-injury is serious. Sometimes people who self-injure may also be thinking about suicide. So it's important to let someone know. This is to keep your friend safe.

  • Be a good listener.

    If your friend wants to talk, do so in a place that's safe and private. If you feel upset, first take some time to calm yourself. If it feels right, ask some questions. And listen closely to the answers. This can help your friend feel better understood.

  • Keep hanging out with your friend.

    When you're together, focus on your friend and not the self-injury. Have fun together. Do the things you like to do. For example, listen to music, go for walks, dance, or play a game.

  • Take care of yourself.

    It's not easy to have a friend who hurts themself. If you're feeling worn-out, it's okay to take short breaks from your friend now and then. And you may want to talk to someone, like a counselor.

  • Learn more ways to help your friend.

    One resource you could try is the Self-injury Outreach and Support website. Go to sioutreach.org to learn more. The site has personal stories, videos, and other tips on how to help a friend.

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.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.