March is Self-Harm Awareness Month.
Self-harm means hurting yourself on purpose. Also known as self-injury, self-harm is a symptom of extreme emotional distress. Individuals, in particular teens, engage in different types of self-harm that can be hard to identify. Learn more:
|Forms of Self-Harm
|When Someone Self-Harms
|Why People Self-Harm
|When to Get Emergency Help
|Risk Factors/Warning Signs
According to the Centers for Disease Control and Prevention, up to 30% of teenage girls and 10% of boys say that they have intentionally hurt themselves. One study found that as many as 25% of young people engage in self-injury.
These rates demonstrate a significant increase over the past 10 years, especially among girls. From 2001-2015, self-harm increased 166% in girls aged 10-14 and 62% in girls ages 15-19. Since 2009, the rate of cutting, the most common form of self-harm, among girls ages 10-14 has increased 18.8% each year.
Self-harm typically occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin. Some forms of self-harm include:
- Burning (with lit matches, cigarettes, or heated, sharp objects like 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 torso are the targets of self-injury, but any area of the body may be used. People who self-injure may use more than one method to harm themselves.
There is no one single factor that causes someone to self-harm. Generally speaking, it may result from:
- Poor coping skills: The inability to cope in healthy ways to psychological pain
- Difficult managing emotions: The inability to regulate, express, or understand emotions (The mix of emotions that triggers self-harm is complex and may include feelings of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred, or confused sexuality.)
Through self-harm, a person may be trying to:
- Manage or reduce severe distress
- Provide a distraction from painful emotions through physical pain
- Feel a sense of control over his/her body, feelings, or life situations
- Feel something, anything, even if it’s physical pain
- Express internal feelings in an external way
- Communication depression
- Be punished for perceived faults
Self-harm usually begins in adolescence, around the ages of 13 and 14, when emotions are more volatile and teens are facing increased peer pressure, loneliness, and conflicts with parents and other authority figures.
Some factors that may increase the risk of self-harm include:
- Having friends who self-injure
- Life issues such as trauma, abuse, unstable family environment, social isolation, and confusion about personal identity
- Mental health issues (self-harm is commonly associated with borderline personality disorder, depression, anxiety disorders, post-traumatic stress disorder, and eating disorders)
- Drug/alcohol use (people who harm themselves often do so while under the influence of drugs or alcohol)
Warning signs of self-harm 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 relationships
- Behavioral and emotional instability, impulsivity, and unpredictability
- Statements of helplessness, hopelessness, or worthlessness
Although self-harm is not typically a suicide attempt, it can increase the risk of suicide because of the emotional distress that triggers self-injury. And the pattern of hurting the body in times of distress can increase the likelihood of suicide.
There is no way to prevent someone from self-harming. But reducing the risk of self-injury includes strategies that involve parents, family members, teachers, school nurses, coaches, and friends.
- Offer help to someone at risk. Someone at risk can be taught healthy coping skills that can be used during periods of distress.
- Encourage social connection. 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.
- Reach out for help. Encourage children, teens, and young adults to avoid secrecy and reach out for help if they have a concern about a friend or loved one.
- Talk about media influence. News media, social media, music, and other highly visible outlets that feature self-injury may inspire children and young adults to experiment. Teaching children critical thinking skills about the influences around them might reduce the harmful impact. (see articles below)
If you’re worried a friend or loved one might be hurting themself, ask them how they’re doing and be prepared to listen to the answer, even if it makes you uncomfortable. This may be a hard subject to understand. One of the best things is to tell them that while you may not fully understand, you’ll be there to help. Don’t dismiss emotions or try to turn it into a joke.
Although you might feel like you are betraying a confidence, self-injury is too big a problem to ignore. Here are some ways to help.
- Your child. Consult 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 parents, a teacher, a school counselor, or another trusted adult.
- An Adult. Gently express your concern and encourage the person to seek medical and mental health treatment.
If you have injured yourself severely or believe your injury is life-threatening, call 911. If you think you may attempt suicide, call 911.
If you are having suicidal thoughts, call the suicide hotline at 1.800.273.8255 or use the web chat on suicidepreventionlifeline.org/chat.
Otherwise, consider these options:
- Call your mental health professional if you are seeing one.
- 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