Disorders and Treatments Guide: Self-injury

By Maria Colenso

Self-injury, cutting or self-mutilation affects an estimated two million Americans. Mostly adolescents and young adults, and mostly female, self-abusers intentionally and regularly inflict harm on themselves through various, often hidden, methods that may include cutting, carving words or symbols into the skin, burning, ingesting harmful substances, punching, breaking bones, biting, pulling hair and piercing the skin.

Self-abusers typically injure as a way to express emotions and gain control, not to commit suicide. The abuse may be spontaneous or planned.

Signs & Symptoms

Self-injurers can be secretive about their self-harm and may hide their injuries under clothing or restrict the abuse to areas of the body that are easily hidden.

Symptoms may include:

Fresh cuts or wounds often in the form of small, linear cuts
Frequent bruises
Broken bones
Scars
Denying self-harm with excuses of accidents or clumsiness
Wearing clothing that covers the arms and legs even in hot weather

For more information, visit Mental Health America's factsheet about self-injury:
http://www.mentalhealthamerica.net/go/information/get-info/self-injury

Therapies

Psychotherapy ("talk" therapy) is often the first step in treating self-injury. It can help the patient learn about and face the problems that trigger self-harm, teach coping skills and increase self-esteem. Psychotherapy may take the form of cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) or psychodynamic psychotherapy.

Self-injurers may also have underlying psychiatric problems that need treatment, such as eating disorders, bipolar disorder, anxiety disorder, borderline personality disorder or schizophrenia. Drug therapies including antidepressants, antipsychotics or other psychiatric medications may be prescribed to alleviate symptoms of depression and anxiety and symptoms of other co-existing mental disorders.

Resources