Self-Injury and Cutting

Identifying people engaging in these behaviors can be challenging. If you are worried a loved one is hurting themselves, it’s essential to know how to recognize the warning signs of self-harm.

Behavioral signs

The behavioral warning signs of self-harm include changes in someone’s actions, such as

• Low mood or tearfulness
• Low motivation
• Loss of interest in pleasurable activities
• Isolation
• Staying out all night
• Spending time with a new group of friends
• Talking about death
• Keeping secrets or changing their normal communication style
• Sleeping too much or too little

Physical signs

The physical signs are usually identified in someone’s appearance. Be sure to pay attention to

• Wearing multiple bandages
• Reluctance to show parts of the body
• Any new, unexplained injuries or any old wounds that are not healing well
• Wearing long sleeves and long pants all year long
• Gaining or losing a lot of weight
• Hair loss anywhere on the body

Other signs

• Someone engaging in or thinking about self-harm could display several other warning signs. Additional warning signs may include
• Spending excessive time researching self-injury online
• Buying a variety of blades
• Stockpiling knives or razors in their rooms
• Hiding bloody rags in the garbage

Self-injury and cutting are a problem with multiple contributors. Each person’s contributors will be unique to their situation. Some possible causes of self-harm include

• Self-harm and substance abuse are strongly connected. It appears that people who misuse alcohol and other drugs are more likely to self-harm than those people who do not. This relationship could be due to the lack of self-control and poor judgment caused by substance intoxication.
• Self-injury is more common among people with mental health conditions than in people without mental health issues. If someone has depression, borderline personality disorder, anxiety or eating disorders, they have a greater chance of self-injury. People living with mental health disorders may need treatment specifically for self-harm and mental illness.
• Lack of comfort and life stability can contribute to self-induced pain. Like other conditions affecting someone’s mental health, traumatic life events, such as abuse, neglect, the threat of violence and loss add to the likelihood of self-injury and cutting.
• Other people may self-harm just because they overhear their peers talking about the experience or they see self-injury carried out in the media. These outside influences may spark curiosity in self-harm, which may lead to someone engaging in the act.

Treatment is based on the specific issues and any related mental health disorders a person might have, such as depression. It is best to get treatment from a mental health professional experienced in self-injury issues. Possible treatment options may include

• Psychotherapy: Known as talk therapy or psychological counseling.
• Medications: If a person is diagnosed with a mental health disorder, such as depression or an anxiety disorder, the doctor may recommend antidepressants or other medications to treat the underlying disorder that is associated with self-injury. Treatment for these disorders may help the person feel less compelled to hurt themselves.
• Psychiatric hospitalization: If a person injures themselves severely or repeatedly, the doctor may recommend hospital admission for psychiatric care. Hospitalization, often for a short-term, can provide a safe environment and more intensive treatment until the person gets through the crisis. Mental health day treatment programs also may be an option.

If a person is injuring themselves, even in a minor way, or if a person has thoughts of harming themselves, they should reach out for help. Any form of self-injury is a sign of bigger issues that need to be addressed. Talk to a trusted person, such as a friend, loved one, doctor, spiritual leader or a school counselor, nurse or teacher who can help take the first steps to successful treatment. A person may feel ashamed and embarrassed about their behavior, but there is supportive, caring and nonjudgmental help available at their reach.