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More on Self-Injury

By: Michelle Wagner, Public Health Educator, Breaking Through Task Force Co-Chair

Approximately two million cases of self harm or Non-Suicidal Self Injury (NSSI) are reported in the United States each year. About 90 percent of those cases are individuals who begin self-harming behaviors in their early teen or pre-adolescent years, with a disproportionate number of those individuals being female.

Those statistics - coupled with recent Centers for Disease Control (CDC) data indicating that teen girls are experiencing record high levels of violence, sadness, and suicide risk - underscore the importance of not only understanding and recognizing the signs of NSSI, but also knowing how to respond and help those who may be engaging in these self-destructive behaviors.

The Breaking Through Task Force has provided some useful information and resources below to help community members recognize when a young person may be self harming, and what steps they can take if they know someone struggling with NSSI.

What is NSSI?

According to the Mayo Clinic, NSSI is defined as “ the act of harming your own body on purpose, such as by cutting or burning yourself.”

NSSI is usually not meant as a suicide attempt but instead is used as a harmful way to cope with emotional pain, sadness, anger and stress. Sometimes, the behavior can stimulate the body’s endorphins or pain-killing hormones and, in turn, briefly raise mood. Or, a person may not feel many emotions and inflict pain on themselves as a way of feeling something rather than emotional numbness.

Self-injury can include:

  • Cutting with a sharp object

  • Scratching

  • Burning with matches, cigarettes or heated objects

  • Carving words or symbols on the skin

  • Hitting, slapping or punching oneself

  • Head banging or hitting a wall

  • Puncturing or piercing the skin with sharp objects

  • Inserting objects under the skin

  • Pulling out hair

  • Picking at existing wounds

While NSSI is not the same as attempting suicide, a person who is hurting themselves may be at an increased risk of feeling suicidal.

What are the signs and symptoms of NSSI?

A person struggling with NSSI may be very adept at hiding their self-harming behaviors, however, they often exhibit signs and symptoms. If you suspect NSSI, here are some signs to look for:

  • Scars that are often in patterns

  • Fresh cuts, scratches bruises, bite marks or other wounds

  • Wearing long sleeves or long pants to hide self injury, even in hot weather

  • Frequent reports of accidental injury

  • Difficulties in relationships with others

  • Behaviors and emotions that change quickly and are impulsive, intense and unexpected

  • Talk of helplessness, hopelessness or worthlessness.

Mental health conditions that are often associated with self-harming behaviors include borderline personality disorder, depression, eating disorders, anxiety and post traumatic stress disorder.

What can you do to help a person struggling with NSSI?

Because self-harm is a serious mental health symptom, it requires evaluation and treatment, according to the National Alliance on Mental Illness (NAMI). NAMI suggests that if you know someone who is engaging in self-harm, encourage them to talk to a mental health professional who can help. Below are some other steps you can take when talking to someone who needs help:

  • Be compassionate, listen and offer non-judgmental support.

  • Avoid making accusations or threats. Consult your child’s pediatrician or a mental health professional about what steps you should take next.

  • Encourage them to seek help or offer to help them find a doctor or mental health professional.

Adults can also offer adolescents some helpful ways to avoid hurting themselves. These coping skills may include: directing the urge at something else such as using a punching bag, screaming into a pillow or ripping up a magazine; self-soothing by taking deep breaths, taking a bath or trying to meditate; expressing oneself by writing how you feel or writing creatively; creating something by painting, drawing or crafting; focusing on music by listening to a favorite song or playing an instrument; exercise by going for a run, dancing or just going for a walk; avoiding alcohol and drugs.

If you or someone you care about is struggling with NSSI, reach out for help. You can find local resources by visiting the Breaking Through Task Force resource page at


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