Nonsuicidal self-injury refers to intentional harm to self that is not intended to cause death. Examples are superficial scratching, cutting, or burning the skin (using cigarettes or curling irons), as well as stabbing, hitting, and repeatedly rubbing the skin with an eraser.
(See also Suicidal Behavior in Children and Adolescents.)
Adolescents with substance use disorders are more likely to injure themselves.
In some communities, self-injury suddenly becomes a fad in a high school, and many adolescents do it. In such cases, self-injuries gradually stop over time.
Self-injury suggests that an adolescent is in great distress. However, in many adolescents, self-injury does not indicate that suicide is a risk. Instead, it may be a self-punishing action that they feel they deserve. Self-injury can also be used to gain the attention of parents and/or significant others, express anger, or identify with a peer group. In other adolescents (those with more severe mental disturbances and less social support), the risk of suicide is increased.
Other factors that may increase the risk of suicide include the following:
Harming themselves often
Using several methods to harm themselves
Feeling less socially connected to other people, especially their parents
Feeling that life has little or no meaning
Seeking mental health care often
Having suicidal thoughts
All adolescents who deliberately injure themselves should be evaluated by a mental health professional experienced in working with mental health issues in adolescents. The doctor tries to determine whether suicide is a risk and to identify the underlying distress that led to self-injury. Doctors try to determine whether the adolescent has issues with low self-esteem or any number of other mental health issues, such as disorders of anxiety, mood, eating patterns, substance use, or trauma.
Treatment usually involves individual (and sometimes group) therapy. Therapy focuses on teaching adolescents how to be more aware of their emotions, how to accept negative emotions as part of life, how to develop more appropriate ways of responding to stress, and how to resist urges to behave self-destructively.
