May is Mental Health Awareness Month – Mental Health Post a Day in May – May 18 – Self Injurious Behavior

Please read my blog post titled “Self Injurious Behavior – I did That”

Self-injury (Cutting, Self-Harm or Self-Mutilation)

Self-injury, also known as self-harm, self-mutilation, or self-abuse occurs when someone intentionally and repeatedly harms herself/himself in a way that is impulsive and not intended to be lethal.

The most common methods are:

  • Skin cutting (70-90%),
  • Head banging or hitting (21%-44%), and
  • Burning (15%-35%)

Other forms of self-injury include:

  • excessive scratching to the point of drawing blood
  • punching self or objects
  • infecting oneself
  • inserting objects into body openings
  • drinking something harmful (like bleach or detergent)
  • breaking bones purposefully
  • Most individuals who engage in non-suicidal self-injury (NSSI) hurt themselves in more than one way.

How Common is Self-Injury?

  • Research indicates that self-injury occurs in approximately as many as 4% of adults in the United States.
  • Rates are higher among adolescents, who seem to be at an increased risk for self-injury, with approximately 15% of teens reporting some form of self-injury.
  • Studies show an even higher risk for self-injury among college students, with rates ranging from 17%-35%.

Why Do People Self-Injure?

People who self-injure commonly report

  • they feel empty inside
  • feel over or under stimulated
  • are unable to express their feelings
  • feel lonely
  • do not feel understood by others
  • are fearful of intimate relationships
  • are fearful of adult responsibilities
  • Self-injury is their way to cope with or relieve painful or hard-to-express feelings, and is generally not a suicide attempt.
  • But relief is temporary, and a self-destructive cycle often develops without proper treatment.
  • Self-inury can also be a way to have control over your body when you can’t control anything else in your life.

A lot of people who cut themselves also have an eating disorder.

By engaging in self-injury, a person intends to: 

  • Obtain relief from a negative feeling or mental state
  • Resolve an interpersonal difficulty, like a disagreement with a friend or loved one
  • Deal with an intrapersonal problem, like boredom
  • Induce a positive feeling state

Warning Signs

Warning signs that someone may be injuring themselves include:

  • Unexplained frequent injuries including cuts and burns,
  • Low self-esteem,
  • Difficulty handling feelings,
  • Relationship problems or avoidance of relationships, and
  • Poor functioning at work, school or home.

People who self-injure may attempt to conceal their marks, such as bruises, scabs or scars with clothing, and you may notice them wearing inappropriate clothing like long sleeves and pants in hot weather. If discovered, a person who self-injures may often make excuses as to how an injury happened (for instance, “I fell” or “The cat scratched me”).


The diagnosis for someone who self-injures can only be determined by a licensed psychiatric professional.

Self-injury behaviors can be a symptom of other mental illnesses such as:

  • personality disorders
  • esp. borderline personality disorderbipolar disorder
  • major depression
  • anxiety disorders
  • esp. obsessive-compulsive disorder
  • psychotic disorders, such as schizophrenia.

Criteria for a Diagnosis of Non-Suicidal Self-Injury 

Intentional self-inflicted damage to the surface of the body with expectation of physical harm, but without suicidal intent for 5 or more days within the past year;

Person injures themself for at least one of the following reasons:

  • To seek relief from negative thoughts or feelings
  • To resolve an interpe​rsonal difficulty, or
  • To bring about positive feelings.

Before the behavior, a person experiences one of the following:

  • Interpersonal difficulty or negative feelings and thoughts  (including depression, anxiety),
  • Preoccupation about self-injury that is hard to resist
  • Frequent urges to self injure
  • The behavior is not accepted by society (body piercing, tattooing, scab picking and nail biting do not qualify for the diagnosis)
  • The person is significantly distressed by the behavior
  • The behavior can’t be explained by another mental, developmental or other medical condition.

Self-Injury and Suicide

  • The relationship between suicide and self-injury is complicated.
  • While people with non-suicidal self injury do not intend to complete suicide, they may cause more harm than intended, which could result in medical complications or death.
  • In severe or prolonged cases of self-injury, a person may become desperate about their lack of control over the behavior and its addictive nature, which may lead them to true suicide attempts.


If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted.

An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing.

Self-injury treatment options include

  • outpatient therapy
  • partial-inpatient (6-12 hours a day)
  • inpatient hospitalization.

When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended.

Effective treatment of self-injury is most often

  • a combination of medication
  • cognitive/behavioral therapy
  • interpersonal therapy
  • supplemented by other treatment services as needed.

Medication is often useful in the management of depression, anxiety, obsessive-compulsive behaviors, and the racing thoughts that may accompany self-injury.

Cognitive/behavioral therapy helps individuals understand and manage their destructive thoughts and behaviors. Contracts, journals, and behavior logs are useful tools for regaining self-control.

Interpersonal therapy assists individuals in gaining insight and skills for the development and maintenance of relationships.

Services for eating disorders, alcohol/substance abuse, trauma, abuse, and family therapy should be readily available and integrated into treatment, depending on individual needs.

Successful courses of treatment are marked by:

  • An individual’s active involvement and committment to their treatment,
  • Aftercare plans with support for the individual’s new self-management skills and behaviors, and
  • Collaboration between all involved professionals (medical and otherwise)

© Copyright 2017 | Mental Health America | Formerly known as the National Mental Health Association. MHA permits electronic copying and sharing of all portions of its public website and requests in return only the customary copyright acknowledgement, using “© Copyright Mental Health America” and the date of the download.

I will be posting something important about mental illness every day throughout the month of May on my blog in honor of Mental Health Awareness Month.

Please keep visiting my blog My Loud Bipolar Whispers and look for statistics or other beneficial information related to mental illness to increase awareness, educate, reduce mental illness stigma and reduce suicides. It is crucial and imperative for all of us to get involved and save lives. 

So, please visit my blog every day, but especially every day throughout the month of May.

Thank you. Hugs and blessings to all of you always and forever.


  1. Hi, I identify with all you’ve blogged. I did every single one of those methods.
    Don’t know how I’m still alive today.
    I’ve just written a blog on my tool box of items that I take out to look at any time I’m in danger.
    Have a look if you get a moment.
    Following you and enjoying.
    Cheers Mo X

    Liked by 1 person

    1. I want look but for some reason I can only get to the I can only get to your
      Home page on your blog… It is probably me. I will try again so I can read your blog. Your blog sounds awesome and we sound similar and that always makes me feel better to know I was and am not alone. Hugs… Must run to work…. Part-time job I have…

      Liked by 1 person

  2. Hi Mo I just wrote a very long post explaining my doctor visit it was very long and it somehow disappeared…. hmmm….. I do not want to write it all again…. I am going to try to write a post about my visit if I get a chance today. In a nutshell I became very sick due to my bipoalr medications and electrolytes and sodium and potassium and all of those such things that I guess you need to make you feel well and live. In severe cases you can have a heart failure…. well that is a bit scary. Anyway I got very sick…. was very weak, sweating a lot, peeing a lot, heart arrythmia I guess, blurred vision, high blood pressure like I neverhad before, headache, fluid retention….. all becasue of my bipolar medication I have taken for at least 7 years or more and took the highest dose possible. The treatment for my syndromes I develpped is to stop taking the med. all together so that is what I am doing. No more bipolar medications for me ever again I will stay on Klonipin though to help my anxiety and mania and ability to relax some and sleep. I cannot wait for my physical health to be well again as it has slowly been getting worse over a few years but I just made other excuses of what must be causing it. Now it all makes complete sense. I pray it all works out. Yay! At least I have an answer for some progressing physical problems.


  3. Reblogged this on J-Dubs Grin and Bear It and commented:
    The world threw me a curve ball and I got behind on re-blogging. I know someone very near and dear who struggled with this. Sometimes she still makes fists so tight as to draw blood and will scratch herself. Hopelessness is watching this flawed coping mechanism.

    Liked by 1 person

  4. Thank you for sharing. I feel like the way I handled mine was biting my nails until they bleed and also biting the inside of my gums until they bleed. I never went bigger than that, I always wanted to appear totally in control and have no physical signs. Small but still synonymous with complete unhappiness, distress and difficulties within myself. Thank you again for sharing.

    Liked by 1 person

    1. You are welcome. It is a blessing for you that you didn’t engage in worse types of SIB. Self Injurious behaviors are very dangerous and are addicting behaviors actually. I engaged in SIB for years to relieve my pain temporarily and distract my mind from it. Praise God I no longer self injure and haven’t for a few years and no longer will. Thank you for your comments and sharing your personal experience with SIB. I appreciate it and love having dialog with other bloggers. Hugs and blessings. Sue

      Liked by 1 person

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