Self-injury is any behavior that someone deliberately does to hurt themselves. It can include any type of bodily harm that someone inflicts on themselves, such as cutting or scratching, burning, picking at scabs or preventing wounds from healing, causing an infection, or punching oneself or objects. People who self-injure often do so repeatedly over an extended period of time as a way of coping with intense stress or other overwhelming emotions. These behaviors pose serious health risks and may be symptoms of a mental health problem. You may have noticed that a friend has some unusual or recurring injuries that led you to wonder about whether they are harming themselves.
Signs that someone may be injuring themselves include:
- Frequent unexplained injury, particularly of the same or similar type.
- Insistence on wearing concealing clothing (e.g., long pants and sleeves in hot weather).
- Being unusually wary about allowing other people to see particular parts of their body that are not typically considered "private" (e.g., feet, arms).
- Difficulty with expressing and managing feelings.
- Low self-esteem.
- Other signs of a mental health problem, such as depression or an eating disorder.
You and a group of your friends decide to spend the day at the beach. One of your friends has been particularly withdrawn lately and seems sad, but she agrees to come along. However, once you're at the beach she refuses to get in the water or even put on typical beachwear. Later in the day you catch a glimpse of her inner arm and notice that it is covered in a series of straight cuts that don't look random or accidental. What do you do?
Make the first move:
- If you witness a serious injury in need of urgent medical attention (e.g., cuts that won't stop bleeding, large/severe burns, swelling indicative of broken bones, etc.), call 911 or take your friend to the emergency room immediately.
- Self-injury is typically not meant to be a suicide attempt but rather a way to cope with emotional pain. Don't assume that your friend is suicidal if you notice self-harming behavior that is not likely to be lethal.
- Be on guard for behavior that suggests worsening symptoms. People who self-injure may increase the severity of their harm over time, cause themselves more harm than they had intended, develop increasingly self-destructive behavior in general, or become suicidal out of a sense of hopelessness.
- Ask your friend about what you have noticed. Express your concern.
- Listen if she wants to talk about what is going on.
- Don't be judgmental or suggest that the cutting is just a way to get attention.
- Express your support and encourage her to seek
professional help to learn better ways to cope with how she is feeling.
We express our appreciation to the University of Arizona C.A.T.S. Life Skills Program for allowing us to use modified versions of their STEP UP! Program content in this USI campus initiative.