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Unfortunately, it’s not uncommon for people, college students included, to occasionally feel like they’ve lost control of their lives. With tests, papers, and other commitments piling up, it might seem impossible to get a handle on things. These feelings can become more extreme in cases of trauma and abuse. There are healthy ways to get back into control. A balanced diet, moderate exercise, catching up on homework, and a good night’s sleep are just a few things that can help. Other students—in fact, over three million—turn to something more dangerous: chronic self-injury.

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What is self-injury?

Self-injury is harm that a person intentionally inflicts upon him or herself. It is also called self-mutilation or self-harm. Sometimes people refer to it by its specific behavior: cutting, burning, kicking, poisoning, etc. It may include any of the following:

• Cutting, piercing, or scratching the skin with a sharp object
• Burning
• Poisoning
• Punching walls and other objects
• Picking at wounds so that they do not heal
• Hitting one's head against hard objects (e.g., a wall)

Self-injury is usually not a suicide attempt; typically, people harm themselves to cope with intense feelings of anger or sadness or to perceive a sense of control over one aspect of their lives. It is still dangerous, however, and it can be the cause of accidental death. For most people who self-injure, the behavior becomes a habit; they do it more than once. Not only does this repeatedly put the body at risk, but it stunts a person’s ability to develop healthy coping strategies that don’t harm the body.

Who self-injures?

People who self-injure come from all backgrounds, genders, races, and ages. What they have in common is low self-esteem, loneliness, a feeling of emptiness, a need to find control, perfectionism, and/or experiences with past trauma. Self-injury can help an individual manage their stress and feel in control of their life, or provide a distraction from emotional pain or trauma. While self-injury can affect anyone, it does particularly affect teenagers and young adolescents. In fact, a 2008 study published in Psychiatry found that one-third to one-half of adolescents in the United States had inflicted a self-injury. For the rest of the population, however, the prevalence of chronic self-injury is only about 1–4%.

I suspect my friend self-injures. What should I do?

People who self-injure often do so in private. In fact, they are usually good at concealing their behaviors, especially if they live in a single dorm or have their own bedroom or bathroom in a shared apartment.

You can still look out for your friends in need. Care about your friends by paying attention to any warning signs or behaviors that seem unhealthy:

• Scars
• Fresh cuts and wounds (often straight, parallel cuts on the arms and legs)
• Fresh burns
• Scratches
• Patterns of bruises
• Broken bones
• Wearing long sleeves and pants, even in the summertime
• Keeping sharp objects around, even when unnecessary (e.g., a knife in a dorm room or a razor in a purse)
• Talking about feeling helpless or worthless
• A drop in school performance

If you notice that your friend is demonstrating some of the above signs of self-mutilation, it’s a good idea to reach out. Oftentimes, people who self-injure want to talk to someone about it, but they have trouble finding the courage. You can show your support by listening and then encouraging your friend to make an appointment with a mental health professional.

What should I do if I self-injure?

If you self-injure, it may not seem like a big deal. It doesn’t affect anyone’s body but your own, and you know when to stop cutting or burning before your injuries are fatal. In fact, it may be something you’ve been doing for years to express your pain or emotions.

Self-injury is not the best way to cope with the outside world. Accidents do happen, and self-injuries can be fatal. They can also leave permanent scars or cause infections. There are healthier coping strategies that reward your body rather than punish it. They include exercise, eating well, getting a good night’s sleep, journaling, meditating, and talking with friends. These activities benefit your emotional and physical health.

You can get help from a number of resources if you self-mutilate. Mental health professionals understand that self-injury is not usually suicidal behavior. Most therapy to overcome self-injury is done on an outpatient basis and won’t involve a hospital stay. Therapists are eager to help individuals who self-injure come up with alternative ways to cope with their stress, emotions, and pain. By working with a therapist, you can determine the root cause of your self-harming behavior and create new ways to cope with your triggers. Instead of turning to self-harm, a therapist will help you develop healthy habits and coping mechanisms.

Do not be afraid to reach out to your parents and friends, and consider joining a peer support group. The people who love you will be eager to help you develop effective strategies for coping with pain, anger, and frustration.

What resources are there for people who self-injure?

For everyone:

• Crisis Text Line
  • Text "HOME" to 741741.
  • Text line is open 24 hours a day, seven days a week.
  • Texts are confidential
• National Suicide Prevention Lifeline
  • Call 1-800-273-8255 toll-free or chat with an online representative.
  • Helpline is open 24 hours a day, seven days a week.
  • Representatives are available in English and Spanish.
  • Calls are confidential.
• SAFE (Self-Abuse Finally Ends) Alternatives
  • Call 1-800-366-8288 for information.
• The Samaritans
  • Call 212-673-3000 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential and anonymous. Caller ID is not used.

For teens and adolescents:

• Thursday’s Child
  • Call 1-800-872-5437 toll-free.
  • Helpline is open 24 hours a day, seven days a week.

For LGBT+ youth:

• The Trevor Project
  • Call 1-866-488-7386 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Chat with a counselor 24 hours a day, seven days a week.
  • Text "START" to 678678 to text with a counselor 24 hours a day, seven days a week.

Page last updated: 03/2019