Youth and Self-Injury

People cope with difficult thoughts, feelings, or situations in different ways. Some people cope by injuring themselves on purpose—and it may be the only way for them to feel better. Self-injury may seem frightening, but it’s important to look beyond the injuries and see what’s really going on.

What is self-injury? Self-injury means that someone hurts themself on purpose but doesn’t intend to end their life. Common acts of self-injury include cutting skin, burning skin, hitting yourself to the point of injury, and preventing wounds from healing. Self-injury itself isn’t a mental illness, but may be a sign that someone needs care and support. In some cases, self-injury can be a sign of a mental health problem. People self-injure for many different reasons. Some people self-injure:

To cope with anxiety or depression
To cope with loss, trauma, violence, or other difficult situations
To ‘punish’ themselves
To turn emotional pain into physical pain
To feel ‘real’ and counter feelings of emptiness or numbness
To feel euphoria
To regain control of their bodies
To simply feel better
People who self-injure are not trying to end their lives, but they can experience those thoughts. When they self-injure, they are trying to cope with difficult or overwhelming thoughts or feelings.

Warning Signs
People who self-injure often hide the behaviour. They may feel embarrassed or ashamed, and they may avoid talking about it. Warning signs include:

Unexplained frequent injuries, such as cuts and burns
Unexplained scars
Wearing long pants and long-sleeved shirts all the time, even in warm weather
Low self-esteem
Problems handling emotions
Problems with relationships
Who does it affect?
Self-injury can affect anyone, but it’s more common during the teenage years and among females. Self-injury is also more likely to affect people who have experienced stressful or traumatic life events, people who have a hard time coping with their feelings, and people who experience low self-esteem.

What can I do if I do about it?
If you self-injure, it’s important to begin talking with someone you trust. This could be a friend, a family member, a teacher, a school counsellor, or anyone you feel comfortable talking with. Your support person can help you work through next steps, like talking with a doctor or other health care professional. If you self-injure, it’s important to take care of your injuries. If you’re worried about an injury, talk to your doctor, go to your local emergency room, or call 9-1-1. You should be treated with respect no matter how you received the injury. Self-injury isn’t a mental illness, but in some cases it can be a sign of a mental health problem. It’s important to talk with your doctor about self-injury and any other problems you’re experiencing. If self-injury is related to a mental illness, treating the mental illness may help you reduce self-injuring behaviours.

Counselling and support
If self-injury isn’t related to a mental illness, it’s still best to talk with a mental health professional or a school counsellor. Your doctor can recommend a counsellor who can help you. They can help you work through the thoughts, feelings, or situations behind self-injury, teach you skills to cope with difficult thoughts and feelings, and help you find alternatives to self-injury. Two types of counselling that may help self-injury are cognitive-behavioural therapy and dialectical behaviour therapy. Cognitive-behavioural therapy (or ‘CBT’) helps you understand the relationship between your thoughts, feelings, and actions. It also teaches you skills like problem-solving and stress management. Dialectical behaviour therapy (or ‘DBT’) teaches you open and flexible ways of thinking. It also teaches skills like acceptance, problem-solving, and coping with difficult or uncomfortable thoughts, feelings, and situations.

It can be very helpful to connect with support groups. They are a place to share your own experiences and learn from others, and help you connect with people who understand what you’re going through. If there isn’t a support group in your area, you may find groups online. Self-help strategies that boost your well-being can also help you work through self-injury.

Self-help might include connecting with family, friends, or a support group, eating well, exercising, getting enough sleep, and spending time on things you enjoy. You’ll find many of these strategies in counselling, but you can practice them on your own, too.

How can I help a loved one?
If you are concerned about a friend or family member, it’s okay to ask about self-injury. Talking about self-injury won’t make someone start hurting themselves. It’s a good idea to learn more about self-injury before you start the conversation. It can be difficult to hear what your loved one has to say. Self-injury may not make sense to you and you may wonder why someone would hurt themself, but your loved one’s feelings are very real. Learning more can help you give support that respects your loved one’s experiences. Many young people aren’t sure what they can do to help a friend. It’s a good idea to talk to someone you trust, like a teacher or school counsellor. There are also help lines and websites to support young people, like the Kids Help Phone. Here are a few more tips for helping a loved one:

Instead of focusing on your loved one’s self-injury behaviours, it may be more helpful to focus on your concern for their well-being.
Don’t demand that your loved one immediately stop self-injuring. New healthy behaviours take time to learn. Instead, focus on supporting new behaviours and celebrate your loved one’s small steps forward.
Avoid guilt, shame or judgement—these can get in the way of open and trusting relationships.
Seek help or support for yourself, if you need it.
Do you need more help?
Contact a community organization like the Canadian Mental Health Association to learn more about support and resources in your area. Founded in 1918, The Canadian Mental Health Association (CMHA) is a national charity that helps maintain and improve mental health for all Canadians. As the nation-wide leader and champion for mental health, CMHA helps people access the community resources they need to build resilience and support recovery from mental illness.