Self mutilation

Definition

Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide.

Causes

Self-mutilation may be caused by associated psychological problems. Self-mutilation may be done to release emotional pain, anger, or anxiety. It may also be done to rebel against authority, flirt with risk-taking, or feel in control. In some cases, the behavior is outside your emotional control and related to a neurological or metabolic disorder.

Brain—Psychological Organ

Self-mutilation is often associated with psychiatric disorders that may be caused by chemical imbalances in the brain.

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Risk Factors

Self-mutilation is more common in females and adolescents. Other factors that may increase your chance of self-mutilation include:

• Childhood sexual, physical, or emotional abuse
• Violence or other abusive relationships in a child's home
• Being in prison
• Intellectual disability
• Psychiatric disorders, such as:
  • Psychosis
  • Borderline personality disorder
  • Depression
  • Antisocial personality disorders
  • Post-traumatic stress disorder
• Certain metabolic disorders
• Alcohol use disorder or drug abuse
• Eating disorders, such as anorexia or bulimia

It can also be associated with neurologic or metabolic disorders such as:

• Tourette syndrome
• Autism
• Lesch-Nyhan syndrome

Symptoms

The symptoms of self-mutilation vary. The most common symptoms include:

• Cutting of skin with a sharp object
• Skin carving or burning
• Self-punching or scratching
• Needle sticking
• Head banging
• Eye pressing
• Finger, lips, or arm biting
• Pulling out one's hair
• Picking at one's skin

Certain behavioral symptoms can be signs of self-multilation. These may include:

• Wearing long sleeves or pants, even in hot weather
• Claiming to have frequent accidents
• Relationship difficulties
• Behavioral and emotional difficulties

Rarely, in very severe cases, self-mutilation can include:

• Broken bones
• Amputation
• Castration
• Eye damage
• Suicide

Diagnosis

Self-mutilation can be difficult to diagnose. People who self-mutilate often feel guilty and ashamed about their behavior. They may try to hide it. Physical harm caused by self-mutilation may be the first sign noticed during an exam. To be diagnosed, symptoms should meet the following criteria:

• Excess thinking about physically harming oneself
• Inability to resist harming oneself, resulting in tissue damage
• Increased tension before and a sense of relief after self-injury
• Having no suicidal intent in the self-mutilation

To make an accurate diagnosis, the psychologist or psychiatrist will assess other conditions, such as personality or mood disorders, and whether there is suicidal intent. A psychosocial assessment may also be given to assess a person’s mental capacity, level of distress, and presence of mental illness.

Treatment

Treatment usually includes medical and psychological treatment, as well as medications.

Medical Treatment

A doctor will assess whether care needs to be provided right away to treat or prevent further injury.

Psychologic Treatment

Psychologic treatment may be done either one-to-one or in a group setting. It is usually aimed at finding and treating the underlying emotional difficulty, trauma , or disorder. It may also include cognitive behavioral therapy .

Medications

Medications used include:

• Antidepressants
• Antipsychotics
• Mood regulators
• Anticonvulsants

Prevention

The best prevention is to get help as soon as possible for depression, trauma, emotional problems, or other disorders that may lead to self-mutilation.