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Diagnosis and Treatment of Self-Injury

The diagnosis and treatment of self-injury can be difficult unless the person who is hurting him/herself discloses his/her own behavior. Too often the self-injury is kept secret, although sometimes it can be discovered accidentally. For example, a doctor could be doing a routine medical examination and may notice physical signs of self-injury, such as scars or fresh burns.

During an initial evaluation for diagnosis of self-injury, a health care provider may ask you such questions as the following:

• When did your self-injury begin?
• How often do you engage in self-injury?
• What types of self-injury do you use?
• What seems to trigger your self-injury?
• What emotional issues do you face?
• What social networks or relationships do you have?
• What previous treatment, if any, have you had?
• What are your feelings about the future?
• Have you had thoughts of suicide?

A definitive diagnosis for self-injury may require evaluation by a mental health professional (as well as a health care provider), who has with experience in treating self-injury patients. A mental health professional may also want to evaluate you for other mental illnesses that sometimes accompany self-injury, such as depression or personality disorders such as Borderline Personality Disorder.

Treatment of self-injury usually requires both psychotherapy and medications, and emergency or psychiatric hospitalization also sometimes becomes necessary. Whether you yourself engage in self-injury or you have a loved one who does, you need to know that there are ways of overcoming this problem, and that healthier options are available to help you cope with emotional distress.

Treating self-injury takes time and hard work. Treatment for this problem will focus on addressing the underlying reasons that you harm yourself. Because self-injury can become so involved and it is often accompanied by other serious mental disorders, treatment with a mental health care professional who has experience with self-injury issues may be necessary.

Treatment for self-injury typically includes:

• Psychotherapy: Also known as “talk therapy” or counseling, psychotherapy can help you with identifying the underlying reasons why you engage in self-injury. In addition, it will help you learn what triggers your self-injury. In particular, Dialectical Behavior Therapy, a special type of psychotherapy, is frequently used for people who harm themselves. Its main objective is to teach behavioral skills that will help you to tolerate stress, to regulate your emotions, and to improve your relationships with other people. Your therapist may ask you to create what is called a “Safety Plan,” which includes steps for you to take that will prevent an episode of self-injury. In addition to individual therapy, other forms of therapy (family therapy, group therapy, etc.) may also be recommended.
• Medications: Unfortunately, there are no medications that specifically treat self-injury; however, your doctor may recommend Antidepressants or other psychiatric medications which can help improve depression, anxiety, and/or other symptoms of mental disorders. With an improvement in those symptoms, you may feel less compelled to harm yourself.
• Psychiatric hospitalization: If you continue to injure yourself severely or repeatedly, your doctor could recommend psychiatric hospitalization for you. Hospitalization may provide a safe environment and more intensive treatment until you get through the crisis

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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