Non-suicidal self-injury (NSSI), also referred to as self-injury, is defined as the deliberate damage to one’s own body tissue without suicidal intent. Another term some people use to describe this behavior is deliberate self-harm. However, deliberate self-harm is often used to describe both NSSI and self-injurious behaviors with suicidal intent (e.g., suicide attempt).
This definition of NSSI typically excludes socially acceptable behaviors that cause tissue damage (i.e., body piercing and tattooing), behaviors which result in unintentional or gradual tissue damage (e.g. substance abuse), and self-injurious behaviors associated with developmental disabilities.
The most recent studies suggest 18% of adolescents and 13% of young adults self-injure at least once in their lifetime. People can self-injure at any age, but most people usually start to self-injure between the ages of 12 and 14 years. Some people will only self-injure once, while others will continue to self-injure for a number of years. NSSI is equally common among males and females, however males and females typically use different methods to injure themselves.
People can self-injure for many reasons. The most common reasons for engaging in NSSI are to manage negative emotions and ease unbearable tension, and to punish, or to express anger and hatred towards oneself. People who self-injure can report overwhelming feelings of sadness, anger, and anxiety, and may self-injure to manage these painful emotions.
NSSI may allow people to communicate their distress to others and express their need for help, help people to gain a sense of control over their emotions, may distract people from overwhelming and painful emotions, can help people to feel alive and allow them to feel something other than numb, and may prevent people who self-injure from thinking about or attempting suicide.
The relationship between NSSI and suicidal behavior is complex. Although NSSI is distinct from suicidal behavior, NSSI is a risk factor for later suicidal thoughts and behavior. People who self-injure are nearly three times more likely to consider or attempt suicide than those with no history of NSSI.
Despite the association between NSSI and suicide, there are important distinctions between the two behaviors, which are important to acknowledge when helping someone who self-injures. People who self-injure are not usually trying to end their lives. Indeed, people may self-injure to overcoming thoughts about suicide and avoid attempting suicide.