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Suicide vs. Self-Injury: Knowing the Difference and How to Get Help

If you or someone you know is considering suicide, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

“Sometimes, I wonder to myself if people see the scars and think it was just a clumsy accident, or does it run through their minds that I harmed myself? I wonder if they silently have thought about trying it themselves, or if they already have,” Jaimie Schmitz said, sharing her story on TheMighty.com.

Jaimie isn’t alone. Self-injury is relatively common in young adults – 25% of teen girls and 15% of youth overall engage in self-harm, and research has found self-injury is prevalent among adolescents whose close friends or peers engage in similar behaviors.

Self-injury isn’t the same as suicide.

Suicide is an act of escaping pain and suffering by ending one’s life.  A person who is suicidal may feel hopeless, trapped and like there’s no way out, or like there is no sense of purpose in life. They may withdraw from friends and family, show dramatic changes in mood, or even talk about death, dying or suicide.

Self-injury, on the other hand, is a nonsuicidal behavior that serves as a coping mechanism. It may relieve unbearable anguish or emotional numbness, and it can go on for weeks, months or even years. It is often a symptom of mental illness or psychological distress that needs professional treatment. While someone who is hurting himself or herself might be at a risk of suicide, another engaging in this behavior may not be suicidal. Their goal is to relieve feelings of distress.

What’s the difference?

It’s not always easy to discern between nonsuicidal self-injury and a suicide attempt. The only way to really know is to ask the person directly if they are suicidal. Ask directly and without any negative judgement – and do not avoid using the word “suicide.” For example, you could ask:

  1. Are you having thoughts of suicide?
  2. Are you thinking about killing yourself?

If the person says yes or you believe they are feeling suicidal, you can use Mental Health First Aid to help them. In a crisis situation, call 911.

A person who says no may be deliberately self-injuring without the intent of suicide. In this situation, follow up with additional questions about the feelings of distress they might have. Listen nonjudgmentally and help them get appropriate professional care. This could be through a primary care physician, mental health professional, certified peer specialist or psychiatrist.

If you’re not sure how to help, take a Mental Health First Aid course today. Mental Health First Aid teaches people how to identify, understand and respond to mental health and substance use challenges, including nonsuicidal self-injury and suicide. With the right information and resources, you can #BeTheDifference for those who need it most.