Self-Injurious Behaviors and Suicidality in Borderline Disorder

Many people with borderline disorder engage in self-injurious behaviors such as cutting, burning and small drug overdoses. Cutting is by far the most common act of this type of behavior. About 9 percent of people with the disorder commit suicide. The most frequent means is by drug overdose. Both types of behavior may occur in the same individual. Cutting behaviors double the risk of suicide in people with borderline disorder.

Self-Injurious Behaviors

In addition to cutting and burning themselves, and taking small drug overdoses, people with borderline disorder hit themselves, pull out their hair, scratch their skin to the point they open wounds, and injure themselves in other ways. Most people with the disorder who injure themselves report that they do so mainly to decrease the intense emotional pain they experience. Feeling empty inside may also lead to self injurious behaviors. Remarkably,it is often reported that the first time cutting and other self injurious behaviors occurred, the idea just came to the indivdual. Finally, they report that these acts usually do result in brief emotional relief.

It is important that family and other loved ones understand that this is the main motive of self injurious behaviors, not primarily to manipulate the situation or the people around them, though this is often a secondary motive.

Risk Factors for Suicidality

There are a number of factors that increase the risk that a person with borderline disorder will commit suicide. Although nothing can be done to reverse some of these factors, others are highly treatable, and deserve immediate attention.

Prevalence Across the Life Cycle:

Self-injurious behaviors do not appear to decrease or “burn out” with increasing age in people with borderline disorder, as do other aggressive and impulsive behaviors.

Management of Self-Injurious Behaviors and Suicidality

General Treatment Interventions for Self-Injurious Behaviors and Suicidality:

Specific Treatment Interventions: Medications


Specific Treatment Interventions: Medications-often as needed (PRN) dose of the antipsychotic agent being used; and crisis sessions of Psychotherapy


* Note: If you have borderline disorder and have a tendency to abuse alcohol or drugs, it is essential that you obtain help to abstain completely from doing so.