What is self-harm?
Self-harm is when someone intentionally damages or injures their body.
There are many ways people can intentionally harm themselves, such as cutting or burning their skin, punching or hitting themselves and poisoning themselves with tablets or toxic chemicals.
In most cases, people who self-harm do it to help them cope with overwhelming emotional issues, which may be caused by:
- Social problems – this can include being bullied, having difficulties at work or school, coming to terms with your sexuality, debt or unemployment
- Trauma – this can include experiencing physical or sexual abuse, the death of a close family member or friend, or having a miscarriage
- Psychological problems – this includes having repeated thoughts or voices telling you to self-harm, disassociating (losing touch with who you are and with your surroundings), or borderline personality disorder.
Self-harm is more common than many people realise, particularly among young people, where it is estimated that one in ten self-harms at some point.
This figure is likely to be much higher, as many people who self-harm do not seek help.
With time, space and support people often find other solutions to cope with how they feel, or these feelings are resolved.
Self-harm is a risk factor for suicide, and over half of people who die by suicide have a history of self-harm.
However, many more people self-harm than die by suicide, and it is important to note that many people who self-harm do not want to end their lives.
Getting support
If you have felt like harming yourself or are harming yourself, it may feel as though you don’t have anyone to talk to. But there are people who can listen to you. It may help to:
- tell a friend or relative
- contact your GP (or mental health team if you have one)
- go to the Accident and Emergency department (A&E)
If you are self-harming, your GP can refer you to healthcare professionals at a local community mental health team, or a team based in the hospital within A&E for further assessment.
This medical assessment will result in your care team working out a treatment plan with you to help with your distress. Health professionals know it is not always possible to stop straight away. You may feel ashamed of self-harming but sharing how you are feeling will help.
Just by talking about your worries, fears and distress with someone you can trust can make you feel better. It can also help you to get things clearer in your mind, to feel more hopeful, and to think about possible solutions.
Treatments for self-harm
Treatment for people who self-harm usually involves seeing a therapist. They will help you to discuss your thoughts and feelings, and to understand how they affect your behaviour and wellbeing.
Your therapist can also teach you coping strategies to help prevent further episodes of self-harm.
If you’re badly depressed or have any other mental health problems, then you may be advised to take antidepressants or other medication. Self-harm is often linked to anxiety and depression.
Tips for people who are self-harming
- Self-harm is often a way of dealing with emotional pain, so it is worth trying to identify what feelings make you want to hurt yourself. Once you are aware of your triggers you can take positive steps to reduce or stop the urge to self-harm.
- We can develop coping strategies when trying to cope with overwhelming feelings and emotions. For example, saying the alphabet out loud or holding something cold or warm. When trying out new coping strategies make sure you are safe. Read more on Papyrus.
- Write a safety plan for yourself. This could include details on what you can do for yourself, and who you can speak to if you need support. It can help to have something written down, and it is more likely to work because you choose the kind of support you feel most comfortable with.
- Look after your physical health as well as your mental health. Getting enough sleep, eating healthily and exercising regularly can help you feel more positive.
- You don’t have to cope with all your problems alone. It is important to find support. If you’re under 18, speak to adult you can talk to and trust.
- If you feel you need support from outside your immediate family, think about speaking to another relative, your teacher, school counsellor, school nurse or your social worker (if you have one), or contact an organisation like Childline (0800 1111) or, if you live in Wales, Meic Cymru (080 880 23456).
- In the longer term try different techniques to build your self-esteem. Practicing positive self-talk can help, as can identifying and challenging any negative beliefs you may have about yourself.
Tips for partners, families and carers
People often try to keep self-harm secret because of shame or fear of discovery.
It’s often close family and friends who first notice when somebody is self-harming, and approaching the subject with care and understanding is very important.
If you think a friend or relative is self-harming, look out for any of the following signs:
- unexplained cuts, bruises or burns, usually on their arms, wrists, thighs and chest
- signs of depression, like low mood, tearfulness or a lack of motivation or interest in anything
- self-loathing and expressing a wish to punish themselves
- not wanting to go on and wishing to end it all
- becoming very withdrawn and not speaking to others
- keeping themselves fully covered at all times, even in hot weather
- signs of low self-esteem, like blaming themselves for any problems or thinking they’re not good enough for something
- signs they have been pulling out their hair
- may have issues eating
- may have a problem with drugs or alcohol
People who self-harm can seriously hurt themselves, so it is important to try and encourage them to speak to a GP about the underlying issue.
Resources
NCMH leaflet: Self-harm
Piece of Mind podcast
In this episode we discuss personal experiences of self-harm and coping techniques, the latest research in the field and how misunderstanding and stigma can stop people who self-harm from seeking help.