Self Harm

Self-harm is when somebody intentionally damages or injures their body.

Some of the reasons that people may self-harm include:

• expressing or coping with emotional distress
• trying to feel in control
• a way of punishing themselves
• relieving unbearable tension
• a cry for help
• a response to intrusive thoughts

Self-harm may be linked to bad experiences that are happening now, or in the past. But sometimes the reason is unknown.

The reasons can also change over time and will not be the same for everybody.

Common causes of emotional distress

Self-harm is most often described as a way to express or cope with emotional distress.

There are many possible causes of emotional distress. It's often a build-up of many smaller things that leads people to think about self-harm.

Some examples include:

• being bullied
• pressure at school or work
• family arguments or relationship problems
• money worries
• low self-esteem
• struggling with stress, anxiety or depression
• confusion about sexuality
• grief after bereavement or loss
• physical or sexual abuse
• being in contact with the criminal justice system
• experiencing complex mental health difficulties that sometimes cause impulsive behaviour or difficulty controlling emotions, often due to past trauma

There is evidence of a clear link between suicide or suicidal thoughts and people who have previously self-harmed.

However, not everyone who self-harms wants to end their life. Some people describe their self-harm as a way of staying alive by responding to or coping with severe emotional distress.

It's important to find the right support or treatment to help deal with the underlying cause in a less harmful way.

Further information and support

• Mind – Why people self-harm
• YoungMinds – Self-harm
• Harmless – Self-harm support

Finding ways to prevent or distract yourself from self-harm may help you get through a difficult moment. Many people who self-harm will eventually stop on their own.

Do

• try talking about your feelings to a friend, family member, trained volunteer or health professional. You could contact Samaritans, call: 116 123 or email: jo@samaritans.org if you need someone to talk to
• try working out if feeling a certain way leads to your self-harm – for example, when you're feeling sad or anxious you could try expressing that emotion in a safer way
• use Calm Harm A free app providing support and strategies to help you resist or manage the urge to self-harm (Can be downloaded from Google Play or App Store).
• Try MeeToo  A free app for teenagers (11+) providing resources and a fully-moderated community where you can share your problems, get support and help other people too. (Can be downloaded from Google Play or App Store).
• try waiting before you consider self-harm – distract yourself by going out for a walk, listening to music, or doing something else harmless that interests you; the need to self-harm may begin to pass over time
• try calming breathing exercises or other things you find relaxing to reduce feelings of anxiety
• write down your feelings – no one else needs to see it
• read about mental health and wellbeing – including help for common feelings such as stress, anxiety and depression

If you think someone you know has started to self-harm, it's important to approach the subject with care and understanding.

It can be very helpful to just be there and let them know they're not alone. But it's important to remember you may not be able to help them on your own.

Signs someone may be self harming

Physical signs of self-harm

• keeping themselves fully covered at all times, even in hot weather
• unexplained cuts, bruises or cigarette burns, usually on the wrists, arms, thighs and chest
• unexplained blood stains on clothing or tissues
• signs that they have been pulling out their hair

Emotional signs of self-harm

• becoming very withdrawn and not speaking to others
• signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything
• signs of low self-esteem, such as thinking they're not good enough
• talking about ending things or not wanting to go on

There are some things you can try that may help someone feel more supported and able to get help.

Do

• encourage them to speak to a GP or free listening service about self-harm
• ask how they would like to be supported
• let them know you're there for them
• tell them about their positive qualities
• try to understand their emotions and experiences, without judging them, rather than focusing on their self-harm
• consider that any amount of self-harm might be a sign that they're feeling extremely distressed
• let them be in control of their decisions, but get them medical attention if needed

Don’t

• do not try to force them to change what they're doing
• do not threaten to take away their control
• do not insult them, for example by saying they're attention-seeking

Where can you get further help

If you're supporting someone who self-harms you should also make sure you take care of yourself.

These organisations offer information and advice for friends and family:

• Mind – for friends and family of someone who self-harms
• YoungMinds – parents' guide to self-harm support
• British Medical Association – coping with self-harm: a guide for parents and carers (PDF, 3MB)
• University of Nottingham – It's Okay to Talk about Self-harm leaflet