What is self-harm?

You hurt or harm yourself – on purpose. This can be for any reason, in any situation, and in a number of ways, such as:

• taking too many tablets – an overdose
• cutting yourself
• burning yourself
• banging your head or throw yourself against something hard
• punching yourself
• sticking things in your body
• swallowing things that shouldn’t be swallowed. 

When someone self-harms, they are usually feeling very emotional and distressed. Many describe their self-harm as a way to release overwhelming emotions. Some people plan it in advance, others act on the spur of the moment. Though some people self-harm only once or twice, others do it regularly – and it can become hard to stop.

There are indirect ways of harming yourself. This could be using alcohol or drugs too much and have accidents as a result, having unsafe sex, or the physical harm involved in the bingeing or vomiting of someone with eating disorder. These are not seen as self-harm in the same way.

Other words that are used to describe self-harm

Other words have been used to describe self-harm, but are now going out of use:

• Deliberate self-harm (DSH): we don’t use the word ‘deliberate’ any more. It makes it sound as though the individual is to blame, that their self-harm was a calmly planned action rather than the result of emotional anguish or intense distress.
• Attempted suicide/parasuicide: these phrases assume that harming yourself is the same as wanting to kill yourself – which is often not the case.

How common is self-harm?

• About 1 in 10 young people will self-harm at some point, but it can happen at any age. 
• This is probably an under-estimate because the research is mostly based on people who go to hospital or their GP after harming themselves. And many do not (see below). 
• Many people do not seek help after self-harm. Some types, like cutting, are more secret and less likely to be noticed. 
• In a large study of self-harming adults in hospital, 80% had overdosed and around 15% had cut themselves. In the community, cutting is probably a more common way of self-harming than taking an overdose. 

Who self-harms?

It seems to happen more often in:

• young people
• prisoners, asylum seekers,  and veterans of the armed forces
• gay, lesbian, bisexual and transgender people – this may be due to the stress of prejudice and discrimination 
• a group of young people who self-harm together- having a friend who self-harms may increase your chances of doing it as well
• people who have been neglected or experienced physical, emotional or sexual abuse during childhood.

What makes people self-harm?

Many people who harm themselves are struggling with intolerable distress or unbearable situations – and they will often have struggled like this for some time before they self-harm. 

Common problems include:

• feeling depressed.
• feeling bad about yourself.
• physical or sexual abuse .
• relationship problems with partners, friends, and family. 
• being unemployed, or having difficulties at work. 

You are more likely to harm yourself if you feel:

• That people don’t understand you or listen to you properly.
• Hopeless. 
• Isolated, alone. 
• That you have no power or control over your life. 

Many people who self-harm may also have alcohol or drug use problems, though this is not always the case. 

How does self-harming make you feel?

Self-harm can give you a sense of control and reduce uncomfortable feelings of tension and distress. If you feel guilty, it can feel like a way of punishing yourself. Either way, it can become a way to deal with negative feelings and distress.

Does self-harming mean I am mentally ill?

This may – or may not be – not be the case. You can, however, find that you also feel depressed, have trouble with managing or controlling your emotions, difficulty connecting with others, and alcohol or drug problems. So it is still a good idea to get some help and support.

Is self-harm the same as attempted suicide?

This is not usually so. But, if you do start to harm yourself, you are more likely than other people to die through suicide. Anyone who self-harms should be taken seriously and offered help.

Getting help

What if I don’t want to stop self-harming?

If you decide that you don’t want to stop self-harming, you can still:

• Reduce the damage to your body by using a method that is not so harmful.
• Keep thinking about how to tackle the problems that make you self- harm.
• Every so often, re-consider your decision not to stop. 

What if you want to stop self-harming?

If you can say YES to half (or more) of the questions below, or more, then it might be time to try stopping.

• Is there someone who knows about my self-harm who I can contact if I get desperate?
• Have I found at least two alternative safe ways to reduce the feelings that lead me to self-harm? 
• Am I able to tell myself, and to believe, that I want to stop hurting myself?
• Can I say to myself that I WILL tolerate feelings of frustration, desperation, and fear?
• Is there a professional who can also give me support and help in a crisis?

If I harm myself and need treatment?

You have the right to be treated with courtesy and respect by the doctors and nurses in the emergency department.

Many emergency departments now have easy access to a health professional who is familiar with self-harm. This could be a psychiatric nurse, a doctor, or a social worker. They will talk with you about how you are feeling and work out ways help you. Staff may want to do a risk assessment by going  through a questionnaire with you.

What can I do if I know someone who self-harms?

It can be very upsetting to be close to someone who self-harms – but there are things you can do. It’s The most important to listen without judgment and to not be critical. This can be very hard if you are upset yourself – and perhaps frightened and angry  about what they are doing. Try to concentrate on them rather than your own feelings – although this can be hard.

Do

• Talk to the person when they feel like self-harming. First, try to acknowledge and understand their feelings. You may then be able to talk about more positive things. 
• Help them find out more about self-harm.  You could show them this leaflet, or find resources online, or at the local library. 
• Find out about getting help – maybe offer to go with them to see someone, such as their GP. 
• Help them to see their self-harm as an ordinary problem that requires support and understanding, not as something secret and shameful. 

Don’t

• Try to be their therapist – you can best help by being their friend, relative or partner. 
• Expect them to stop overnight – it usually takes time and effort. 
• React strongly, with anger, hurt, or upset. This will probably make them feel even worse – and this makes it harder to change.  
• You can, honestly and openly, tell your friend or relative about the effect their self-harm has on you.  But you have to be calm to do this , so that you can talk in a way that shows how much you care for them. 
• Struggle with them when they are about to self-harm. It’s better to walk away and to suggest they come and talk to you about it rather harm themselves. 
• Make them promise not to do it again. 
• Say that you won’t see them unless they stop self-harming.  
• Feel responsible for their self-harm or become the person who is supposed to stop them. Make sure that you have someone to talk to as well – so that you also get the support you need too.