Self-harm isn’t a mental illness, but it is often linked to mental distress. Everyone has their own reason for self-harming. People who self-harm might not be able to articulate the reasons they feel the need to self-harm, they might just feel like they need to, and know that it feels like helps them in some way. Self-harm doesn’t usually result from one thing, it’s often a complicated combination of thoughts, feelings, events, emotions, distress and overwhelm. It’s common for people to self-harm in secret, but if they don’t, it’s not attention seeking, even if it is a form of communication – they are communicating distress, and possibly seeking care. There is nothing wrong with wanting to be noticed, and to have our distress acknowledged and taken seriously. Self-harm might be a one-off or recurring action. It can become the way a person deals with life’s difficulties because of the temporary relief it brings – for example, digging your nails into your hands while in a difficult situation – you stop when the situation ends. But for people who have an underlying issue the relief is only temporary because the underlying issue is still there.
Self-harm can also occur in relation to ‘good’ things – if a person isn’t used to positive experiences, they can be overwhelming, or of they feel that they don’t deserve them, it can be difficult to deal with the feelings that it causes. Self-harm can be addictive, so it may be the case if someone has engaged in self-harm for a period of time that they are no longer doing it out of choice, but because they feel compelled to. Drinking a lot of alcohol or taking drugs may increase your risk of self-harm. You are more at risk of death if you self-harm because of the risk of accidental suicide. People who engage in self-harm don’t usually want to die, although it can result in death through unintentional suicide. It’s important to note that the degree of harm inflicted by a person to themselves is not an indicator of the level of distress they are in.
I self-harm and want to get help:
If you are struggling with any mental health problems, whether you have a mental disorder or not, you are not alone and help is out there. It’s ok to ask for help – this page lists several sources of help, for general and specific mental health issues.
Its important to seek medical attention for self-harm as soon as possible if that is what you need. You deserve help and you will be given medical help, no matter how the injury was caused. It is important to remember that you are not wasting anyone’s time in seeking help – seeking help for self-harm is a health need and that’s what medical care is there for.
There is no shame in having engaged in self-harm. The sooner you get help, the easier it will be to learn other ways to cope and work towards recovery. But it is possible to learn how to stop self-harming and get support in that process, no matter how long you have been doing it.
It can be hard to know how to start the conversation with someone about self-harming, so think about ways that you can make it easier for yourself. Consider writing it down for someone to read if you don’t think you can say it out loud. Choose someone that you trust to tell, and that you feel comfortable with if you can.
What is self-harm?
Self-harm is harming yourself on purpose. This includes engaging in self-damaging behaviours. It is sometimes also call self-injury.
Who engages in self-harm?
Self-harm can affect anyone of any age or background, but there are certain factors that increase the risk or likelihood of someone engaging in self-harm. For example, younger people tend to self-harm more than older people, especially if they have anxiety or depression.
You are more likely to self-harm if you:
- Have a mental health issue such as
- Borderline personality disorder
- Eating disorder
- Have a substance abuse issue
- Are female
- Are an asylum seeker
- Are part of the LGBTQ+ community
- Have lost someone through suicide
- Are a survivor of any kind of abuse as a child or adult (including bullying)
Reasons that people might self-harm can be grouped into three broad categories:
- Social problems
- Being bullied
- Having difficulties at college or work
- Having relationship difficulties with friends or family
- Coming to terms with sexuality or gender identity
- Coping with expectations of others
- Abuse of any kind
- Death of a close family member or friend
- Having a miscarriage
- Psychological issues
- Having repeated thoughts or voices telling them to self-harm
- Disassociating (losing touch with who they are and their surroundings)
- Borderline personality disorder
- Eating disorders
What causes self-harm?
Generally, a person self-harms because the things we are trying to cope with outweighs our existing coping mechanisms. The reasons can change over time.
You might find it difficult to cope with your moods or how you feel. You might feel like your thoughts and feelings aren’t acceptable to other people. You might not want others to know, as you might be anxious about what they think. You might self- harm to try and deal with strong emotions like anger/ sadness – feelings can be overwhelming like guilt, sadness, or hopelessness. Similarly you might do it to get relief from feelings – you might find them physically uncomfortable; you might feel the need to release tension/ release pressure. You might want to distract yourself from your feelings – you might feel they are unacceptable or unmanageable. If you have memories that are traumatic, you might want to be distracted from them.
You might self-harm as a way to punish yourself for things you think you’ve done wrong – for feelings or behaviours that you think are your fault. Even if you didn’t do anything wrong, you might feel like you hate yourself. You might not understand why you feel this way or be able to link these feelings to something that has happened. You might punish yourself through displaced anger – if you’re angry at someone or something but you can’t express that to the person or sort the situation out. You might do it to feel in control of your body or environment. If you have negative body image you might feel the need to engage in disordered eating behaviours
You might self-harm to help make yourself feel ‘normal’- to feel in control of your day-to-day life. If you feel numb, or if you dissociate (feeling like you are detached from yourself, or reality) it might help you to feel real.
You might self-harm as a way to make others aware of how you are feeling – you might find it hard to put your feelings into words.
Self-harm and urges
When we think about wanting to self-harm, people often describe feeling an ‘urge’ to do so. It can be important to identify what the urge feels like within yourself, as this can tell you that it is time to take steps to keep yourself safe or seek help.
The feelings of an urge to self-harm can include
- Racing heart or feelings of heaviness
- Strong emotions
- A disconnection from yourself or a loss of sensation
- Repetitive thoughts about harming yourself or how you might harm yourself
- Unhealthy decisions like working too hard to avoid feelings
What can I do?
Talking to someone about how you feel can help you feel less alone. This might feel really difficult but saying your feelings or problems out loud can provide relief and release. There might be particular things that trigger your feelings of needing to self-harm. Try to identify what they are, and try to take steps (with help if necessary) to be prepared for the feeling they trigger in you
Grounding techniques can help you to focus on the present moment instead of getting swept away by strong emotions and might help us to remain in control. One example of this involves engaging each of your senses:
- Find five things you can see
- Find four things you can touch
- Find three things you can hear
- Find two things you can taste
- Find one thing you can smell
Delaying self-harm might help you to not self-harm as badly, or maybe not at all. Give yourself an aim, e.g. I’m going to wait X amount of time before I self-harm. Then fill that time with a distractive action – going for a walk, contacting someone etc. As you use this technique, try increasing the amount of time with little by little
Do something symbolic but distractive – try doing something like folding paper, or ripping it up, or if it feels safe to do so, cutting it up. Some people put the pieces of paper into a container as a visual reminder of how they did this action instead of self-harming, and they use it as a celebration of all the times they resisted the urge to harm themselves.
Write down how you are feeling and then tear or rip it up, or keep it to reflect on later. Think about the following questions to help you put words on your feelings:
- Why do I feel the need to hurt myself?
- What has happened to make me feel like this?
- How do I feel right now?
- Have I been here before?
- How did I deal with this in the past?
- What have I done to make myself feel better in the past?
- What else can I do that won’t hurt me?
- Do I need to hurt myself?
- Can I avoid what has made me feel like this, or deal with it differently in the future?
Think about the negative things that you say to yourself when you feel this way. Can you swap it for something nice that you think about yourself, or even something a bit less negative? Try and think about positive things other people have said to you in the past. Write them down and put them somewhere that you will see them regularly
Crying is not a sign of weakness; it is a healthy way to express emotions and those emotions don’t have to be just sadness.
Some other things you can try if you feel the urge to self-harm could include:
- Punch a punch bag or kick something soft
- Scream into a pillow
- Go for a walk or run
- Play a sport, exercise, or go to the gym
- Bites into a piece of ginger or a chilli
- Squeeze or hold an ice cube, or put an ice pack on your chest
- Snap an elastic band or hair bobbin on your wrist
- Go to a friend or relative’s house
- Have a hot bath or a hot or cold shower
- Do something active like clean up or clear out your wardrobe
Remember that recovery from anything is rarely something that proceeds in a straight line, so if you lapse, that’s ok. It doesn’t mean that you have failed
Other things that might help
Harm reduction is a key part of moving away from self-harm. This can include finding different actions to take instead of self-harming. It also might help to ensure where possible that sharp items or things that you tend to use to self-harm are not within your immediate presence when you are feeling vulnerable.
Information on types of self-harm:
People self-harm in different ways, including some of the following:
- Banging/ scratching your body
- Eating or drinking things that are poisonous
- Not letting wounds heal
- Taking too much medication
- Putting ourselves in unsafe situations
- Picking fights where you know you will be hurt
- Skin picking
- Over or under eating
- Over exercising
- Ingesting things that don’t belong in our body
- Drinking too much alcohol