Self-harm. What is it?

Self-harm is when somebody intentionally damages or injures their body. It’s usually a way of coping with or expressing overwhelming emotional distress.

Sometimes when people self-harm, they feel on some level that they intend to die. Over half of people who die by suicide have a history of self-harm.

However, the intention is more often to punish themselves, express their distress or relieve unbearable tension. Sometimes the reason is a mixture of both.

Self-harm can also be a cry for help.

Frequency

Self-harm is more common than many people realise, especially among younger people. It’s estimated around 10% of young people self-harm at some point, but people of all ages do.

In most cases, people who self-harm do it to help them cope with overwhelming emotional issues, which may be caused by:

  • social problems – such as being bullied, having difficulties at work or school, having difficult relationships with friends, family or partners, coming to terms with their sexuality if they think they might be gay or bisexual, or coping with cultural expectations, such as an arranged marriage
  • trauma – such as physical or sexual abuse, the death of a close family member or friend, or having a miscarriage
  • psychological causes – such as having repeated thoughts or voices telling them to self-harm, disassociating (losing touch with who they are and with their surroundings), or borderline personality disorder

These issues can lead to a build-up of intense feelings of anger, guilt, hopelessness and self-hatred. The person may not know who to turn to for help and self-harming may become a way to release these pent-up feelings.

Cause and symptoms of it

People often try to keep self-harm a secret because of shame or fear of discovery. For example, if they are cutting themselves, they may cover up their skin and avoid discussing the problem. It’s often up to close family and friends to notice when somebody is self-harming, and to approach the subject with care and understanding.

Look out for any of the following signs:

  • unexplained cuts, bruises or cigarette burns, usually on their wrists, arms, thighs and chest
  • keeping themselves fully covered at all times, even in hot weather
  • signs of depression, such as 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  • becoming very withdrawn and not speaking to others
  • changes in eating habits or being secretive about eating, and any unusual weight loss or weight gain
  • signs of low self-esteem, such as blaming themselves for any problems or thinking they’re not good enough for something
  • signs they have been pulling out their hair
  • signs of alcohol or drugs misuse

Treatments

Self-Harm is an area that is particularly difficult for those who have never experienced these problems to understand, which could result in feelings of alienation for those who self-harm.

Treatment for people who self-harm usually involves seeing a therapist to discuss your thoughts and feelings, and how these affect your behaviour and wellbeing. They can also teach you coping strategies to help prevent further episodes of self-harm. If you’re depressed, it could also involve taking antidepressants or other medication.