Sometimes when people self-harm, they feel on some level that they intend to die. More than half of people who die by suicide have a history of self-harm.
But the intention is more often to punish themselves, express their distress, or relieve unbearable tension. Sometimes it's a mixture of all three.
Self-harm can also be a cry for help.
If you're self-harming, you should see your GP for help. They can refer you to healthcare professionals at a local community mental health service for further assessment.
This assessment will result in your care team working out a treatment plan with you to help with your distress.
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 badly depressed, it could also involve taking antidepressants or other medication.
Lifeline freephone helpline
If you're at risk of self-harm or feeling anxious, you can telephone Lifeline. The helpline is confidential, free and open 24 hours every day. If you're concerned about a friend or family member, you can also contact Lifeline for advice.
Lifeline is a free, confidential telephone helpline. It is available anytime every day.
- telephone 0808 808 8000
Types of self-harm
There are many different ways people can intentionally harm themselves, such as:
- cutting or burning their skin
- punching or hitting themselves
- poisoning themselves with tablets or toxic chemicals
- misusing alcohol or drugs
- deliberately starving themselves (anorexia nervosa) or binge eating (bulimia nervosa)
- exercising too much
People often try to keep self-harm a secret because of shame or fear of discovery.
For example, if they're 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.
Signs of self-harm
If you think a friend or relative is self-harming, 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
People who self-harm can seriously hurt themselves. So it's important that they speak to a GP about the underlying issue and request treatment or therapy that could help them.
Why people self-harm
Self-harm is more common than many people realise, especially among younger people.
It's estimated about 10 per cent of young people self-harm at some point, but people of all ages do.
This figure is also likely to be an underestimate, as not everyone seeks help.
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 problems at work or school, having difficult relationships with friends or family, 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.
Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police.
Although some people who self-harm are at a high risk of suicide, many people who self-harm don't want to end their lives.
In fact, the self-harm may help them cope with emotional distress so they don't feel the need to kill themselves.