What is self-harm?
Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themself is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing. Extreme injuries can result in broken bones.

Hurting yourself—or thinking about hurting yourself—is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term.

Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended. And it takes time and energy away from other things you value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships.

Why people self-harm?
Self-harm is not a mental illness, but a behavior that indicates a need for better coping skills. Several illnesses are associated with it, including borderline personality disorder, depression, eating disorders, anxiety or posttraumatic distress disorder.

Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at the most risk are people who have experienced trauma, neglect or abuse. For instance, if a person grew up in an unstable family, it might have become a coping mechanism. If a person binge drinks or uses illicit drugs, they are at greater risk of self-injury, because alcohol and drugs lower self-control.

The urge to hurt yourself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring yourself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. Or if a person doesn’t feel many emotions, they might cause themself pain in order to feel something “real” to replace emotional numbness.

Once a person injures themself, they may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt themself again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it.

Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting themself, they may be at an increased risk of feeling suicidal. It’s important to find treatment for the underlying emotions.

What to do when someone self-harms?
Perhaps you have noticed a friend or family member with frequent bruises or bandages. If someone is wearing long sleeves and pants even in hot weather, they may be trying to hide injuries or scarring.

Keep in mind that this is a behavior that might be part of a larger condition and there may be additional signs of emotional distress. They might make statements that sound hopeless or worthless, have poor impulse control, or have difficulty getting along with others. If you’re worried a family member or friend might be hurting themself, ask them how they’re doing and be prepared to listen to the answer, even if it makes you uncomfortable. This may be a hard subject to understand. One of the best things is to tell them that while you may not fully understand, you’ll be there to help. Don’t dismiss emotions or try to turn it into a joke.

Gently encourage someone to get treatment by stating that self-harm isn’t uncommon and doctors and therapists can help. If possible, offer to help find treatment. But don’t go on the offensive and don’t try to make the person promise to stop, as it takes more than willpower to quit.

Advice
Keeping safe
Self-harm is not a positive way to deal with things. However if you are self-harming it can be difficult to stop, especially when you feel distressed or upset. If you don’t feel you can stop right now, it is important that you do keep yourself safe.

Wounds and injuries of any type can be dangerous and carry the risk of infection, which can be serious, so they need to be looked after. If you have serious injury, feel unwell or feel that you are going into shock (fast breathing, racing heart, feeling faint or panicked) you should seek help immediately. If you find yourself in this situation, find a trusted adult or friend who can get you the medical attention you need. This doesn’t mean you have to discuss your self-harm with them (although it may help); it is about allowing someone to support you medically in a moment of crisis.

Many people stop hurting themselves when the time is right for them. Everyone is different and if they feel the need to self-harm at the moment, they shouldn’t feel guilty about it – it is a way of surviving, and doing it now does NOT mean that they will need to do it forever. It is a huge step towards stopping when they begin to talk about it, because it means that they are starting to think about what might take its place eventually.

Make a safe box and a plan
You can create a safe box to help you through times when you feel overwhelmed by emotion and have the urge to harm yourself. Fill it with things that make you happy and calm, to help you to get through this feeling. Some suggestions: activities such as crosswords, your favourite book, CD or movie. You could also include a list of things to do that make you calm when you are feeling triggered.

Talk to someone
When you are feeling overwhelmed, talk to a friend, family member or trusted adult. Let them know what you are thinking. This can help relieve the pressure that you are feeling. Make a list of people you can talk to at these times and keep it somewhere safe. Knowing who you can talk to in times of crisis at 3am, weekends or when you are at school can make it easier to ask for help when you need it. Add these to your safe box. This will remind you that you are not alone and there are people you can talk to when you need to.

Avoid alcohol and drugs
We often drink alcohol or take drugs to change our mood or to avoid our feelings. Some people drink to deal with fear or loneliness, but like self-harm the effect is only temporary and can end up making you feel worse. [28] Alcohol is a depressant, which means it slows down brain activity. This changes how you think and feel, so can increase feelings of anxiety and depression. When it wears off you can end up feeling worse because of the effects it has on your brain and your body.

Do something you enjoy and relief you anger
Remember that there is more to you than self-harm. Do things that remind you of this and make you happy. Maybe this is a sport, or a hobby you like doing such as writing.

Doing things that you enjoy and makes you feel happy, helps you look after your mental health. It helps to improve your self-esteem and can help you remember that you are important and have value. When you feeling angry:
– Hit a pillow or cushion to vent your anger and frustration.
– Have a good scream into a pillow or cushion.
– Take a minute and breathe or meditate

Don’t be too hard on yourself
Many young people who self-harm can be perfectionists and high achievers [31]. You might put pressure on yourself to do things in a certain way, or feel that nothing you do is good enough.

Try to not be so hard on yourself about not getting things perfect. Recovery is about knowing that it is okay for your work or performance to be ‘good enough’.