Encourage the person to seek support for themselves, or offer to help them make contact with one or more of the suggested supports. If your child, friend or other family member is self-harming, or you think they might be, seeking support from a mental health professional is important for you too. However, upsetting it can be to see a loved one in trouble, remember that self-harming behaviour is treatable and not everyone who self-harms is suicidal. Usually they are deeply ashamed and go to great lengths to hide it from others.
They may suffer in silence and really need support to open up about how they are feeling. No one has to cope alone; self-harming behaviour is treatable. Support can include working on recognising triggers, learning how to manage difficult emotions and help with self-care such as caring for wounds and learning other coping strategies.
For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. It can take time to break the cycle of self-harm and there may be setbacks along the way. It can be difficult to break away from self-harm. Treatment will include learning to find other ways to manage intense feelings. By distracting or diverting the behaviour, feelings and urges may become less intense and decrease over time. The person who is self-harming may like to develop their own ways to distract themselves, or use some of these ideas:.
People of all ages self-harm, but young people are more at risk. It is more common among girls than boys, and usually starts around the ages of 12 to 14 years, just after the onset of puberty. Aboriginal and Torres Strait Islander young people aged 15—24 are five times more likely to self-harm than non-Indigenous young people. There are many reasons why people self-harm. Even for one person the motivation can vary.
Some people do it as a way of expressing their distress, taking back control or escaping from situations they find troubling. Some people find self-harm gives them a sense of relief. Whatever the reason, self-harm is normally a sign that a person is feeling intense emotional pain and distress. For young people, many stressful things stressors happen all at once.
Unless the problems that are causing the self-harming behaviour are addressed, people will continue to use it as a way to cope. Unfortunately, self-harm can be dangerous — it can lead to serious injury and even accidental death.
It can also lead to a higher risk of developing physical and mental health issues, substance misuse and unemployment. Some people who self-harm have feelings of shame, self-loathing and helplessness and may have suicidal thoughts. Many people who attempt suicide have a history of self-harm. This page has been produced in consultation with and approved by:.
A person with agoraphobia is afraid to leave familiar environments, because they are afraid of having a panic attack. The Alexander technique stresses that movement should be economical and needs only the minimum amount of energy and effort. Know that you are not alone, push through the anxiety of sharing to get help. Some people who cut have had a traumatic experience, such as living through abuse , violence, or a disaster. Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic experience.
Or it may be a way of reliving the pain they went through, expressing anger over it, or trying to get control of it. Although cutting may provide some temporary relief from a terrible feeling, even people who cut agree that it isn't a good way to get that relief. For one thing, the relief doesn't last.
The troubles that triggered the cutting remain — they're just masked over. People don't usually intend to hurt themselves permanently when they cut. And they don't usually mean to keep cutting once they start.
But both can happen. It's possible to misjudge the depth of a cut, making it so deep that it requires stitches or, in extreme cases, hospitalization. Cuts can become infected if a person uses nonsterile or dirty cutting instruments — razors, scissors, pins, or even the sharp edge of the tab on a can of soda. Most people who cut aren't attempting suicide. Cutting is usually a person's attempt at feeling better, not ending it all.
Although some people who cut do attempt suicide, it's usually because of the emotional problems and pain that lie behind their desire to self-harm, not the cutting itself. Cutting can be habit forming. It can become a compulsive behavior — meaning that the more a person does it, the more he or she feels the need to do it. The brain starts to connect the false sense of relief from bad feelings to the act of cutting, and it craves this relief the next time tension builds.
When cutting becomes a compulsive behavior, it can seem impossible to stop. So cutting can seem almost like an addiction, where the urge to cut can seem too hard to resist. A behavior that starts as an attempt to feel more in control can end up controlling you. Cutting often begins on an impulse. It's not something the person thinks about ahead of time. Shauna says, "It starts when something's really upsetting and you don't know how to talk about it or what to do.
But you can't get your mind off feeling upset, and your body has this knot of emotional pain. Before you know it, you're cutting yourself. And then somehow, you're in another place. Then, the next time you feel awful about something, you try it again — and slowly it becomes a habit. Natalie, a high-school junior who started cutting in middle school, explains that it was a way to distract herself from feelings of rejection and helplessness she felt she couldn't bear.
I guess part of me must have known it was a bad thing to do, though, because I always hid it. Once a friend asked me if I was cutting myself and I even lied and said 'no.
Sometimes self-injury affects a person's body image. Psychologist Dr. Vijayeta Sinh, PhD, owner of NYC Family Therapy , says children as young as 9 and 10, teens, college students, and even adults in their 40s and 50s cut. Kirsten began cutting when she was 13 years old after her father made an insensitive comment about her acne.
Her self-esteem, she says, was already low. Penny, 36, first cut herself when she was 15 years old as a way of dealing with the emotional pain of having been raped by a family friend. She cut when she was depressed and would shut down emotionally. SIRRR reports that self-harm can be cyclical.
Someone may cut frequently and then stop for long periods before relapsing. After suffering physical and verbal abuse at the hands of her older brother, she cut herself from ages 11 to People who cut often describe a specific type of high, relief, connectedness, or sense of calm.
The euphoria Brandy describes may be attributed to endorphins the body releases when we get injured. Sinh explains. Another woman we spoke to, Ariel, 21, started cutting when she was 17 years old. I cut myself because I was bored. I justified my reasons and came up with excuses because I loved it.
Who do I tell? For example, you may want to tell: a friend or family member, your GP, someone on an emotional support line, where you can remain anonymous if you prefer. What do I tell them? When do I say it?
Where do I tell them? Why am I telling them? You might tell them because: you want to share that you self-harm or why you do it, you might feel that you have given them the wrong impression about how you feel or why you self-harm, or you want support to stop self-harming. What do I do if they struggle to understand? The two main ways recommended by NICE to manage self-harm are: Short term management of self-harm, and Long term management of self-harm.
There is no safe way to self-poison. Your GP should still monitor your physical health. Long-term management of self-harm If you need long-term management for your self-harm, your GP may offer you an assessment with your local community mental health team CMHT.
This should contain information such as: how to stop your self-harm from getting worse, how to reduce or stop harm caused by your-self harm, how to lessen risky behaviours, how to improve your ability to function, and how to improve your quality of life.
Your care plan should also: identify goals that you would like to achieve in life, such as employment goals, identify team members and what they should be doing for you, include a risk management plan, identify short term goals linked to your-self harm, and be shared with your GP.
It should look at: current risk, long term risk, things that increase your risk of self-harm, and a crisis plan. You may be offered: cognitive behavioural therapy, psychodynamic therapy, or problem solving therapy. Your therapist should help you understand the reasons why you self-harm. Ending care with the specialist mental health team When your treatment and care is due to end professionals should: tell you what is likely to happen when your care ends tell you ahead of time so that you can get used to the change give you extra support if you need it, make sure you have a clear crisis plan in place, share your care plan with any other professionals who are taking over your care, give you a copy of your plan and what has been agreed, and give your family or carer a copy of the plan if you agree You can find more information: Talking Therapies by clicking here.
Care Programme Approach by clicking here. Medication — choice and managing problems by clicking here. What if I am not happy with my treatment? There is more information about these options below. Treatment options You should first speak to your doctor about your treatment. Second opinion A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. Advocacy Advocates help you to deal with and overcome issues that you have.
These are available in all areas. Community or mental health advocates can support you to get a health professional to listen to your concerns. These are available in some areas only.
You can find out more about: Second opinions by clicking here. Advocacy by clicking here. Complaints about the NHS or social services by clicking here. Going to hospital What will happen if I need to go to hospital? The assessment is to understand your: physical risk of harm, your mental state, your mental capacity, your willingness to stay in hospital for further assessments, your distress level, and any possible mental health issues Everyone who self-harms should: have treatment for serious injuries, have a risk assessment, and be offered a needs assessment.
Have you been drinking or taking illegal drugs? Why did you self-harm? Do you have a history of self-harm? Do you have a mental health condition? Do you have mental capacity? Do you have a plan to kill yourself? Are you feeling hopeless or depressed? You may have a risk assessment and needs assessment at the same time. You can leave if you want to unless: Professionals have assessed you and think you lack capacity to make that decision.
Or, You are detained under the Mental Health Act. You can find more information about: The Mental Health Act by clicking here. Mental capacity and mental illness by clicking here. Stay in hospital. You may be kept in hospital overnight.
You may be kept in hospital if you were going to go back to an unsafe place. This may be because you were too distressed or under the influence of alcohol or drugs. An assessment of your needs should be done with you as soon as possible. You may be referred for further assessment and treatment. This will be a joint decision between you and health care professionals. The decision to refer you should be based on the assessment of your needs and risk.
You may be discharged without a follow up appointment. This decision will be based on your needs assessment and risk. The assessment should be written in your medical notes and passed to your GP and any other relevant mental health services.
Helping myself How can I help myself? Delay self-harm You may self-harm straight away when you are distressed. Non-harmful ways to manage how I feel Talk to someone who understands. If you feel that you have to self-harm, try the following instead: Write down how you are feeling and then tear it up or rip it up.
Punch a punch bag or kick something soft. Scream into a pillow. Go for a walk. Play a sport, exercise or go to the gym. Bite into a piece of ginger or a chilli. Squeeze an ice cube as hard as you can. Snap elastic bands on your wrist.
Form an image of yourself feeling empowered. For example, try imagining yourself as superhero. Or try to remember a time you felt strong and positive about yourself. If you are feeling low or anxious you could try the following. Pamper yourself. Have a bath with bath oil. Do something active. Clean up or clear out your wardrobe. Choose a random object and think of 10 different uses for it.
Before harming, write down the answers to these questions. Why do I feel I need to hurt myself? What has happened to make me feel like this? How do I feel right now? Have I been here before? What did I do to deal with it? How did I feel then? What have I done to make myself feel better before? What else can I do that won't hurt me? Do I need to hurt myself? How will I feel when I am hurting myself? How will I feel after hurting myself? How will I feel tomorrow morning? Can I avoid what has made me feel like this, or deal with it better in the future?
Make sure anything you cut yourself with is clean. For example, use new blades. Think carefully about where you cut. Avoid areas such as the insides of the wrists or the tops of the legs, as it can be risky to cut here. Make sure you are up to date with your tetanus jab.
Tetanus is a serious infection. Scar tissue may not be as strong as your skin. Think about cutting down on or avoiding drugs or alcohol. They can affect your judgement. Learn first aid and keep first aid supplies nearby. Such as antiseptic wipes and bandages. Have an emergency plan, such as keeping a phone nearby so that you can ring an ambulance if you need to. Set yourself limits before you self-harm and stick to them. Such as decide how many cuts you will make and how big they will be.
This is a good way of learning the skills you need to stop. Try other techniques such as snapping elastic bands on your wrist. If you self-harm by hitting yourself, put towels, or something else around your fists to soften the blow. Think of other options instead of swallowing medication or substances.
See the previous section for ideas. How can I deal with my scars? How can I deal with questions about my scars? You could think about what you want to say if someone asks you. How can I reduce my scars?
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