Self-harm

Self-harm is when somebody intentionally harms or injures them self. This is often a way of coping with or expressing feelings and emotions that become overwhelming and overpowering to the individual.1

Self-harm describes any behaviour where someone causes harm to them self, usually as a way to help someone cope with difficult or distressing thoughts and feelings.2 It most frequently takes the form of cutting, burning or non-lethal overdoses, however it can be any behaviour that causes injury, no matter how minor or high risk the behaviour.3

Any behaviour that that causes harm or injury to someone as a way to deal with difficult emotions can be seen as self-harm.

The UK has the highest self-harm rate of any country in Europe with estimates of 400 in 100,000 people self-harm.4 These figures are likely to be higher as many people who self-harm do not tell anyone about it. Self-harm can affect anyone however the majority of people who report self-harm are aged between 11 and 25.5

High rates of self-harm are reported by individuals who also have borderline personality disorder6, depression7 and eating disorders.8

The self-harm cycle

Self-harm usually starts as a way to relieve the build-up of pressure caused by distressing thoughts and feelings. For some people, self-harming might give them a temporary relief from the emotional pain that they are feeling. It’s important to know that this relief and ‘feeling better’ is only temporary because the underlying reasons still remain. Soon after feelings of guilt and shame might follow which can continue the cycle of self-harm.9

Because initially the individual experiences may feel a temporary relief from the emotional pain they feel, it can be easy to slip into these behaviours and self-harm can become someone’s normal way of dealing with life’s difficulties. It is important to talk to someone as early as possible to get support and help. Learning new coping strategies to deal with stress can make it easier to break the cycle of self-harm in the long term.

Why do people self-harm?

Everyone has things that stress them out and worries them. For some people, they can manage these troubles by talking to friends and family, while for others these difficulties can feel overwhelming.

When we don’t express our emotions and talk about the things that make us distressed, angry or upset, the pressure can build up and become unbearable. Some people turn this in on themselves and use their bodies as a way to express the thoughts and feelings they can’t say aloud.

When it all gets too much, this is when some people harm themselves. If you self-harm, you might find that when you feel angry, distressed, worried or depressed, you feel the urge to hurt yourself even more. Someone’s reason to self-harm can be very different from other people who self-harm.

Some of the reasons that young people report as triggers or reasons that lead them to self-harm include:

  • difficulties at home.
  • arguments or problems with friends.
  • bullying.
  • depression.
  • anxiety.
  • trauma.
  • low self-esteem.
  • transitions and changes, such as changing schools.
  • alcohol and drug use.

Treatment

If you are worried about self-harm it is important that you speak to your GP or a health professional who can put you in touch with the appropriate treatment to help support you. This may include treating the injuries caused by self-harm directly or it may require helping to treat the underlying cause which leads to the self-harm behaviour, for example depression or borderline personality disorder.

There are a wide range of local counselling services, IAPT services and self-help support groups available. Talk to your GP for information about services close to you or follow the links at the bottom of the page for help and support

Treatment for an injury or overdose is available at A&E, the minor injuries unit or your GP surgery, depending on severity. If you are worried about an injury or an overdose of alcohol, drugs or other toxic substances it is important that you call 999 and get help immediately.10

Treatment can vary depending on severity and the nature of self-harm and may include:11

  • brief psychological therapy such as cognitive behavioural therapy
  • intensive psychological therapy such as dialectical behavioural therapy  
  • psychiatric care
  • medication
  • self-help support 
  • group therapy.

Recovery

It is important to remember that recovery is entirely possible with the right help and support. Recovery involves understanding why someone uses self-harm, thinking about how you might like to cope differently and developing different strategies for dealing with emotions and difficulties.

The longer someone self-harms the harder it is to break the cycle, so it is important that if you are worried about self-harm you seek-help early.

References

1National Self Harm Network. “What is Self-Harm?” Available at: http://www.nshn.co.uk/whatis.html [Accessed on 17/11/15].

2National Self Harm Network. “What is Self-Harm?” Available at: http://www.nshn.co.uk/whatis.html [Accessed on 17/11/15].

3PSHE Association (2015). ‘Teacher guidance: preparing to teach about mental health and emotional wellbeing.’ Available at: https://pshe-association.org.uk/resources_search_details.aspx?ResourceId=570&Keyword=&SubjectID=0&LevelID=0&ResourceTypeID=3&SuggestedUseID=0 [Accessed 01/02/16].

4Horrocks, J., House, A. & Owens, D. (2002). Attendances in the accident and emergency department following self-harm; a descriptive study. University of Leeds, Academic Unit of Psychiatry and Behavioural Sciences.

5NICE (2003). “Self-harm in over 8s: long term management.” Clinical Guideline 133. Available at: https://www.nice.org.uk/guidance/cg133/resources/selfharm-in-over-8s-longterm-management-35109508689349 [Accessed on 17/11/15]

6Haw, C., Hawton, K., Houston, K. & Townsend, E. (2001). Psychiatric and personality disorders in deliberate self-harm patients. Br J Psychiatry.178, 48–54.

7Skegg, K. (2005). Self-Harm. Lancet, 366, 1471-1483.

8Claes, L. & Muelhlenkamp, J.J. (Eds). (2014). Non-suicidal self-Injury and Eating Disorders: Dimensions of Self-Harm. Springer: London.

9Brain, K.L., Haines, J. & Williams, C.L. (1998). The psychophysiology of self-mutilation: Evidence of tension reduction. Archives of Suicide Research.4 (3).

10NHS Choices (2015). “Self-Harm – Getting Help.” Available at: http://www.nhs.uk/Conditions/Self-injury/Pages/Treatment.aspx [Accessed on 17/11/15].

11NHS Choices (2015). “Self-Harm – Getting Help.” Available at: http://www.nhs.uk/Conditions/Self-injury/Pages/Treatment.aspx [Accessed on 17/11/15].