Self-harm is when somebody intentionally damages or injures their body. It is a way of coping with or expressing overwhelming emotional distress.
Sometimes when people self-harm they intend to die but often the intention is more to punish themselves, express their distress or relieve unbearable tension. Self-harm can also be a cry for help.
Your doctor will usually offer to 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.
Treatment for people who self-harm will usually involve seeing a therapist to discuss your feelings and thoughts and how these affect your behaviour and wellbeing. If you are badly depressed it could also involve taking antidepressant medication.
Read more about getting help if you self-harm.
Self-harm is more common than many people realise, especially among younger people. A survey of people aged 15-16 years carried out in the UK in 2002 estimated that more than 10% of girls and more than 3% of boys had self-harmed in the previous year.
In most cases, people who self-harm do it to help them cope with unbearable and overwhelming emotional issues, caused by problems such as:
These issues can lead to a build-up of intense feelings of anger, hopelessness and self-hatred.
Although some people who self-harm are at a high risk of ending their lives, many people who self-harm do not 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.
Read more about the causes of self-harm.
There are many different ways people can intentionally harm themselves, such as:
People often try to keep self-harm a secret because of shame or fear of discovery. For example, they may cover up their skin and avoid discussing the problem.
Therefore, it is often up to close family and friends to notice when somebody is self-harming, and to approach the subject with care and understanding. The signs may include unexplained injuries and signs of depression or low self-esteem.
Someone who is self-harming can seriously hurt themself, so it is important that they speak to a doctor about the underlying issue and request treatment or therapy that is likely to help them.
Read more about the signs of self-harm.
There are many different forms of self-harm and they are not always easy to notice.
People who self-harm usually try to keep it a secret from their friends and family and often injure themselves in places that can be hidden easily by clothing.
If you suspect that a friend or relative is self-harming, look out for any of the following signs:
If you are worried about someone who is self-harming, there are a some things you can do to help them:
It's important not to react in a strongly negative or critical way (such as getting angry), as this kind of reaction is likely to make the problem worse.
If they don't want to discuss their self-harm with you, you could suggest they speak to an anonymous helpline or see their doctor.
Read more about getting help for self-harm.
There are many reasons why people self-harm and these can change over time, but the causes usually stem from unhappy emotions.
Self-harming has been described as a "physical expression of emotional distress". Some people find that the physical act of hurting themselves helps them deal with overwhelming emotional and psychological issues.
Research has shown that social factors commonly cause emotional distress in people who self-harm. These include:
Self-harm could also sometimes be a way of coping with a traumatic experience. For example:
The distress from a traumatic experience or an unhappy situation can lead to feelings of low self-esteem or self-hatred. You could also have feelings of:
The emotions can gradually build up inside you, and you may not know who to turn to for help. Self-harm may be a way of releasing these pent-up feelings. It can be a way of coping with overwhelming emotional problems.
Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age. Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police.
In some cases, there may be a psychological reason for the self-harming. For example:
It is important for anyone who self-harms to see their doctor. They can treat any physical injury and recommend further assessment if necessary.
Your doctor is likely to ask you about your feelings in some detail. They will want to establish why you self-harm, what triggers it and how you feel afterwards.
Your doctor may ask you some questions to see if you have an underlying condition such as depression, anxiety or borderline personality disorder. If the way you self-harm follows a particular pattern of behaviour, such as an eating disorder, you may be asked additional questions about this.
Your height, weight and blood pressure may also be checked, and you may be asked about any drinking or drug-taking habits.
It is important that you are honest with your doctor about your symptoms and your feelings. If you don’t know why you self-harm, tell your doctor this.
After an initial assessment, your doctor should offer to refer you for a further assessment with healthcare professionals at a local community mental health service.
This assessment, which may take place over several meetings, is used to find out more about you and your self-harming behaviour. The results of the assessment will be used to help determine the treatment and support you need.
During an assessment, you will usually be asked about:
Any further treatment will normally be decided jointly between you and your team of healthcare professionals. It will be a specific programme for you according to your needs and what is likely to be effective. You will be asked for your consent before any treatment begins.
In most cases, psychological treatment (also known as talking treatment) is recommended for people who self-harm.
Psychological treatments, such as cognitive behavioural therapy (CBT), involve sessions where you meet with a therapist to talk about your feelings and thoughts and how these affect your behaviour and wellbeing. Evidence suggests these kinds of treatments can be effective in the long term for people who self-harm.
If you have a mental health problem such as depression, borderline personality disorder or schizophrenia, your treatment plan may involve medication as well as psychological treatment.
If psychological treatment is recommended, you will usually have a number of sessions with a therapist.
Once treatment finishes, you and your care team should discuss steps you can take to deal with any further crises and you should be told how to contact your care team if necessary.
During your assessment and treatment, there are a number of different healthcare professionals you may see, such as:
You may also see some other specialists, depending on the underlying reasons why you self-harm.
For example, if you have lost a close relative, you may be referred to a specialist bereavement counsellor for help coping with bereavement. If you are self-harming after an incident of rape, or physical or mental abuse, you may be referred to someone who is trained in dealing with victims of sexual assault or domestic abuse.
Some physical injuries may need treating in an accident and emergency (A&E) department, minor injuries unit or walk-in centre. For example, you may need to call for an ambulance if:
If your injury is not serious, you could be treated at a minor injuries unit (MIU). These healthcare services are run by doctors or nurses to assess and treat minor injuries, such as minor burns and scalds, infected wounds and broken bones.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.