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What is self-harm?
Self-harm is when someone hurts themselves on purpose to help them cope. It might be in response to difficult feelings, thoughts, or memories.
Self-harm is not a mental health condition – for most people who self-harm, it’s a way of coping. Some (but not all) people who self-harm also have a mental health condition such as depression or anxiety.
Unfortunately, there are lots of stereotypes about self-harm, including that it’s something that people of certain ages or genders do, or that it’s linked to the music you listen to or clothes you choose to wear. The truth is that people of all ages and genders struggle with self-harming.
If you’re thinking about self-harm, or have hurt yourself, you deserve support and there are people who want to help you.
If you’ve hurt yourself and it might need medical attention, go to A&E or call NHS 111 for help.
In an emergency, always call 999.
How do people self-harm?
Self-harm is often talked about (and shown in TV shows and films) in stereotypical ways, but any way of hurting or harming yourself (or damaging your body) can be a form of self-harm. This can include things like misusing alcohol or drugs, as well as things that cause an injury.
We’ve chosen not to put a list of different ways of self-harming here, because it can be triggering or upsetting.
But the way in which someone hurts themselves (or how medically ‘severe’ any injuries are) is not a representation of how distressed they are. People should be able to access support for self-harm no matter how they are harming themselves.
Does self-harm hurt?
Self-harm is different for everyone, and everyone has different pain tolerances.
For some people, feeling pain is part of the reason that they self-harm, while others might be temporarily unaware of pain while they are self-harming (though they experience pain afterwards).
Does self-harm mean someone wants to die?
No, self-harm does not automatically mean that someone wants to die or thinks about ending their own life.
It’s common for people who have suicidal thoughts to have previous experience of self-harm. But lots of people who self-harm say it’s a way of coping (and staying alive) and not related to wanting to die. For some people, it’s about wanting something to be different in their lives.
Why do people self-harm?
Self-harm is complex, and people can self-harm for lots of different reasons. It is often a way of coping in the short-term, but it does not make difficult feelings, thoughts, or situations go away – and lots of young people say that it brings up difficult emotions like regret too. Some people feel ‘stuck’ in a cycle of self-harming to cope, and it’s also important to remember that self-harm has risks too.
Coping with distress
Lots of people use self-harm as a way of coping with difficult feelings. There are lots of different reasons that people might be struggling to cope with their feelings, including bullying, stress, grief, physical health, or mental health conditions. Some people find that self-harming is a way to dull the intensity of emotions they’re struggling to manage.
Expressing themselves
Sometimes people who are struggling with difficult thoughts and feelings might use self-harm to make the things they’re struggling with visible. They might also want to try to change their emotional distress into physical pain, or ‘release’ their thoughts and feelings.
Not feeling numb
Some people talk about their self-harm as a way to feel something when everything else feels numb or when they feel isolated or cut off from the world.
Feeling in control
Sometimes people self-harm because it allows them to feel in control of something when a situation in their life (or their whole life) feels out of their control. They may also think that self-harm allows them to control their feelings.
Punishing themselves
For some people, self-harm is about punishing themselves. They may feel they’ve done something wrong or failed to achieve something, or they might feel frustrated with themselves for their thoughts or feelings.
Because of intrusive thoughts
Some people use self-harm as a way to cope with distressing intrusive thoughts, or as a compulsion if they have OCD. Intrusive thoughts are common, and most people experience them. Find out more about intrusive thoughts, obsessions, and compulsions on the OCD page.
Is self-harm a ‘cry for help’ or attention seeking?
It’s not helpful to label self-harm as ‘attention seeking’ because the term carries a lot of judgement. It’s often used to wrongly suggest that seeking attention is bad, or that self-harm isn’t also a way of coping (that often involves a lot of distress).
For some people, self-harm can be a way of communicating, but this is not true for everyone – a lot of people hide their self-harm. For some people, self-harming is linked to feeling they need to manage on their own, without sharing their problems with anyone else.
If someone does use self-harm to express something that’s hard to put into words, or to show that they need help, they should not be judged. Everyone needs (and deserves) to feel noticed, listened to, and supported. While self-harm is not a healthy way of getting these needs met, using it in this way does not mean someone’s distress or need for support is any less ‘real’ or valid.
‘If a young person self-harms as a way of bringing attention to themselves, they always need compassion and support – especially from the health professionals seeing them. It’s OK for them to want other people to know how much they’re struggling. Over time, and with the right support, they can learn other ways to ask for the attention and help they need.’
Dr Ritu Mitra, Consultant Child and Adolescent Psychiatrist
How does self-harm impact someone’s life?
People who self-harm often find themselves in a tricky cycle. Self-harm provides temporary relief from their thoughts and feelings. But as soon as this fades, they have to deal with everything they were trying to cope with in the first place, alongside their feelings about self-harm (and any consequences of the way they’ve harmed themselves) as well.
Self-harm can also leave people feeling less confident about their ability to manage challenges and difficult situations. The next time they’re struggling or feeling overwhelmed, it can be even harder for them to believe they can get through it without self-harming. This does not mean that they can’t manage without it – it’s about their belief in themselves, not any lack of skills and strengths.
Self-harming can feel really isolating, especially if you’re worried about what might happen if other people find out you’re hurting yourself. It’s common to worry about people judging you if they find out that you self-harm.
Some people are also scared that if someone else finds out they are hurting themselves, they’ll be sent away to hospital, but this is very rarely the case. Unless there’s another reason that they need to stay in hospital, most people who self-harm are supported in the community, which means they stay living at home while getting the help they need to recover.
Often, people don’t intend for self-harm to be a long-term coping strategy, but they find that once they start, it’s difficult to stop. Some people find that they break ‘limits’ they set themselves around how often they hurt themselves, the ways in which they self-harm, or where on their body they injure themselves.
Many (but not all) ways of self-harming can leave people with visible scars. If you have scars from self-harm, you might feel you have complicated feelings about them – for example, you might feel proud that you have survived really difficult things while also feeling sad or disappointed that you have scars. Lots of young people in recovery say that they feel really vulnerable when other people can see that they’ve self-harmed in the past, even before they get to know them.
How to get support if you’re self-harming
The first step to getting help is to tell an adult you trust, like a parent, carer, or teacher at school.
Emergency?
If anyone is in immediate danger, call 999 now.
If you need urgent help for mental or physical health, call NHS 111 or get help from NHS 111 online.
Watch: How to tell someone about self-harm
Watch this video to find out more about telling someone you’re self-harming.
If you have thoughts about self-harming (or have hurt yourself on purpose), you should make an appointment with your GP (or the mental health service supporting you, if you’re already accessing mental health care).
You could ask an adult you trust to help you make the appointment or to go with you, if you would find that helpful. You can also access immediate, confidential support by texting NATTER.
Text NATTER for help
Anyone can text ‘NATTER’ to 85258 to seek
help, wherever they are in the UK. It’s a free, anonymous service and available 24/7.
More about NATTER
What happens when you tell a medical professional about self-harming?
When you speak to a GP or someone in CAMHS or a talking therapy service about self-harm, they’ll ask you more about your experiences. It’s common to be asked more about your thoughts and feelings, as well as the reasons you might be using self-harm to cope. It’s also likely that you’ll be asked about how you harm yourself, and they may ask if you’ll show them any injuries you have.
It can be really difficult to talk about the specifics of self-harm, but the questions are designed to make sure you are safe and to find out more about what’s going on for you so you can get the right support.
Depending on your situation, your age, and where you live, you might be offered talking therapies such as cognitive behavioural therapy (CBT) or dialectical behavioural therapy (DBT).
There is no medication specifically for people who self-harm. If you’re diagnosed with a mental health condition like depression or an anxiety disorder, you may also be offered medication to help with the symptoms of the condition.
Looking after yourself if you’re thinking about self-harming
If you’re struggling with the urge to self-harm right now, here are some ideas about safer ways to cope.
Get some support
If you’re struggling with self-harm, you deserve support.
It can make a big difference for an adult to understand what you’re going through and how you’re feeling, and they might be able to help you think about other, healthier ways to cope as well.
Some people find it helpful to come up with a code word (or signal) they can use with a trusted adult to make it easier to say when they’re struggling and need some support. This could be sending them a certain word or emoji, for example. It can also be helpful to agree in advance what the trusted adult will do to help when you send them the signal.
If there’s no one around you feel you can talk to, you can always text NATTER or contact another trustworthy helpline or service. You could also invite or ask someone to do something distracting with you (there are some tips further down this page), even if you don’t feel comfortable telling them why you need a distraction.
Delay self-harming
It might feel impossible to think about a future without self-harm – but could you manage another 5, 10, or 15 minutes without hurting yourself? Try to think about what you’ll do to cope during this time and check in with yourself afterwards to see if the urge to self-harm has changed, and whether whatever you tried was helpful.
You might feel that you can wait out the urge if you take it a few minutes at the time – and even if you don’t get through the whole day (or week, or month), you’ve given yourself the chance to practise other ways of coping. With time, you may be able to sit with the urge until it fades.
Think about why you want to self-harm
Understanding a bit more about the urge to self-harm can help you choose another way of coping. If someone has the urge to use self-harm to express anger at a situation, for example, they might choose a different coping method from someone who wants to self-harm in response to an intrusive thought.
If your urge to self-harm is linked to intrusive thoughts, read our page about OCD.
Remind yourself of reasons to recover
The urge to self-harm can feel overwhelming, but it can be helpful to remind yourself of the reasons you have for stopping (or reducing) self-harm to motivate you to try other ways of coping.
Some people find it helpful to collect things that remind them of important people in their life, happy memories, or the goals they have for the future, which they can look at when they’re struggling.
Find other ways to comfort yourself
If you need to calm your body and/or mind down safely, you could try:
- wrapping yourself in a blanket or using a weighted blanket
- cuddling a soft toy or stroking a pet
- listening to soothing music, or a positive audiobook or video
- reading a book you know well or watching a familiar TV show or film
- taking care of your body, for example, by moisturising your skin, painting your nails, or moving your body in a safe way (for example, by dancing to an energetic song or putting your energy into hoovering your room)
- using (safe and moderate) heat to comfort yourself, for example an ‘instant heat’ pack or microwaveable heat bag
- finding ways to engage your senses in comforting, safe ways, for example through a favourite scent or fidget toy
Find other ways to express yourself
If you’re feeling overwhelmed or can’t name or understand what you’re feeling, you could try:
- Writing things down and see if it makes things any clearer
- Expressing yourself in a creative way, for example, drawing, collage, or making music
- Using an emotion wheel to help understand what’s going on in your head
If you feel really distressed (at a situation or someone else), you could try:
- Writing a letter you’ll never send to a person (or a situation)
- Destroying a piece of paper by scribbling on it or tearing it up (you could write or draw on it first)
- Reading more about coping with feelings including anger, fear, embarrassment, and stress
- Moving your body in a safe way (for example, by dancing to an energetic song or putting your energy into hoovering your room)
- Shouting or screaming into a pillow
- Letting yourself cry
- Throwing something safely – you could take a ball to a nearby park or throw a soft stress ball onto your bed
If you feel angry at yourself or want to punish yourself, you could try:
- Writing down how you’re thinking and feeling, and trying to write yourself a reply with the sort of kindness you’d show to a friend
- Drawing on your body with a skin-safe, water-based pen
- Holding an ice cube, or rubbing ice on your body
- Destroying a piece of paper by scribbling on it or tearing it up (you could write or draw on it first)
- Moving your body in a safe way (for example, by dancing to an energetic song or putting your energy into hoovering your room)
- Throwing something safely – you could take a ball to a nearby park or throw a soft stress ball onto your bed
Drawing on your body with a skin-safe, water-based pen - Holding an ice cube, or rubbing ice on your body
- Destroying a piece of paper by scribbling on it or tearing it up (you could write or draw on it first)
- Moving your body in a safe way (for example, by dancing to an energetic song or putting your energy into hoovering your room)
- Throwing something safely – you could take a ball to a nearby park or throw a soft stress ball onto your bed
Ground yourself in the moment
Sometimes, people want to self-harm if they feel numb or disconnected. In these situations, it can be helpful to find ways to ‘bring yourself back’ to the present moment.
Find out more about ways to ground yourself, including breathing exercises.
Distract yourself with something else
It can sometimes be hard to figure out why you want to self-harm, or what else you can do to manage the urge. If you’re struggling to figure out what to try, or the urge to self-harm feels more manageable but hasn’t gone away entirely, it might help to distract yourself.
Distraction is personal to everyone – it’s about finding something that you find interesting and enjoyable so you can shift your focus. You could try:
- playing a game, whether it’s a video game or card or board game. It’s up to you whether you choose something you can play on your own or whether you get a friend involved
- read or listen to a new story – you might be able to borrow e-books from your local library and can find your nearest library on the government website
- watch a new TV show or film, or an old favourite
- get into something creative – you could write, draw, colour, collage, make music, or follow an online tutorial for something like origami
- find more ideas through the five ways to wellbeing
Recovering from self-harm
With the right support, it is possible to recover from self-harm. It’s often a long process – it can take time to learn new ways of coping with difficult thoughts and feelings, and to find ways of managing urges in other, healthier ways.
For lots of people, recovery means planning ways to cope with urges in advance. Some people find it helpful to make a specific self-soothe box with items and reminders they can use when they’re experiencing the urge to self-harm.
You might also hear people saying that recovery is not linear – this means that it isn’t always like following a straight line. You might slip up, or face setbacks, but this does not mean that you are not making progress. The most important thing is learning how to get back on track after setbacks to continue working towards recovery.
How can you tell if someone else is self-harming?
Self-harming is not always obvious, and it’s not always easy to notice if someone is hurting themselves on purpose.
Some signs that someone might be harming themselves include if they:
- have unexplained injuries or marks
- are covering their body more than is usual for them (for example, if they won’t take a jumper or jewellery off or won’t wear shorts or a swimming costume when they would normally do these things)
- have blood stains on their clothes or bedding, or have bloody tissues in their bag or bin
- are spending a lot more time than usual on their own
- seem more secretive
- are less talkative and don’t want to spend time with people
- have changes in their mood, for example, if they seem low
- are talking really negatively about themselves or often blaming themselves for things
- talk about feeling hopeless
It’s important to remember that self-harm does not always involve physical injuries, and that self-harm that involves physical injury does not always leave marks you can see.
If you’re worried about someone, it’s OK to talk openly about what you’ve noticed. You can tell them that you know it can sometimes be a sign that someone has self-harmed and ask them if they’ve hurt themselves on purpose. Research shows us that asking people about self-harm or suicidal thoughts does not put the idea into people’s heads.
How to help someone else who’s struggling with self-harm
If someone you care about is self-harming, it can be difficult to know how to support them. As well as being a good friend and including them in the things you do, there are some things you could try to help them.
Learn about self-harm
If you learn more about self-harm, people who are hurting themselves don’t have to spend as much time raising awareness. It also means you can better understand what’s going on for them, which can be helpful if they do something you find difficult, like not wanting to do certain activities.
Listen to what they tell you
Everyone has their own experience of self-harm, so it’s important to listen to people if they want to tell you what it’s like for them. It’s OK to ask how you can help, too, or if there’s anything you need to know about how they communicate.
Help them be kind to themselves
If someone is struggling with urges to harm themselves, you can show them that you understand it’s hard, while encouraging them to use any strategies they have to take care of themselves. Celebrating their ‘little wins’ is also a great way to show support.
Avoid saying unhelpful things
It is not helpful to talk about self-harming as ‘attention seeking’, for example. It’s also best not to comment on someone’s injuries (unless to suggest they might need to get medical help) – telling someone that their injuries are ‘minor’ or ‘superficial’, or sharing your thoughts about how injuries look, can make them feel judged.
Know that recovery takes time
Recovering from self-harm is rarely quick or simple. It is not helpful to try to pressure someone into not harming themselves (including asking them not to ‘for you’). Instead, reassure them that you believe in them and that you care about them regardless of their self-harm – and let them know when you’re able to listen, or help with distractions too.
Do normal ‘friend stuff’
When someone’s struggling with their mental health, spending time together talking about shared interests (or doing a hobby you both enjoy) can help them feel more like themselves again. This might mean continuing to invite someone to do stuff, even if they’re not always able to say yes.
Support them to get more help
You could offer to go with them to speak to a trusted adult or help them decide who they could talk to. It can be difficult for people to open up, but speaking to an adult they trust is often the first step towards them getting the help they need. Sometimes, you might need to tell an adult about your concerns if you’re worried that a friend isn’t safe.
Supporting other people
Find more information about supporting others, including how to ask someone if they’re OK, how to listen, and understanding boundaries and responsibility.
There’s also support if you’re a young carer, and tips for looking after yourself while supporting someone else.
