12201 Self Harm

Overview

Self-harm, also called self-injury, is when someone deliberately hurts their own body. It is often a way to cope with very difficult emotions, stress, or painful memories. It is not usually an attempt to end life, but it can lead to serious harm and should always be taken seriously.

Yes. Self-harm is more common than many people realise, particularly among teenagers and young adults. Many people who self-harm do so in private and are never formally recorded, so the true number may be even higher.

Self-harm can affect anyone regardless of age, gender, background or culture. It often begins in the teenage years, but it can also happen to children and older adults. It affects people of all walks of life.

Symptoms

Common symptoms

• Unexplained cuts, burns or bruises
• Wearing long-sleeved clothing even in hot weather
• Having sharp objects or tools in unusual places
• Frequent stories about accidents or fights
• Withdrawing from friends and activities
• Signs of depression or anxiety

Symptoms in children

• Unexplained injuries or frequent 'accidents'
• Changes in mood or behaviour
• Talking less or spending more time alone
• Declining school performance
• Finding hidden items like razor blades or lighters in their room

Symptoms in older adults

• Bruises or injuries that don't match their explanations
• Stopping important medications or medical care
• Increasing isolation and talk of loss
• Difficulty with daily tasks
• Signs of self-neglect

Causes

Main causes

• Feeling overwhelmed by intense emotions such as anger, sadness, fear or emptiness
• Trying to regain a sense of control when life feels out of control
• As a way to punish themselves or express self-hatred
• To communicate pain that cannot be put into words
• As a distraction from painful memories or flashbacks

Risk factors

• Experiencing abuse, violence or neglect
• Having depression, anxiety, post-traumatic stress disorder or another mental health condition
• Feeling isolated or withdrawn from others
• Low self-esteem or self-critical thoughts
• Difficulty talking about feelings
• Recent major life stress such as loss, relationship problems, or pressure at school/work

When to see a doctor

See a doctor urgently if:

• If you or someone you know has serious injuries or is at immediate risk, call your local emergency number. Do not wait.
• If you are thinking about ending your life, go to an accident and emergency (A&E) department or call a crisis helpline immediately.

Book a routine appointment if:

• If you are self-harming or have urges to self-harm, make an appointment with a GP who can listen without judgement and help you get support.
• If injuries are not healing or you are concerned about infection, see a GP or nurse.
• If you are caring for a child who may be self-harming, seek support early.

Diagnosis

Self-harm is not a separate illness. A doctor or mental health professional will ask you about your feelings, thoughts and behaviour. They may also ask about your life, relationships, and any difficult experiences. The purpose is to understand what you are going through, not to label you.

Tests that may be done

• There is no laboratory test for self-harm. However, your doctor may ask to look at any injuries to check how serious they are.
• Your doctor may arrange blood tests to look for underlying issues like anaemia, thyroid problems, or signs of infection.

What to expect at your appointment

Your first appointment will usually be with a GP. They will talk to you in a kind, gentle way and may ask a few questions. They might refer you to a community mental health team or a counsellor. You are allowed to bring someone you trust for support.

Treatment

The most effective treatments for self-harm focus on understanding the feelings that lead to it and learning safer ways to cope. Treatment is usually delivered by talking therapies, and in some cases medication is used for an underlying mental health condition. Recovery takes time, but it is possible.

Self-care at home

• Reach out to someone you trust – it can start with one honest sentence.
• Create a safety plan with a GP or mental health worker, including numbers to call when urges are strong.
• Try distraction techniques like holding ice, drawing, writing, or using a safe physical activity.
• Remove or put away sharp objects when you feel an urge rising.
• Keep a mood note to understand patterns and triggers.
• Practice breathing slowly and grounding yourself by naming things you can see, hear and feel.

Medical treatments

Talking treatments are the main approach. These may include cognitive behavioural therapy (CBT), which helps you recognise and change negative patterns, or dialectical behaviour therapy (DBT), which teaches skills for managing intense emotions. Some people are also offered medication for depression or anxiety, but this only works under medical supervision and is never the whole answer. A doctor or mental health professional will help you decide what is right for you.

Living with this condition

Living with self-harm can feel exhausting, but recovery is a step-by-step process. Some days are better than others. The goal is not to be perfect, but to notice the moments when you choose a different way to cope. It helps to keep a regular routine, stay connected to supportive people, and be gentle with yourself.

Lifestyle tips

• Keep a regular sleep schedule – poor sleep makes emotions harder to manage.
• Build small daily habits that give you a sense of achievement.
• Spend time in nature or with animals, which can calm the nervous system.
• Limit alcohol and recreational drugs, as they can make self-harm urges stronger.
• Learn relaxation skills like breathing exercises or mindfulness.

Diet and exercise

A balanced diet and regular physical activity can help stabilise your mood and reduce anxiety. You don't need to run a marathon – a short walk, some gentle stretching, or dancing to music can make a real difference. Stay well hydrated and try not to skip meals.

Mental health and emotional wellbeing

Self-harm is often accompanied by shame, guilt and secrecy, which can make depression and anxiety worse. It can also affect your relationships and self-worth. It is important to remember that self-harm is a coping strategy, not a personality flaw. With support, you can develop healthier ways to handle pain.

Prevention

Self-harm is not inevitable. While it may not always be possible to prevent someone's first episode, earlier support for emotional distress, trauma, and mental health conditions can reduce the risk. For people who already self-harm, learning coping strategies and having a safety plan can prevent repeat incidents and injuries.

Complications

If left untreated

• Repeated injuries that may become infected or leave permanent scarring.
• Accidental injury to important structures like tendons, nerves or arteries.
• A higher risk of suicide – self-harm is a strong risk factor for suicidal thoughts.
• Worsening mental health, including depression and anxiety.
• Growing isolation as the secret becomes harder to keep.

Long-term outlook

With the right support, most people who self-harm can learn to cope differently and recover. Many people go on to live full, meaningful lives. Healing is not a straight line, but every step you take to understand yourself is a step forward. You deserve hope, compassion and professional help.

Find support

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