Self-harm is an expression of personal distress, rather than an illness, although it can be linked to other mental health conditions such as depression. It is when somebody intentionally damages or injures their body and is a way of expressing deep emotional feelings such as low self-esteem, or a way of coping with traumatic events, such as the death of a loved one.

If you are self-harming, you should see your GP for help. You can also contact Breathing Space or call the Samaritans on 116 123 for support. Read more from NHS Inform about where to get help if you self-harm.

There are many different ways people can intentionally harm themselves, such as:

• Cutting or burning their skin
• Punching or hitting themselves
• Poisoning themselves with tablets or toxic chemicals
• Misusing alcohol or drugs
• Deliberately starving themselves (anorexia nervosa) or binge eating (bulimia nervosa)
• Excessively exercising

People often try to keep self-harm a secret because of shame or fear of it being seen. They may cover up their skin and avoid discussing the problem.

It's often up to close family and friends to notice when somebody is self harming. They should approach the subject with care and understanding.

Someone who is self-harming can seriously hurt themselves, so it is important that they speak to a GP about the underlying issue and about any treatment or therapy that might help them.

If you suspect that a friend or relative is self-harming, look out for any of the following signs:

• Unexplained cuts, bruises or cigarette burns, usually on their wrists, arms, thighs and chest
• Keeping themselves fully covered at all times, even in hot weather
• Signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything
• Changes in eating habits or being secretive about eating, and any unusual weight loss or weight gain
• Signs of low self-esteem, such as blaming themselves for any problems or thinking they are not good enough for something
• Signs they have been pulling out their hair
• Signs of alcohol or drug misuse

The person who is self-harming may feel deep shame and guilt, or may feel confused and worried by their own behaviour. It’s important to approach them with care and understanding.

They may not wish to discuss their self-harm with you, but you could suggest that they speak to an anonymous helpline or see their GP.

There are many reasons why people self-harm, but the causes usually stem from unhappy emotions.

Self-harming has been described as a "physical expression of emotional distress". If somebody is feeling overwhelmed with unhappy emotions, they may find that the physical act of hurting themselves makes them feel better.

If you are feeling like this, you can speak to your GP, contact Breathing Space or call the Samaritans on 116 123 for support.

Social Factors and Trauma

Research has shown that social factors commonly cause emotional distress in people who self-harm. These include:

• Difficult relationships with friends or partners
• Difficulties at school, such as not doing well academically
• Difficulties at work
• Being bullied, either at home, school or work
• Worries about money
• Alcohol or drug misuse
• Coming to terms with your sexuality if you think you might be gay or bisexual
• Coping with cultural expectations, for example, an arranged marriage

Self-harm could also sometimes be a way of coping with a traumatic experience. For example:

• Sexual, physical or emotional abuse, including domestic abuse and rape
• The death of a close family member or friend
• Having a miscarriage

Emotional Distress

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:

• Anger
• Guilt
• Anxiety
• Loneliness
• Grief
• Numbness or emptiness
• Feeling unconnected to the world
• Being unclean, unworthy, trapped or silenced if you have been abused

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 and finding a way to cope with your problems. It is not usually an attempt to seek attention, but a sign of emotional distress.

Some research has suggested that people who self-harm may have difficulty managing or "regulating" their emotions. They use self-harm as a way of managing tension and anger. Research has also shown that people who self-harm are poorer at problem solving.

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.

Psychological Causes

In some cases there may be a psychological reason for the self-harming (where the cause is related to an issue with your mind). For example:

• You may hear voices telling you to self-harm
• You may have repeated thoughts about self-harming and feel like you have to do it
• You may disassociate (lose touch with yourself and your surroundings) and self-harm without realising you are doing it
• It can be a symptom of borderline personality disorder (a condition that causes instability in how a person thinks, feels and behaves)

Taking care of yourself is an important step for managing self-harm. It might feel hard to start talking about how you are feeling, but many people find that just sharing their experiences can help them feel better. It may be that just having someone listen to you and show they care can help in itself.

Top Tips

• Spend time with family and friends. Talk about your feelings to a friend or family member. You can also contact free helplines such as: Breathing Space on 0800 83 85 87 or Samaritans on 116 123. If you would rather get support via text messaging you can text Shout for free on 85258. 

• Understand, Distract and Delay. You can use Mind's Coping with Self-Harm Guide. Interrupt your urge to self-harm by doing something else. You can use distraction when you are feeling the urge, when you are aware you are actually self-harming, or even if you think you might feel your urges soon.

Living with self-harm can be very difficult, but there are steps you can take that might help. These self-help guides, websites and apps may be helpful as you work towards eliminating self-harming behaviours. Like any new skill, it may take a bit of time and practice before you notice any changes in the way you feel.

Whether you sometimes think about self-harm, or you’ve already hurt yourself, Samaritans are there to listen. For every 10 calls they answer, one is about self-harm. And many people call because they want to avoid harming themselves in that moment. Contact Samaritans on 116 123.

Self-help Guides

NHS Ways to Avoid Self-Harm

NHS Inform Breathing and Relaxation

Websites

NHS Every Mind Matters offers a free Wellbeing Plan. Just answer 5 questions to get your free plan with tips to help you deal with stress and anxiety, improve your sleep, boost your mood and feel more in control.

Wellbeing Glasgow offer information to support you to manage how you feel, change the way that you think about some things and improve your problem-solving skills and confidence

• Worry and Anxiety Self-Help
• Panic and Anxiety Self-Help
• Top Tips
• Relaxation Resources
• Learn about CBT

Citizens Advice Scotland offer advice about benefits, debt problems, legal issues and local services. The Citizens Advice Bureau website has a directory listing its local offices.

Get Active is a great place to start if you are looking to become more active or increase your physical activity. They have a list of options to help you identify classes and activities offered throughout Greater Glasgow and Clyde.

Free Courses

Lifelink offer a variety of free online courses such as ‘Re-Assess your Stress’, ‘Art of Relaxation’ and ‘Coping with Change’. Each 2-hour class is delivered experienced facilitators. Participants with a Glasgow postcode can attend as many classes as they like. You can register directly for these classes without the need for any pre-assessment.

Living Life to the Full offer a course to help you learn new skills and tackle problems in your life that may be causing you to feel low worried or hopeless.

Get Support Now 

Some people find that talking with friends and family about their feelings can be a real source of support for coping with distress or suicidal thoughts. It might be helpful for them to map their support network and think about people they could call if their feeling suicidal. Other people may prefer to seek more professional support or call a helpline such as Breathing Space, Samaritans or Shout.

• Breathing Space: Call 0800 83 85 87
• Samaritans: Call 116 123
• SHOUT Crisis Text service also available 24/7 Text SHOUT to 85258

For some people they may be finding it difficult to cope and may think of ending their life, if you are concerned about your mental health and wellbeing, you can contact your G.P. within opening hours. If you feel you are in immediate danger, please call 999 for assistance.