You should feel at ease, even while talking through your most personal issues. While cutting and self-harming occurs most frequently in adolescents and young adults, it can happen at any age. Because clothing can hide physical injuries, and inner turmoil can be covered up by a seemingly calm disposition, self-injury in a friend or family member can be hard to detect. However, there are red flags you can look for:.
Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest. Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather. Needing to be alone for long periods of time, especially in the bedroom or bathroom. Isolation and irritability. This can cause them to withdraw and isolate themselves. Fact: The painful truth is that people who self-harm generally hurt themselves in secret.
In fact, shame and fear can make it very difficult to come forward and ask for help. Fact: It is true that many people who self-harm suffer from anxiety, depression, eating disorders, or a previous trauma—just like millions of others in the general population. Self-injury is how they cope.
Fact: When people self-harm, they are usually not trying to kill themselves—they are trying to cope with their problems and pain. In fact, self-injury may be a way of helping themselves go on living. Whatever the case, you may be feeling unsure of yourself. What should you say? How can you help? Deal with your own feelings.
You may feel shocked, confused, or even disgusted by self-harming behaviors—and guilty about admitting these feelings. Acknowledging your feelings is an important first step toward helping your loved one. Learn about the problem. The best way to overcome any discomfort or distaste you feel about self-harm is by learning about it.
Understanding why your loved one is self-injuring can help you see the world through their eyes. Remember, the self-harming person already feels distressed, ashamed and alone. Offer support, not ultimatums. Encourage communication. If the self-harmer is a family member, prepare yourself to address difficulties in the family.
This is not about blame, but rather about communicating and dealing with problems in better ways that can benefit the whole family. Authors: Melinda Smith, M. Encourage the person to seek support for themselves, or offer to help them make contact with one or more of the suggested supports.
If your child, friend or other family member is self-harming, or you think they might be, seeking support from a mental health professional is important for you too.
However, upsetting it can be to see a loved one in trouble, remember that self-harming behaviour is treatable and not everyone who self-harms is suicidal. Usually they are deeply ashamed and go to great lengths to hide it from others. They may suffer in silence and really need support to open up about how they are feeling. No one has to cope alone; self-harming behaviour is treatable.
Support can include working on recognising triggers, learning how to manage difficult emotions and help with self-care such as caring for wounds and learning other coping strategies.
For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. It can take time to break the cycle of self-harm and there may be setbacks along the way. It can be difficult to break away from self-harm. Treatment will include learning to find other ways to manage intense feelings. By distracting or diverting the behaviour, feelings and urges may become less intense and decrease over time. The person who is self-harming may like to develop their own ways to distract themselves, or use some of these ideas:.
People of all ages self-harm, but young people are more at risk. It is more common among girls than boys, and usually starts around the ages of 12 to 14 years, just after the onset of puberty.
Aboriginal and Torres Strait Islander young people aged 15—24 are five times more likely to self-harm than non-Indigenous young people. There are many reasons why people self-harm. Even for one person the motivation can vary. Some people do it as a way of expressing their distress, taking back control or escaping from situations they find troubling.
Some people find self-harm gives them a sense of relief. Whatever the reason, self-harm is normally a sign that a person is feeling intense emotional pain and distress. For young people, many stressful things stressors happen all at once. Unless the problems that are causing the self-harming behaviour are addressed, people will continue to use it as a way to cope. Unfortunately, self-harm can be dangerous — it can lead to serious injury and even accidental death.
It can also lead to a higher risk of developing physical and mental health issues, substance misuse and unemployment. Some people who self-harm have feelings of shame, self-loathing and helplessness and may have suicidal thoughts. Many people who attempt suicide have a history of self-harm. This page has been produced in consultation with and approved by:. A person with agoraphobia is afraid to leave familiar environments, because they are afraid of having a panic attack.
The Alexander technique stresses that movement should be economical and needs only the minimum amount of energy and effort. Know that you are not alone, push through the anxiety of sharing to get help. If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted. An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing.
Self-injury treatment options include outpatient therapy, partial-inpatient hours a day and inpatient hospitalization. When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended.
Eating disorders are real, complex medical and psychiatric illnesses that can have serious consequences for health, productivity and relationships. With practice, everyone can do a better job of dealing with their negative emotions in healthy ways. By engaging in self-injury, a person intends to: Obtain relief from a negative feeling or mental state Resolve an interpersonal difficulty, like a disagreement with a friend or loved one Deal with an intrapersonal problem, like boredom Induce a positive feeling state [3].
Call a friend or family member and talk to them. Do something creative: make a collage of colours to represent your mood or to remind you of your favourite things. Listen to music you like or watch a film you enjoy. Go online and look at self-help websites. Talk to someone about what is triggering you or seek help from a professional. Talk to someone When you are feeling overwhelmed, talk to a friend, family member or trusted adult. Avoid alcohol and drugs We often drink alcohol or take drugs to change our mood or to avoid our feelings.
Do something you enjoy Remember that there is more to you than self-harm. I am worried about someone else If you are worried that someone you know is self-harming, it is important to know what to look out for and what to do. Signs to Look Out For It can be difficult to tell whether someone is self-harming.
Here are some signs that might suggest someone could be self-harming [32]: Withdrawal or isolation from everyday life. Signs of depression such as low mood, tearfulness or a lack of motivation or interest in anything.
Changes in mood. Changes in activity and mood, e. Talking about self-harming or suicide. Abusing drugs or alcohol. Expressing feelings of failure, uselessness or loss of hope.
Risk taking behaviour substance misuse, unprotected sexual acts. Signs of low self-esteem such as blaming themselves for any problems or saying they are not good enough. Unexplained cuts, bruises or marks.
Covering up all the time, when in hot weather. Being quieter than usual. Lacking energy. What to do if you are worried about someone If you are worried that someone you know is self-harming, it can be difficult to know what to do. Some tips for talking to someone about self-harm [34]: Set plenty of time aside to talk to them where you will be free from interruption.
If possible, remove distractions such as computers and phones being on. This will allow you to give your full attention, letting them know you are there to listen to and support them. Instead talk about how they are feeling and what they are going through.
Try not to react shocked or disgusted. Know your limits: the person who has experienced self-harm might tell you to keep it a secret and not to tell anyone else. If you believe they are in immediate danger or have injuries that need medical attention, you need to take action to make sure they are safe. Reassure them that you are there for them and that there are lots of sources of support available to them. You might not understand what they are going through or why they do it but remind them you are there for them regardless.
Furthermore, this may stop them talking to you and you might not get the chance to discuss the topic again. Offer them help in seeking professional support and provide information on ways to do this. You might want to offer to go the GP with them, or help them talk to a trusted adult or family member. Try not to take control and allow them to make decisions. Be positive and let them know that things will get better and recovery is possible! You can also get more information or support through the websites below: SelfHarm.
Some websites that have been recommended to us by young people include: www. International Journal of Mental Health Nursing, 24 6 , BMJ — PSHE Association Brain, K. The psychophysiology of self-mutilation: Evidence of tension reduction. Archives of Suicide Research.
The Lancet , Whitlock J Self-injurious behaviour in adolescents. Deliberate self-harm in adolescence. London: Jessica Kingsley Publishers. Nitkowski, D.
Non-suicidal self-injury and comorbid metnal disorders: a review. Fortschr Neural Psychiatr, 79 1 , Paul, T. American Journal of Psychiatry, 3 , Department of Health Preventing suicide in England: A cross-government outcomes strategy to save lives. Liu, R. American Journal of Preventive Medicine, 42 3 , Royal College of Psychiatrists Self-harm, suicide and risk: self-harm. College Report, CR Hawton, K. Suicide and deliberate self harm in young people.
BMJ, , Gardner, F. Hove: Brunner Routledge. Laye-Gindhu, A. Journal of Youth and Adolescence, 34, 5, Klonsky, D.
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