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Self-harm and self-injury

Self-harm is when people deliberately hurt their bodies. People sometimes self-harm as a way to cope with strong physical or emotional pain and distress.

What is self-harm? Self-harm is a term that has historically been used to cover a broad range of behaviors. It refers to deliberately causing pain or damage to your own body, and can be suicidal or non-suicidal in intent. Self-injury is a type of self-harm, and refers to deliberately causing pain or damage to your own body without suicidal intent.

Self-injury is more common in young people. Some people who self-harm may also have suicidal thoughts. Self-harm can take on different forms and its frequency can vary from person to person – some may do it once, while others can do it for many years.

  • taking harmful substances (such as poisons
  • or over-the-counter or prescription medications). Self-harm is normally a sign that a person is feeling intense emotional pain
  • distress. There are many support options for self-harming behavior
  • whether you are seeking support for yourself or someone you care about

If you are self-harming and you are worried, try to talk to someone you trust – like a friend, family member, doctor, teacher or school counselor. It can be hard to build up the courage to open up to someone, but remember, they care about your wellbeing. It may take time for them to understand, but it doesn’t mean they aren’t there for you.

If you would rather talk to someone you don’t know, there are many options.

If you have a mental health condition, your doctor can work with you to draft up a mental health treatment plan, which can include counseling sessions at a low cost. to talk to a counselor.

You can do this online or over the phone (. – normal call charges apply on mobile). It’s confidential, so you don’t have to give your name, and it’s available to young people aged 12–25 and their families and friends.

– there are centers all over United States where young people (12–25 years) can get health advice, information and support – usually free or at a low cost. ) – Kids Helpline is for young people aged between five and 25. You can talk to a counselor about anything at any time. to talk to a counselor at any time (. for youth-friendly information on self-harm, and online programs to help young people who may have depression and anxiety.

Sometimes the distress you feel can be so overwhelming that you may have thoughts about ending your life.

If you or someone you know is badly hurt or is at serious risk of harm, contact emergency services. Dial your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) or visit your nearest emergency department.

You can also contact your doctor or mental health crisis service. You can also call: (.

How do I know if someone is self-harming? It can be difficult to recognize whether someone is self-harming as many people who self-harm keep it a secret.

Trust your instincts, especially if you think they are distressed or in trouble. Some signs may include: avoidance – not attending activities they once enjoyed or avoiding occasions where their injuries will be exposed (such as the beach or pool) being secretive – hiding sharp or dangerous objects.

People who self-harm need care, understanding and support in order to recover#

Stigma from others can be damaging and may stop them from getting the support they need. According to a 2012 report by Orygen (Looking the other way: young people and self-harm), it is thought up to half the people who self-harm never seek help.

If you think someone you know might be self-harming, it is important to try to talk to them about it, and encourage them to seek professional help.

Don’t try to force them to stop, as it can make matters worse. Talking to people who self-harm about their behavior can be safe and very helpful if done in a supportive way. It can be difficult to approach someone who is self-harming.

If you cannot do it on your own, ask someone else for help. have some helpful advice on how to start a conversation with someone who self-harms. Try the following suggestions: Ask them how things are going or how they are feeling.

Let them know you are there if they feel down or stressed. Tell them you are worried about them, and why.

Ask if they are thinking about suicide#

If they are, or you think they might be, call your local hospital or mental health service.

Or call a helpline such as (#

Stay calm, listen carefully and don’t judge them.

If they seem upset or angry it may just mean they are feeling ashamed or worried about what you might think.

Encourage them to seek support from a person they trust –such as a doctor, teacher or counselor.

If the person who is self-harming is not ready to talk about it, try another time or suggest they speak to someone who makes them feel comfortable. Other ways to lower their distress may include: diversion – find a substitute action that causes no injury (such as punching a pillow or squeezing an ice cube) deep breathing.

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.

Talk to someone you trust about what’s going on and how you feel.

However, upsetting it can be to see a loved one in trouble, remember that self-harming behavior is treatable and not everyone who self-harms is suicidal. Self-harming is a serious behavior – it’s a sign someone is feeling significant distress and they’re not doing it to seek attention.

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. Although self-harming behavior can be treated, many people don’t seek support because they: are afraid people (including health professionals) will react negatively to their self-harming behavior – perhaps because they have in the past believe they should be able to cope on their own.

No one has to cope alone; self-harming behavior is treatable. Support can include working on recognizing 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 realizing it is a not a long-term solution to problems is a step in the right direction.

Once they make a decision to seek support, it’s important that they take it slowly and are not too hard on themselves. 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 behavior, 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: be mindful – do some coloring, try meditation, relaxation or do a craft activity like knitting or painting make your environment safe – get someone you trust to take away any harmful objects and keep you away from any places where you are likely to harm keep a distraction box – store some things that bring you comfort in a box or bag (such as photos, a favorite toy, chewing gum, fiddle toys, craft).

Keep it somewhere handy and explore it when you feel like self-harming. Who is at risk of self-harm? People of all ages self-harm, but young people are more at risk. According to the 2015 American Child and Adolescent Survey of Mental Health and Wellbeing, around one in ten American teens have self-harmed.

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. Those who are at increased risk of self-harm include young people: who identify as lesbian, gay, bisexual, trans and gender diverse, intersex, queer and asexual (LGBTIQA+). Aboriginal and Torres Strait Islander young people (aged 15–24) are five times more likely to self-harm than non-Indigenous young people.

Why do people self-harm? 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. Others may find it makes them ‘feel’ something when they are numb and devoid of all feelings. 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. Not only are they dealing with changes to their bodies, they are trying to juggle demands they didn’t have when they were younger (such as study, work, relationships, being more independent and having more responsibility).

Stressors that may increase the risk of self-harm include:

  • past trauma
  • neglect or abuse. Personal factors that may increase someone’s risk of self-harm include
  • difficulties with problem solving. What are the risks of self-harm? Although self-harm may bring relief in the short-term
  • it doesn’t help the person address the reasons they are doing it in the first place

Unless the problems that are causing the self-harming behavior 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.

Although most people who self-harm don’t want to die, their behavior can become more frequent and addictive as they seek out methods to deal with overwhelming emotions. 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.

Getting support for self-harming behavior See a doctor, counselor or psychologist Contact eheadspace Visit a headspace center Call Kids Helpline ( 1800 55 1800 Call Beyond Blue 4636 ).

Beyond Blue also provides youth-friendly information on self-harm Visit ReachOut Seeking help for suicidal thoughts If you are thinking about suicide, don’t be afraid to ask for support Lifeline ) SuicideLine Suicide Call Back Service Kids Helpline 1800 55 1800 new marks on the body (such as bruises, cuts or burns) withdrawal from friends, family, school and work a drop in performance at school, work or activities changes in mood, sleep and eating patterns wearing unsuitable clothing to cover up wounds making excuses for injuries or behavior Supporting someone who self-harms How to talk with someone who self-harms ReachOut and eheadspace Lifeline ) or SuicideLine distraction – go for a walk, play a game, watch a movie or listen to their favorite music It can be helpful to draft up a safety plan or learn mental health first aid Support people need support too Self-harming behavior is treatable think people will not understand do not trust their information will be kept private do not believe anyone will be able to help are ashamed, guilty or angry about their self-harming behavior Finding alternatives to self-harm wear a rubber band around your wrist and snap it when you feel distressed eat an ice-cube – the sensation can take your mind off intense feelings hold an ice-cube in your hand keep a journal and jot down your thoughts exercise – it releases endorphins and can help lift your mood draw on your body in the areas where you normally hurt punch a pillow aged 15–19 with a mental health condition or personality disorder from Aboriginal or Torres Strait Islander backgrounds in immigration detention or juvenile justice facilities in out-of-home care who live in rural and remote areas family breakdown or conflict relationship difficulties knowing others who self-harm having a family history of self-harm being bullied school or work problems alcohol and drug abuse a previous history of self-harm experiencing aggression or violence mental health conditions low self-esteem poor body image and self-hatred physical illness or disability impulsivity – acting without thinking poor coping skills

Where to get help#

Key Points#

  • Self-injury is more common in young people
  • If you or someone you know is badly hurt or is at serious risk of harm, contact emergency services
  • Once they make a decision to seek support, it’s important that they take it slowly and are not too hard on themselves
  • Treatment will include learning to find other ways to manage intense feelings
  • Who is at risk of self-harm? People of all ages self-harm, but young people are more at risk

Sources & further reading

For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.

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