What is self-harm?

People who harm themselves are not 'mad' or 'bad'. They are usually finding life difficult and see self-harm as a way to cope. The Mix takes a closer look at what self-harm is, and what it isn't.

Understanding self-harm

Rates of self-harm in the UK have increased over the past decade and are amongst the highest in Europe. The Truth Hurts report found that rates of self-harm are highest among young people, with around 25,000 11-25 year-olds admitted to hospital each year after self-harming.

While self-cutting is the most common form of self-harm, perhaps affecting as many as one in 15 young people, it is not the only one. Truth Hurts describes self-harm as “a wide range of things that people do to themselves in a deliberate and usually hidden way, which are damaging”.

Self-harm is often a way of coping with painful and difficult feelings and distress. Someone may harm themselves because they feel overwhelmed and don’t know how else to deal with things. It’s usually a very private issue and motivations and methods will differ from one person to another. Some forms of self-harm carry a serious risk, but this doesn’t mean someone who self-harms is always intending to cause themselves serious injury.

Self-injury

Self-harm can take many different forms. Cutting is the most common form of self-injury, but others can include: burning; scalding; stabbing; banging heads and other body parts against walls; hair-pulling; biting; breaking bones; jumping from heights or in front of vehicles; and swallowing or inserting objects.

Self-poisoning is the term used for overdosing with a medicine or medicines or swallowing a poisonous substance. It may also be that someone self-harms by inhaling/sniffing harmful substances. The majority of people who attend Accident & Emergency (A&E) because of self-poisoning have taken over-the-counter medication. Others may overdose on medicines that have been prescribed by their doctor, such as antidepressants. A small number of people will take a large amount of an illegal drug or poison themselves with another substance.

The relationship between self-harm and suicide

Although people who self-harm are not usually trying to take their own lives, they could be at a higher risk of killing themselves, whether it’s intentional or not. Research suggests that the intention to commit suicide is present in up to 15% of those who self-harm. Although it’s wrong to presume that people who self-harm are trying to kill themselves, a small proportion of people who self-harm go on to take their life within two years.

“We would be more concerned about suicidal feelings if the person is saying ‘I just don’t want to live’ and there is a real intention to end their life,” says Frances McCann, a senior mental health practitioner. “There’s a big difference between someone saying they self-harm when they feel angry and a young person saying that they can’t go on any more and want to end everything.”

People who are suicidal can be more likely to avoid asking for help and may even carry out final acts, such as writing a will, or choosing a violent means of self-harm that result in little chance of survival. The risk of suicide is also increased in people diagnosed with bipolar disorder, depression or schizophrenia.

Could it be Borderline Personality Disorder? (BPD)

This is a condition that affects how a person thinks, feels and behaves. People with BPD can have mood swings and act impulsively in a way that could be damaging to them. Just because someone self-harms it doesn’t mean that they have BPD – this is just one of the symptoms that may lead to a diagnosis of BPD, which is a very complex condition.