Deliberately hurting yourself may sound extreme, but many people find that it is the only way they can cope with their emotions.

What does a self-harmer do?
• Anything that hurts.
• This can include cutting, punching, burning, picking skin, pulling hair out, taking overdoses and hitting yourself or your body against something.

  What causes it?

• There is no single cause, but for most people, self-harm is a way of dealing with great emotional pain.
• Self-harm is another coping mechanism in the same way that people turn to other harmful things like drink, drugs and gambling when they want to forget their problems.

  The reasons behind a person's distress can include:

• Low self-esteem.
• Poor physical self image.
• Painful experiences in childhood.
• Neglect or abuse.
• Experience of a violent or chaotic family background.
• Experience of physical or emotional cruelty.

  Who suffers from it?

• People from all walks of life.
• Self-harmers can appear successful and happy with no outward sign that anything is wrong.
• Self-harm is more common amongst women but both sexes use it as a way to block out painful feelings.

  Some people who self-harm claim it helps them:

• Release unbearable tension caused by anxiety, grief or anger.
• Put their pain 'outside' where it's tangible and easier to cope with.
• Relieve feelings of shame or guilt.
• Tell people, including themselves, they need help.
• Feel real and alive.
• Feel they have control over something in their life.

  Even though self-harm is usually the result of mental anguish, damaging your body can lead to:

• Blood poisoning.
• Infections from wounds.
• Scars and lasting damage to your body that can be embarrassing and painful.

  Other problems associated with self-harm can include:

• Alcohol and substance abuse
• Eating disorders
• Homelessness
• Suicide - self-harmers can become suicide statistics if their distress is left unchecked or a self-inflicted injury goes too far.

  Relationships can also be affected as:

• Self-harm is stigmatised and people don't feel they can be open which puts barriers up between people.
• Self-harmers often find it hard to trust other people.
• Friends and relatives of self-harmers can be frustrated by the self-harmers' behaviour and the fact that their support doesn't appear to help.

  How do I help someone I know who is self-harming? How do I help someone I know who is self-harming?

• Be aware you cannot necessarily change your friend or relative's life or coping mechanisms.
• Be caring, respectful and willing to listen and allow the self-harmer to retain their dignity.
• It may be hard, but do not patronise, condemn, judge, attempt to explain or control, or panic.
• Becoming part of the self-harmer's support network is a step towards helping them develop other coping mechanisms.
• Be patient - your support will make a big difference even though it may not seem like it.

  How can I manage my self-harming?

• Try and understand why and when you self-harm.
• Recognise people who support you and help you feel good about yourself.
• Be patient. Change takes time and one set back doesn't mean you haven't improved.
• Talk to somebody who you see as 'safe'.
• Don't suffer on your own - doctors, counsellors, your friends and family can help.

Things I do to stop myself from cutting.

• Approximately 24,000 teenagers were admitted to Accident and Emergency for self-harm in England and Wales in 1998.
• Three teenagers self-harm every hour.
• Self-harm among men aged 15-24 has doubled as men find it harder to express their emotions.
• Almost half the population knows someone who has self-harmed.
  The Mental Health Organisation estimates that:
• 1 in 130 people (or nearly half a million people) across the UK self-harm.
• 142,000 hospital admissions are a result of self-harm every year in England and Wales.

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  There is a light at the end of the tunnel - people do stop self-harming when they've sorted their problems out and found other ways of coping. It might take a long time and they might need help, but things can get better.

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