Self-harm

People go to great lengths to protect themselves from pain and injury. But some people hurt themselves on purpose to help them deal with bad feelings or thoughts. This is called self-harm. People who self-harm don’t do it to end their life—instead, self-harm may be the best way they know to survive.

On this page:

• What is it?
• Who does it affect?
• What can I do about it?
• How do I know if someone I love is self-harming?
• What can I do if someone I love self-harms?
• Where do I go from here?

What is it?

Self-harm means that you hurt yourself on purpose, but you don’t intend to die as a result. It isn’t a mental illness—and in many cases, it isn’t a sign that someone has a mental illness. Instead, self-harm is usually a way to deal with difficult feelings or show distress.

When you self-harm, you cause some kind of damage to your body. The most common ways to do this are cutting or burning the skin, scratching that breaks the skin, hitting to the point of bruising or breaking bones, biting or falling. Some people also take a minor overdose of a substance (for example, they take more than the recommended dose, but not a lethal dose, of an over-the-counter medication) to harm themselves.  Acts of self-harm are sometimes done on impulse, and sometimes they’re planned. Certain people who self-harm say that don’t feel pain when they hurt themselves, or that they do it to feel physical pain.

Why do people self-harm?

• To deal with uncomfortable or unwanted feelings like anxiety or depression
• To cope with grief, loss, violence or chronic illness
• To punish themselves or to express self-hatred or self-anger, or feelings of failure
• To make their emotional pain feel like physical pain
• To  feel “real”, feel anything or to cope with feelings of emptiness or numbness
• To regain control over their body
• To just feel better

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Who does it affect?

• Teens—Self-harm affects 1% to 4% of the population, but rates of self-harm among teens range from 14% to 39%. Some teens may feel extreme emotions. They may have more conflicts with adults and may have to deal with loneliness and peer pressure.
• People with certain ways of coping or thinking about themselves—Self-harm seems to be more common in people who feel poorly about themselves. It’s also more common in people who feel like they can’t express their feelings or who have a hard time dealing with negative events or emotions. Self-harm may also be a way to deal with abuse.
• People living with a mental illness—Sometimes self-harm is a sign of a mental illness. It’s seen with a few different illnesses, including eating disorders, depression, anxiety disorders, substance use disorders and some personality disorders.

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What can I do about it?

It’s important to talk to someone about self-harm because it can result in a serious injury or become a habit.¹⁶ Self-harm may also be a risk factor for future suicide attempts.¹⁷

What can I do about self-harm injuries?

• In an emergency—As in any health emergency, call 911 or go to the nearest emergency room.
• At home—Care for any injuries properly. It’s always a good idea to see your doctor if you’re not sure what to do. In BC, you can also call 811 and talk to a registered nurse.

What can I do about self-harm behaviours?

Many people who self-harm don’t have a mental illness. But some people self-harm as a result of a mental illness. That’s why it’s important to tell your doctor if you’re experiencing any other symptoms, like troubling thoughts or feelings. If self-harm is related to an illness, treating that illness can reduce the thoughts or feelings that lead to self-harm.

The following treatments may be helpful on their own or as part of your treatment plan:

• Cognitive-behavioural therapy (CBT): CBT teaches you how your thoughts and behaviours affect your mood. This may be particularly helpful for people who self-harm because it may reduce the feelings that trigger self-harm. CBT may improve anxiety, depression, self-esteem, problem-solving skills and coping skills in people who self-harm.
• Dialectical behaviour therapy (DBT): DBT teaches you how to replace extreme and rigid ways of thinking with more open and flexible ways of thinking. It also teaches skills like acceptance and problem-solving, and can teach you how to cope with uncomfortable or difficult thoughts, feelings and situations.
• Self-help: Regular exercise, eating well, getting enough sleep, staying in touch with family and friends, joining a support group and doing things you enjoy are some things that are good for everyone’s mental health. If you’re struggling with self-harm, it may be helpful to find other healthier ways to cope that work for you, like talking to friends, writing in a journal or practicing relaxation exercises. It’s also a good idea to avoid any media (like TV shows or movies) that makes self-harm look glamorous or ‘cool.’

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How do I know if someone I love is self-harming?

It may be hard to tell if someone self-harms, and someone who self-harms may try to cover up their injuries because they’re embarrassed or ashamed. While people may hurt themselves in different ways, here are a few warning signs:

• They often have unexplainable wounds like cuts, burns or bruises
• They have many unexplainable scars
• They often say that they’re “accident-prone” or have many accidents
• They cover their body, even during warm weather

Remember, someone who self-harms doesn’t want to die. But if you aren’t sure if someone you love self-harms or feels suicidal, it’s best to be cautious and get help immediately.

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What can I do if someone I love self-harms?

It’s natural to feel shocked, angry, frustrated, confused or guilty if you find out that someone you love self-harms. But it’s important to remember that self-harm is a sign that someone you love is in distress. A compassionate approach is the best way to help. While everyone’s situation is different, here are some general things you can do to help:

• Educate yourself about self-harm
• Avoid anger and judgment. Your loved one isn’t trying to hurt you, make you feel guilty or get attention
• Focus on your loved one’s concerns or issues, not the act of self-harm
• Encourage positive, healthy coping methods. It takes time to learn the positive coping skills that can replace harmful coping skills. Don’t demand that your loved one stop self-harming immediately
• Let your loved one know that you’re willing to listen, but don’t force them to talk
• Encourage your loved one to seek professional help

Helping someone you love can be hard. It’s important to take care of yourself, too. For example, do things you enjoy, talk with a friend about your own feelings and/or set boundaries for how much you can help the person you love. If you’re having a hard time coping with loved one’s self-harm, extra support from a mental health professional or support group may be helpful.

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Where do I go from here?

Note: If you hurt yourself badly, or see that someone you care about has, call 911 or go to the nearest emergency room. If you ever feel like ending your life, talk to someone and get help right away. If you need help or think that someone you love needs help, call 1-800-SUICIDE.

In addition to talking to your doctor or mental health professional, check out these resources for more information about self-harm:

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for info sheets and personal stories about self-harm. You’ll also find more information, tips and self-tests to help you understand many different mental health problems.

Kelty Mental Health
The BC Children’s Kelty Mental Health Resource Centre provides mental health and substance use information and resources, assistance navigating the mental health system, as well as free personalized support from parent peer support workers for families across BC and Yukon. Contact Kelty Mental Health at www.keltymentalhealth.ca or 1-800-665-1822 (toll-free in BC) or 604-875-2084 (in Greater Vancouver).

INSYNC (Interdisciplinary National Self-Injury in Youth Network Canada)
Visit www.insync-group.ca to learn more about self-injury and find links to other websites for youth who self-injure, as well as information and links for families and friends.

Resources available in many languages:
*For each service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you’re worried about, or talk with a pharmacist about medication questions.

1-800-SUICIDE
If you’re not sure if self-harm is a suicide attempt, call 1-800-SUICIDE (1-800-784-2433) to get help right away, any time of day or night. It’s a free call.

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

© 2013

This info sheet was prepared by CMHA BC Division on behalf of the BC Partners for Mental Health and Addictions Information and HeretoHelp. Funding was provided by BC Mental Health and Substance Use Services, an agency of the Provincial Health Services Authority. For more resources visit HeretoHelp.bc.ca.