Non-Suicidal Self-Injury (NSSI / Self-Harm)

1) What it is

Self-harm is when someone intentionally hurts themselves to cope with emotional pain, numbness, overwhelm, or distress. It is often a coping strategy rather than a wish to die, but it still requires care, understanding, and support.

2) What it feels like

• “I need relief from this feeling.”
• “It’s the only thing that calms me.”
• “I feel numb and want to feel something.”
• “I hate myself afterwards.”

3) Common signs

• cuts, burns, hitting, or scratching
• hiding arms or legs
• avoiding situations where skin shows
• shame and secrecy
• emotional overwhelm or numbness
• relief after harm followed by guilt
• repeated urges

4) Causes

• emotional regulation difficulties
• trauma
• depression or anxiety
• shame and self-hatred
• overwhelming stress
• bullying
• neurodiversity-related overwhelm

5) Triggers

• rejection or conflict
• criticism or shame
• feeling trapped
• loneliness
• panic or numbness
• anniversaries or trauma reminders

6) What helps now

• delay urges by 10 minutes
• hold ice or snap an elastic band as a safer replacement
• brief intense exercise (for example, star jumps)
• write feelings instead of acting on them
• contact someone safe immediately

7) Longer-term support

• therapy (DBT is very effective)
• building distress-tolerance skills
• removing easy access to tools
• creating a safety plan and coping list
• treating underlying depression or anxiety

8) Treatment options

• GP support
• NHS Talking Therapies
• crisis team involvement if risk is high
• specialist mental health services

9) Medication

Medication may help underlying depression or anxiety, but it does not treat self-harm directly.

10) Practical tips

• shame makes self-harm worse; compassion supports recovery
• tell one person you trust
• treat wounds and seek medical help if needed
• replace harm with safer coping tools

11) When to seek urgent help

Urgent help if:

• serious injury or heavy bleeding
• infection risk
• suicidal thoughts
• you cannot keep yourself safe

12) UK help & support

• NHS urgent mental health services
• Samaritans 116 123
• Shout: text SHOUT to 85258
• NHS 111 (if unsure what to do)

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