Depression and low mood

Depression, self harm & suicidal feelings

Self-harm is purposeful injury or harm to oneself. Some people self-harm as a way of dealing with very difficult thoughts and feelings that they can’t cope with in more positive ways. Many young people self-harm and it is thought that around 10% of young people self-harm at some point (NHS Choices June 2015). Not everyone with depression self-harms, and similarly, many young people who self-harm are not depressed. Self-harm can also be a suicidal act although not everyone who self-harms is suicidal. Those who self-harm may be at a higher risk from suicide though.

Here young people talk about self-harming, how it had started, their motives for self-harm and the support they had received from family, peers and professionals. Some young people we spoke with had also experienced suicidal feelings or had attempted suicide and here they talk about those experiences and how to get help if feeling suicidal.

If you need help visit our resources section for confidential helpline numbers.

Beginning
A few people remembered starting to first self-harm at the age of 9 and 10 but most started self-harming in their teens. Those who had started at a younger age, said they didn’t necessarily realise at the time that it was ‘self-harm’ but more just about causing physical pain or as one woman described, “being accident-prone”.

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Quite a few people also said that self-harm had started off with what they described as harmless “scratches” but had gradually become worse, and more frequent, leading to injuries and for few, permanent physical bodily damage. These people said they had never intended self-harm to become a regular thing but that they had become “obsessed” or “addicted” to it over time. One woman said it was “never meant to go that far” and another that it had just “spun out of control”.

Making sense of self-harm
Young people described how complex self-harming was and talked about the wide-ranging reasons behind their behaviour. Many said they were very aware of the reasons why they were self-harming at the time of doing it, rather than it being a random act.
 
Many people described self-harm as “a form of control”. For them, it was a way to control or contain what otherwise felt like uncontrollable feelings of upset and depression, or an “overwhelming” life. In this sense, self-harming was like “a bad coping strategy” for young people who didn’t know how else to ease their pain.
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Similarly, many also described it as “a release” of pain, upset, stress or anger. One woman said for her, self-harm was the only way to “express her feelings” and another one described it as a way to “let out the pain inside”. A couple of people compared the effects of self-harming to crying; a release of tension and sadness. When they were unable to shed tears they would self-harm. For many, self-harming was closely connected to depression and they said they self-harmed because they felt so low and down. Some said they only self-harmed during depressive episodes and bad periods of life. In turn, scars from self-harm could then make depression worse and make people feel bad or ashamed about themselves and their bodies. Many young people also said that self-harming was like an addiction, and compared it to smoking or drugs.

For some people, self-harming was about punishing themselves and causing pain and injury because they felt so low and negative about themselves. A couple of people said they felt unable to deal with “extreme emotions”, especially happiness, and hence self-harmed, as a way to “balance” out their emotions.
 
People also pointed out that sometimes, and in some ways, self-harming was a way of to seek attention. They wanted to clearly distinguish between seeking attention for the sake of it, and seeking attention as a way to get help. One man described his self-harming as “cries for help”. A couple of people emphasised that “attention seeking” through self-destructive behaviour is always a problem and maybe the only way for someone to seek help.

Other people’s reactions
People felt there was a general lack of understanding about self-harm. Many felt criticised and judged for doing it. They had experienced people staring at the scars, whispering behind their backs or openly making fun of them. Many wanted to keep the scars or marks hidden at first but said in time they had learnt to accept them as a part of themselves and their past and didn’t want to hide them anymore. Some had been approached by strangers on the street or in the pub commenting or questioning their behaviour.

Those whose parents had found out about self-harming, said their parents didn’t quite know how to handle the situation. Many said their parents had been really worried for them and also upset when they found out. Some parents had blamed themselves for young people’s self-harming, others had got angry. Many parents had also been very helpful and supportive, trying to speak with young people or help them to go for counselling. A couple of women said their partners or parents had been so desperate for them to stop that they’d tried to physically restrain them.

Some people felt that professionals and even hospital staff were unsure how to handle self-harming or how to best help young people. A couple said their schools had been aware of the self-harm. One person said the school completely ignored the problem whereas another one had great support from college, including flexibility around assignments and deadlines when needed.
 
A few people also expressed worries about their work prospects and how visible scars might affect their future employment. A couple of them worked with children or wanted to do a course in child care. One woman felt it might be inappropriate for her to work with children who would see the scars and another said in her work she always covers the scars.
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People described self-harming as something directed internally towards themselves and wanted to dispel the myth that people who self-harm would be a danger or a risk to other people.
Getting support for self-harming
Some of the people we talked with felt there was very little information, support and knowledge about self-harm, however there is support available for self-harm. Many people we spoke with said they’d been keen to stop, but the support they received did vary. All the people said they were very aware that self-harming was “bad” for them but it wasn’t so simple to just stop. One woman compared self-harming to smoking and said:
 
“like smoking it’s an addiction and just saying, “Right I want it to stop now, and that’s it.” It doesn’t really work like that I’m afraid.”
Many wanted to keep self-harming a secret and hide it from family members, for example. A few said they themselves hadn’t seen self-harm as a problem straightaway but only much later. Several people had looked for help, but said that stopping self-harming had been difficult and often a long process. One woman said that after years of resorting to self-harm it was very hard to learn to “cope without it”.
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There were tips the people had been given to help them to try and control the urge to self-harm. These included squeezing an ice cube in their hand or flicking themselves with rubber bands. Some people found that distracting themselves by, for example, listening to music, reading or going out helped them occupy their mind so that they weren’t consumed by thoughts of self-harm.

Some had been to counselling for depression and had been able to process the issue of self-harm too but said they were given no information specific to self-harm. A few had also looked out for information actively themselves, read self-help books and a couple of people had found good support websites and forums for people who self-harm. However, one woman also pointed out that going on the websites sometimes got her down and made the urge to self-harm worse rather than better.


For more on self-harm see our website Self-harm: parents’ experiences​.

Suicidal feelings
A few young people we spoke with had experienced suicidal feelings or had attempted suicide. Some described having suicidal “thoughts” or “urges” but said they would never act on them. For them, it was more an aspect of their negative or pessimistic mindset. Some described suicide attempts more as a way to harm or hurt themselves than to end their lives, and a couple of people compared a suicide attempt to self-harm in the sense of attempting to exercise control over their life.

A couple of the people who had attempted suicide made a distinction between those attempts which were serious “cries for help” and the ones when they had really wanted to end their lives. Those who had attempted suicide several times said it had become a cycle, and they often ended up back in the A&E.
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People who had suicidal thoughts described having felt “utterly hopeless”, like they lacked a future or the desire to live. A couple had had a “breakdown” or felt that they’d struggled a long time and had “had enough”. Some said they felt like a “burden” or “baggage” to others. For most, a suicide attempt had been an accumulation of several things going wrong at school, at home and in relationships. For some, it had involved problems with alcohol and drugs and long term depression.
 
The process of getting over suicidal behaviour had been long and gradual but successful for many. Most had been admitted to hospital, for emergency crisis care as a minimum, or for a longer stay on the ward. People pointed out that it was the underlying urges of suicidal thoughts which needed to be tackled, rather than just the acts themselves. This way they had felt able to regain control over their lives and to rebuild their lives. Taking the first step to get the help and speak about what they were feeling had been the hardest but the best step young people said they had taken.

For links to more information and support, please see our resources section.

Last reviewed June 2017.

Last updated June 2017.

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