Self-harm

Also known as self-injury

Self-harm is when you damage or injure your body on purpose. It can be a way of coping with intense emotions or distress brought on by overwhelming feelings or situations.

Key points

  1. Self-harm is not uncommon, especially in young people.
  2. If you self-harm you are not weak or crazy or attention seeking. It just means you are overwhelmed by how you are feeling right now and this is a way you have found to cope.
  3. Sometimes when people self-harm, they feel on some level that they want to die. While some people who self-harm are at a high risk of suicide, others who self-harm don't want to end their lives.
  4. Self-harming can make you feel better in the short term but it won’t make the feelings go away in the long term. Fortunately, there are other things you can do that will help you start to feel better both now and in the long term.
  5. If you are harming yourself, talk to someone you trust. It’s up to you to decide when to stop self-harming. It’s also up to you to decide if and who you want to talk to. Remember, though, that it’s a lot easier on yourself if you can find someone you trust to talk things through with.
  6. If you don’t want to talk to someone in person, you can call a helpline where you can remain completely anonymous, yet be able to talk to someone who understands what you are going through:
  • Call or free text 1737
  • Call Lifeline on 0800 543 354
  • Call Youthline on 0800 376 633, or text 234
  • Call Healthline on 0800 611 116
  • Call Samaritans on 0800 726 666
  • Contact a doctor.
If you have seriously injured yourself, taken something poisonous or overdosed on medicine or drugs, call 111 and ask for an ambulance.
If you are trying to stop yourself from hurting yourself right now, you can get help from your local DHB’s mental health crisis assessment team. Find your local service by looking online at Get help in a crisis or free call or text 1737.

Why do people self-harm? 

There are many reasons why someone might self-harm. In most cases, people self-harm as a way of coping with overwhelming emotions or distress. The intense or difficult feelings that can lead to self-harming, such as depression, anxiety, anger or numbness, may be caused by:

 Social problems ­– such as:

  • being bullied
  • exam or work pressures
  • relationship stress or breakups
  • identity issues to do with sexuality or culture
  • poverty or money worries.

Trauma – such as:

  • emotional, sexual or physical abuse, or neglect
  • the death of a close family member or friend.

Health issues – such as:

  • an illness or physical problem
  • anxiety or depression
  • psychological problems such as psychosis (loss of touch with reality), or repeatedly having thoughts or hearing voices telling them to self-harm. 

Sometimes there is no clear reason why someone is self-harming.

What treatments are there for self-harm? 

In most cases talking therapy such as cognitive behavioural therapy (CBT) is recommended for people who self-harm. Talking therapy involves attending sessions with a therapist to talk about your thoughts and feelings, and how these affect your behaviour and wellbeing. You also learn healthier ways of managing difficult thoughts and feelings and how to cope with distress. 

You can ask your GP to recommend someone or find a counsellor yourself. You can find a health practitioner who has a kaupapa Māori approach to wellbeing in this directory.

There are also online therapy modules listed below where you can learn different ways of managing difficult thoughts and emotions. 

If you have other health problems as well, such as significant anxiety or depression, your treatment plan may involve medicines to treat these. 

How can I look after myself if I am self-harming? 

The best thing you can do to help yourself is to tell someone you trust – a friend, family member or your doctor – or phone one of the helplines listed below. You don’t have to cope with this on your own. 

It’s up to you to decide when to stop self-harming. It’s also up to you to decide if and who you want to talk to. Remember, though, that it’s a lot easier on yourself if you can find someone you trust to talk about things with. Getting help when you need it is a sign of strength, not weakness. 

Small steps are the key to change – choose what feels manageable and build from there. The following may help you stay safe: 

  • Learn what your triggers are – the things that make you want to hurt yourself. It could be places, certain behaviours in other people, times of day, etc. You can use a journal to note these down as well.
  • Staying connected to family, whānau and friends can help you feel better. If you are spending a lot of time with people who self-harm, find other people to be with and do things together that you enjoy.
  • Learn to recognise the warning signs of how you feel before you want to hurt yourself: physical sensations, such as a racing heart, shallow breathing, feeling ill; starting to feel as though you aren’t in your body or strong emotions like anger, or sadness or desperation.
  • Think about what sorts of things you can do to distract yourself if you feel the urge to hurt yourself. Try exercise, music, talking on a helpline, putting ice on your forehead, having a very cold drink, draw or paint. No matter how strange it may be, if it works for you it’s important.
  • Learn slow breathing as this is a great tool to calm yourself when you are distressed. Try CALM (Computer Assisted Learning for the Mind)
  • Write a list of the things that work for you, and keep it with you to remind yourself when you notice your warning signs.
  • Look after yourself – get enough sleep, eat good food and exercise. Cut down on or stop taking alcohol and recreational drugs.
  • Find a support group ­– ask your doctor or counsellor if there is a support group near you for people who self-harm.
  • Don’t ignore any difficult feelings you have – have a plan for those times. Talk to a counsellor or learn skills for managing emotions on one of the websites listed in the online resources below.
  • It’s wise to keep taking any medication your doctor prescribed for you and keep attending all your appointments. If you have concerns about any medications you are taking it is better to talk to your doctor before stopping them.

See also how to support someone who is self-harming

What support is available for someone who is self-harming?

Helplines 

  • Need to talk? Free call or text 1737 any time for support from a trained counsellor
  • Lifeline 0800 543 354 (0800 LIFELINE)
  • Depression Helpline 0800 111 757
  • Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO) – for people in distress, and people who are worried about someone else
  • Healthline 0800 611 116
  • Samaritans 0800 726 666
  • Youthline 0800 376 633, free text 234 or email talk@youthline.co.nz
  • What's Up 0800 942 8787 – for 5 to 18-year-olds, Monday to Friday midday–11pm and weekends 3pm–11pm
  • Kidsline 0800 54 37 54 (0800 KIDSLINE) – 24/7, for young people up to 18 years of age
  • OUTLine NZ 0800 688 5463 (0800 OUTLINE) – provides confidential support for sexuality or gender identity issues

Online resources

  • SPARX.org.nz An online self-help tool that teaches young people the key skills needed to help combat depression and anxiety.
  • The Journal NZ-based self-help programme designed to teach you skills that can help you get through mild to moderate depression more effectively.
  • Big White Wall Free for Auckland DHB residents. A UK-based professionally facilitated, peer support community of people who are experiencing common mental health problems.
  • Aunty Dee Structured problem-solving website using CBT (cognitive behavioural therapy).
  • CALM Computer-assisted learning for the mind. Includes audio modules, eg, meditation, mindfulness, dealing with anger, preparing for exams.
  • The Lowdown For young people aged 18 to 25 years struggling with anxiety or depression. Includes self-help resources, a chat forum (requires registration), and free text or email with trained counsellors.
  • Smiling Mind Mindfulness meditation
  • An online training module from the Australian Centre for Clinical Interventions to help you learn how to tolerate distress better
  • DBT self-help Modules on managing a range of issues including self-soothing, building self-compassion and facing your feelings.
  • Common Ground A website to help parents, families, whāanau and friends support young people to manage hard times and enjoy positive mental health and wellbeing. 

Learn more

Self-harm KidsHealth, NZ, 2018

References

  1. Self-harm NHS, UK, 2015
  2. The health and wellbeing of New Zealand secondary school students in 2012 The University of Auckland, NZ, 2013
  3. Self-harm Mental Health Foundation, NZ,  
Credits: Health Navigator Editorial Team. Reviewed By: Dr David Codyre, consultant psychiatrist, East Tamaki Healthcare Last reviewed: 02 Jul 2019