Understanding yourself
Self-harm
“It’s the only thing that makes the noise stop.”
Self-harm is a sign of overwhelming pain, not attention-seeking. With understanding and the right help, many people find other ways through.
Ishita is sixteen, top of her class, wears long sleeves even in the April heat, and posts aesthetic photos with captions about being “fine, actually”. Her best friend saw the marks on her wrist during the school trip to Srimangal. Ishita made her promise not to tell. Her friend is frightened, and has not slept.
An illustration drawn from common experience. The person is invented; the pattern is not.
Understanding self-harm
Self-harm means intentionally injuring or poisoning oneself. For most people it is a way of coping with overwhelming emotions, numbness, shame or distress, rather than an attempt to die, although it does increase the risk of suicide and must always be taken seriously. It is common in adolescents and young adults, often hidden, and frequently linked to depression, anxiety, bullying, abuse, relationship problems or pressure at school. It is not attention-seeking.
Signs and symptoms of self-harm
- Unexplained cuts, burns or bruises, often on arms or legs
- Long sleeves in hot weather, avoiding swimming or changing in front of others
- Withdrawal, low mood, or sudden changes in behaviour
- Talk of hopelessness, or of being a burden
Treatment for self-harm
Responding with calm and care, not anger or panic, is the first help. UK national guidelines on self-harm (NICE, 2022) call for a careful psychosocial assessment, a safety plan where suitable, and a structured psychological therapy tailored to self-harm; they advise against offering medicines specifically to reduce self-harm. Any depression or other condition is treated, and families learn how to support without blame.
What getting better can look like
Ishita’s first step might be one honest conversation with her mother, a therapist she trusts, and a summer in short sleeves.
Common questions about self-harm
Is self-harm the same as a suicide attempt?
For most people, self-harm is a way of coping with overwhelming emotions, numbness or distress, rather than an attempt to die. It does increase the risk of suicide, so it should always be taken seriously. A careful assessment helps understand what it means for that person.
What should I do if a friend tells me they are self-harming?
Stay calm and listen, without anger or panic. Encourage them to tell a trusted adult and to see a doctor; you do not have to carry the secret alone. If someone has seriously injured themselves or taken an overdose, call 999 or go to the nearest hospital emergency department.
When to see a psychiatrist
If you are harming yourself, please tell someone you trust and see a doctor. If someone has seriously injured themselves or taken an overdose, call 999 or go to the nearest hospital emergency department now.
Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.
If some of this sounds familiar, a first conversation is a good place to start. You do not need the right words, or to be certain.
Dr. Tajreen is consulting in Uttar Badda now, until 8:00 pm. Call +880 1847-331010Every address and its hours
Sources
- NICE guideline NG225, Self-harm, 2022
You do not need to have everything figured out before you begin.
