There are many reasons why people self-harm and these can change over time, but the causes usually stem from unhappy emotions.

Self-harming has been described as a "physical expression of emotional distress". Some people find that the physical act of hurting themselves helps them deal with overwhelming emotional and psychological issues.

If you are feeling like this, you can speak to your GP, call the Samaritans on 08457 90 90 90 for support or visit the website of Mind, a mental health charity, for further advice.

Social factors and trauma

Research has shown that social factors commonly cause emotional distress in people who self-harm. These include:

• difficult relationships with friends or partners
• difficulties at school, such as not doing well academically
• difficulties at work
• being bullied, either at home, school or work
• worries about money
• alcohol or drug misuse
• coming to terms with your sexuality if you think you might be gay or bisexual
• coping with cultural expectations, for example, an arranged marriage

Self-harm could also sometimes be a way of coping with a traumatic experience. For example:

• sexual, physical or emotional abuse, including domestic abuse and rape
• the death of a close family member or friend
• having a miscarriage

Emotional distress

The distress from a traumatic experience or an unhappy situation can lead to feelings of low self-esteem or self-hatred. You could also have feelings of:

• anger
• guilt
• anxiety
• loneliness or isolation
• grief
• hopelessness
• numbness or emptiness
• feeling unconnected to the world
• being unclean, unworthy, trapped or silenced if you have been abused

The emotions can gradually build up inside you, and you may not know who to turn to for help. Self-harm may be a way of releasing these pent-up feelings. It can be a way of coping with overwhelming emotional problems.

Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age. Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police.

Psychological causes

In some cases, there may be a psychological reason for the self-harming. For example:

• you may hear voices telling you to self-harm
• you may have repeated thoughts about self-harming and feel like you have to do it
• you may disassociate (lose touch with yourself and your surroundings) and self-harm without realising you are doing it
• it can be a symptom of borderline personality disorder (a condition that causes instability in how a person thinks, feels and behaves)