Self-harming has been described as a 'physical expression of emotional distress'. If somebody is feeling overwhelmed with unhappy emotions, they may find that the physical act of hurting themselves makes them feel better.

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
• grief
• 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 and finding a way to cope with your problems. It is not usually an attempt to seek attention, but a sign of emotional distress.

Some research has suggested that people who self-harm may have difficulty managing or 'regulating' their emotions. They use self-harm as a way of managing tension and anger. Research has also shown that people who self-harm are poorer at problem-solving.

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 (where the cause is related to an issue with your mind). 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).