It's not always easy to understand why you feel the need to harm yourself.

It can be different for everyone, but self-harm might feel like a way of dealing with difficult situations, such as:

• Pressures at school or work
• Bullying
• Money worries
• Sexual, physical or emotional abuse
• Bereavement
• Homophobia, biphobia and transphobia
• Breakdown of a relationship
• Difficult feelings, such as depression, anxiety, anger or numbness.

If you feel the urge to self-harm, try doing something which will distract you and give you some breathing space.

Distraction ideas

• If you feel angry, try exercising, hitting a cushion or tearing something into small pieces
• If you're feeling sad or scared, wrap yourself in a blanket, spend time with a pet or try deep breathing
• If you want to self-harm because you want to feel something, you could try taking a cold shower, holding ice cubes for a short time or flicking elastic bands against your wrist.

Another good idea is to keep a diary and write down what happens, before, during and after your self-harming. It can be difficult to write about something which makes you feel bad, so when you've finished do something enjoyable and relaxing.

Talk to someone you trust or your GP for help - don't keep it a secret. Don't feel embarrassed or ashamed - talking about it can really help.

Try to think about what makes you want to hurt yourself. It might be a person, a situation or an anniversary - these are your triggers and if you know what they are, it might help you plan how you can deal with them next time you experience them.

Try to remember how it feels when you have an urge to self-harm - you might feel your heart racing, or have very strong feelings of sadness or anger. If you can recognise the urges before they get too strong it can help you to cope with them without turning to self-harm.

You can use all of this information to make a safety plan so that you feel prepared for the next time it happens. Review your safety plan regularly in case your feelings change.

Doing things that make you happy and relaxed is very important if you have had any feelings of wanting to self-harm.

If you have any hobbies, make time for them. Exercise and activities like drawing, listening to music or writing can also help lift your mood.

Getting enough sleep is also very important, as is eating healthily.

You could try mindfulness, which involves some simple activities to help you stay in the present moment and not worry about the past or the future. The app below is free and is a good way to get you started.

Smiling Mind mindfulness app

Make a list of emergency contacts in case you need help right away and include them with your safety plan. This might include a trusted person who you have already spoken to about your self-harming and who has agreed to help you.

Include the numbers of helplines, like Samaritans (116 123) or if you're under 19, Childline (0800 1111). You can also text "SHOUT" to 85258 to contact the Shout Crisis Text Line.

If your life is in danger, you should call 999.

General advice to keep yourself as safe as possible if you are going to self-harm:

• Be aware of basic first-aid and have a well-stocked first-aid kit handy.
• Make sure anything you cut yourself with is clean; for example, using new blades.
• Make sure you are up to date with your tetanus jab. Tetanus is a serious infection you can get through bacteria getting into wounds. 
• Avoid alcohol and drugs - being high or drunk might mean you cause more damage and affect your ability to react to an emergency.
• Think carefully about where you cut because it's dangerous - avoid visible major blood vessels, tendons and nerves, such as the insides of the wrists or the tops of the legs.
• You are less likely to cause serious long-term damage if you cut slowly and do not cut deeply.

If you have a small cut, scratch or graze, you should:

1. Clean the wound with running water (no lotions or creams)
2. Pat the area dry with clean, non-fluffy material
3. Cover the cut completely with a plaster or dressing.

If you have a minor burn, you should:

• Hold the burn under cold, slowly running water for 10 minutes.
• Chemical burns, for example from strong cleaning fluids, should be rinsed under cold, slow running water for 20 minutes and seek medical advice.
• If you can easily remove jewellery or clothing in the area of the burn, gently do so. The burnt area may swell up and/or become sticky and attached to them. However, if clothing or jewellery is already stuck to the burn, or cannot be removed without touching the burn, leave it alone and seek medical advice.
• Do not apply any creams, oils, grease, butter, ointments, adhesive dressings or cotton wool. Cling film can be used to loosely cover the burn and prevent it getting infected.
• Never interfere with the burn or break any blisters – this will delay the healing.

IMPORTANT! If you’re ever in ANY doubt as to how serious the injury is, always seek medical advice.

For serious cuts that bleed more, you should:

1. Apply direct pressure to the wound using a clean cloth. Apply the pressure for 10 minutes, and avoid lifting up the pad to look.
2. Raise the injured area above the level of the heart to slow down the bleeding.
3. Bandage the pad or dressing firmly to control bleeding, but not so tightly that it stops the circulation to fingers or toes.
4. Do not remove bandages as this can interfere with blood becoming sticky to seal the wound. If bleeding seeps through, cover with a second bandage.
5. If you lose a lot of blood, you can go into shock. This can be very serious and needs medical attention as soon as possible.

Your cut may need stitches if:

• The cut will not stop bleeding
• The cut is more than ¼ of an inch or 1 cm long
• The cut is gaping (i.e. the edges don’t stay together and you can see tissue or fat).

If something is stuck in a wound:

1. Leave it in place – don’t try to remove it as this may cause further bleeding
2. Raise the body part if possible
3. If you can, firmly push together the edges of the wound to try to stem blood loss
4. Gently cover the wound and object with a sterile dressing if possible and go to get medical attention as soon as possible.

For burns, seek medical attention if:

• If the burn is larger than a 50 pence piece, painful, charred (white) or seems to be getting worse.
• If the burn is on the face, hands, genitals or across the joints – burns to these areas can cause long-term movement problems.
• If the burn is chemical (from liquids like cleaning fluids).

If you have taken an overdose or poisoned yourself, you should:

• Seek help immediately – the longer you leave it, the greater the likelihood of serious damage.
• Write down what medication you’ve taken, including the number of tablets and dosage, plus if you have drunk any alcohol.
• Take the packaging and any remaining medication with you to the Emergency Department (A&E).
• If you have called an ambulance or other help, consider leaving your door unlocked so that they can get in if you lose consciousness.
• Don’t try to make yourself vomit – this can be dangerous.
• Don’t drive yourself to hospital. If you are too unwell to use public transport, call 999 and ask for an
  ambulance.

IMPORTANT! If you’re ever in ANY doubt as to how serious the injury is, always seek medical advice.