CW: This article mentions self-harm and topics relating to mental health
Self-harm is a deeply personal and nebulous experience, presenting very distinctly and differently for each individual. The acts can vary from burning, to cutting, to taking part in high risk or dangerous sports, and substance abuse. Currently, in the UK, there is an epidemic of teenage girls self-harming; studies have shown a fifth of 14 year-old girls have self-harmed. Notably, there is a higher incidence rate for people that experience same-sex attraction, with 46% self-harming out of a survey of 11,000 children. Moreover, NHS statistics show that in the last 20 years the number of girls admitted to hospital for self-harm have doubled.
But why is this happening?
There are a myriad of reasons for self-harming. To an outsider, purposely inflicting pain on oneself might be baffling, to say the least. I know that, for me, the idea brought on feelings of revulsion and genuine sorrow. What could make someone feel so bad that hurting themselves was an appealing coping mechanism? The answers are, predictably, unhappy ones.
For some, it’s a last resort because they don’t know how to cope with their feelings in a healthy way. For others, it brings relief as a way to release negative emotions. For me, there were several reasons. It certainly hurt less than the mental pain I was suffering with, and was also a distraction from it. I was consumed with the idea that I was not good enough; that everyone I loved would be better off if I wasn’t around. It took more energy than I care to admit to get out of bed every day. Simply sending a text to a friend back home felt like an insurmountable challenge. Existing was exhausting.
All of these things compounded one another and made me detest myself even more. I was plagued with thoughts about how pathetic I was – how could I not be able to send a text or sit on a chair because it ‘felt like too much’? In some ways, I think it was a way to prove to myself and others that I was hurting and needed help; the cuts were a physical representation of the mental pain that I couldn’t even begin to describe.
But, at the same time, I felt massive feelings of shame and embarrassment around the bloody marks on my skin. I wanted to hide them. I didn’t want my friends to worry or my tutors to notice. I didn’t want to answer the question that I knew they would ask – why? Self-harm is not a problem in a vacuum; it’s a distressing symptom of mental health issues that are being ignored. We cannot address it without dealing with the underlying cause.
I was depressed and often suicidal, and I couldn’t fathom saying that to my friends or my family as I couldn’t face the looks of horrified shock that I expected. I was terrified of disappointing them, that they would feel let down or ashamed that I had sunk to these sad depths. However, although I was met with some alarm when my friends did see the marks, I was also met with love and compassion as they weren’t ashamed or disappointed. Perhaps the only thing they were disappointed by was that I hadn’t told them what I was going through; they wanted to help.
If I’ve learned anything from this experience, it’s that we need to change our attitudes to self-harm. Shock and concern are, of course, natural reactions to learning that someone has been self-harming, but showing this shock and repulsion is not the best way to respond. It can push the person to shut down with the shame and embarrassment, at the time when they most need to open up. Instead, I would suggest approaching it with a calm desire to understand. There is a fine line that needs to be walked between de-stigmatising and normalising self-harm, of course.
This article has been uncomfortable to write, and I’m sure it’s no more comfortable to read. However, it is necessary. The most uncomfortable thing in all of this is the numbers of people that are suffering. To help, we must try to understand and, for better and for worse, that means facing the discomfort straight on. This can range from action on an individual level, such as approaching friends that appear to be struggling or at risk, to calling for governmental action.
An obvious change that is needed is more funding for mental health services for the NHS but also in schools and universities. I had to wait 5 weeks for an initial appointment with a university counsellor and for many people they simply cannot wait that long. Moreover, as part of de-stigmatising self-harm, we must change our approach to mental health. Mental health education must be a bigger part of the national curriculum and mindfulness techniques and healthy coping mechanisms need to be a part of this.
Mental illnesses, particularly anxiety and depression (which often come hand in hand), are ubiquitous in the UK as one in four people suffer with one each year. Yet over 70% of these people receive no treatment. This has to change. We cannot hope to address the increase in self-harming without changing our attitude towards and treatment of mental health and well-being. Most of what I have proposed concerns treatment, but prevention is better than that. Whether that means restricting screen time or time on social media, dedicating more time to exercises known to improve mental well-being, or making big changes to reduce the stress that is epistemic in our labour market and educational system, we must do something.
If you are concerned about your health or are affected by any of the topics covered in this article, visit nhs.co.uk or talk to your GP. If you have an urgent medical problem, you can call the NHS on 111 or 999.
You can also contact Samaritans 24 hours a day, 365 days a year, by calling 116 123 or emailing jo@samaritans.org.