Thoughts of self-harm

When you need help now

If you feel like you might harm yourself in the near future, have already started doing so, have trouble controlling impulses, or are having suicidal thoughts at the same time, seek emergency help now.

Call 103 in Ukraine or go to your nearest emergency department.

If possible:

don't be alone;

Tell your loved one that it’s difficult for you to stay safe right now;

go to where other people are nearby;

increase the distance between yourself and objects or substances that can cause harm to yourself;

Avoid drinking alcohol or other substances that can increase impulsivity.

What is important to know

Self-harm can serve different functions. For some people, it temporarily relieves intense internal tension, helps them shift from emotional pain to physical sensations, or restore a sense of reality when experiencing emotional numbness.

For others, the desire to harm themselves is associated with strong self-blame, feelings of guilt, shame, or a desire to punish themselves.

The short-term relief from self-harm can reinforce this way of coping with emotions, so over time the impulses sometimes become more frequent.

This does not mean that a person is “manipulating” others or simply needs to show more willpower. It is important to understand the function of self-harm and find safer ways to cope with the condition.

What to pay attention to

How long have thoughts of self-harm appeared?

How often do they occur and do they become more intense?

What situations, emotions or events usually precede them.

Whether there is a feeling of internal tension, emptiness, anger or emotional numbness.

Do you have a desire to punish yourself?

How difficult it is to switch from the impulse to harm yourself.

Have you had episodes of self-harm before?

Do they become more frequent or more severe?

Do you have thoughts of death or suicide at the same time?

Do you feel like you might lose control of your behaviour?

Whether alcohol or other substances are used.

Is there significant depression, anxiety, feelings of worthlessness or hopelessness?

Is there a person to whom I can report what is happening?

What can help

It is important not to be alone with such thoughts. Even if you're sure you don't want to die, it's worth talking to a psychiatrist, psychotherapist, or other mental health professional about thoughts of self-harm.

Together with a specialist, identify situations and emotional states that usually precede an impulse, and choose safer ways to reduce stress.

In a moment of strong impulse, increasing your distance from potentially dangerous objects, moving to a safe place near other people, contacting a loved one, grounding, slow breathing, or switching your attention to neutral physical activity can help.

You can also work with a professional to create a safety plan: identify the early signs of a crisis, actions that can help you get through the worst of it, the people and services you can turn to, and ways to make the environment safer.

When to ask for help

If thoughts of self-harm recur, it is worth contacting a mental health professional even if you are not currently harming yourself and have no suicidal intent.

It is especially important not to delay consultation if the thoughts become more persistent, episodes of self-harm are already occurring, the person is increasingly using them to regulate emotions, or there is a feeling of loss of control.

Emergency help is needed if:

there is an immediate risk of serious harm to yourself;

the impulse cannot be controlled;

self-harm has already occurred and medical attention is required;

suicidal thoughts, intention or plan appeared at the same time;

you are not sure that you can maintain your own safety.

In such a situation, call 103 in Ukraine or go to the nearest emergency department. If possible, do not be alone.