To explain self-harm to someone who doesn’t understand, describe what you’re struggling with, say what support you need and choose how much you want to share. You can speak, write or use a message. You don’t need a perfect explanation to ask for help, and you don’t have to show injuries to be believed.
Content note: this guide discusses self-harm and suicidal thoughts without descriptions of methods or injuries.
Finding the words can feel like another job on top of everything you’re already carrying. You might worry about being judged, upsetting someone, losing privacy or having every future bad day treated as an emergency. If people already dismiss your illness, disability or distress because they cannot see it, asking to be believed again can be exhausting.
You can start smaller than the whole story. One person. One sentence. One request for something that would help today.
About this guide: Karsun Hill’s original lived-experience account was published on 13 June 2019. The personal reflections quoted here are Karsun’s. URevolution has added the practical guidance and research below; example messages are suggested wording, not quotations from Karsun or research participants. This is general information, not an individual clinical assessment.
How to explain self-harm: words to start with
Here is a starting point you can change to sound like you:
“I’ve been hurting myself, and I need some support. I find it hard to explain what’s happening. Please listen before asking lots of questions. Could you sit with me while we work out who I can talk to?”
If saying “self-harm” feels impossible, you could start with: “I’m worried about how I’m coping, and I don’t feel able to manage it alone.” Then share more when you can. Be direct about any immediate danger or injury that needs care.
You can show someone this page, hand over a note or read from your phone. The NHS guidance on telling someone about self-harm includes writing things down and practising what you want to say. It also makes clear that you do not have to answer every question immediately.
How do I explain why I self-harm?
Self-harm means deliberately hurting yourself. The reasons differ between people and can change over time. It may be connected with overwhelming feelings, numbness, painful memories or difficulty expressing distress. You might recognise one of those descriptions. You might not yet know what explains your own experience.
In Karsun’s original account, feeling out of control and struggling to find understanding were central. That is one person’s experience, not a definition everyone has to fit.
Mind’s explanation of self-harm describes how a brief feeling of relief can be followed by returning distress, guilt or shame. Understanding that pattern does not make self-harm safe. It helps explain why “just stop” may miss the difficulty someone is facing.
If these examples fit, you could say:
- When feelings are overwhelming: “Everything builds up until I don’t know how to manage it. I need help with what happens before I hurt myself, too.”
- When you feel disconnected: “Sometimes I feel numb or far away from myself. It’s difficult to describe, but it’s frightening, and I need support.”
- When you don’t know why: “I haven’t worked out the reasons yet. Please don’t make having an explanation a condition of helping me.”
You do not need to explain a diagnosis, childhood history or every difficult relationship in the first conversation. “I don’t know” is useful information for a clinician, too.
Does self-harm mean someone wants to die?
Not necessarily. But you cannot assume that someone is safe because they describe their behaviour as self-harm. Some self-injury happens without suicidal intent; clinicians may call that non-suicidal self-injury, or NSSI. Other episodes involve suicidal thoughts or intent, and a person’s intentions may be mixed or change.
The wider term “self-harm” does not, by itself, tell you someone’s intention. NICE’s self-harm guideline covers intentional self-injury or self-poisoning regardless of the apparent purpose. The NHS advises seeking support because some people who self-harm have a higher risk of suicide.
When explaining your own situation, say what is true now. You do not have to reassure someone by denying feelings you are having.
“I need to be honest: I’m also having thoughts about dying, and I need help staying safe.”
If you are listening, it is appropriate to ask plainly whether the person is thinking about suicide. The US National Institute of Mental Health reports that asking does not cause or increase suicidal thoughts. If there is immediate danger, help them get urgent care and stay with them if it is safe to do so.
Choose a person and a way of talking that feel safe
The person closest to you is not automatically the best first person to tell. Think about who listens without turning a difficult disclosure into gossip, an argument or a test of loyalty. That might be a friend, relative, GP, therapist or another trusted professional.
A 2025 interview study of 15 university students aged 18–25 found that trust, context, fear of reactions and choosing what to share shaped decisions to disclose self-injury. It is a small study of young adults, not a prediction of how your conversation will go. It does help explain why choosing carefully can matter.
If there is no immediate emergency, give the conversation some room. Ask whether the person can listen privately. Choose a format that works for you: in person, a call, a voice note or written words. Plan whom you could contact afterwards if you need more support.
If someone has threatened, abused or controlled you, you do not have to make them your first confidant. Tell a safer person or professional. If you are under 18, try to involve a trusted adult; when a parent or carer is unsafe, that could be a teacher, school counsellor or healthcare professional.
Talk about privacy without promising absolute secrecy
It is reasonable to ask who will be told and why. You could say: “Please don’t share this casually. If you think someone else needs to know to help keep me safe, please explain that to me and involve me wherever possible.”
Friends cannot safely promise to keep an immediate threat to life secret. Professionals also have limits to confidentiality, especially around serious danger and safeguarding. Before sharing, you can ask a professional what those limits mean in your situation. Mind’s guidance for young people encourages talking about confidentiality and asking to be told when someone needs to involve others.
You can decline to show injuries to friends or relatives. A clinician may need to examine an injury to assess treatment. You can ask them to explain what they need to do and discuss adjustments that would help.
Messages you can adapt for a parent, partner or friend
Use only the parts that fit. These examples are invitations to a conversation, not words you have to get right.
To a parent or carer
“There’s something about my mental health I’ve been afraid to tell you. I’ve been self-harming. I need you to listen without getting angry or asking me to explain everything at once. Can you help me arrange some professional support?”
To a partner
“I want you to know because you matter to me, and keeping this to myself has been hard. I’m struggling with self-harm. I’m not asking you to manage this alone. Could you listen, then help me think about the support I need?”
To a friend, by text
“Could we talk privately when you have some time? I’ve been hurting myself and I’m finding it difficult to ask for help. You don’t need to have all the answers. I’d appreciate some company while I decide what to do next.”
A text may not be seen promptly. If you need immediate help, contact an urgent service or someone who can be with you now rather than waiting for a reply.
To a GP or therapist
“I need help with self-harm. I’ve written this down because I may struggle to say it aloud. I’d like us to discuss my safety, anything that needs medical care and what support is available. Please explain the next steps before we finish.”
You can add what is difficult about getting care: cost, transport, fatigue, sensory overload, communication, previous discrimination or fear of not being believed. Those barriers belong in the conversation.
If someone tells you they self-harm, start by listening
Karsun described wanting understanding and receiving hurtful reactions instead. This line from the original essay is a useful reminder of what is at stake:
“I wanted compassion and understanding, but that’s not what I got.”
A helpful first response can be brief: “Thank you for telling me. I care about you. Do you need medical help or support to stay safe right now?” Then listen to the answer.
NHS advice for supporters focuses on understanding the person’s feelings, asking how they want support and avoiding threats or insults. You do not have to understand every part of self-harm to take someone seriously.
- Instead of asking for a promise that it will never happen again
- Ask what support they need today and whom you can help them contact.
- Instead of calling it attention-seeking
- Take the distress seriously. Needing someone to notice that you are struggling is a reason for care.
- Instead of demanding to see injuries or hear details
- Ask whether medical care is needed. Let a healthcare professional assess injuries.
- Instead of making the disclosure about your shock or guilt
- Listen first. Find your own support for your feelings afterwards.
Calling someone “crazy” when they disclose distress can shut down the conversation. Our guide to ableist language explores how disability and mental illness become insults. Here, the practical question is simple: will your words make it easier for this person to ask for help again?
Mind advises supporters to stay calm, avoid judgment and keep relating to someone as a whole person. Continue ordinary invitations and conversations. Their disclosure has not erased the rest of their life.
What if they don’t understand or react badly?
A poor response does not prove that you explained it badly. Someone might need time to understand; they might also behave in a way you should not have to absorb.
If it is safe, you can set a boundary:
“I can see this is difficult to hear. I need us to talk without insults or threats. I’m going to pause now and contact someone else for support.”
You can offer a reliable page to read later. You do not have to keep arguing for compassion while distressed. If one conversation goes badly, try another trusted person or a professional. If you need urgent help, do not wait for the first person to change their mind.
A 2025 qualitative study of self-injury stigma among 97 young adults described shame and reluctance to disclose, including the effect of anticipated judgment. Its university sample cannot represent everyone who self-harms. The findings support taking an unkind response seriously; they do not mean every future conversation will go the same way.
For a conversation you want to return to, our guide to handling uncomfortable conversations offers ways to manage pauses and defensiveness. Your safety comes before finishing a discussion.
Support should fit how you communicate
For disabled, chronically ill and neurodivergent readers, “just talk to someone” can leave out the difficult part. An appointment may be physically inaccessible. Pain or fatigue may shorten the time you can speak. A noisy room or rapid questions may make it hard to find words.
NICE recommends adapting information and assessment to a person’s disability, health conditions and communication needs. It also recommends alternatives when someone cannot easily describe distress aloud. Practical requests might include:
- “Please let me use this written note or my communication device.”
- “Ask one question at a time and give me time to answer.”
- “Can we use a quieter space or take a break?”
- “Please speak to me directly, even when my support person is here.”
If physical pain, treatment effects or inaccessible care are part of what is happening, say so. Ask for those problems to be considered alongside your mental health. A discussion about self-harm should not make your other healthcare needs disappear.
Make the next step small and specific
After the first conversation, choose one practical action: contacting your GP or therapist, asking someone to accompany you, or arranging a check-in. You can seek help for urges as well as for self-harm that has already happened.
A professional assessment can explore what has been happening, injuries, suicidal thoughts and the support you need. Treatment is individual; it may include psychological therapy and care for coexisting conditions. No particular diagnosis or level of visible injury should be treated as the price of asking for help.
A collaborative safety plan can record warning signs, coping approaches you have found helpful, people and services to contact, and agreed steps to make your surroundings safer. Work on it with a clinician where possible. NICE explains why these plans should be developed together and be accessible when needed. Keep yours somewhere you can reach when speaking or thinking clearly becomes difficult. A plan supports care; it cannot replace urgent medical help.
If you are supporting someone, be honest about when you can be available and help them build support beyond you. You can care deeply without becoming their only source of help.
“Self-harm may seem foreign to you, but seriously, we’re just like you.”
You can leave the first conversation with questions still unanswered. Having someone understand enough to stay, listen and help you reach care is a worthwhile beginning.
Where to find support
For ongoing support, contact a GP, primary-care clinician or mental health professional. Tell them about self-harm or urges, any injuries and any thoughts of suicide. If you have already received a care or crisis plan, use the contacts and instructions in it.
In Australia: Lifeline offers 24-hour crisis support. Call 13 11 14, text 0477 13 11 14, or use https://www.lifeline.org.au/crisis-chat/.
Outside Australia: contact a crisis service where you live. In immediate danger, contact your local emergency service or go to an emergency department. A crisis conversation is not a substitute for medical treatment after a serious injury, overdose or possible poisoning.
Sources and editorial note
This revision draws on NHS and Mind guidance, NICE guideline NG225, Healthdirect, NIMH and the linked 2025 studies. Sources were checked on 17 October 2026. Publication dates and study populations are identified where relevant; newer research does not make every older guideline obsolete. No independent clinical review is claimed.
The original article’s categorical separation of self-harm from suicide has been corrected. Graphic descriptions and song lyrics have been removed. Karsun Hill’s quoted words remain unchanged; the surrounding practical guide is a URevolution editorial addition.
