Some people who self-harm say that it's an immediate emotional release; an action they can take when things get too much. But although it can provide instant relief, there are longer-term consequences that you need to be aware of.

Cutting

"It's important to remember that all injuries will leave permanent scarring," says Hamish Laing of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).  This can come as a surprise to people who expect to have their scars removed, he says, when often there's very little that can be done.

As well as scarring, cutting your skin can have more serious consequences. "If you are cutting your wrist, you're not very far away from the mechanics of the inside of your arm," says Hamish. "We see lots of people who have injured tendons, nerves, blood vessels and muscles. And although some of these can be repaired, if you cut a major nerve in your wrist you can be left with permanent weakness or numbness in your hand, or both. It's a very significant injury."

That's something that 20-year-old Lara experienced: "I self-harmed for five years, usually cutting around once a week. Eventually, I'd cut so much that I was starting to lose feeling in my left wrist and, over a period of a few months, I completely lost feeling from my elbow down to my hand."

Prevention techniques when cutting

Hamish says that prevention is always better than cure, but there are steps you can take if you are going to cut that can help reduce the long-term effects. The first is to avoid doing it deeply. "Secondly, it's important get help so that wounds won't become infected, as that always makes scarring worse. Finally, don't make cuts all over your body; cuts limited to a small area will mean smaller wounds and less scarring."

The ice-cube technique, where you allow the sting of the cold ice to act as a way of feeling a release, has worked for Lara. "The ice cube gives me a buzz similar to cutting and can be safer," she explains.

Burning

Burning is similar to cutting in that it causes damage to the skin and can leave a scar. "Burning yourself with a cigarette will leave you with a small - rather painful - scar, but not really any long-term consequences," says Hamish. However, he warns about using chemicals or acids: "These can cause massive destruction and people can even lose limbs. Potentially it can be life threatening."

Head banging

Because of the fragility of the head and brain, repeatedly banging your head against a wall or another object could do long-term damage. While there hasn't been particular research into head banging as a form of self-harm, researchers have investigated whether footballers are at risk of brain damage through heading footballs.

In 2002, a coroner ruled that Jeff Astle, a former England World Cup player, died from a brain disease that was caused by constantly heading footballs. Meanwhile, research from America found that the greater the number of times a ball had been headed, the more that reaction time and flexibility of thinking was reduced.

Overdosing

"An overdose of any drug is not healthy for your body, and the effects will vary depending on what you took, and the quantity," says Dr Gemma Newman, a GP based in west London. "The main organs affected by paracetamol overdoses are your liver and kidneys. Assuming the initial effects are treated, there is then a chance that long-term organ damage can occur.

"The main thing to do is get yourself checked out as soon as possible following an overdose - usually in A&E. For long-term follow-up and advice, your GP, or possibly a specialist, should be involved to help you."

Taking steps to recovery

If you're worried that your self-harming may lead to some of these longer-term effects, now might be a good time to try and take some steps towards recovery. This can seem like a daunting prospect, but if you take it one stage at a time it may feel more achievable. One of the most effective ways to take your first steps is to use coping tips and distractions to deal with urges. If you haven't done so already, confiding in someone you know, or even someone you don't, such as a doctor (GP) or professional counsellor, can also help you to reflect on things more objectively. Knowing that person's there to support you through a difficult time can be a real comfort.

Updated: 23/07/2009