Support and understanding

Getting support and understanding from friends and family can give you the space to start dealing with the issues behind your self-harm. "If loved ones can accept you might not be ready to seek help, but offer their support for when you are, it helps you feel respected," says Claire Usiskin from YoungMinds.

There may be times when even though friends and family are trying to understand, they may still feel confused and upset by what you do. If you can be open about how you feel and why you are self-harming, it can help them understand you better and give you the support you need.

Dealing with guilt trips and disapproval

People can respond very negatively to finding out you self-harm. They may disapprove, believing the common myth that you're attention-seeking, or get angry with you and try to make you feel guilty or ashamed.

It might be upsetting, but it's best not to be defensive. "You could explain that we all have coping mechanisms that may be a little destructive. At the moment this is yours, but in time you're hoping to develop other ways to cope," suggests Wedge from First Signs.

Don't let other people's reactions stop you seeking help. Try to get support from:

• A  family member or trusted friend
• A professional, such as a youth worker, teacher, counsellor, nurse, or doctor (GP)
• A moderated online forum with a sense of community and understanding

Your partner

If you're in a relationship, your self-harming can have a huge impact on your partner. They might feel:

• Fearful and upset; not understanding why you would do this if you loved them
• An overwhelming sense of personal responsibility to make sure you don't self-harm
• Inadequate: thinking they should be able to make you happy
• Isolated and rejected; feeling that you're shutting them out or pushing them away when they're trying to help

It's important to communicate. "Don't leave your partner feeling they're on the outside. Keep reassuring them it's not their fault and help them understand so they don't feel excluded," says Dr Andrew Reeves, from the University of Liverpool Counselling service.

You might feel ashamed of undressing or getting intimate if there are scars or wounds on your body, but talk to your partner about it and listen to their response. A loving partner needs to understand what they're seeing is a symptom of the distress and pain that lies beneath and be accepting and supportive of you.

Effect on friends and family

Knowing someone they love is self-harming can be distressing for your family and friends. They may feel:

• Guilty: parents can blame themselves and feel like they've failed you in some way
• Uncomfortable or reluctant to talk about it with you, not knowing what to say or worrying that talking about it might trigger you to self-harm
• Angry with you for putting yourself and the rest of the family through any kind of emotional turmoil
• Helpless: feeling scared it could get out of control or lead to suicide

Try and understand their reaction as it can help you to support each other. But it's also important to try not to feel responsible for or guilty about other people's reactions. "When I saw how hurt my best friend and parents were, and how much my actions affected them, it helped me stop," says Claire, 19. "They felt they were bad parents, but they weren't. It was just my way of coping."

After a serious self-harm episode

People might react angrily, shout or say hurtful things if you've hurt yourself badly - maybe because of shock, confusion or concern.  It's important you don't let such reactions stop you getting medical attention if you've seriously hurt yourself.

Try and work out what made you take a step too far, and if you can, explain to family, friends or professionals why you harmed yourself so seriously. If you weren't trying to kill yourself, you should make that clear and tell them what kind of help you would like, such as someone to talk to or advice on looking after your injuries. However, if you do feel suicidal or not sure about whether you want to live, try and be honest about this - it will help mental health professionals decide on the right treatment and support for you.

When someone breaks your confidence

It can feel like a betrayal if someone you trusted breaks your confidence and tells someone else, even if they do it because they're worried, want you to get help, or need support for themselves. You might feel angry and resentful, but try and talk to the person and find out why they did it. This can help you to understand and begin to resolve any issues between you.

A professional or counsellor should not break your confidentiality unless they are concerned about your safety and they ought to discuss this with you first. Don't let your fear of people finding out stop you asking for help.

If you're really worried, you can talk about your emotional issues without going into detail about the self-harm or you can call a helpline anonymously. If you're concerned that your self-harm is getting worse or you're worried about your own safety, it's good to be honest about this so you can get the right level of help.

Updated: 31/01/2012

Written by Marcella Carnevale