Speaking out to someone about self-harm for the first time can be really daunting, but speaking out is the only way you can help yourself or others around you who you know are self-harming.

Self-harm is when somebody intentionally damages or injures their body.

Self-harm isn't just about cutting; it could also include burning yourself, biting your nails excessively or developing an eating disorder.

Self-harm is mainly a coping strategy and can provide a release from emotional distress and enable an individual to regain feelings of control.

Approximately one out of every eight people will take part in some form of self-harm and, currently, it is more widespread than it has been previously.

It is important to remember that each person who self-harms is different and not all start for the same reason.

In addition, some individuals may not show any of the warning signs.

Here are some risk factors and signs that are associated with self-harm in young people:

Risk factors:

?Knowledge that friends or acquaintances are self-harming

?Difficulty expressing feelings

?Extreme emotional reactions to minor occurrences (anger or sorrow)

?Stressful family events (divorce, death, conflict)

?Loss of a friend, boyfriend/girlfriend, or social status

?Negative body image

?Lack of coping skills

?Depression signs

?Wearing long sleeves during warm weather

?Wearing thick wristbands that are never removed

?Unexplained marks on body

?Secretive or elusive behaviour

?Spending lengthy periods of time alone

?Items that could be used for self-harm are missing

If you require help to tackle self-harming, it is important to seek professional assistance such as going to your GP, who can put support in place to try and find out why someone is self-harming and to begin appropriate treatment to the road of recovery.

For young people, there is help out there. 'Alumina' is an online course started by selfharm.co.uk for young people aged between 14 and 18.

It doesn't matter how long you've been self-harming or what it means to you, Alumina is an opportunity to think more about it and work out what your next step might be.

Mind – a mental health charity – helps to support those who may be self-harming and gives out information on where to seek treatment. See http://tinyurl.com/lxj5ty3 to link to the self-harm section on the Mind website.

Childline offers a free service and coping techniques for those who are struggling with self-harm and how to deal with not hurting themselves by doing something else rather than self-harming. See www.childline.org.uk/Explore/Self-harm/Pages/about-self-harm.aspx.

There is a light at the end of the tunnel.

It is possible to change certain thoughts and feelings to learn how to cope with any problems or weaknesses in a different way.

The most important thing is to have a strong support network in place for when you are ready.

For more information on self-harm and other health issues, visit the Youth Health Matters webpages on the NHS Great Yarmouth and Waveney Clinical Commissioning Group website www.greatyarmouthandwaveney ccg.nhs.uk/ and follow us on Twitter- @YHMatters.

Amara Cunningham,

Apprentice, NHS Great Yarmouth and Waveney CCG.