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Signs that someone may be struggling:

This week we are focusing on education around mental health, in particular low mood and depression, self harm and suicide. We will look at the signs to look out for, how to reach out for support if you are struggling and how we can all reach out to help others.
Early intervention and knowledge around the signs of low mood, depression, self harm and suicide can go a long way to supporting an individual who is struggling before safeguarding risks increase. Remember – if anyone shows signs of being at risk to themselves or others we have a duty to report it. If you’re at work, speak to your line manager about how this report should be made and to whom it should be made. If you’re with a friend, family member or anyone else – contact the emergency and/or statutory services.

There is no single cause of low mood, depression, self harm or suicide and it can often take a long time for an individual to recognise and admit to themselves that they are struggling. Opening up about it to others can be particularly difficult but there’s a lot that we can do to help.
• Understanding and recognising the signs that you or someone you know is struggling is the first step in reaching out to receive or to offer support.
• There are a number of factors that contribute to or increase the risk of developing low mood, depression, self harm and suicide. These include (but are not limited to) stressful or traumatic events, personality, family history, giving birth, loneliness, alcohol and drug dependency or illness. Not everyone who has gone through any of these things will go on to develop low mood, depression, and self harming behaviours or become suicidal but the right support for those who do, can make all the difference.
• Recognising the signs is the first step in understanding where there may be safeguarding risks. These could be physical signs, things that they say, change in behaviours or their feeling and emotions.

Signs and symptoms of depression/low mood


  • Moving or speaking more slowly than usual
  • Changes in appetite or weight (usually decrease but sometimes increase)
  • Constipation
  • Unexplained aches or pains
  • Lack of energy
  • Low sex drive (loss of libido)
  • Changes in your menstrual cycle
  • Disturbed sleep (e.g. difficulty falling or staying asleep or waking up early)

Psychological symptoms:

  • Continuous low mood or sadness
  • Having low self esteem
  • Feeling hopeless and helpless
  • Feeling tearful
  • Feeling guilt-ridden
  • Feeling irritable and intolerant of others
  • Having no motivation or interesting things you previously enjoyed
  • Difficulty making decisions
  • Not getting enjoyment in life
  • Feeling anxious or worried
  • Having suicidal thoughts or thoughts of self harm

Social symptoms

  • Not doing well at work
  • Avoiding contact with friends or family
  • Taking part in fewer social activities
  • Neglecting hobbies or interests
  • Having difficulties in your home and family life 

Conversational signs

  • No future – “What’s the point? Things are never going to get any better”
  • Shame – “I’m not good enough”, “there’s something wrong with me”, “I’m not worth your love and support”
  • Guilt – “It’s all my fault, I’m to blame”
  • Escape – “I can’t take this anymore”
  • Alone – “I’m on my own … no-one cares about me”
  • Damaged – “I’ve been irreparably damaged… I’ll never be the same again”
  • Helpless – “Nothing I do makes a bit of difference, it’s beyond my control”
  • Talking about suicide or death
  • Planning for suicide
What is self harm?


  • Self harm is a physical response to emotional pain and can be very addictive.
  • Some of the behaviours considered to be self harm can include cutting, burning, pinching, punching or hitting themselves, pulling out their hair, poisoning with tablets or toxic chemicals, excessively exercising as well as abuse of drugs or alcohol or having an eating disorder.
  • Risk taking behaviour can also be a sign of self harm, for example, driving too quickly, gambling, engaging in illegal activities or engaging in sexual risk taking.
  • Self harm is more common in younger people (approx. 10% of young people self harm) but it can occur in all ages. Statistics are difficult to estimate because very few people speak out or seek help.
  • Most people who self harm do so to help them cope with issues such as bullying, family/friend/relationship breakdowns, struggling with sexuality, trauma, loss, psychological causes and some borderline personality disorders.


De-bunking the myths of self harm

  • Self harm is not attention seeking – most people who self harm often hide it out of shame or fear of having to discuss the reasons behind it – it is a coping mechanism which in time can be replaced by healthier tools and techniques while treatment for the underlying reasons are sought.
  • Many think that those who self harmer enjoy the pleasure that the pain brings – they don’t. For some, depression makes them feel so numb that they self harm to feel something while others do it as a form of self punishment that they feel they deserve
  • While some who self harm go on to develop suicidal thoughts or attempts to take their own lives, self harm is often more of a way of getting through difficult times.


Signs of self harm:

  • Those who self harm can be very good at covering it up and typically harm parts of their bodies that they can keep covered but there are some signs to look out for:
    • Unexplained injuries
    • Keeping covered even in hot weather
    • Signs of depression, low mood, tearfulness, lack of motivation or interest
    • Self loathing and shame
    • Becoming withdrawn, not engaging in activities or speaking to others
    • Weight loss or weight gain
    • Self blame talk
    • Drug or alcohol misuse



Signs of suicidal thoughts are similar to those seen in depression or low mood but can also include:
• Mood swings,
• Becoming confrontational or quiet
• Threatening to kills or harm themselves
• Talking or writing about death, dying or suicide
• Preparing to end their lives (e.g. storing medication)
• Putting their affairs in order
• Joking about their emotions or saying something alarming but disguising it as a joke.

As with self harm, spotting the signs of suicidal thoughts can be extremely difficult – do not blame yourself for not noticing but go with you gut. If something feels off to you – check in on them and ask them if they want to talk.