During the pandemic, counselling psychologist Sule Joseph noticed 'a marked increase' in the reporting of children using 'mal adaptive coping strategies' such as self harming.

'There are positive coping mechanisms like exercise, meditation, art and so on, but you can have negative ways of coping with stressful situations like smoking or drinking excessively, taking pills, extreme risky sexual behaviours and the like. Like self harm, you find some activity that gives you some immediacy in terms of relief or distraction from the stress in the short term.'

Specialising in child and family therapy, Joseph compared it to having a dirty bedroom. For some, the easiest way to deal with it, or not deal with it, would be to sleep. But when the person wakes up, when the drugs, sex or pain stops, the bedroom would still be dirty.

All mal adaptive mechanisms worsen over time because as the body adapts to whatever the person is continually doing to it, the less it works and the more extreme the act has to be to get the same feeling. As a result, if they do not deal with the root of the problem, some people fall into addiction. Unintentional suicide can also be an extreme side effect of self harm.

He said self harm presents differently with each individual but, in general, females tend to physically hurt themselves while males put themselves in risky situations with a high possibility of pain or injury.

Self harming in girls is easier to identify because it is mostly physical. But because of the way it manifests in boys - picking fights they would probably lose or generally putting themselves in risky or high adrenaline situations - people tend to dismiss it as 'boys being boys' or that they are looking for attention.

'We may have a situation, I can't say with 100 per cent certainty, where the increase in violence in schools could have something to do with self harm and children putting themselves in situations to treat with the anxieties and issues they feel coming out of the pandemic.'

He said there is little to no national statistical information on the matter but, in his experience, self harm is more prevalent in females and high-performing students. However, it depends on many factors including people's life experiences, stress tolerance, personalities, support systems and more.

Possibly, an empathetic person, or a person with an A type personality - competitiveness, impatient, likes to be in control, base their self-worth on external achievement - could be more susceptible. Or if a person had to deal with stressful situations or disappointment at an early age, they may be better equipped to deal with other life stresses.

But there are no hard and fast rules as people self harm in a way that makes them feel most comfortable. It could include pulling hairs from their scalp, eyebrows, eyelashes, or pubic area, cutting, burning, alcohol and drug misuse, disordered eating when they do not have a diagnosable eating disorder, self-destructive behaviour and more.

'Research has shown us that parts of the b