It can often be used as a distraction from emotional distress and a way to release the feelings the person has had help for for so long. They often feel relief and a sense of calm after completing the act. This is called excision or self-mutilation. Some forms of self-harm include cutting, burning, hair pulling, pinching, scratching, scratching scars, and head banging. People who self-harm often have a history of abuse, whether sexual, emotional, or physical. Self-harm often occurs alongside other mental health issues such as eating disorders, substance abuse, schizophrenia, depression, bipolar disorder, post-traumatic stress disorder, and many other mental illnesses . Most people who self-harm often have low self-esteem and are perfectionists. They are often very impulsive and have difficulty solving problems.