This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage self-harm — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 63-year-old woman with a long history of hypertension. She lives alone and has never married because of her fear of passing on Huntington's disease to any children. She was also heavily involved in caring for her mother until she died 20 years ago and had no time to develop relationships. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.