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Mental Health Prevention Self-Harm

Spotting and Stopping Self Harm in Teens

Although not a mental health disorder, self harm in teens is a serious issue – and it is not limited to cutting. An estimated one in four teen girls deliberately harmed themselves in the last year, and up to 30 percent of teen girls in the US say that they’ve intentionally hurt themselves without intending to commit suicide at some point. Among boys, about one in ten engages in self-harm, although suicide rates are higher in boys than girls.

Self-harm should be seen as an issue separate from suicide, although the two are often linked. Self-harm does increase the likelihood of suicidality and future suicide attempts, but the two are not always part and parcel – many teens commit self-harm without intending to take their lives but for other reasons. Understanding these reasons is important for understanding why so many teens – especially girls – hurt themselves and how their self-harm might have started.

What Constitutes Self Harm in Teens?

Clinically, self-harm is intentional physical injury. Self-harm might be ruled when there is sufficient evidence to show that a teen’s injuries were inflicted purposefully, by themselves, and not through coercion or by accident. Self-harm usually also rules out the influence of drugs or alcohol – meaning it is a sober decision.

This also means that all data that revolves around self-harm identifies self-harm as any form of intentional bodily harm, from cutting to burning, hair-pulling, skin-scratching, pricking, and other forms of pain or damage.

But self-harm can also be more abstract than this. It can, given the correct circumstances and context (i.e., seeking out harm intentionally), include non-direct pain and harm, such as unnecessary risk-taking, thrill-seeking, and dangerous activities. These include unprotected sex, driving drunk, speeding, or illicit drug use.

Why Do Some Teens Struggle with Self-Harm?

Self harm in teens is very prevalent. This does not make it less harmful, but it does make it important to understand that it is not out of the ordinary for teenagers to struggle with emotions and thoughts that might lead them to seek self-harm for any number of reasons, including shame, guilt, emotional pain, anger, or even stress-relief.

An argument can be made that pain-seeking behavior is a form of “self-medication” in cases of abuse or stress, where it offers a short-term burst of relief and ensures the release of endorphins for comparatively “little” harm, such as a minor cut or short pinch with a safety pin.

Depression is another common thread between thoughts of suicidality and self-harm. Low mood and lack of joy in depression can be accompanied by feelings of guilt and worthlessness. In these cases, self-harm can be a way to “feel” something or a way to seek out physical punishment without resorting to suicide.

Self-harm can also be a form of attention-seeking. This is not meant in the derogatory sense. Teens that feel neglected or genuinely struggle with a condition or personality disorder that requires them to be attended to might utilize self-harm as an effective way to draw attention to themselves. In other cases, the intention to “use” self-harm is less calculated and an emotional response to feeling invisible.

Identifying Signs of Self Harm in Teens

Because self harm in teens comes in many shapes and forms, there are many signs a parent or friend should watch out for. Some of the behavioral signs are important to keep in mind but not necessarily critical – a teen might self-harm regularly while appearing chipper and “normal.” Some common signs of self-harm include:

  • Hiding away “tools” for self-harm, such as box cutter replacement blades, straight razors, lighters, needles, and pins.
  • Always wear long sleeves and long-necked clothing or one-piece swimsuits to cover up potential fresh cuts and marks.
  • Repeated skin infections, especially from continuously scratching the same areas.

In addition to traditional signs of self-harm, there are also other forms of “self-punishment” that can be a cause for concern. These include:

  • Illicit drug use or binge drinking.
  • Intentional starvation, binge eating, and other harmful eating habits.
  • Spending hours and hours overexercising at the gym, not for a goal, but as “punishment.”
  • Intentionally sabotaging important relationships – making up gossip, pushing away friends, and being mean to partners.
  • Canceling appointments at the doctor’s office or letting an injury get worse without telling anyone.
  • Skipping or throwing out medication.
  • Intentionally looking up depressing or harmful content online.
  • Embracing toxic or dangerous relationships or jumping headfirst into “red flags.”
  • Overspending, binge shopping, and using budgets irresponsibly.
  • Giving in to compulsive behavior that you know is harmful.
  • Intentionally dressing up “against” the weather, such as wearing excessively hot clothing in the summer and excessively light clothing in the winter.

Does Self-Harm Mean Depression?

Self-harm does not always mean depression, although it is a common sign of depression. Self-harm is also associated with anxiety disorders such as obsessive-compulsive disorder (OCD) and generalized anxiety, as well as eating disorders and personality disorders.

It is important not to assume a cause for your or your teen’s self-harm. Instead, talk to them about getting professional help. It might not be helpful to try and label what you or your teen are going through before talking to a professional about it and getting a better grasp of the situation.

Being able to conclusively name and identify what it is you are going through can help make sense of the way you feel and give you or your teen the ability to fight back against these thoughts and compulsions.

Can Self Harm in Teens Be Treated?

Yes, there are treatment methods to address the different causes behind a person’s tendencies toward self-harm – even when there isn’t a clear diagnosis. Talking to a therapist about the need to hurt oneself can be a good first step toward getting professional help and experimenting with different forms of treatment.

Therapists often utilize cognitive behavioral therapy to help patients identify and separate the thoughts that cause them to harm themselves from other healthier, normal thinking patterns – and thus learn to isolate and contradict those thoughts with practice through both mental affirmations and exercises, such as journaling and self-care.

What Should I Do to Help My Teen?

Supporting someone going through something so severe that they turn towards self-harm as a solution is immensely difficult. You are watching a person hurt and maybe even destroy themselves intentionally, whether through indirect “bad choices” or active harm, such as cutting.

Your best course of action is to work towards convincing them to get help with you. Do not scold or judge them. Even in treatment, it is never a good idea to shame someone for relapsing towards self-harm or failing to take care of themselves as per their treatment plan. Shame and guilt will always result in worse symptoms and bigger problems. Be empathic and understand that this is often a compulsive issue. It takes time, patience, and a lot of attempts to finally overcome the urge to self-harm.

For more information about self harm in teens and mental health treatment, contact Visions Treatment Centers.

Categories
Bullying Self-Harm

How Bullying Increases Risk for Self-Harm in Teens

We all learn from a pretty young age that bullying is bad. Yet, that doesn’t stop bullying from happening. While the reasons for bullying are aplenty, most bullies know that bullying can have consequences for the bullied person. However, they might not realize just how significant and long-lasting these consequences can be. There’s more to bullying than just hurting someone’s feelings for a quick rush – a bully can do severe and long-term damage to a person’s self-esteem and mental health, feed existing or create new insecurities, and encourage them to do horrible things to themselves out of self-loathing, ranging from self-harm to suicide.

Coincidentally, children are most likely to remember cases of bullying from when they were between the ages of 11 to 13, marking the early teen years as the most formative for these kinds of memories. In fact, current estimates say that about one in five children between the ages of 10 and 18 engage in self-harm. Regardless of whether you’re being bullied in person or through a screen, a person’s hurtful words and actions – even when it’s a stranger – can feel worse than a punch to the face. The feeling some people are left with after being bullied doesn’t go away nearly as quickly as a bruise does, either. Memories of bullying can persist for decades, and the damage they deal can accumulate and show itself later in life through depression, anxiety, eating disorders, and even suicidal ideation.

Why Bullying Is a Bigger Deal at a Younger Age

Children and teens are not equipped with the experience and coping knowledge that might come with age. Self-harm, while obviously self-destructive, is a dangerous coping mechanism in its own right. Pain can relieve and release stress, partially through the resulting release of endorphins and because of the catharsis of self-punishment. This also creates a dangerous feedback loop where someone will return to self-harming behavior when feeling bad as a way to feel better, only to realize what they’ve done, resulting in feelings of shame and embarrassment that can result in more harm.

Additionally, bullies breed bullies. Being a victim of bullying can, in turn, lead to victimization further down the social hierarchy, from middle siblings to younger siblings, classmates to younger schoolmates, or from senior coworkers to new hires. Sometimes, bullying becomes a learned behavior from home, a way of getting what you want, either because you’re used to seeing it being used by others or because you had a history of using it that way.

Bullying may also be brought about through feelings of envy, anger, perceived power imbalances, severe insecurities, or to gain something. Not all bullies are sociopaths, though some bully out of a sense of satisfaction or because they feel no remorse nor empathy for those they hurt. Does that mean we should stop worrying about bullying? Absolutely not. Just because something is widespread or even normalized does not mean it should not be challenged.

Bullying, the Internet, and Self-Harm

We’d be remiss to talk about bullying and not mention the elephant in any teenager’s room: the Internet. Cyberbullying is just as harmful as face-to-face bullying, if not more so due to its ubiquity, the heinousness of some of the messages and bullying that occurs online, and the sheer volume of it. Examples of cyberbullying include:

  • Forum mobbing
  • Cyberstalking
  • Doxing (revealing personal information about someone online, including their name and address)
  • Trolling
  • Swatting
  • Revenge porn
  • Impostor accounts
  • Harassment (private and public)
  • And more

A person being bullied through the internet may not just be targeted by their classmates, but by total strangers from throughout the school, community, city, country, and world. Furthermore, by hiding behind anonymity and a virtual distance, bullies receive little to no direct feedback from their victims through which they might feel remorse. They aren’t watching someone react in front of them when they send hateful messages or spread hurtful content online. Cyberbullying that is perceived as public (i.e., publicly posted rumors or callouts, posts that can be shared and seen by anyone, etc.) is perceived as much worse than private messages. Even with the ephemeral nature of the Internet – where the content appears and sinks amid an endless ocean – the emotional scarring never completely goes away.

Some Teens Face More Bullying

There are risk factors associated with bullying, aside from the aforementioned parenting styles. These include being a minority among your peers (skin color, country of origin, culture, nonbinary gender identity, sexual orientation, being over/underweight, disabilities, other special characteristics), trouble socializing with others, struggling with anxiety or depression, and being perceived as less popular than average. Bullying does and will continue to do emotional and physical harm to children and adults alike and can lead to dangerous physical and mental consequences such as self-harm. Victimization is particularly harsh among overweight children and children or teens who belong to the LGBTQIA+ community.

Furthermore, these children also possess a higher risk of developing problems with self-harm and self-esteem and signs of severe depression or anxiety disorders later in life. Whether you’re a friend, a victim, a bully, a parent, or all of the above at some point in time, we all owe it to ourselves and each other to practice and preach a little more empathy – and help children who are victims of bullying find ways to assert themselves, and practice ways to protect themselves from bullying through self-esteem boosting activities.

Parents with children who might be out of the ordinary in a way can help their kids prepare for bullying by helping them strengthen their sense of self, foster stronger self-esteem by encouraging their emotional growth, and helping them learn how to be positively assertive towards others. There is also a perceived link between parenting styles and a child’s likelihood of being bullied and being a bully, with children from authoritarian households (where rules are absolute, and children are punished for expressing themselves) being more likely to find themselves on either end of the spectrum.

Categories
Self-Harm Suicide

Teens and Self-Injury

Self-harm is a concept that can be frightening and confusing to parents. Why would a youngster use self-injury to actually make themselves feel better? The truth is that self-harm can be a form of self-medicating against some types of mental illness or the stresses and strains of daily life. Like drugs and alcohol, the behavior can even become addictive for some kids, making it nearly impossible for them to stop the destruction. Parents can help their children by learning what self-injury is, why it typically occurs and what can be done to break the pattern and heal their kids.

Types of Self-Injury

There are many ways teens can inflict harm on themselves:

  • Scratching or picking at the skin to cause an injury
  • Cutting the skin with a sharp object like a razor blade
  • Biting or burning the skin
  • Pulling out hair
  • Hitting themselves or banging their heads against a wall
  • Piercing the skin with sharp objects
  • Swallowing dangerous objects or substances

Some teens may try self-harm a few times and then stop because it doesn’t bring them the relief they are hoping for. Others can get into a routine of self-injury that becomes very difficult, if not impossible, to stop on their own.

Signs of Self-Injury

As a parent, you never want to think your child is injuring himself without your knowledge, just like you probably wouldn’t want to face the reality of drug or alcohol abuse. However, ignoring the situation won’t make it go away, and will likely allow things to get worse. If you suspect your child might be self-harming, there are a few telltale signs to watch out for:

  • Your child wants to wear long sleeves, even in the heat of summer
  • Your child seems to have numerous, unexplained wounds or injuries
  • Tools like broken glass or razors are found in the trash or in your child’s room
  • You see increased isolation in your child as they avoid friends and social situations
  • Your child begins to spend more time alone, locked in their room or bathroom
  • Other symptoms are present, such as irritability, poor self-esteem or impulsivity

In most cases, the injuries will be found on the arms, legs or stomach because these are areas your teen can easily reach and cover up afterward. Your teen may also be visiting websites that talk about self-harm, another red flag for parents to seek help for their kids.

Reasons for Self-Injury

There are plenty of misconceptions about why teens self-harm. It is important to set the facts straight so you understand the possible reasons behind your child’s behavior. Most teens that injure themselves are not looking for attention, which is why they spend so much time and energy covering up the evidence. They are also not usually suicidal – in fact, they are looking for a way to survive rather than give up.

Teens that harm themselves intentionally often do so to escape intense feelings of sadness, loneliness or anxiety. The injury makes them feel something besides the dark emotions inside, which gives them a break from feeling so bad. They can even begin to crave the release self-injury offers, which is why this behavior can become addictive over time.

Treatment Options that Work

Treatment for self-injury generally requires a multi-faceted approach that includes individual and family therapy. In addition, many teens that self-injure also abuse substances, so they will require treatment for both disorders in order to see the best results. Treatment may take some time as your teen learns to replace harmful behaviors with healthy methods of dealing with negative feelings and emotions.

The staff at Visions Adolescent Treatment Centers works with teens struggling with self-harm as well as drug and alcohol abuse. To learn more about this disorder or get help for your teen, contact Visions today at 866-889-3665.

Categories
Addiction Depression Mental Health Self-Harm Suicide

What Parents Need to Know About Cutting

Cutting is a form of self-injury or SI. Contrary to how it might seem to someone on the outside looking in, cutting is not a way to get attention. It is not a suicide attempt. Cutting is a sign that the person is in deep emotional pain and that pain must be addressed before the self-injuring behavior can stop. If you suspect your child is self-injuring, there are some basic facts about this behavior that you need to know.

What does Cutting Look Like?
Cutting can be done with any sharp object found around the house; razors, thumbtacks, scissors or even the edge of a soda can pop top. The cuts usually occur on the arms, but some teens also cut on the thighs or abdomen. Most cuts are straight lines, although some teens might also cut words into skin to reflect their deep feelings leading to their self-injury.

Common symptoms of cutting might include:

• Fresh cuts or scratches
• Scars along the arms or other areas
• Sharp objects in the trash or hidden in the teen’s bedroom
• Wearing long sleeves even on hot days
• Spending longer periods of time alone
• Feelings of helplessness or hopelessness
• Other disorders, such as an eating disorder or substance abuse
• Extreme mood shifts or out-of-control behavior

Hiding the Pain

Kids that cut may find some type of emotional relief from the behavior, but they also know it is not “right” or “normal” to others. They will make every effort to hide their cutting, wearing clothing that covers up the injuries and scars or lying about how the injuries occurred. Parents often feel

Cutting is a form of self-injury or SI. Contrary to how it might seem to someone on the outside looking in, cutting is not a way to get attention. It is not a suicide attempt. Cutting is a sign that the person is in deep emotional pain and that pain must be addressed before the self-injuring behavior can stop. If you suspect your child is self-injuring, there are some basic facts about this behavior that you need to know.

The Pain Principle
If cutting is not done to get attention, why do kids do it? In most cases, kids begin cutting because they are experiencing deep emotional pain – from an event like a death, previous abuse or intense stress or anxiety. The cutting actually relieves the emotional pain, almost like drugs or alcohol numb the senses.

Teens that cut are not looking to end their lives from this behavior. However, there are cases where the cutting goes deeper than the person intended, requiring stitches or even hospitalization. Kids that cut are also suffering deep emotional issues that could lead to suicidal thoughts and ideations in the future if the issues are not addressed.

Cutting is a serious problem that can become almost addictive over time. The behavior is often associated with food addictions or substance use disorders. If your teen is cutting, help is available. Contact Visions Adolescent Treatment Centers today at 866-889-3665 to learn more about cutting or get the help your child needs.

Categories
Anxiety Depression Mental Health Self-Harm Stress Suicide

New study: Self-harm in Teens

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Even as someone in recovery from self-harming behavior, the statistics regarding who and how many continue to self-harm still hits home. A recent study by Dr. Paul Moran at the Institute of Psychiatry at King’s College at the Murdoch Children’s Research Institute, Melbourne, found that “1 in 12 young people self-harm as adolescents, with the balance skewed toward girls.” Moran’s study followed a group of “young people from Victoria, Australia, from adolescence (14-15 years old) to young adulthood (28-29 years old) between 1992 and 2008.” According to the study, out of the 1802 participants responding to the adolescent phase, 149 (8%) reported self-harm. More girls (10%) than boys (6%) reported self-harm, which translates to a 60% increased risk of self-harm for girls compared to boys.1 Self-cutting/burning was the most common type of self-harming behavior seen in adolescents, but other forms of self-harm include self-battery, poisoning and overdose. Additional findings in Dr. Moran’s study show that self-harm was also associated with “antisocial behavior, high-risk alcohol use, cannabis use, and cigarette smoking,” but that “most adolescent self-harming behavior resolves itself spontaneously.”

Self-harming behaviors are often symptomatic of anxiety and depression, acting as a salve to those otherwise unable to feel or process their feelings in a more skillful way. It is, in many ways, an effort by the one self-harming to regulate their mood and can also act as a kind of emotional steam valve for difficult emotions or even as a means of self–punishment. Regardless, self-harming behaviors indicate mental-health issues that do need to be addressed. No one self-harms out of pride or because they’re happy about something. The truth is, there is a lot of shame associated with self-injurious behaviors.

Still, there continues to be a high risk for suicide completion in those who have a history of self-harming, particularly those who continue to do it into adulthood. When addressing this, we must remember that it’s not usually a self-aggrandizing act, but rather something one does in a poor attempt to feel better, or to simply feel something. The rate of suicide rates are sobering: according to this significant report from the World Health Organization, almost a million people die from suicide each year, giving a mortality rate of 16 per 100,000, or one death every 40 seconds. In the last 45 years, suicide rates have increased by 60 percent worldwide. And according to the CDC, “suicide rates are among the 10 leading causes of death in the US.”2

More often than not, you won’t see signs of self-harm, because typically, injuries are inflicted in places easily hidden by sleeves or other articles of clothing. Still, if you’re worried about your child, make an effort to show concern and get them some help. Keep in mind, if your parenting style has been of the lecturing or authoritarian type, or the particularly reactive type, this may be a good time to use a different tactic. Someone who’s suffering in this way will only shut down when faced with an impending firm, albeit worried, lecture. If your child shows signs of stress, anxiety, or begins isolating more than usual, it’s likely that trouble may be brewing. Worrying aside, your kids need to know you are there for them, no matter what.

__________

1: https://www.kcl.ac.uk/newsevents/news/newsrecords/2011/11November/Studyfinds1in12teenagersself-harmbutmoststopbytheirtwenties.aspx

2: https://www.afsp.org/index.cfm?page_id=04ea1254-bd31-1fa3-c549d77e6ca6aa37

For more information, see:

Medscape

Canadian Medical Association

National Institute of Health

Categories
Anxiety Depression Mental Health Recovery Self-Harm

Cutting: Beyond YouTube

Cutting is back in the spotlight after a study by TheJournal of the American Academy of Pediatrics brought attention to the high numbers of YouTube videos showing teens and young adults exhibiting self-harming behaviors. By simply typing “self-harm” and “self-injury” into YouTube’s search engine, Dr. Steven P. Lewis, et al, discovered numerousvideos showing various levels of self-harming behavior.After extensive review and documentation, these were the findings:

“The top 100 videos analyzed were viewed over 2 million times, and most (80%) were accessible to a general audience. Viewers rated the videos positively (M = 4.61; SD: 0.61 out of 5.0) and selected videos as a favorite over 12 000 times. The videos’ tones were largely factual or educational (53%) or melancholic (51%). Explicit imagery of self-injury was common. Specifically, 90% of noncharacter videos had nonsuicidal self-injury photographs, whereas 28% of character videos had in-action nonsuicidal self-injury. For both, cutting was the most common method. Many videos (58%) do not warn about this content.”

Researchers worry that these videos might lead to a normative view of cutting and self-harming. As one who self-harmed for years (even into my sobriety), my concern isn’t whether or not this will be viewed as normal, but rather, is anyone taking action and listening to this loud cry for help?
It’s not fun to self-harm. It isn’t a source of pride. It’s not something you share with those around you. It’s not something you do to feel “a part of” or to be “cool.” For me, it was something I did to actually feel because I was so numbed out. In the flash of the adrenaline rush, I felt alive and present when I self-harmed. I felt like it was the only way to feel “real” in my otherwise surreal life. I also felt immediate and devastating shame. It was scary. It was embarrassing. Having to explain abhorent injuries to the curious when the perpetrator is you is nightmarish.
Getting help took an act of bravery on my part. I had to tell someone. I had to talk about it…openly. I had to face my shame and fear so I could transform it into something positive. I had to do some deep, spiritual work in order to learn how to turn self-harm into self-care. I continue to do this work, so I can  revel in self-care and be of service to others. I had to build a fellowship of support that would be there if I slipped back. I empathize for the kids on YouTube. I hope someone reaches out the hand of recovery and lets them know they don’t have to hurt like that anymore.

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