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.

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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
Body Image Eating Disorders Mental Health Recovery Therapy

Starving at 8

image © sarit photography

I know an 8-year-old who’s been known to choose an outfit specifically because it makes her “look thin.” This same 8-year-old often doesn’t finish meals because she thinks she’s fat. She’s the same 8-year-old that has begun to develop food rituals, often leaving the table with a reorganized plate full of uneaten food. Simply put, she already has an irrational fear of getting fat.
It’s hard being a girl. It’s hard to find a way to look at your unique self without comparing it with images of Barbie or Bratz. It’s hard to accept that  the beauty standard set by Cinderella or Sleeping Beauty isn’t actually real. But children, whose minds are filled with wonderful imagination and fantasy, aren’t going to cognitively recognize images that are potentially harmful. Instead, many will attempt to achieve the pink, thin, fluffiness of a Disney princess, or the skinny sass of a Bratz doll. Often times, even when parents are encouraging a healthy body image, the education on the school yard has a dramatically different lesson plan than the one from home. I’ve overheard conversations on the school yard that have made me pause – -it’s clear that body-image issues are in abundance and the pressure to look thin and svelte is invasive and intense.

So what can parents do? Start with eliminating the shame game. This might mean letting your daughter dump that maple syrup on her pancakes or having a cupcake at a birthday party. It’s a treat, not a vehicle for punishment!  Encourage healthy eating, but can you do it with compassion rather than the mallet of criticism?  Eliminate “fat talk”: your kids don’t need to hear it and frankly, it’s not good for you either. Stop trying to control what those around you eat. It’s not your job!  I’ve seen dads controlling the food intake of their wives and daughters to the point of devastating eating disorders (my dad was one!); and I’ve seen moms spewing “fat talk” or signing up for any and every diet fad while their daughters learn to eat in secret or restrict because they’re terrified of the incendiary reaction of their parental food monitors. These behaviors certainly don’t encourage self-love. If anything, they sow the seeds of self-destruction.

If you’re worried that your son or daughter might be developing an eating disorder (note: boys are not immune to this!), look out for some of these signs.

(Please note, certain behaviors are warning signs, but in combination and over time, they can become quite serious):

Behaviors specific to anorexia:

  • Major weight loss (weighs 85% of normal weight for height or less)
  • Skips meals, always has an excuse for not eating (ill, just ate with a friend, stressed-out, not hungry).
  • Refuses to eat in front of others
  • Selects only low fat items with low nutrient levels, such as lettuce, tomatoes, and sprouts.
  • Reads food labels religiously; worried about calories and fat grams in foods.
  • Eats very small portions of foods
  • Becomes revolted by former favorite foods, such as desserts, red meats, potatoes
  • May help with meal shopping and preparation, but doesn’t eat with family
  • Eats in ritualistic ways, such as cutting food into small pieces or pushing food around plate
  • Lies about how much food was eaten
  • Has fears about weight gain and obesity, obsesses about clothing size. Complains about being fat, when in truth it is not so
  • Inspects image in mirror frequently, weighs self frequently
  • Exercises excessively and compulsively
  • May wear baggy clothing or many layers of clothing to hide weight loss and to stay warm
  • May become moody and irritable or have trouble concentrating. Denies that anything is wrong
  • May harm self with cutting or burning
  • Evidence of discarded packaging for diet pills, laxatives, or diuretics (water pills)
  • Stops menstruating
  • Has dry skin and hair, may have a growth of fine hair over body
  • May faint or feel dizzy frequently

Behaviors specific to bulimia

  • Preoccupation or anxiety about weight and shape
  • Disappearance of large quantities of food
  • Excuses self to go to the bathroom immediately after meals
  • Evidence of discarded packaging for laxatives, diuretics, enemas
  • May exercise compulsively
  • May skip meals at times
  • Teeth may develop cavities or enamel erosion
  • Broken blood vessels in the eyes from self-induced vomiting
  • Swollen salivary glands (swelling under the chin)
  • Calluses across the joints of the fingers from self-induced vomiting
  • May be evidence of alcohol or drug abuse, including steroid use
  • Possible self-harm behaviors, including cutting and burning

If you notice even one of these, it’s time to address it. Talk to your daughter or son, talk to your doctor. If necessary, elicit the help of a treatment facility. In other words: Get help. Showing our kids that we care and are willing to stop our own negative behaviors in order to help them is invaluable. It’s a family problem, not an individual one.

Some helpful links:

NEDA
WebMD
Voice in Recovery
Peggy Orenstein
maudsleyparents.org
Also, check out “Brave Girl Eating: A Family’s Struggle With Anorexia” By Harriet Brown

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.