Self-Harm in Teenagers and Young Adults
The Wave is a specialist centre for the treatment of young people who self-harm, offering evidence-based treatments and programs to support young people and their families.
Self-harm, self injury or non-suicidal self-harm in teenagers and young adults is characterised by deliberately causing hurt or injury to oneself. Young people may self-harm when they feel powerful and uncomfortable feelings. Self-harm is in expression of emotional distress or dysregulation and requires assistance from trained mental health professionals. 90% of young people who self-harm begin to do so in their teenage years.
The Wave specialises in the treatment of self-harming behaviours in young people.
Self-Harm in Teens and Adolescents – Quick Facts
17% of young people regularly cut or self-harm. That is 1 in 5 girls and 1 in 7 boys regularly engaging in self-harming activities.
Self-harm is a mental health concern, which usually starts in adolescence. The average age of onset is between 11–14 years old.
Self-harm is more common in girls than boys. Teenage girls aged 14–24 are 60% more likely to self-harm than boys of the same age.
Being part of the LGBTQ community significantly increases the risk of adolescent self-harm. Looked-after children, and even young people living away from home at school or university, can be at increased risk of self-harming.
Research indicates that young adults who self-harm are 100 times more likely that the general population to complete suicide.
Self-harm is not attention-seeking.
Many people who self-harm do so in secret
Not all people who self-harm have thoughts of suicide.
Full recovery from self-harm and co-occurring conditions in teens and young adults is possible.
What is Self-Harm in Teenagers?
Self-harm is any deliberate act intended to cause hurt, harm or wounding to oneself. It usually begins as a way to relieve the pressure that builds up internally following distressing thoughts and feelings. Self-harm can feel like a temporary relief until guilt and shame follow. The underlying reasons for anxiety and depression have not gone away. Guilt and shame increase the feelings emotional suffering, isolation and loneliness. This, in turn, leads to an emotional overload, panic or crash which leads to self-harm on a circular pattern of anxiety and harming behaviours.
Self-harm can quickly become a young person’s way of dealing with difficulties or emotionally unpleasant feelings. It becomes a coping strategy, which is often driven by anxiety and fuelled by obsessive and compulsive thoughts of injury or harm to oneself.
Self-harm can be:
- cutting
- burning
- scratching
- picking
- pulling (hair, skin, teeth)
- punching
- piercing
- breaking bones intentionally
- inserting objects into the skin
- self-strangulation.
Whilst most incidents of self-harm cause superficial or surface wounds, some young people go on to cause more severe injury and wounds.
Teenage Self-Harm – Know the Signs and Symptoms
Here are some signs and symptoms that may indicate that a teen is self-harming:
- Unexplained cuts appearing in the same areas of the body
- Fresh cuts, scratches or wounds on the wrists, arms, abdomen or thighs
- History of overdose or taking more medication than prescribed
- Poisoning
- Wounds that are slow to heal or seem to get worse
- Finding sharp objects or broken objects (pens, glass, needles, push pins, scissors, etc.)
- Increased isolation
- Depression or persistent low mood
- Change in clothing style (e.g. long shirts, pants, long skirts – even in warm weather)
- Avoiding social activities or sports (e.g. swimming, P.E., uncovered activities)
- Accessing First Aid (plasters, bandages, antiseptic, alcohol wipes, etc.)
- Homemade tattoos
- Avoiding changing rooms
- Talking about or researching self-harm
- Hair patches (missing eyebrows, hair, eyelashes, etc.)
- Burn marks, scolds, cigarette burns, lighter burns
- Friends who self-injure
- Increasingly severe injuries
- Numbing, dissociation, substance abuse
- Pro self-injury websites – reading, researching and acting out.
Cutting is the most common form of self-harm. Young people may use any sharp object to cut themselves. This may be a knife, broken glass, a razor, pins, ceramics or other object that can cause injury. Some teenagers and young adults may use their fingernails to cause injury to themselves.
Why do Young People Self-Harm?
Teenagers and young adults who self-harm often do so to deal with difficult feelings and emotions. Self-harm is incredibly dangerous and can be life threatening.
Young people who self-harm often say that they are not sure where to turn for help. They describe feeling lost and alone, trapped or helpless. Self-harm can be a way that young people feel more in control.
Young people also describe feeling tense, rage or angry inside. Self-injury can feel like a release of this tension and energy inside.
Some young people have large feelings of guilt, shame and remorse or may feel that they are bad, mean or unworthy of love and friendship. Self-harm can feel like an adequate self-inflicted punishment for these big feelings in young people.
Trauma and abuse can often be linked to self-harm. Dissociative episodes, numbing out, or feeling ‘dead inside’ is frequently described by teens who have experienced adverse childhood experiences. For young people who feel disconnected and detached, self-harm can leave them feeling more connected and more alive.
Teenagers who have frequent thoughts of suicide, or who feel overwhelmed and extreme levels of distress are more likely to self-harm. Teenagers often describe feeling overwhelmed and isolated by problems that they feel there is no way out of and that the only solution is to die. There is always a solution.
The Wave is one of many solutions focused on recovery for teenagers and young adults, providing confidential care, with love, safety and security. Young people can feel assured of confidentiality and support in dealing with all of life’s problems.
Causes for Self-Harm in Teenagers and Young Adults
Teenagers and young adults are more likely to self-harm if they have:
- Mental health problems
- Emotional disturbances, depression, anxiety and/or distress
- Problems at school and/or at home
- Parents having mental health issues
- Thoughts of suicide
- Parents having issues with drugs/alcohol
- Issues with alcohol or drug use themselves
- Problems with police or the legal system
- Are looked after children
- Peer pressure
- Problems with bullying
- Low self-worth
- Transitions and changes at home or school
- Hormonal changes
- A relative or friend who has attempted or completed suicide.
What Can I Do to Help My Teen Who Self-Harms?
Finding appropriate specialist mental health treatment for your child is the imperative. As with all mental illness, early intervention is one of the key indicators of long-term remission and full recovery.
Talk to someone. Parents can often feel overwhelmed and experience severe anxiety when they find out that their child is self-harming. Parents can make a list of three people who they are able to reach out to, day and night, for support and a gentle listening ear.
The next step is to find a trauma-focused therapy team and CAMHS psychiatrist who can assess your son or daughter and prepare a treatment plan with the family. Inpatient or residential care is usually preferable, to prevent further harm and minimise the risks for every young person.
If your child, teenager or family member is at risk, has harmed themselves for the first time, or harmed themselves severely, please proceed to your nearest Accident and Emergency Department for advice from the on-call psychiatrist.
All children and young people who have self-harmed should be assessed by specialist child and adolescent mental health services.
Keep medicines and sharp objects locked away. Paracetamol is the most common medicine taken to overdose by teenagers in many countries around the world. In the UK, Paracetamol is the number one drug used in teenage overdose, resulting in A E visits and emergency admissions. Paracetamol overdose in teenagers can cause serious liver damage and, even in small amounts, can be fatal.
When the situation is calm and any emergency treatment concluded, help your child to create a ‘safe box’. In your safe box, you may choose to put a selection of the following:
- your therapist’s telephone number
- something soft and soothing to touch
- something that smells great (a roll on essential oil is always a good choice)
- a word puzzle or some paper and pencils for writing/drawing
- an MP3 player pre-charged with favourite music.
The ‘safe box’ can be a wonderful tool for grounding and distracting young people.
Therapy for Self-Harm and Self-Injury in Teens and Young Adults
The Wave is a specialist centre for the treatment of young people who self-harm, offering evidence-based treatments and programs to support teenagers, young adults and their families. The Wave programs are designed to treat the symptoms of self-harm and any emotional distress and anxiety that often precedes self-harm in children and teenagers.
Families often need support to find out the reasons why self-harm has happened and to process the big feelings for all members of the family. Families may need ongoing support to reduce the risk of dangerous behaviours at home or school. Inpatient or residential treatment may be required if the self-harm is persistent or if there are indications that there is extensive trauma or co-occurring serious mental illness.
Self-harm often occurs in young people who have more than one mental health concern or psychiatric diagnosis. Young people who self-harm may also be diagnosed with Borderline Personality Disorder, Anxiety Disorders, Eating Disorders, Complex or Developmental Trauma, Substance Use Disorder, Conduct and Oppositional Disorders or ADHD, along with other mental health issues.
Treatments include:
References:
The Centre for Suicide Research – Oxford University, UK
National Institute for Clinical Excellence, UK (NICE) Guidelines (2004) (2011): CG16 Self-Harm & Self-Harm Longer Term Management
Royal College of Psychiatrists: Child and Family Public Education Board. Dr Vasu Balaguru
If you are self-harming you are not alone. Full recovery is possible.
