Mental Health And Self Harm
Mental health has become a bit of a buzzword in the media nowadays. Everyone has an opinion on what's the right way to handle such a big topic, but the fact is that no two people will experience the world in the same way, so there isn't one single correct way to approach the subject.
We're living in unprecedented times. Everything is changing faster than anyone can keep up, so it's understandable why so many young people feel on shaky ground when it comes to their mental health. The world that your children are experiencing is so different from the one that you're living in, it's important that we keep that in mind when we're looking at their behaviour and wondering what's going on.
Early Warning Signs
Look, you know your kid, and you know what's normal for them. No one is suggesting you start panicking every time they're having a bit of a rough day. However if their behaviour stands out as lasting a long time, feels like it's out of proportion for what's going on around them, or just makes you doubt that everything is okay, sitting down and having a conversation with them is never a bad idea.
Remember that a single sign doesn't always equal a crisis. Look for patterns in their behaviour, and consider the duration, the impact, and possible causes. The best course of action is always to start by creating an environment where your child feels they can come and talk to you about what's going on in their life.
Emotional Signs
• Sadness
• Hopelessness
• Anxiety
• Irritability
What's Normal?
Reacting to negative or stressful life, school, and social situations with these feelings is normal. These feelings are part of the human experience, and your children are (probably) human.
What's Not?
When these feelings are bigger or last longer than are proportional to an event or trigger, it can be a sign that something deeper is going on. If there's no clear cause for these feelings but they're just sort of... there... it might mean it's time to take action.
Behavioural Signs
• Isolation or withdrawing
• Risk taking
• Academic performance drop
• Sleep changes
• Drastic change in appearance
What's Normal?
Children, especially teenagers love privacy. They're discovering who they are, and sometimes they just don't want an audience. Sometimes they won't think through the repercussions of their actions, or they'll just have an off day at school, maybe because they stayed up too late. Sometimes they just want to see what they'd look like if they cut off all their hair (which goes hand in hand with not thinking through repercussions).
What's Not?
When these behaviours start becoming the norm, or if you see them becoming either more frequent, or more serious.
Physical signs
What's Normal?
Your child's body is constantly changing from when they're born until they're done with puberty, which means they could keep growing until they're 18, 19, or even 20 years old. They're going to go through growth spurts, and sometimes weight loss (or gain), tiredness, and just looking a bit raggedy may just be a normal part of growing up.
What's Not?
Ticks and twitches are a definite sign of stress, especially if they're new. Aches, pains, injuries, nausea or vomiting that don't have any clear cause are a big indicator that something's going on. Dramatic changes in appetite (and any weight changes that go with it) are something to keep an eye on, and restlessness or agitation can be a sign of distress.
Social Signs
• Conflicts with friends or family
• Giving up or quitting hobbies or activities
• Bullying (victim or aggressor)
What's Normal?
Kids argue with their friends. They take up activities and decide they don't like them, and sometimes they're just not in control of who's mean to them at school. There is a reality that learning to navigate social situations means that there will be conflict, chaos, and confusion. A bit of drama is normal.
What's Not?
If your child seems to be having more conflict than usual, if the conflicts are lasting longer than usual, or if they've just stopped talking or engaging with people (someone specific or in general), it could be a chicken or egg situation. The break down of relationships can cause mental health problems, but mental health problems can cause the break down of relationships. Quitting or giving up the things that they used to love can be an indicator of low mood, as it can be hard to get the motivation to do anything, even the things you enjoy when you're feeling down.
If your child has started bullying someone, that's a big red flag that something's going on, as bullying is often a way for a person to deflect and distract from their own feelings.
Coping Mechanisms
There are lots of coping mechanisms that people (including you child) might use to deal with stressful or uncomfortable situations. Some of these mechanisms are healthier and more positive than others. Some of them will be deliberate actions taken after a need is identified. Some of them might be things that a person does without even realising it's a coping mechanism. These are the ones you probably inherited from your parents and never realised how weird they were. I'm talking about rearranging all your bedroom furniture in the middle of the night, or going out for a run at 5am in the rain because 'it makes you feel better'. It doesn't, that's a lie, it makes you feel cold.
Self Care
Self care is something that everyone talks about but no one does a very good job of actually explaining. In online spaces it's often shown as a very specific genre: journaling, face masks, meditating, shopping, colouring in, and drinking fancy coffees or teas. However, it actually looks totally different for different people, and generally it falls into these five categories: rest, nutrition, routine, movement, and recovery. It could look like taking the night off and having a nice relaxing bath, or it could look like actually putting away all of those piles of laundry so you don't have to feel guilty about them any longer. It could be going for an aesthetic hike to a picturesque tea house at the top of a hill, or it could be... getting up for a run at 5am in the rain because 'it makes you feel better'.
The younger a child is, the less self care they need, because, well, they have someone else caring for them. As they get older and more independent, you may have less input over when they sleep, what they eat, where they go, and what they do, so they will need to learn to structure these elements of their lives without you.
Self Soothing
Self soothing behaviour are things that we do to calm ourselves when we're feeling tense, uneasy, or stressed. It's not exactly bad if your child is performing these behaviours, most people do them without even realising what they're doing, but if you notice an increase in the amount your child is self soothing, it might be an indication that they're experiencing more stress than usual.
Some examples of unconscious self soothing behaviours are:
Fingernail biting or skin picking
Jaw clenching or grinding teeth
Sucking or chewing on thumbs, pencils, clothing or other objects
Rocking, bouncing, or other repetitive movements like hand wringing or rubbing clothes
Knuckle cracking or playing with hair or jewellery
Fidgeting with objects
Lip chewing, or nose picking
Some self soothing behaviours are more damaging or potentially inappropriate than others, and some are deliberately self-destructive.
These might look like:
Drinking or using drugs
Binging, overeating, or starving self
Head banging
Pinching, biting, or scratching self
Cutting or hitting self
Pulling hair, eyebrows, or eyelashes
Compulsive behaviour like shopping, shoplifting, or taking risks
Sexual behaviour or masturbation
Doom scrolling
Most self soothing behaviours are formed during childhood and adolescence, and they're often learned within the family environment. Your kids are always learning from you, and even if you don't realise it at the time, you're constantly modelling behaviours that they will grow up to think are normal. Teaching your child positive and healthy self soothing behaviours from a young age is a great tool for them to have as the get older.
Some positive examples are:
Squeezing a stress toy or playing with a fidget toy or tool
Cuddling or playing with a pet
Doing some explosive exercise like dancing or hitting a punch bag to wear out the feelings
Having a hot (or refreshingly cold) shower to wash away the big feelings
Laying on the floor and listening to music
Meditating, journaling, taking a bath, and all of those typical self care activities you see on social media
Snapping an elastic band or hair tie against your wrist to reconnect with your body
Getting outside and getting some fresh air
Breathwork and breathing techniques
Digging a hole (and either filling it in, or planting something in it when you're done)
Sometimes your child will need to self sooth when they're not able to go for a nice long walk, and sometimes they'll need to decompress in a bigger way than breathing deeply and counting to ten, so having a variety of different techniques that works for them is just generally a pretty good idea.
Self Harm
Self harming - specifically cutting - is the number one risk indicator that a person will make an attempt on their own life. It's very important that any instances of self harming are treated seriously, and with respect. There's an underlying narrative in the media that children self harm because they think it makes them look cool, or edgy, or that they're just doing it for attention. Sometimes this is true, and sometimes it isn't, but even if they are 'only doing it for attention', it means that they NEED MORE ATTENTION, because deliberately hurting yourself isn't a normal, healthy, or safe coping mechanism.
People self harm for all sorts of reasons, it could be to distract from something they're feeling, experiencing, or reliving, or to feel SOMETHING if they're down or depressed which can induce a sense of numbness. It could be that they're going through something that they don't know how to express and it's a way to communicate that they're not okay, or a way to feel in control of some part of their life if everything else feels uncontrollable or chaotic. Sometimes it's a punishment for people who feel like they 'deserve' the pain, and sometimes it's a combination of multiple elements. Self harming is often associated with mental health conditions like depression, anxiety and PTSD (among others), but it is not limited to people with a diagnosis.
Self harm doesn't just look like physically self injury there are multiple forms of self harm, which I touch on below.
Physical Pain
Cutting is the most 'recognisable' form of self harm but without going into too much detail, hitting or punching, scratching, biting, burning, swallowing dangerous objects, or using chemicals to damage the skin are also ways a person may perform self harm. Any unexplained, unexplainable, or 'secret' injury could be the result of self harm, especially if you're seeing a trend or repeated instances of it.
It may also look like your child working out or training to excess, or as a way to punish themselves or create discomfort. There IS too much of a good thing, so if your child is trying to push through injuries or is doing so much exercise and not taking enough time to recover, it may be a sign that they're deliberately trying to cause themself pain.
Substance Abuse
As your children get older, they're likely going to start experimenting with alcohol, and possibly with drugs too. I'm not going to judge you on how you choose to handle it, the law is the law, and I would certainly never encourage or recommend that you encourage that behaviour. However, you can't control your child twenty four hours a day, and there is a reality that it's very common, and at a certain point you'll need to trust them to make good choices.
Please just keep in mind that abusing substances can look a lot like 'normal' experimentation, especially at the beginning, and the younger a person develops a substance abuse tendency, the harder they will find it to manage as they get older.
Food Abuse
Food abuse can look like overeating, undereating or restricting, binging, purging, or any other behaviour where food is used to create discomfort, pain, or punishment. These behaviours are also present in eating disorders which may have other triggers than wanting to cause pain or discomfort. Whether your child is using food as a way to harm or hurt themselves, or they have an eating disorder, it can be easy to miss these behaviours, especially if they are of a healthy size and weight, or they appear 'normal'.
Interfering With Healing Or Healthcare
Some people may pick scabs or interfere with wounds or injuries so that they can't or won't heal properly. They might stop taking prescribed medications, damage or discard mobility aids, deliberately miss medical appointments, or engage in behaviours that worsen chronic conditions, like smoking with asthma, or eating sugary sweets with diabetes.
This form of self harm can be incredibly hard to spot, incredibly dangerous, and may be part of a complex relationship with their sense of autonomy and 'ownership' over their body - especially in children who have a lot of responsibilities around their physical health.
Emotional Sabotage
Self harm may not be physical at all. Your child may deliberately create or seek out situations that reinforce feelings of shame, guilt, or self loathing. They might remain in social circles that make them feel bad about themselves because the feel like they 'deserve it', or they might sabotage opportunities or act out so that they get punished by authority figures. They may las out and distance themselves from friends and family who support them, or they may actively look for abusive relationships.
Risk Taking
Sometimes self harm is just doing dumb stuff and hoping for, or at least not caring if there is a negative outcome. I couldn't possibly list the multitudes of dumb things children and teenagers can come up with, but as a general rule, if it results in injury, was completely predictable or avoidable, and the risks were understood at the time they were taken, it could be deliberate risk taking behaviour. Of course, you don't want to wait until there actually is an injury for this to be addressed, so if you notice your kid stepping out on the road without looking, or jumping off of the shed roof even though they KNOW they could get hurt, maybe take a minute and ask them what's going on with them.
What To Do
It can be so so scary to find out your child is self harming, but in some ways that's already easier than just suspecting that they are. If you know the problem exists it's easier to find a solution, but you can still start addressing the behaviours that are worrying you, even if you don't KNOW that they've escalated to a true breaking point.
Remember that self harm isn't THE problem, it's the outcome of a problem. If you ask someone who self harms, they might even tell you it's the solution to the problem, so what you want to focus on is identifying the real problem - what's causing the behaviour - and finding a better solution together. If you only focus on the behaviour itself, it's like focusing on the crutches and ignoring the broken leg.
Stay Calm
Take a deep breath. This isn't a reflection of you or your parenting, and though it's natural and normal to feel guilty, scared, maybe even a little bit angry, but right now, it's not about you. Your job is to keep it together, and create an environment where your child can trust you enough to open up. Getting angry, frustrated, or punishing your child for self harming is literally just going to make it worse.
Talk To Them
Choose a quiet moment, and have a gentle, private conversation with your child. They may have raised the topic with you, or they may have been hoping you would notice and bring it up with them. Reassure them that they're not in trouble, tell them you're worried, and focus on giving them space to talk, rather than on trying to get them to understand.
Validate their feelings, even if what they tell you scares you, and take their emotions seriously. Prioritise listening over interrogating - remember that this conversation is for their benefit, not yours, so you may not come out of it with all the information you'd like.
Don't Focus On The Actions
Don't ask them for specifics on exactly what they did or why they did it. You don't need that information. In can feel like you're demanding that they justify or explain their behaviour, even if that's not at all what you're trying to do. Instead, focus on things like how they're feeling, what triggered the behaviour (in only as much detail as they want to give), and what support you can offer them.
Create A Plan
This isn't a moment for you to dictate or control the situation, so let your child set the tone. Work together to figure out what you can do with or for them to reduce the things that trigger these behaviours, including removing or securing harmful items if needed. You'll want to discuss coping strategies on an immediate scale - what to do and how you can help when they're actively having the impulse to self harm - and on a general scale - how to improve the situation so those impulses are less frequent and less powerful. Seriously consider seeking professional support for both your chid and yourself, and let your child be part of choosing who they talk to and what kind of help they want to receive.
If It All Goes Wrong...
Don't panic.
It's very unlikely that this will be a 'one and done' kind of conversation. You may have no luck even having a conversation the first time you try, but remember that this is for them, not for you. I'm going to say it again.
This is for them, not for you.
You may not be the person they want to talk to about this, and you need to be okay with that. You may want to try again another time once your child has realised that you're not trying to trick them and they're really not going to be in trouble if they open up. Don't take it personally if your first attempts are meant with stony resistance, you need to remember to stay calm and be gentle.
Maintain as normal a routine as possible, and make an extra effort to connect with your child in a way that they can tolerate. Low pressure and low stakes is the goal. You want your child to know that you're there for them, and that you're not expecting anything from them in return.
If you see signs of escalating distress, or an increase in concerning behaviour you should seek urgent support.
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