Self-harming is a highly complex issue but from friendships to body dissatisfaction to social media and exam pressures, there is little doubt that life as a 21st century teenager can feel stressful – especially without a healthy coping strategy. Priory child and adolescent psychiatrist Dr Hayley van Zwanenberg offers her insight – and advice.
A study reported by the British Medical Journal said self-harming is a ‘major public health problem’ and the incidence of self-harm has risen threefold over the past 15 years, according to the charity Young Minds.
A study reported by The Guardian said that self-harm reported to GPs among teenage girls under the age of 17 in the UK increased by 68% over just three years. The study found that self-harm among young people aged 10-19 was three times more common among girls than boys. The data from 674 GP practices across the UK explored the rates of self-harm among 10-19 year-olds.
However accurate statistics on self-harm are difficult to find as the problem is often hidden. Many sufferers are never admitted to hospital, and a significant proportion may never seek professional help.
Dr van Zwanenberg, Clinical Director for Priory’s national outpatient clinics (Priory Wellbeing Centres) and Group Associate Medical Director, said: “If a young person is suddenly wearing long sleeves for example for sport when they used to wear short sleeves, or tracksuit bottoms instead of shorts, they may be trying to hide marks.
“Some young people start wearing lots of jewellery on their wrists to cover up marks. You may find self-harm tools wrapped in tissue in their room or a bag. Self-harm is not just cutting. Self-harm is any intentional damage to body tissue. This can occur in many different ways. If you see anything unusual such as a burn mark, a strange bruise, swelling of the hand, loss of hair in patches, I would sit down calmly with the young person to talk through how this might have happened, if anything is upsetting them and how they were feeling at that time.
“Self-harm is a serious problem for teenagers with around 1 in 12 children aged between 10 and 16 carrying out self-harming behaviours. Parents frequently tell me they want to help their children but don’t always know how or what is best, and that is understandable. Every child and every situation is different. Those of us who work on the frontline in mental health, talking to teenagers and their families, can help.”
Dr van Zwanenberg is among experts from the Priory Group, the leading mental healthcare specialists, attending a conference of leading UK prep schools, run by the Independent Association of Prep Schools, in March 2018 to advise on social media use among school children and other key issues which have an impact on children’s mental health.
Ten practical tips for parents worried about self-harming from Dr van Zwanenberg:
1. If children have intense emotions and turn to self-harming, Dr Hayley van Zwanenberg suggests a less painful form: ‘Tell your child to hold some ice really tightly (it feels like it is burning but will not do damage). As the ice melts they might feel their tension melt away.
2. If the young person is struggling to talk, parents or carers could suggest forming a communication system that involves less talking but allows you to keep an eye on the child’s risk. Parents could use a traffic light system for communicating. They should sit with the young person when calm and say to them: ‘If you say or text you are the colour “red”, what does that mean?’ The young person may say ‘”Red” means I am at risk of harming myself’.” The parent can then ask how the child would like them to react if they say they are in a “red” frame of mind. The child may say they do not want to be asked lots of questions but neither do they want to be left alone, and they would like to watch a film with their parent or walk the dog with them until they feel they are “amber”. Parents can do the same if the child describes their mood as “amber” (less high risk than red) and “green” (low risk), and then there will be a plan in place for communication about risks that makes everyone feel safer.
3. Remind your child it’s normal to experience strong emotions such as sadness, anger, fear and anxiety, but these don’t last, and you can do things to help them such as watching funny YouTube clips, talking things through, taking exercise together.
4. Young people often ‘catastrophise’; they believe they will fail in life spectacularly. Help them look at the true evidence regarding their hard work and their individual skills and qualities, so they can challenge irrational thinking with evidence.
5. Help children ‘problem solve’ and form a plan so that even if their immediate hopes are not fulfilled, there are options and a future.
6. Remind your child you love them unconditionally.
7. Let your child know they can always contact a supportive charity such as ChildLine or the Samaritans anonymously by telephone or via a web chat if they need a confidential discussion.
8. Encourage them to exercise vigorously for 20 minutes each day; it will help improve mood and sleep patterns.
9. Encourage your child to ‘stop their thought train and get off it’. Encourage them to build a brick wall, metaphorically, between themselves and their stressful thoughts.
10. Urge them not to think about their exam or test worries except for short periods, say 10 minutes morning and night. (This is not suggesting they don’t revise, but that they block out the worry.)
If the anxiety does not seem to improve, and anxiety feels it is outside the normal range in severity, or length, get help from your GP. Dr van Zwanenberg says parents should also make sure they lock away or dispose of unwanted medications at home.
Your doctor can refer your child to a psychiatrist and having brief therapeutic intervention can make a significant difference in a short period. Priory’s Wellbeing Centres offer Child and Adolescent Mental Health services, with fast access to mental health experts. For further details on how Priory can provide you with further assistance regarding self-harm help, call 0800 787 0019.