Madison* started cutting her arms when she was 13. She was dealing with high levels of stress from school pressures, body image, and relationships with friends, and did not have the healthy coping skills needed to manage her feelings. She knew of girls who cut themselves as a means of feeling better, and she decided to try it. She found it helped temporarily relieve her emotional pain. But, she was also ashamed, and hid the cut marks under long sleeves, even in warm weather. By the time her mother noticed the marks, cutting had become an addiction, and the only way she knew how to control her emotions.
It’s a story that is repeated across communities; and rates of self-harm are growing. In the US, 1 in 4 teen girls and 1 in 10 teen boys self-harm without suicidal intentions. Self-harm has tripled among 10- to 14-year-old girls since 2009.
The most common forms of self-harm among girls are poisoning and cutting. Boys are more likely to harm themselves by punching an object. Other methods of self-harm include head-banging, biting, burning, scratching or picking scabs to prevent healing, and pulling out hair, eyelashes, or eyebrows. The location of injuries from self-harm is most often arms, torso, thighs, feet, or genitals – areas easily hidden by clothing.
Ironically, self-harm is intended to relieve or escape emotional pain, to control feelings, or to feel something in a world of emotional numbness. It is not an attempt to die; it’s a way to stay or feel alive. For some, it is a way to reduce anxiety, anger, or loneliness. For others, it may be a form of self-punishment, or a way to communicate to others they need help. Research suggests that acts of self-harm may release endorphins, chemicals in the brain that create a temporary, pain-relieving, opioid-like euphoria.
Teens who self-harm may be experiencing depression, anxiety, low self-esteem, bullying, relationship problems, or difficulty managing emotions. Teens identifying as LGBT are also found to have a higher likelihood of self-harm. They may attempt to hide scars, bruises, and scabs with clothing. Wearing long sleeves and pants in hot weather or other unusual settings may be a sign that a teen is self-harming.
If you suspect a child is self-harming, it is important to address the issue in a compassionate, understanding manner, and encourage them to get help. The teen may try to deny there is a problem or avoid the conversation. A licensed mental health professional can help children who self-harm understand and process the emotions and feelings that lead them to self harm, and help them develop healthier problem-solving, communication, and coping skills. Medication may also be helpful for those diagnosed with depression or anxiety.
While Madison received both outpatient counseling and inpatient treatment, she admits that, as a young adult, she still experiences urges to self-harm during periods of high stress. However, her scars have faded, and she continues to practice healthy coping skills, such as talking with friends, knitting, and caring for her pets, as an alternative to self-harm.
*Madison gave permission to share her story, however her name was changed to protect her privacy.