Self-harm in adolescents

SELF-HARM (NON-SUICIDAL self-injury, NSSI), even though perceived by many as fairly new, has been around for quite some time but has been done in secrecy and is typically hidden under clothing. More recently, selfharm has become more prevalent and is becoming more visible and a growing concern among adolescents. Parents often may not be aware of self-harm within their own home. Self-harm is most often used by adolescents as a means of release from psychological pain, it is usually repetitive and can be addictive. It is commonly missed by parents who are unaware of the concept of self-harm as well as features of self-harm, which are usually hidden under clothing.

Self-harm behaviours are not limited by socio-economic status, gender or educational level. It may affect any of our adolescents. However, selfharm most commonly starts during adolescence and is more frequent in females.

‘CUTTING’

Self-harm in adolescents often involves ‘cutting’, seen as thin scrapes usually on the inner aspects of their forearms, but may also involve their legs and abdomen. Simple everyday objects are usually used to inflict harm – razor blades, scissors and pins, and adolescents will most times choose a solitary place, e.g., the bedroom or bathroom.

Self-harm is used as an inappropriate coping tool to ease tension, anxiety, feelings of depression or anger. It may also be done to feel some sense of control over their bodies or in response to a sense of guilt or self-hate. Self-harm may represent a transient period of distress without further risk, but may also be an indicator of significant mental health problems which, if unaddressed, may persist into later life and seriously impair quality of life. Self-harm in adolescents is not synonymous with a plan for suicide. However, if the adolescent has an associated mental illness, e.g., depression, then these adolescents have to be even more closely assessed and monitored by a health-care provider.

The most important thing to note is that self-harm is a behaviour, not an illness, and we need to identify and solve the underlying issues. Most adolescents who engage in self-harm will improve with the appropriate help. So, if you think your child or adolescent may be cutting, please seek professional help as soon as possible.