A recent study published by the Journal of the American Medical Association highlights some extremely alarming current trends. This 15 year study, which recorded emergency room visits from 66 hospitals around the country has found that the number of teenage girls admitted for nonfatal self-harm has risen since 2008. Curiously, before 2008 rates were stable, so it is important to examine why this rise is taking place. Although suicide rates are on the rise for both boys and girls in the US, the rise in self-harming behaviours is limited to girls.
Self-harming behaviours including cutting, poisoning and overdosing on drugs are strong indicators of suicidal intentions or co-occurring mental illness such as anxiety or depression. Amongst the self-harming behaviours recorded, ingesting pills or poison was the most common method.
Self-harming is more common than many people may be aware. Prevalence rates are estimated to lie around the 10% mark and is not limited to young people.
It is also worth noting that the data discussed as part of this study involves admissions to emergency rooms only. It does not include injuries that were treated in doctors’ offices or that were never treated at all. As a result, the worrying findings highlighted by this study may not even reflect the full scope of the problem.
WHY IS THIS HAPPENING?
One theory which has been put forward by researchers is that teens are spending too much time on their smartphones. It has been found that teens who spend five hours a day or more on their smartphone are 71% more likely to be at risk of suicide than those who spend an hour or less.
Although smartphone use may not be the actual cause of self-harm, it may put already vulnerable teenagers at further risk as it leads to increased social isolation (spending time alone scrolling through social media) and detracting from healthier behaviours such as exercise.
A more sinister reason that smartphone use may have a role to play in the rise of self-harm amongst girls is the growing online culture where teenagers encourage each other to self-harm and share photos and videos of the practice.
Social media may be normalising a behaviour that is extremely dangerous. It would be remiss to attribute all the blame to social media platforms, but it is certainly likely to be a factor, and with numbers rising it may be pertinent for parents and educators to speak openly to teenagers about self-harming behaviour.
SIGNS OF SELF-HARMING
- An obvious sign may be unexplained injuries such as cuts, bruises or burns. These will often be on the wrists, arms, thighs or chest
- Remaining covered-up even in warm weather
- Changes in eating patterns or weight-loss/weight-gain
- Signs of depression-this can include lethargy, tearfulness or being generally down
- Expressing a wish to punish or harm themselves
- Signs of hair-pulling
- Becoming withdrawn and avoiding social situations
- Signs of low self-esteem such as self-blame or expressing feelings of inferiority
- Alcohol or drug misuse
WHY DO PEOPLE SELF-HARM?
Self-harm is an extremely complicated behaviour which may be rooted in a myriad of issues. Often the individual who is self-harming may be experience emotional issues for which they require an outlet. It would be impossible to list all the possibilities but the following are some of the more common causes:
Social Problems: This encapsulates all the interpersonal difficulties an individual may be having. This could be being bullied at school, difficulties with co-workers or coming to terms with their sexuality.
Psychological problems: There is a link between self-harming and borderline personality disorder. Sometimes, those who self-harm have heard voices telling them to do so or have been disassociating (losing touch with their surroundings).
Trauma: Individuals who self-harm may often (but not always) have a history of trauma. This could be a bereavement, a history of physical or sexual abuse or any incidence which causes a high level of distress.
These issues, whether alone or combined, can lead to a build-up of negative emotions such as anger or self-hatred. The individual will often feel like they cannot speak openly of these feelings or turn for help, and so self-harm becomes an alternative method through which to express this.
WHAT CAN YOU DO IF YOU SUSPECT THAT YOUR CHILD OR SOMEONE YOU KNOW IS SELF-HARMING?
It is important not to respond in a negative manner to suspected self-harm. Don’t react in anger or disgust, or minimize the behaviour as “attention seeking”.
Ask what is going on in their life generally, and try to ascertain whether there is anything which may make him/her want to self-harm. Let them know that you are there to listen or to give any help that they may need right now.
Although it is difficult, it does not help to “confiscate” any tools that are being used to self-harm without prior agreement. The individual will find a way around this, ultimately eroding the trust you are trying to build.
It’s also important to express to them that this is a worry for you and something which needs a plan of action.
The first point of contact will often be your GP who can put you in touch with the relevant services. Schools may also have a child protection officer, or someone qualified who you may speak to.
Treatments include individual, group and family treatments and the family often have an important role to play in recovery.
The following resources may be helpful when a family member or friend is self-harming.
http://www.mentalhealthamerica.net/conditions/self-injury-and-youth
https://www.psych.ox.ac.uk/research/csr/research-projects-1/coping-with-self-harm-a-guide-for-parents-and-carers
It is also important to remember to look after yourself when dealing with a loved one who is self-harming. This will ultimately be distressing for you too and make sure to speak to someone you trust or seek help when needed.
References:
Mercado, M. C., Holland, K., Leemis, R. W., Stone, D. M., & Wang, J. (2017). Trends in Emergency Department Visits for Nonfatal Self-inflicted Injuries Among Youth Aged 10 to 24 Years in the United States, 2001-2015. Jama, 318(19), 1931-1933.