Depression and self-harm

When young people are very low or depressed, they may engage in self-harm behaviour. This refers to any harmful act or behaviour that is aimed towards themselves, either directly (eg cutting or burning the skin or banging one’s head against a hard surface) or indirectly (eg engaging in risky behaviour such as drug taking or unprotected sex). It’s understandable for parents and other adults to be very concerned about self-harm, but it’s important to remain calm in order to try to understand what might be going on for them.

Self-harm can be very transient or last for a longer period of time, but normally takes place when a young person feels anger, distress, fear or worry (when they feel overwhelmed or hopeless). In other words, it’s an attempt to cope with something that feels very difficult.

Read the following quote from a young person which gives an insight into this behaviour:

‘Cutting for me releases all the built-up anger and frustration and pain I feel inside. There are many things that happen to me in my life which cause the pain I feel and how I release it. Mostly the feelings of isolation like being outcast pretty much from relationships altogether. I don’t feel like I am a very stable person and I hate myself a lot of the time. I think body image also has a lot to do with my cutting. School is stressful, home life I can’t handle sometimes’.

Self-harm might be triggered by a variety of things, including relationship difficulties, trauma, bereavement, abuse, bullying, negative life events and general pressure (eg around exam time) and may fulfil a number of functions including:

• Feeling anything else apart from the distressing emotion
• Escaping from fear, depression, fear or guilt
• Escaping from distressing images
• Relieving feelings or anger or frustration
• Regaining a sense of control (when everything else feels out of control)
• Following the behaviours of others to gain a sense of belonging

Whilst it’s understandable to be very concerned about a young person who is self-harming, it may not be helpful to simply ask them to stop; this may not even be possible for someone who has been using this as a coping mechanism for some time, and may increase the pressure they feel under. If you want to discuss the self-harm, it may be useful to think about the following aspects:

• What seems to set off the self-harm or make it more likely (what are the triggers)?
• What function does the self-harm have (how does it help with things – eg does it stop the overwhelming thoughts, or block out painful emotions)?
• What seems to help (are there any situations or people which help your child not to self-harm)

These questions can help you and your child to understand the self-harm better, and to consider alternative coping strategies which may be less harmful to them. For further information about understanding self-harm, keeping your young person safe and offering alternative coping strategies, the UK websites Young Minds and Harmless are useful.

The Young Minds website also has resources for parents/carers, professionals and young people which can be accessed here.