Self harming

[Swishyswash]

My 16 yr old DS has a history of depression. He's on medication and has had lots of counselling in the past. The counselling hasn't really helped. He won't engage with anyone.

He's going through a very low period again at the moment, we're due to see the GP on Monday.

He has self harmed in the past cutting his arms and legs. I've just found a kitchen knife in his bedroom. I don't know how to react to this any more. I'm so upset and angry. I want to inspect him to see what he's done to himself. I want to scream and shout at him. I am so worn down. Of course I won't. How should I react?

I am at such a loss as to what to do next.

That all sounds very worrying OP. I am just bumping this for you in case anyone has any advice for you.

Thank you

So sorry you're going through this Swishy, it must be such a worrying time. You're right to hold back from screaming and shouting at him. I think staying calm is the best thing you can do. Be honest with him about having found the kitchen knife in his room and give him the space to open up to you (which he might or might not).

Make sure he knows where first aid supplies are (steristrips, bandages, antiseptic etc), let him know that you're not angry with him, because he can't help feeling the way he feels, but that you need him to make sure he's looking after his cuts and to tell you or someone he trusts if he's worried he's gone to deep or there's signs of infection. I know it sounds cold written out like that and of course your instinct is to want to see what he's done, but the priority is for him to be as safe as he can be until he can get more help.

I hope the GP is able to offer something on Monday. If he hasn't tried it already, DBT is the best therapy for people who struggle with self-harm, especially if they don't like/don't feel able to talk about their feelings. It's worth mentioning to see if it's something that's offered in your area. The DBT diary card & skills coach iphone app is pretty good, if you think your DS might consider using it.

From experience the best you can do is make sure he has a clean towel, antiseptic wipes and dressings. Keep pills under lock and key, continue to love him, try to keep channels of communication open and be the best and most tenacious advocTe for him you can be vis a vis securing care. Confirm everything agreex with CAMHS in writing, keep ringing, keep pushing, keep loving him.

Oh and look after yourself, with therapy if needed.

Young Minds have a parent helpline
The Royal College of Psychiatrists website is very good followed by MIND imo.

Try to get him assessed by a psychiatrist rather than a nurse.

Make sure the professionals check for any underlying neuro developmental disabilities and don't be fobbed off. Write to your MP if necessary.

We went through this five years ago, with the right care and support, although we had to pay for it, dd recovered.

Relate are now oroviding therapy for yoyng people. We found them invaluable because it was as needed rather than prescriptive blocks. £35 a session

MH care for young people in the UK is dire. Research and persist.

Apols for typos

We've been to the GP this morning. He has a referral to CAMHS form earlier this year, but we've heard nothing. He saw the GP on his own then she called me in.

She's going to chase the referral and wants to see him again in 2 weeks. She won't increase his meds without the input from CAMHS. So we're no further on.

It is so frustrating. There's so much publicity around mental health issues, but practically nothing is changing. If he had an infection or a broken limb he'd get some active treatment. It's like wading through treacle.

If he's been referred already, why don't you chase it too. Once chased, write to them, recorded delivery confirming your call, the urgency and anything you have agreed over the phone.

Good plan, I'll write now.

I know what you're going through. This is a really obvious point but you ( and anyone else close to him) are the ones who can help the most. As you say, if it was a broken limb the NHS would help but mental health isn't at all the same - the publicity is so misleading on this. We don't have any cures for mental distress and some treatments actually make people worse. I hate to say this but have you considered that about his current medication? It probably isn't a factor but not impossible.
I know how awful it is to see your child go through this but your love, concern and hope for his future are hugely important and could be what helps him get well. Don't feel deskilled by thinking a psychiatrist will have all the answers.

I'm too tired to read all replies so sorry if this has been said, but I wanted to pop my advice in since I am an ex-teenage-self-harmer.

The most important thing to do is positive support. Mention the knife in his room and ask him if he wants to talk.

If he opens up to you, great. Then make sure he has adequate first aid supplies and let him know that you can help with dressings or plasters or whatever he needs. Don't confiscate any implements right away but do create a space in which he feels safe enough to tell you if he ever needs medical intervention.

If he doesn't open up to you, gently let him know that you expect all knives to stay in the kitchen where they belong, but don't take it away there and then. Let him do that, he needs to feel in control.

Self harm is a known coping mechanism. It does need to be stopped but no one can stop cold turkey. Don't take away any implements straight away as this can lead to a person looking elsewhere and using something dirtier or more dangerous. But do let him know that you're there and that you'll help him get through this part of life and it'll stop eventually. It will be a slow process though. And it will raise its head again and again throughout his life. It still does with me.

Oh also, advice online is that if anyone is threatening to self harm they should be taken to A&E. I'm less inclined to believe that because it's all dependent on the severity, so that bit is up to you to decide.

Please ask GP for blood tests if this hasn't been done already, my friend's daughter was B12 deficient when she was self harming, although there were other reasons too. My son was Vitamin D deficient and this wasn;t picked up or suggested by anyone as a cause for depression/low self esteem (although he never self harmed). Just in case you hadn't considered these aspects, GPs usually do bloods to rule out, but if it was a long time ago that you first saw GP, things may have deterioated/changed. My friend's daughter no longer self harms at all.

@Swishyswash

I'm so sorry you are going through this.. I have a 16 year old and it breaks my heart to imagine him doing it.

But.. I will have to say although I feel the above I am a self harmer in times of great distress if I blame myself for it. It's something no one knows about me apart from my brother and my partner. My partner worked it out and my brother I told because he was doing it and in a bad way, so I felt I could tell him that I did and that things get better.

So now I'm thinking to myself what would have helped me..

To know how much it hurts the people I love would have made me think a bit more, because it's all about punishing yourself and a release of some kind. It does something to our brain that calms it.

It makes you angry because you love him and can see what he has to offer world and indeed what the world has to offer him. In his head he's stuck in a bubble, a bubble that doesn't let him see the real world and the bigger picture right now. No doubt the more he does it the more he hates himself, a vicious cycle.

Do you know of any underlying reason why? Weight issues? Stress issues ? Friend issues ? Self image?

He may just have the horrible low self esteem, so no matter how lovely they are, handsome, clever or popular they will not see it. Anti-depressants help, they help by lifting your mood, your feelings of love for yourself but the first few weeks can risk the opposite affect as it can make you feel worse at beginning. Sadly it's all down to self control in the end, stopping yourself, just stopping when you want to do it.

Does he self medicate with anything? Drink? Weed?

Drink makes self harming easier, gives you the balls to do it when alcohol has sent you into a spin of sadness.

Weed may mellow you out at time but the negative affect of bringing you down lasts when the nice affects wear off.

Even if he rejects you, continue to tell him you love him, that if he does that it breaks your heart, if there's something he needs to write it in a letter or text if he doesn't want to talk, so you can understand but the truth is he doesn't understand it either.

His brain is wired now to find something sharp when feeling bad, even to have it near by is enough sometimes to calm the brain.

Teenage years are such delicate times there really is a chance he can get over this. I would if he isn't already get him on antidepressants, they work, the up your feelings of worth but you have to be careful of alcohol with some of them.

Wish you all the luck in the world, it's so horrible to watch it happen to someone you love, anger is high because your emotions are high. Remember to look after your own well-being too.

If there is anything you want to ask me, feel free too.

Thanks everyone for you kind words.
He doesn't open up to me or his dad, I think he has self esteem issues. He is overweight and is trying hard to lose weight. He's a very keen rugby player and is looking forward to the season starting in September.

There's a lot of pressure at school at the moment. The teachers are obsessing about university applications. He really doesn't want to go and we support him in his decision. I'll be glad when school is finished, 1 more year

The medication he's on has been extremely beneficial for him. He doesn't dabble with drugs, occasional alcohol but not excessive.

The GP practise rang back and they want to see him again on Monday. Hopefully she's been in contact with CAMHS with news about some CBT.