14yo cutting and purging

[flattopgrinch]

I've found out that my (literally just) 14yo DD has been self-harming and purging. I'm totally blindsided by this and really don't know what to say or do to try and help her recover. I wouldn't have guessed for a million years that this was coming - she is the sunniest person I know, bubbly, confident, sassy, joyous (or so it seemed), laid back (no perfectionist tendencies) and I just have no idea what has triggered this. I can't believe she's been in such pain for months and I just want to wrap her up with love and protect her from the world. Obviously, that's not practical, but you know what I mean. I can't help feeling that social media has a lot to answer for as well, as when I was late-13 yo I had absolutely no idea what purging was, or that people chose to cut themselves. But maybe I'm being naive.

She doesn't really want to talk to me about it at the moment, which I can only respect, though she has discussed with a counsellor at school and she also has a GP's appt now. I'm terrified of saying the wrong thing to her as well. And would it be helpful or not to tell her about my own very minor ED if she asks? I never really managed to make myself sick, thank god when I look back on it now, and it was all over in a year or so at uni.

Any thoughts gratefully received. Thank you.

(Small note: not a mental health professional or anything along those lines, just giving advice based on what would have helped me ).

Hi OP, sorry this is probably a slightly late response but I was looking through Mental Health and I didn't want to read and run.

First off, I'm really sorry both you and your daughter are going through this. I hope you have some additional support that you can access while you try to support her! If she's got a counsellor and GP appointment, that's great as a first step and she's on the road to recovery. Has she expressed any reasoning for why she feels she needs to / has been self harming?

From the perspective of someone who suffered disordered eating and cutting from a little younger than your daughter's age, the best thing you can do is be empathetic, and avoid getting stuck in your own shame spiral (e.g. address any of your negative emotions with a support system that doesn't involve her, like a partner or therapist, and try to keep in mind that your guilt may end up unintentionally causing her guilt). I know that can be challenging and may be hard to hear, but if you can keep it together for right now then that will help by not put any more pressure or worry on her shoulders about how you're coping.

If she's got a GP's appointment, I think the next natural step on her progression is probably a CAHMS mental health assessment. That can either go well or poorly (full disclosure: I had a shit experience with them at around 11/12 for self harm and suicide but I know it's really helped some people). If she's not already diagnosed, there's a potential for that to lead to a depression diagnosis due to her self harming, which depending on her preferences, could lead to anti-depressants. I started taking Sertraline as my first anti-depressant and I think that's the one they tend to start most people on, especially adolescents.

I'm not sure if you have any prior experience of cutting (?) but I think it's important to know that like all addictive behaviours, it's not a linear pathway to recovery. There will be highs and lows and try to avoid taking it as either a flaw on your part or on the part of your daughter. If it brings you any comfort, I did it around her age to avoid committing suicide so it can sometimes be a preventative (and therefore hopeful) measure. Also, a point to be noted is that for me, there needed to be a replacement behaviour. I was self harming to cope, and so people telling me I needed to stop doing that didn't help if they couldn't provide another method to help me cope - there needed to be the yang (self care) to my yin (self harm), as cheesy as that sounds. If she has any special interests, or things that make her happy even if it's going out for ice-cream, then what could be useful is promising to participate in something related to it anytime she feels the urge to cut or purge.

Re; telling her about your own disordered eating, I would say it could be a good idea providing you treaded lightly. E.g. not saying "this is how my eating disorder manifested, this is what I did" as that could be triggering, but I think you could say "I had a similar thing when I was young, so I'm always here to support you and you're not alone."
However try to avoid mentioning methods of purging or really anything related to weight, as these are common triggers for relapse.

Social media can be toxic in relation to self harming behaviours, especially sites like Tumblr (lots of glorification of mental health issues) but keep in mind that there is a reason why susceptible young people are drawn to those sites. Even if she's seen a photo of self harm or something similar and thought "That looks cool, I'll try that" it will usually still be to escape some pain. Happy people aren't taken in by this stuff. So I'd be a bit wary about pinning too much to social media.

This also ties into not doing anything drastic. I see you've mentioned wanting to wrap her up in a blanket (which is lovely) and I think you absolutely should give her all the affection you can. However, anything dramatic like making her delete her social media / take the door off the hinges / lock up the kitchen cabinets all add to the feeling of being out of control. I'm not saying you'd do this, but I think when someone you love is hurting themselves you want to do what's practically safest even if it's not great for their state of mind. So, try and remain level-headed and empathetic is my over-arching advice.

There was also an NHS article here; (^www.nhs.uk/news/mental-health/nearly-quarter-14-year-old-girls-uk-self-harming-charity-reports/^) that states that nearly a quarter of 14 year old girls self harm, so this is a problem but you are not alone in this and neither is she.

I'm going to leave you with some links for additional support here.

This (^youngminds.org.uk/find-help/for-parents/parents-guide-to-support-a-z/parents-guide-to-support-self-harm/^) is the Young Minds' Parents Guide for supporting young people with self harming problems. It's got some recovery videos that you may find comforting. There's also a Parent's Helpline: 0808 802 5544 providing you are in the UK.

If your daughter needs confidential support, up until age 19 she can ring or chat with Childline: 0800 1111. There's an online login at the Childline website if she prefers messaging.

This (https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-harm/helping-yourself-now/^) is the Mind website, which has a list of potential tips / distractions from the compulsion to self harm. Maybe good to have a look through and see if any would work for DD. I would also highly recommend this as a list of distractions from the Adolescent Self Injury Foundation. (https://www.adolescentselfinjuryfoundation.com/things-to-do-besides-self-harm^)

And for you, in case it gets too much text SHOUT to 85258 for some free text-based support and advice. Here's a link to the site: (^giveusashout.org/^)

Sorry that turned out to be such a massive post, but I really hope it helps and I wish you and DD all the best with the recovery process. Tons of luck and blessings your way, best wishes

Covid, thank you so much for such a helpful and practical reply. It means a lot!

No, there seems to be no reason she or I can see behind her self-harming. No bereavements, stable home, not being bullied/bullying, she's popular in a strong group of friends. It makes me wonder if there might be a physical component as she's said that along with feeling low she's also felt she has absolutely no energy or motivation to do things. I really haven't noticed this - she gets up and out to school every day (when it was on). I feel that the GP should maybe do a blood count just in case she's low on iron or something, though obviously I know this isn't the whole problem.

What you said about highs and lows rang true and I'm worried that now this has started, it will just be a long rollercoaster of these behaviours for years and years. I know my eating certainly got worse in late school/early uni as I had all that freedom to go and buy whatever I wanted. I'm sorry to hear about your own self-harm experience - what would you say got you through it and how old were you when you felt that you recovered?

I'm not going to delete her social media or anything like that, I know that would completely backfire! She doesn't want me to tell DH about any of this either, so I'm having to keep it a secret from him. I don't really mind this and would never betray her trust, but it's just a slight added complication.

No, I myself have never had the urge to self-harm - it's just never crossed my mind. I have heard that people can use elastic bands to snap on their wrist as an alternative to cutting - would you have found that suggestion helpful at that age? I'd like to offer, but worry that I'm being patronising and she'll think I just don't understand (which I know I don't).

I understand it can take two years to get a CAMHS appt in my area, which isn't great, but I will do everything I can to get other support in place and see what the GP says. The idea of her taking ADs seems pretty foreign to me as she honestly comes across every day as happy, giggly, engaged and interested - it's such a bizarre situation. But she's clearly not, when she's alone in her room.

I get what you're saying about not expressing my own negative emotions with her. I'm also just worried then about coming across to her as blase about the whole thing. It's a fine line! But I just want to do everything I can to support her.

Thank you for the links too, I will contact Young Minds. I think all my DC know the Childline number off by heart as they've always threatened to call it when DH and I were asking something unreasonable of them ("Please wipe up the water you spilled" etc) - haha! That massive list of alternatives to self-harming looks amazing to me too. I will pass it to DD, though I don't want to bombard her with stuff and have promised not to pester her.

Thank you again, Covid - your post was so useful and positive.

I just wondered about the not telling your DH thing which jumped out for me.

On the surface she wants to be able to control your talking to him but I wonder if deeper down she would be reassured by your saying - dad is my husband and I share important things with him. You could say you take this seriously and you share serious things with your dh and he with you.

I did think that one of the outcomes otherwise might be that you and dd are drawn into a secret problem between you and she has got between you and your dh and caused you to keep things secret.

Like it is a way of drawing you close and into something with her. I wondered if she is anxious about her relationships and her place in the family/with you - now she's starting to grow up.

Sorry if not helpful. I was just struck with how you have the potential because of your understandable worry and concern to sideline your dh I wondered on the one hand your dd really wants that but on the other (like a small child pushing boundaries) she will be frightened if she succeeds in getting you to keep important secrets from dh.

Bumpsadaisie, thank you. I don't think DD necessarily wants me to keep it a secret from DH for ever, it just feels that things are at such an early stage I think she doesn't want lots of people getting involved. As she's 13, I don't think DH automatically has a right to know everything, but obviously it would be good to share things eventually. I think he would react with incredulity at first, knowing our DD as we do, and I feel I just want to deal with her at the moment before having to deal with him about it too! I'm just glad she's chosen to confide in me for now, feel that's the main thing and trying to take things one day at a time.

GP's appt on Monday so we're just holding out till then.

Hi OP I'm a YP counsellor and work frequently with adolescents facing the same challenges as your daughter.

The only thing you can do is offer the space to talk when she needs or wants to. I wouldn't offer your own experiences of EDs, but just frequent (un-pressured) check-ins to let her know she can talk about her feelings with you without judgement. The fact that you know about her challenges means she does want you to know what is happening with her, she will probably start to open up more over time. When she does - listening without offering advice is key, even if you want to try and 'fix' (so hard for a parent I know).

If she is is seeing GP and counsellor at school she is on the right pathway. I would suggest some separate support (counselling maybe?) for yourself - this is really difficult for parents too.

Thank you, porger, that's really helpful.

I feel as though almost all I can offer her is empathy and a listening ear because I can't be inside her head and I know I just can't tell her to do something or stop doing something else. I really don't feel I have advice to give, but I do want to try and prepare myself if she does ask.

Is she trying yo copy someone?
Even a celebrity?

Is she trying to lose weight?

to not yo

I don't think so, lightand. We haven't spoken about it enough yet - she's glad I know, but doesn't want a big discussion yet. But I think she said to the counsellor that it wasn't about losing weight, but more about control. I don't know.

EDs are almost never about simply losing weight (although can start out that way). They are a form of self harm and as you said OP, are predominantly a way to control something when everything else feels out of control.

If the GP refers her to CAMHS (which they should be doing) then usually they take a systemic approach and look to involve parents in recovery. This will hopefully allow you to feel you are helping your DD. Honestly though, just providing a space for her to talk is so valuable. And not putting too much emphasis on food - our instinct as parents is to make sure they eat (it's one of our main jobs) but this has to be approached delicately with someone like your DD.
If CAMHS referral takes too long and money allows, there are specialist private clinics like the Priory that could help also. If money doesn't allow, I would be inclined to put my energies into 'shouting the loudest' to make sure she is seen by experts ASAP.

Thanks again, porger. I'm pretty sure she will be referred to CAHMS but we'll need to put something else in place before then as it will be such a long wait - and I will definitely shout loudly.

I want to tell her that she should tell me straight away if she is feeling suicidal on any particular day, but I think she'd think I was putting too much pressure on her. But the not knowing is extremely worrying.

Hi, OP here under minorly different username – for some reason I lost my login details and have had to reregister.

I just wanted to vent a bit as I still feel completely in the dark about what is going on with my DD and am constantly worried. She will not discuss any of her issues with me at all.

She has had a CAMHS emergency appointment now and they have, thankfully, assessed her as not being at imminent risk of suicide and put her on their regular (8/9 months) waiting list. She is getting a weekly zoom counselling session through the school. But I don't know if she is purging and/or how often she is cutting herself. I wake up throughout the night as I hear her getting up to go to the toilet and am just waiting for sounds of vomiting.

I am hyper alert to little things she says - eg the other day she asked DH to fix a broken light in the downstairs bathroom and also, in the same breath, to fix her squeaky bedroom door. To me, I am wondering whether this is her making plans to go downstairs and purge during the night.

She also lent me a strip of ibuprofen the other day when I had period pains and had run out. She asked for it back when she saw it on my desk –this makes me paranoid about her trying to stockpile for an overdose. I can't get these thoughts out of my head. (We do normally keep all painkillers like this in the bathroom btw.)

I want to tell her how terrified I am that she will attempt suicide, and feel that she probably doesn't have any real understanding at her age of the utter, permanent devastation to her family and friends that would follow. I worry that by being laid back and casual about things, like I have been, not pressuring her about anything, that she feels I am not really that bothered or worried about the whole thing.

I know this whole situation is not about me, and that's why I'm getting it out on here. I don't want to put stuff on her. But I'm still worried about simply leaving things alone, which is what she's asking.

There's also a hell of a lot of secrecy going on. I have a full report from CAMHS with what she discussed at her emergency meeting. She has implored me to let her read it first when it arrives (it's just arrived and she doesn't know it has yet). She is annoyed with CAMHS that they want me to know everything and thinks it should be confidential. I've agreed to let her read it "first" as I didn't want to steamroller over her feelings, but I don't believe she'll give it to me once she's seen it. It does go into a bit more detail than what I knew before, but not a whole lot.

She also doesn't know that I've told DH everything now. She thinks he only knows about the self-harming - not the purging or suicidal thoughts. It's all such a mess.

Is it worth trying a diary approach with? You could write her a message in a notebook and say if she wants to, she can respond and leave it in a designated space for you to read? Sometimes that is easier than face to face. You could let her know in your message that you won't ask her about the diary in person, to take some of the pressure off. It might not work but could be worth a try as a way of opening up communication that is on her terms?

Thank you Rustnot. That's been suggested and she's just not interested in opening up to me at all, nor the suggestion of a set of emojis to let me know if she's feeling bad. I am only allowed to text her details of appointments –admin-type stuff –and nothing else. I'll text after her sessions and ask how they went, or just how she's been feeling the last few days or whatever, and I get a one-word answer like "Fine" – or just no answer at all.

I just worry that she'll be in crisis in the middle of the night or something, and I'll know nothing about it.

So I gave DD the CAMHS report to read, treating her as a mature kid, and as I could have guessed, she's now refusing to give it to me as she says it's confidential information I don't need to know, and that I know enough. Wtf to do now? CAMHS want me to know what's in it, it was addressed to me, but DD will be furious if I phone them up to get a copy, and her state of mind is fragile enough as it is. WWYD?

Hi OP, I think you need to give her CAMHS caseworker a call. If they require your involvement then I would suggest there is a valid reason for that. 14yo is very young to be doing all this alone without involved support from parents. They may suggest some good methods to do that.
In nearly all my YP work, clients don't want parent involvement because they are frightened of a reaction to the details of their difficulties - anger, sadness, disappointment. Is it worth reflecting on why she is being so vehemently defended around this, what is she sacred of? This isn't to imply that you have made her feel this way, YP often have set ideas of what their parents can or cannot handle emotionally.

Thank you, porger – well, unexpectedly, DD handed the report over to me today, which I was astonished at. She caveated it with the remark that it was all "lame" and not accurate, the things she said in it aren't really true, and that she was in the best place she’d been in in 6 months when she had the meeting with CAMHS. This is really worrying me, as the report goes into detail about her self-harm etc, and if that was her on a “good” week, then how on earth must she be feeling now? (She won’t tell me.)

However, it’s definitely a step she’s taken, giving me the report, so I’ll take that for today.

Am just living in terror of a suicide attempt – or a success, and no idea how I could stop it or whether she would even try to.