Teenage DD and possible self-harm - what do I do?

[Poledra]

Bot of background - 15-yo DD, oldest of 3 DCs. DH and I still married, we do bicker sometimes but mostly are fine, no threats of family split.

She didn't have the easiest ride through primary school, as she never really found her people. She had friends, but was desperate for a 'best friend' which she never really got (one girl was a best friend for a while but turned out to be rather unpleasant, which upset DD greatly at the time). Secondary school, again did well academically but not in a close group and a bit of a third wheel.

So, in Yr 10 she changed schools (start of this academic year) to a specialist school which only takes in from Yr 10. So everyone started together, and she has found her people! She has a big group of friends and is often out socialising etc. So far, so good.

However, she was wearing shorts yesterday, and I noticed some scratches at the top of her legs. Didn't really think anything of it, just said, 'Oh, what have you done there?' She said something about the cat scratching her and she'd fallen off her bike (true). She also immediately tugged the shorts down to cover the marks.

But it's just not ringing true to me as I think about it. The scratches were right at the top of both of her legs. parallel to each other and just the right size to be a single-blade razor pressed into the skin. DH briefly saw the scratches when I asked about them and agrees that they did not look accidental to him either. What do we do?? He thinks we need to watch and wait, and see if we notice any other marks now that we are on the alert for them, and warmer weather means she'll be wearing fewer clothes. I rarely see her without her clothes on these days (naturally!) but he was wondering if I could engineer to catch her in semi-undress to see if there are marks anywhere else. He is also thinking that perhaps it was an experiment (the marks all looked the same age, as it were ) and we could make things worse by drawing attention to it if it's a one-off. I want to rush upstairs, grab my darling darling daughter and talk to her until she tells me whats going on. I've been awake since 05:30 fretting, I cannot believe she is in such distress that she needs to do this

What do I do?

You don't judge and you make sure the door is always open for her. It's a coping mechanism that suggests inner turmoil. Talk to her about life in general and how she is, is there anything she needs support with emotionally or academically. Let her know you are there to arrange it. Make sure she has antisptic wipes available. It is rarely a one off or an experiment. Inform yourself - I found the Royal College of Psychiatrists website the best. Identify good counselling for her and be prepared to pay for it. Alongside that inquire about a camhs referral but be realistic about timeframes but get her in the system in case your support and counselling is not enough.. Don't tell them you have any means for private support.

Thanks for the response, Ohtheroses. There is absolutely no judgement here, we just want to help. She talks to me all the time, which is what I can't understand - she even jokes about making me a cup of tea so she can come and sit down and talk at me (i.e. download her entire day/week/ whatever it is she wants to talk about). I always make time for this in the evening if she wants it.

It's just so shocking that it has happened now, when she seemed to be in such a good place. DH wondered if she might be struggling with her sexuality - there has been very little talk of boys other than as good friends. This is a non-issue to DH and me, as she knows this but he did say it still can be a difficult thing to come to terms with.

Getting counselling, private or otherwise, is not a financial problem. We will manage it. And I'll look up the RCPsych website too.

And what if I'm wrong? What if I'm taking a molehill and making a mountain? I didn't think about the possibility of self-harm till later in the evening so now I'm desperately trying to remember exactly what the marks looked like, in case I'm catastrophising.

Sorry, still a bit all over the place here.

Bump for other thoughts?

Hi I think asking her wouldn't make a mountains out of Molehill, maybe she wanted you to see them, it can be very hard for some ppl to ask for help and if it's nothing and she says so at least you will have asked and she knows you will have cared and been brave to approach the situation. I'd doesn't sound like your being judgemental at all and just want to help your little girl. If she says she could do with some help maybe talk therapy might help. I know it's probably hard to but please try to talk to her, I was diagnosed with lots of stuff @ 15 and medicated when all I really needed was to be heard and understood x

Also Poledra you can't make her tell you. I would as calm and breezy as possible and just say you seen her leg and if she wants to talk about it that's no problem etc be straight with her and don't beat around the bush and let her know there is no harm in going to therapy etc it's not a weakness but a sign of strength to help yourself. I'm very passionate about this I hate seeing kids going through stuff it's heartbreaking and so hard for them to talk x

I used to self harm at that age. It sounds like she has a great, open relationship with you and will hopefully open up if/when she needs to. Don’t push too much. Maybe a way in could be saying something like “those cuts looked a bit sore, do you want some antiseptic cream?” I wouldn’t ask her outright, especially as you’re not sure if she was actually telling the truth about the cat and bike. I think if she knows that you’re not judgemental/angry/disappointed about the cuts then she may be more likely to open up. (Not saying you’re any of those things, but I used to feel ashamed and embarrassed about it, like a failure and that I’d disappointed and upset my parents).

My arms are covered in scars from my teenage years / early 20s. My mum absolutely lost her shit when she found out so I just got better at hiding it. You seem very different.

Things escalated for me into injuring myself in ways that I thought could seem accidental (being a teenager I wasn’t particularly smart about this, breaking your wrist with a hammer is not going to look like you’ve tripped and fallen) until one of these incidents went very wrong and I ended up far more injured in a different way that I didn’t expect. Never did it again, but I was lucky to survive it at all, let alone in one (albeit badly scarred) piece.

I also developed an eating disorder in my teens, all related to the same issues I was having.

If it helps at all, my mental health now is good, no self harming, I have a job, I’m married and have a family.

Getting help was really important for me in terms of getting better. If she’s usually willing to talk I would try to talk to her about whether anything is bothering her, but don’t force it at this stage.

Hi Poledra, my DD1 has been self-harming on and off since age 12 - she's 18 now and it's a rare thing now, though saying this, she did her legs exactly the same as your dd last weekend. She and i have been through so much since her problems started and although I would never, ever want to minimise how awful self-harm is, i really do see it now as the least bad thing she can do in response to completely unbearable feelings. There are certainly worse things she could do and has done. Self-harm is a coping mechanism as others have said.

With your dd there are 2 main possibilities - one is that this could be shortlived and experimental (as loads of girls are self-harming and she'll be aware of this). The other is that she does have some major difficulties going on and needs a way to manage. If it's the latter, as in my dd's case, then talking is definitely the way to go imo and you sound like you'll be in a great position to do this. My dd and I are the same. The biggest piece of advice i can give you is don't expect or assume that 'professional help' is the answer. First of all she may not want or accept it and secondly, what's available may not be that great, even if you can afford to pay. We've tried a few things, all of which have made dd feel worse, now she won't go near any services. My view (and I say this as someone who works in mental health) is that parents are often the ones who can help the most and the thing that makes the most difference is love. More specifically - a deep desire to understand without judging or giving too much advice, calmness in the face of frightening/upsetting things and perhaps most important of all, a strong sense of optimism about your dd and her future - a feeling that this WILL get better in time. For them to sense this from us is hugely helpful i think.

Thank you all for taking the time to respond. Today's been quite busy, so no opportunity to do or say anything else to her about it. This is probably a good thing, as it's given me time to get calmer about it. This should mean that when (if!) she does talk to me, I can listen to her whilst not letting her see how upset I am. This is not about me.
I'm thinking through how to approach this with her and really appreciate all your input.

Lauren850 with all due respect the consultant psychiatrist dd was referred to was her absolute saviour. She was the person who took on board that dd had the very best life and "something" was going on. She was the one who prescribed the fluoxetine and propranolol. She was the one who gained dd's trust. She was the one who diagnosed the ADHD, at 17! Counsellors, yes, were hit and miss but that was all the GP and CAMHS recommended and both told me to get them off the internet. Yes love is the best thing, usually with the help of properly qualified specialist drs for advice and guidance.

Lauren850 very wise words.

DD2's self harm has taken different forms at different times. The worst was an overdose which resulted in hospitalisation. As a result of this she did get support from CAMHS. I cant criticise them. DD2 was diagnosed with depression and ASD. The treatment was of limited value but did give her something to think about. A family therapy workshop was 'interesting'.

In the end what worked was time.

OhtheRoses - good for you, I am genuinely happy for your great outcome, although I dislike the faux 'respect'.
I have one dd with crippling anxiety who also suffers from depression and another with ADHD - the drugs haven't worked for either of them. If you knew the truth on pharmacology (keep in mInd my career is in mental health) you would understand that this is all too common. Actually the best thing in your case was probably finding a lovely psychiatrist as that positive relationship will undoubtedly have been a significant thing in helping your dd and you. Fluorextine is actually only fractionally more helpful than a placebo (read the research) and is also well documented for making some patients a lot worse, with adolescents more at at risk. As for adhd medicatIon, it's far more successful than anti-depressants but still at least 30% of patients don't benefit at all and another chunk loathe the side effects so much they struggle to take it.

Poledra Please use medication as a last resort after trying all other avenues. I agree with Lauren about love and understanding I think f that's absent the poor kid will think it's a burden and want the meds as it won't want to cause issues for you, kids pick up on your emotions even if they don't say so. It's such a fragile thing the mind of a child at this age and need all the support and encouragement a calm caring parent/guardian brings x all the best and do let us know how you get on I'll be thinking of you xxx

I totally disagree re the drugs. Fluoxetine made an enormous difference to me many years ago re pnd. DD was not in a good enough enough place to engage with therapy before the anti depressents helped. Further a tiny increase in dose, contrary to NICE guidelines made a phenomenal difference. I wholly agree that finding a lovely psychiatrist was the best thing; it was the only thing as even when dd was cutting and overdosing, CAMHS didn't want to know.

Just a quick update. DD and I had a very frank conversation tonight as we crossed over in the bathroom on our respective ways to bed. The upshot is the scratches do indeed appear to be the work of our cat (who adores DD, and spends most of his days sitting on her lap while she does homework). She's been wearing thin leggings and shorts in this nice weather, and he has accidentally clawed her legs.

We talked about how she can tell me anything she wants, and I will listen. I also said to her that if there is ever anything she needs to talk about but she cannot talk to me or her dad, then she should tell me and we would get her someone else to talk to. And I told her I loved her and would always always listen to her.

Her reactions all seemed very normal and not at all rehearsed. At the end of the conversation, she was actually laughing at me in an 'OMG mum, where did you get that idea?' Now, I'm not a complete innocent abroad, so I will continue to keep an eye on her. But I am hopeful.

Thank you all.

I'm delighted for you and well done xxx

Poledra do please maintain a watching brief. We didnt realise the about our DD's self harm until she ended up in hospital because of an overdose. Across a couple of years she had burned herself on a number of occasions resulting in significant scars but all hidden.

Lauren850 I think this is something that is very individual from person to person. Dd had lovely CAHMS psychiatrists and therapists whom she trusted and wanted to work with: she was still too ill to engage with any therapy until they put her on the meds, though we had to wait for a long time due to her age.

Once she had the combination of meds and therapy, she became a different person: her anxiety was dampened to the point where she was able to work with the therapy.

After a few years she tried to come off them (very carefully managed withdrawal) but became ill again and was unable to cope with the HE course she had always dreamed of. Now back on meds and again a totally different person: has got into a different, more challenging course and is absolutely loving it.