Self harming 14 yo - what happens?

[Minasama]

My 14 yo daughter is very up and down. Recently she has self harmed twice though on both occasions has played it down afterwards, not wanted to get help. I took her to the GP today who was lovely and has sent us some online self help and will send an ADHD questionnaire (her teacher suspected ADD then she seemed ok during Covid and after an unrelated school move so we didn’t pursue a diagnosis.)

My question is - has anyone had a young teen who self harmed and it resolved or is it always a harbinger of worse problems to come? The GP will see her again in a month and decide whether to refer to CAMHS which I understand can be a long process. We are fortunate in that we could pay privately for therapy etc which she has so far declined. I’d want advice on what type of therapy may be beneficial as well.

My daughter self harmed, she attended group sessions with CAMHS which helped a little bit. I think with her it was partly a phase, also some friendship changes helped. I hope your daughter gets through this x

In the short term it might be a sign of worse to come - if she hasn't actually resolve the root of the problems...

But in the long term, (including myself) I knew many people who self-harmed during school, and the vast majority got through it and it didn't go on to ruin their whole lives or grow into even worse issues.

Personally I think you need to keep pushing to explore the root of her feelings (which she might not be aware of herself) or the root of the MH issue at hand. That will then inform the steps to take in terms of lifestyle changes, therapy, etc. But without having some idea of the cause, it is impossible to advise on any changes.

One thing I do think helps in a lot of cases though is removal from the situation/context. It is the summer soon, is it possible to take her away somewhere? Get her out of the house/school/place that is associated with whatever problems she is facing now, and to somewhere peaceful/different/disconnected etc.

The distance it gives, can sometimes be a bit of a reset and enable things to get back on track, and communication to flow a bit better.

My DS started to self harm a few months ago and I think we are seeing the light at the end of the tunnel. He was diagnosed with ADHD - it had been long suspected but teachers always said was manageable with different classroom strategies. What we didn’t know is that anxiety, depression, SH, etc. are co-morbidities for ADHD in puberty. He also started after being introduced to it by a girl in his class.

We have professional help (outside the UK so works differently) - online clinical psychotherapy, a psychiatrist (to prescribe meds), and an educational psychologist to guide us and the school on ADHD. He has also been put on an SSRI - which has been transformative. Over the summer (which has already started) we have kept him busy reconnecting with the things he loves.

SH is sadly not uncommon among young people, it seems there is an element of contagion. We have worked to find the source of the contagion and blocked all access to her outside school. We tried every way of talking to him (and shouting) and have found the best to be calm, open conversation where we express concern, love, non-judgment. I don’t know if we’ve cracked it completely but we’re in a much better space to a couple of months ago - unrecognisable really.

Like a pp said, I know multiple people who SHed when young and then stopped as they grew and learned new coping mechanisms. I think about SH as a harmful coping mechanism - trying to turn emotional pain into physical, and use that as my guide - you need treat the emotional pain and the rest will follow.

For therapy - my DS refuses at first until I explained exactly what it is (he had an idea from TV about it and misunderstood). I also explained that lots of people get therapy - the tipping point was that a friend who is an ambassador had just told me she was getting therapy and I was able to say - even someone like an ambassador gets therapy (change the job title to one that might resonate with your kid as being someone ‘important’). He has clinical psychotherapy online (it’s not available here in person) - CBT, DBT, and EDMR. Look for someone or a group that can do both CBT and DBT. (His EDMR therapy is for bullying and something else). Someone with experience working with teens and ADHD.

It is really frightening and I am sending you much strength.

DD15 did, started at 14. I think due to school pressure, ups and down hormones and feeling lonely. We got a therapist, I have also been more mentally present and supportive of her and all the ups and downs. I wasn’t as present before as was recovering from work born out; but I feel better and she and my other daughter are my priority.

I give her vitamins to help with hormones ups and downs. Well teen her and omvits omega 3, suggest that excercise , good sleep but in general I check on her and make sure she is feeling ok; spend more time with her if she is feeling stressed/down; give her a massage, put a meditation on; just being more present and listening more. I also read a book called the book you wished your parents read. It good advice about feeling with them.

Plus therapy is helping

Oh and like the PP, in addition to the SSRI, I now give my DS omega 3 as there is some research around benefits for ADHD, iron for tiredness, and addressed sleep. He was finding it really hard to get to sleep (having preciously had no issue) - I now give magnesium and melatonin (I think the latter is hard to get in the UK but magnesium alone really helps). Definitely worth having a look at her sleep and see if she’s getting enough.

I say all this because just the act of me giving these ‘medicines’ has happened my son - he feels like we care and we’re taking action.

I mean without knowing her reasons for it it’s difficult to say.

Does she do it because of low self esteem as a form of self punishment?
Or because she finds seeing the emotional pain she is suffering inside, presented on the outside helps somehow? Or because she feels she has no control in her life and this, she can control? Or, for attention because she feels ignored or lonely?

Thank you, these are helpful questions. I believe it is emotional pain but could also be the last one - I will try to ask these in a gentle and not obvious way.

Does she have a phone? Instagram TikTok etc. They often get the idea from there to try it. Maybe delete those app if possible. 2 of my kids did it a bit but seemed to grow out of it. Hopefully.

Similar to other posters - we were lucky to get an immediate referral to a mental health team and DD had 6 or so weeks I think it was of one to one talking therapy - we also did more to engage her, spend more time out of her room and with the family, and continued to encourage her involvement in her hobbies. We did a lot of positive talk, building up her self-esteem and providing reassurance. Hers was driven by anxiety and overwhelm - I think the therapy helped her to see some of this was quite normal and she wasn’t “weird”. About a year on, things are much better.

We already had social media blocked but did put some time limits on other websites that seemed to be becoming a bit obsessive.

Yes she does, and in fact the first time she did it was when we removed her phone after she was in trouble at school. A big cause of contention is the phone as she thinks she is hard done by and her limits (4 hours a day) are too strict.

I agree TikTok and Instagram are awful, but all her friends are on them and deleting them will likely be counterproductive although if this continues we’ll consider it. Maybe the threat might act as a deterrent?

My son doesn’t have a smartphone or social media but had become obsessive about his laptop. Screen addiction is a huge problem with ADHD.

We banned the computer over summer. It was hard and he didn’t like it (understatement) but it’s been hugely positive. We are very lucky to have the time/leave entitlement/family/resources to keep him busy during this period. Before that (when we needed his computer for school) we just banned everything but school websites he needed.

I encourage you to stand firm on the screen and social media. Help her stay contacted with healthy hobbies/pastimes off screen to keep her connected to herself.

A psychiatrist and clinical psychotherapist will be able to help you answer the question ‘why’ and as well as therapy, give you tools to support her.

I would just like to say thank you so much from me and DH for all of these thoughtful, supportive and informative responses. These have really helped us and given us both reassurance and ideas. Thank you! Also wanted to wish all of your young people well xx

Good luck with it all op. Hopefully it’s just a phase she will get through!

I’m so sorry I don’t have any first hand experience but I just wanted to share this….a couple of years ago myself and my husband were having a meal at Pizza Hut and our waitress was in her early 20,s and her poor arms….they were very very badly cut , but they were also old and healed scars …at the end of the meal after some chat with her I whispered very quietly “ I hope you’re better now” and she gave me the most beautiful smile and said “ thank you so much, yes I am”…… she had obviously been through the mill bless her but she had come through it …good luck to your daughter, she has lovely parents x

Dd did this around that age but hasn’t for a couple of years. She has fluoxetine which she takes from the mid point of her cycle until the start of period and this has really helped as she had extreme mood swings previously. She is way better now. It’s a bit difficult to know but it doesn’t always mean things can’t improve.

It is really common these days unfortunately which is both reassuring and not. You always have to take it seriously though, as I'm sure you are. It is really easy (speaking from personal experience) to want to minimise it and at the same time want to lock up everything sharp in the house and never leave the kid unattended, which is if course impractical.

I think the main thing as a pp has said is that is the emotions causing the self harm that need attending to. You need to keep an open mind and be very matter of fact about what might be causing those emotions even if you don't like what you hear.

In our case it has resolved but I'm assuming it's resolved for now rather than permanently.