Durban – Self-harm is a growing concern among teenagers, according to child psychiatrist Dr Terri Henderson.
Self-harm is the act of deliberately inflicting pain and damage to one’s body by means of cutting, burning, scratching, and self-poisoning through medication or substances in order to relieve emotional distress
Henderson, who is a member of the South African Society of Psychiatrists (Sasop), said self-harm is a cry for help and should never be ignored, downplayed as attention-seeking behaviour or a means of “acting out”.
Citing a 2021 Unicef report, Henderson found that more than 65% of South Africa’s young people have had some form of mental health issue but did not seek help; over a quarter did not think their mental health problem was serious enough to seek support; 20% did not know where to access help; and 18% were afraid of what people would think.
“Contributory and co-occurring challenges for a teen such as depression, anxiety, post-traumatic stress disorder, ADHD and substance misuse often lead to self-harm as one of the methods teenagers engage in to cope with their undiagnosed and untreated mental health conditions,” she said.
Henderson said the age of onset of self-harm is about 12 years, though there is a stronger association to puberty rather than chronological age.
“The number of teens presenting with self-harm infliction is increasing significantly due to heightened levels of anxiety, depression and stress experienced among teenagers, availability to medication, alcohol and drugs, and the social transmission of the behaviour via social media channels,” she said.
Henderson said research showed that 50% of teens who self-harm will self-harm repeatedly. She attributes the high rate to depression, ongoing physical, verbal and sexual abuse, continuing interpersonal negative experiences and dysfunctional support systems.
She said parents who discover that their teen is self-harming are inevitably going to be frightened, and filled with questions as to the underlying reasons for the behaviour.
“Parents may feel confused, angry and helpless when they see signs that their child or teen is engaging in self-harm,” she said.
Henderson said there are signs that parents can look out for:
- Clues that may lead one to detect that a teen is self-harming include behaviour that is trying to hide scars such as wearing long sleeves no matter the weather or flinching in pain if their arm is touched.
- Other signs of mental distress are often present such as depression, increasing isolation, withdrawal from activities, friendships, schooling and sports, decreased focus on self-care behaviours such as bathing, changes in sleeping and eating patterns, irritability or markedly erratic moods.
She said once self-harm has been identified and it appears to be minimal and limited to one or two incidents, a short-term intervention with a family doctor or psychologist should be adequate.
“But more specialist support and intervention is required for severe or recurring cases, especially if there is concomitant suicidality (risk of suicide). Group or individual dialectical behaviour therapy is an effective therapeutic intervention. Medication is not used to treat self-harm but may be necessary to treat psychiatric disorders such as depression and anxiety co-occurring with self-harm,” Henderson said.
“As a parent, your role is to provide support and make changes that allow your teen to know that you support them 100%. You are not able to fix them, but walking with them through support and treatment is going to get you and your teen into a much better and healthier mental health space,” she said.
Contact the South African Anxiety and Depression Group 0800 567 567 to speak to a counsellor if you are worried about your teen.