After the definition and explanation of the problem of depression in adolescents in the previous article, we are now going to delve into one of its most noticeable signs: self-harm.

Nonsuicidal self-injury (generally called self-harm), is defined as the act of deliberately harming one’s own body. These damages can be caused in various ways: cuts, burns… Normally, not It is not intended to transform or be a suicide attempt, but rather an erroneous way to deal with negative feelings. Thus, it is not considered suicidal behavior.

And why do we resort to self-harm? Although at first the idea causes us rejection (and it should be so, since it is an instinctive behavior), Self-injury can bring with it a momentary sense of calm and release of tension. Usually, after suffering this self-harm, guilt and shame appear, and negative feelings also return. This behavior also entails the possibility of more aggressive or serious actions against oneself, which may even be fatal. Currently, according to studies, it can occur at a frequency of 8% to 14% in adolescents, and more in women than in men.

These types of injuries usually occur in private, and are carried out in a controlled manner or even in the form of rituals, which often leaves >specific patterns on the skin. They tend to occur mostly on the arms, legs and the front part of the torso, but they are considered self-injury anywhere on the body. Anger or rage can trigger the impulse to self-harm, so many people do it a few times, and then they stop. strong> stop. While it remains worrying, the main danger is that it becomes a long-term repetitive behavior.

How can we intuit what is happening?

Signs and symptoms of self-harm may include:

  • Wounds: usually, in certain patterns. These are usually cuts, scratches, bruises, bite marks… Excessive rubbing of an area can also be used to create a burn.
  • Always keep dangerous objects within reach: knives, razors, scissors…
  • Wear clothing that hides the body, even when the temperature is high.
  • Increase in accidental injuries.
  • Difficulties whenestablishing or maintaining interpersonalrelationships.
  • Emotional instability, impulsiveness and unpredictability.
  • Statements offrustration, lack of courage, sadness or hopelessness.
  • Social isolation: the adolescent may be quieter than usual, or try to go unnoticed in everyday life.

There are certain risk factors, in addition, that can increase the likelihood of self-harming behavior occurring:

  • Environment with people who self-harm.
  • Emotional problems or mental health, and especially, depression.
  • Abuse of alcohol and/or other substances.

What self-harm exists?

  • Cutting: generally, deep cuts or scratches, made with sharp objects. This type of self-harm is especially dangerous, since the more times the person has cut themselves, the more they will need to do so.
  • Burns: with matches or cigarettes, with boiling water, or with otherhot objects .
  • Recording of words and/or symbols on the skin.
  • Hitting oneself, especially in the head.
  • Perforation of the skin.
  • Insertion of objects under the skin.
  • Ingestion of poisonous elements.
  • Dermatillomania: stopping the healing of wounds.
  • Trichotillomania: impulse topull hair from the body.

Any of the aforementioned behaviors is aggravated by the consumption of alcohol and other substances.

Depending on the severity of the self-harming behaviors, we can classify self-harm:

  • Stereotypical self-harming behaviors: they can be performed anywhere and vary the severity of the injuries.
  • Major self-harming behaviors: involve some type of amputation. Associated withserious and psychotic psychopathology.
  • Compulsive self-harming behaviors: repetitive and ritualized, occurring multiple times a day.
  • Impulsive self-harming behaviors: existence of concern when it comes to self-harm. It producesanxiety and a feeling of relieflater.

Causes of self-harm

First of all, we must keep in mind that it is very unlikely that self-harm occurs due to a single cause. Normally, they are the result of the combination of several factors:

  • Existence of a depression.
  • Lack of ability to cope with certain situations: for example, when dealing with pain in a healthy way.
  • Difficulty controlling and/or managing emotions: trying to control or reduce stress or distress; distract yourself from negative emotions; the avoidance of the feeling of emptiness; communicate feelings of depression or anxiety; self-punishment…
  • Self-rejection: poor body image, low self-esteem…

In summary, in most cases, self-harm is the result of poor emotional regulation. Since adolescents are still in an early stage, which is also one of the most complicated in life, they have not learned to correctly regulate their emotions. and, therefore, they do not have the tools or the experience necessary to cope with negative feelings.

How to deal with self-harm

When we discover this negative behavior in a person around us, at first we may act with surprise or fear. The first thing to do is take the matter seriously, and establish communication with the subject. If you do not respond appropriately, we must obtain emergency help, based on the severity of the situation. and injuries. Ultimatums must be avoided at all costs, as they could worsen the adolescent’s behavior.

The psychological treatment for this behavior is, as in depression, psychotherapy, combined with psychiatric medication. . The main objective of treatment is to identify the reason for this self-harm and to teach the adolescent to correctly manage his emotions and his problems. .


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