A matter of life or death: protecting your teen’s mental health

Sometimes, teens do not cope well with stress.  Two things I deal with a lot working with tweens and teens are self-harming behaviors and suicidal feelings.


Self-harm, (also called cutting or self-mutilation) is a practice that many teens, especially girls, use as a way of dealing with the stress and emotional pain in their lives. There are a lot of reasons why teens experience emotional pain. Some of the reasons include feeling rejected by their peers, or sometimes it is as a result of conflict in their homes.

Many teens who project an appearance of being “tough” on the outside are actually very sensitive and often they hide their emotions rather than express them in healthy ways.  Self-harming is a coping mechanism some teens resort to because they haven’t learned good ways of coping with their overwhelming emotions and feelings.

Teens who harm themselves typically use knives, razor blades, pins, broken glass or other sharp objects to cut marks into their skin, usually on their arms, legs or stomach. Sometimes instead of cutting, a teen will burn herself using hot metal or friction from a rubber eraser.

It’s a myth that all teens that self-harm are suicidal. However, this behavior can lead to serious health risks if a cut is accidentally made too deep or becomes infected.

What to watch for:

Small, linear cuts. Often, the cuts are straight lines, parallel like railroad ties carved into an arm or sometimes legs. (Sometimes teens will carve negative words into their skin, like “loser” or “worthless”.)

Unexplained cuts, burns or scratches, particularly when they appear regularly. (When asked, many kids will lie and tell you, “My cat—or dog or hamster—scratched me” or “We were only playing a game to see who would flinch first.”)

Note: Most teens who self-harm do not flaunt their cuts. They are usually hidden under clothing or bracelets. When you confront them about it, they often will lie about it at first.

Why do they hurt themselves?

Many teens say they use the practice as a way to release the feelings that they can’t seem to let out in any other way. Others say they feel so dead and numb inside, that seeing themselves bleed makes them “feel alive”.

When they are in emotional pain, physical pain distracts them, and gives them relief.

Others say that cutting produces a temporary “high” for them and provides short-term relief from the emotional pain they are feeling.

(What we know from science is that the body releases endorphins when injured so there really is a painkilling effect when skin is cut.)

Self-injury becomes an addictive cycle for most of the teens who try it. Unless they find a more suitable way to deal with negative emotions, they will return to cutting the next time distressing circumstances arise.

What you can do

Encourage open communication. Once you are aware of the cutting, let her know you know.

Calmly ask her why she is cutting. And then quietly listen to the answer. Even though inside you may be freaking out, scared, worried and confused, the most important thing to do when you talk to your teen about this is to STAY CALM.  Be direct and don’t become hysterical.

Tell her you’re concerned and you want to help.

Get her an appointment with a counselor, preferably one who has expertise in working with self-injurers. Explain to your teen that a counselor will help her learn other tools for coping with emotional stress. (If you need help finding a counselor, your family doctor or your health insurance provider is a great resource.)

Be patient (and I can’t say this enough: stay calm.) Punishment, ultimatums, surveillance, bribery, etc. are not going to help. Your teen needs a good support system. She needs treatment for underlying disorders like depression. She needs to learn better coping mechanisms. And she needs a loving, safe place to talk about the emotional turmoil she is feeling.

For more information, go to http://www.sioutreach.org/learn/parents.


According to the U.S. Center for Disease Control and Prevention, suicide is the 3rd leading cause of death in people ages 15-24 (after accidents and homicide).

In a 2011 nationally representative sample of youth in grades 9-12 in the U.S.:

15.8% of students reported that they had seriously considered attempting suicide during the 12 months preceding the survey;

12.8% of students reported that they made a plan about how they would attempt suicide during the 12 months preceding the survey;

7.8% of students reported that they had attempted suicide one or more times during the 12 months preceding the survey; and,

2.4% of students reported that they had made a suicide attempt that resulted in an injury, poisoning, or an overdose that required medical attention.

The top three methods used in suicides of young people include firearms (45%), suffocation (40%) and poisoning (8%).

Source for statistical data: http://www.cdc.gov/violenceprevention/pdf/suicide_datasheet-a.pdf)

The good news: Suicide is preventable!

There are a lot of myths and misconceptions about suicide. But what I want you to know is this: suicide is preventable.

Over 90% of people who die by suicide have clinical depression or another diagnosable (and treatable) mental disorder.

When someone is depressed, he doesn’t think, feel or act the way he normally would. A depressed person often believes there is no hope. But with help (treatment), they can start to feel better and see that there are other solutions besides suicide.

A suicidal person does not want to die; he just wants to feel better.

Risk Factors

According to the American Foundation of Suicide Prevention, (www.afsp.org), the follow are risk factors for suicide:

  • Depression, including Bipolar Disorder;
  • Other mental disorders such as Schizophrenia, Borderline or Antisocial Personality Disorder, Conduct Disorder (in youth), Psychotic Disorders and Anxiety Disorders;
  • One or more prior suicide attempts;
  • Family history of mental disorder or substance abuse;
  • Recent loss (e.g., death, divorce, moving, break-ups, trauma, etc.);
  • Family history of suicide;
  • Exposure to the suicidal behavior of others;
  • Family violence;
  • Physical or sexual abuse or neglect;
  • Chronic physical illness, including chronic pain;
  • Trouble with the law;
  • Low self-esteem;
  • Struggling with sexual orientation.

Warning Signs of Suicide

The following are warning signs that someone may be thinking about or planning to commit suicide:

  • Always talking or thinking about death;
  • Clinical depression—deep sadness, loss of interest, trouble sleeping and eating that gets worse;
  • Sudden changes to appearance, school behavior and attitude;
  • Having a “death wish” (tempting fate by taking risks that could lead to death, such as driving fast or running red lights);
  • Losing interest in things one used to care about;
  • Making comments about being hopeless, helpless or worthless;
  • Putting affairs in order, tying up loose ends or giving away prized possessions;
  • Visiting or calling people to say goodbye;
  • Saying things like “it would be better if I wasn’t here” or “I want out”;
  • A sudden, unexpected switch from being very sad and depressed to being very calm or appearing to be happy. (Once a suicidal person makes the decision to actually do it, he feels relieved knowing an end to his pain is near);

Source: www.afsp.org

What you can do


If you believe your teen is a suicide risk, take him to your family physician or if you cannot get an appointment right away, take him to an emergency room. All hospitals have a crisis worker on duty who can assess the situation and make recommendations.

Make sure your teen knows the importance (and life-saving necessity) of reporting to you or another adult if he is ever worried someone is suicidal. Explain to him that it’s always better to err on the side of caution: better to report and be wrong then to not report it. It could save a life. Also, prepare him for the fact that his friend might initially be really mad that he told. Explain to him that it’s better to have a mad friend than a dead friend.

There is also a 24-hour National Suicide Hotline anyone can call: 1-800-273-8255. Their website is http://www.suicidepreventionlifeline.org/