Understanding Self-Harm in Adolescents: Causes, Risks, and Solutions

2023-06-08 03:20:00

It is surprising that many adolescents, especially girls, deliberately and repeatedly inflict self-harm without explicit suicidal intent. The most frequently used means are knives or scissors to cause cuts in the arms, wrists or thighs, lighters to produce burns or the nails themselves to make deep scratches. Sometimes these young people can hit their head or fist against a wall or other solid surface until bruising occurs. Most of the time these self-injuries take place in the solitude of the room. Girls are more prone to superficial injuries to their legs and arms, while boys resort more frequently to more violent methods, such as burning or beating.

Self-inflicted injuries are a public health problem. Hospitalizations for self-harm in Spain in the population aged 10 to 24 have almost quadrupled in the last two decades: from 1,270 in 2000 to 4,048 in 2020, according to data from the Ministry of Health. About 18% of adolescents in Western countries inflict self-harm with non-suicidal intent at some point in their development.

It is not easy to answer the question of why this type of behavior occurs. Non-suicidal self-injury temporarily reduces negative emotions of anxiety and discomfort and can produce feelings of relief, making it easier to repeat. It is a pathology that consists of hurting oneself to regulate emotional pain or seek new exciting experiences. Affected adolescents do so to express emotions such as anger, anger, guilt, or loneliness. This emotional storm starts from a hostile or negative thought, followed by a psychophysiological activation, such as increased heart rate, and an impulse to self-injurious action.

What underlies this behavior is a subjective feeling of loneliness and helplessness, where adolescents feel that their emotions are not taken into account and their daily problems are not adequately perceived by their loved ones. You want to express psychological suffering through physical damage. It is also a way to punish yourself, for example, for not liking your own body, the result of low self-esteem, or to redeem guilt for something bad that you think you have done. Self-inflicted injury offers a temporary sense of control over disturbing emotions. Ultimately, it is about launching a cry for help to their closest family or social environment.

What is surprising is that some of these young people, in a dissociative state of mind, do not feel pain, but can experience self-injury as something even pleasurable. It is a self-regulatory behavior of maladaptive affects that can become addictive, with a tendency to increase in intensity and frequency. In fact, some teens who engage in these behaviors display compelling urges to harm themselves, as well as a need to increase the severity of self-harm to achieve the same relieving effect (tolerance). The more addictive components the self-injury presents, the greater the clinical severity.

Sometimes there are specific reasons, of various kinds, that explain involvement in this type of behavior. Thus, there are adolescents with eating behavior problems who can carry them out to mitigate a feeling of guilt for having eaten excessively or for the suffering caused to their parents. Other young people, especially those who have suffered traumatic events, may show an existential emptiness and want in this way to feel alive.

A stressful situation can be the trigger in young people with a precarious emotional balance.

Some adolescents who self-injure may seek social desirability, that is, to be talked about, even in a worrying tone. They may also want to escape painful situations, such as living with parents who have a conflictive relationship, or trying to deal with a situation of bullying or a dependency on online gaming. In short, a high level of emotional distress usually precedes self-injury and is followed by a momentary reduction in stress. But this cycle repeats itself inexorably if the core problem is not adequately addressed.

These behaviors are more frequent in adolescents with low self-esteem or who suffer from other clinical problems, particularly borderline personality disorder, eating disorders, consumption substance abuser addictive and autism. But also the feeling of loneliness or the perception of lack of support can trigger these self-injurious behaviors. In short, a stressful situation can be the trigger in young people with a precarious emotional balance.

The increase in self-harm among vulnerable adolescents has contributed to the uncontrolled use of the Internet and, specifically, the dissemination of explicit images on Instagram and other social networks, which can have a contagious effect. If young people, especially when they have many followers, cut themselves in a state of apparent placidity, photograph themselves, post it on Instagram and receive a I likeThey encourage other people to imitate their behavior.

However, there are differences between self-harm and suicidal gestures. Self-harm respond to emotional states of anger, profound discomfort, or anguish, while suicidal gestures are usually related to repeated suicidal ideation, deep feelings of hopelessness, and persistent desires to end life. Likewise, the methods used in self-harm are less serious and are generally not dangerous enough to cause death.

Although there is no explicitly autolytic intention in self-harm, they constitute a future risk factor and may be a precursor to suicide, especially if there are depressive symptoms, family psychiatric problems, or a history of suicide in the immediate environment. For this reason, it is important to seek psychological help to acquire emotional regulation and problem-solving strategies, deal with stress effectively, incorporate healthy habits, and surround yourself with adequate family and social support. Ultimately, it is about detecting the sources of stress and coping with emotional challenges with adaptive psychological resources.

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