Self Harm in Teens, What Parents Can Say and Do

If you've already had the first conversation and it went badly, you can have a second one. Most first conversations go badly. You were frightened, frightened people reach for the wrong sentence, and a teenager who heard the wrong sentence on Tuesday can hear a better one on Thursday. Nothing about self harm in teens is settled by the first five minutes. This guide is written for you, the parent.

Self harm in teens, what you are probably seeing

Teenage self harm signs are rarely dramatic. Often the first thing is an explanation that didn't quite fit. A mark with a story attached, a cat that doesn't scratch, a fall nobody saw.

Then the pattern around it. Long sleeves in weather that doesn't call for them. Getting changed with the door shut, when that never used to happen. A bag or a drawer that's suddenly private. Sleep gone strange in either direction.

And sometimes nothing visible at all. A teenager can be cheerful in company and fine at school while this is going on. Much of what gets written concerns self harm in teenage girls, and none of the signs below change if your teenager is a boy. If what you've got is a feeling rather than evidence, that's still worth acting on.

Parents call us about this more often than you'd guess. A free fifteen-minute conversation with a teen counsellor lets you ask the awkward questions before your teenager is in the room.

What is going on underneath

Almost always, relief. Something inside has got bigger than they can hold, or gone so numb that feeling anything is preferable, and this brings the volume down fast. That's the hard part for a parent: it works, briefly, which is why it repeats.

Underneath the relief there's usually something else. Low mood that's been running for months. Anxiety with no off switch. A breakup, a friendship that turned, bullying, something that happened that they haven't told anyone. Sometimes it's self-punishment, from a teenager who has decided they deserve it.

Why do teens self harm rather than talk? Because talking means trusting that the listener can take it, and most teenagers haven't tested that. They also know how frightened you would be, and protecting you from that keeps them quiet.

Is self harm the same thing as being suicidal? Usually not. Most young people who hurt themselves are trying to keep going rather than to stop. Both things are true at once: it is not an attempt, and it does raise risk over time. You take it seriously without assuming the worst out loud.

It is not attention seeking. Even where a young person does want to be noticed, that is a request worth answering rather than a crime.

What to say the first time you bring it up

How to talk to my teen about self harm starts with picking the moment. No audience, no deadline, and side by side rather than face to face, so a car or a walk helps.

Start by removing the two things they're braced for, anger and panic:

"I saw your arm. I'm not angry, and I'm glad I know."

Give them a way to say nothing without it being a failure:

"You don't have to explain it now. I'd like to sit here for a minute."

Ask what it does for them, rather than why they'd do it:

"Can you tell me what it does for you? I want to understand it before I say anything else."

Ask the other question plainly, because it changes what happens next:

"Sometimes when things get this heavy, people also think about not being here. Has any of that been happening?"

Say what you're going to do, and leave them a say in it:

"I'm going to find you someone good to talk to. You get a say in who it is."

And close the loop, so honesty isn't a one-time offer:

"If it happens again, you can still tell me. I'd rather know than not know."

Your tone matters more than your wording. Low, slow, unhurried.

What not to say, and why those lines land badly

"Promise me you'll stop." A promise extracted while you're frightened protects you, not them, and what it produces next is a lie.

"Do you know how this makes me feel?" It lands as one more person to look after, which is often part of how they got here.

"Show me." Inspecting them turns you into someone to hide from. Ask whether anything needs cleaning or covering instead.

"Is this because of that boy?" A fast cause settles your nerves and dismisses theirs. It is rarely one thing.

"You're doing it for attention." This is the sentence that ends the conversation for good.

Nothing at all. Some parents ask once, hear an answer they can't handle, and never raise it again. From the other side that reads as: even my parent couldn't cope.

What to do this week

Reduce access, calmly and out loud. Put the obvious things somewhere less immediate and say why. Do it with them if they'll let you, and don't make it a search of their room, which costs more trust than it buys. Urges rise and fall rather than hold steady, and a few steps between your teenager and the means gives one room to fall.

Keep basic first aid in the house and tell them it's there. It's an uncomfortable thing to say, and better than an infection they hide.

Don't take the phone as a punishment. Whatever else it is, it's where their friends live, and removing the support along with the behaviour leaves them with less.

Keep the ordinary going. Meals, lifts, the dog, the jokes. A household entirely about this exhausts everyone, and normality steadies.

Book something. Privately, our teen counsellors are days away rather than months. For children and youth up to 18 in Waterloo Region, Front Door at Starling Community Services is the publicly funded way in, on 519-749-2932, Monday to Friday, 8:30am to 4:30pm. In Ottawa, public intake goes through OCCARS, which a doctor or the school applies to on your family's behalf rather than you phoning in.

Tell one adult at school, with your teenager's knowledge. Not the details. Ontario schools have social workers and child and youth workers you can ask for.

Looking after yourself

You'll go over the last two years looking for the moment you missed. Most parents do, and it rarely produces anything useful. Young people arrive here through many doors, most out of a parent's sight.

Find one adult outside the house to talk to, so your teenager isn't managing your fear.

Expect to feel angry as well as frightened, and guilty about the anger. Both are ordinary, and neither makes you a bad parent.

Sleep when you can, and share the worrying with another adult if there is one.

When to push harder, and who to call

Move faster if the marks are getting worse, if it's happening more often, if they've talked about not being here, or if they can't tell you they'll be safe tonight.

Waterloo Region has Here 24/7, and the number is 1-844-437-3247, staffed overnight as well as through the day. From anywhere in Canada, 9-8-8 is there for your teenager and for you, by call or by text. Ottawa has the Youth Services Bureau crisis line on 613-260-2360, and 1-877-377-7775 for callers beyond the city. Parents can use it as readily as young people 17 and under. If the risk is right now, call 911 or get to an emergency department. That's what those lines are for, and it isn't what our practice does.

Teen suicide warning signs covers the signs worth knowing, and depression in teens covers the low mood underneath. If this is something you do yourself, self harm in adults is written for you rather than a parent.

In counselling, our clinicians work on the feeling the behaviour manages and build other ways to bring it down, often drawing on DBT skills, developed for exactly this. Our teen counsellors are at all five of our offices, and video is an option when getting a teenager into a building isn't realistic. Billing goes straight to your insurer, a family doctor doesn't have to be involved to start, and your teenager isn't joining a queue.

Not knowing the next step is where most parents start. Describe what you've found in a free quarter-hour with one of our teen counsellors and we'll work out the next move together.

Financial Stress and Mental Health, Where It Shows Up

You told them work was mad this month. Work is fine. Turning down a fifty dollar evening is easier than explaining why fifty dollars is the obstacle, so you gave the reason that cost nothing to say and paid for it in a different currency, which is one more subject you can't be honest about. Financial stress and mental health get tangled together long before anything dramatic happens to a bank balance. Here's where it lands, one place at a time.

In your body

Money worry is a threat with no off switch, and a body can't tell the difference between a predator and a payment date. So the alarm runs at a low setting, all month, for months.

That shows up as sleep that's technically happening and isn't restoring anything. Waking at the same hour most nights, usually with arithmetic already running. A jaw you keep finding clenched. A gut that's unreliable, and a doctor who can't find a reason for it.

Then there are the jolts. A call from a number you don't recognize. An envelope with a window in it, face down on the table for three days. A card machine taking longer than usual to think. Your heart does what it would if something were chasing you, and then you carry on with the conversation.

Underneath it all there's a particular kind of tiredness. Not the tiredness of having done too much. The tiredness of never once having been off duty.

Money is an ordinary thing to bring to counselling. A chat with a counsellor, fifteen minutes and free is the part of it that costs nothing at all.

In your thinking

The first thing money anxiety takes is attention. Working out whether a bill can wait uses the same mental space as remembering to send the form, so the form doesn't get sent. Then you conclude you're careless, when what's happened is that a large part of your head is permanently occupied. People who are sharp in every other setting get treated as scatty during a bad financial year, including by themselves.

The second thing it does is shorten the horizon. When there isn't enough slack, near-term fixes look more attractive than they should, because a problem next month is theoretical and a problem on Friday is not. That's how a costly short-term fix beats a cheaper long-term one, and it's a predictable response to scarcity rather than a personal failing.

Then the sentences. "I should have started saving at twenty-five." "Everyone else can do this." "If I say it out loud they'll know." Money shame is unusually good at making a person silent, and silence removes the one thing that reliably helps, which is another person who knows the actual number.

And the loop at two in the morning, where you run the same arithmetic you ran yesterday and arrive at the same answer.

In what you do and avoid

Avoidance is the most common shape, and it makes sense right up until it doesn't.

• The unopened mail. A pile, then a drawer, then a drawer you don't open.

• The balance you won't look at, or the balance you check fourteen times a day, which is the same anxiety with the opposite strategy.

• The dentist you haven't booked, the prescription you're stretching, the physio you stopped.

• The small purchase that gives twenty minutes of relief and then joins the pile of reasons to feel worse.

• Invitations declined with a reason that isn't true, until people stop asking.

• Working every hour available, which fixes some of the money and none of the dread.

• The lottery ticket, the bet, the high-cost credit. When the gap between where you are and where you'd need to be looks unbridgeable by ordinary means, a long shot starts to look rational. That's the mechanism, not a character defect.

In your relationships

Financial stress in relationships shows up as arguments that are almost never about money. They're about safety, fairness and what each of you learned money meant growing up. One of you came from a house where it was discussed openly and one where it was a silence with a mood attached, and now you're running one budget on two operating systems.

The common pairing is a tracker and an avoider. One partner checks constantly, which reads as controlling. One partner won't look, which reads as reckless. Each behaviour makes the other worse, and both are doing the same thing, which is managing fear.

Secrecy does the real damage. A card the other person doesn't know about, a debt kept quiet, a bonus not mentioned. The concealment usually starts as protection and ends as the thing that has to be confessed.

Children pick it up without being told. Not the figures, the temperature. A kid who has stopped asking for things has usually worked out more than you would like.

And there's the isolation, because most ways of seeing people cost something. You say no a few times, the invitations thin out, and now you're carrying it with fewer people around you.

What it is not

It isn't a budgeting problem you're too lazy to solve. Most people in financial difficulty know exactly what they spend. Knowing is not the missing ingredient.

It isn't proof that you're bad with money. A low income is not a skills deficit, and neither is a rent increase, a reduced shift schedule, an illness or a separation. Much of what people bring us as a personal failing is cost of living stress in Canada landing on one household.

It isn't a mental illness on its own. Money worry in genuinely hard circumstances is a reasonable response, and treating it as a disorder is both wrong and insulting. What can happen is that a long stretch of it tips into something a clinician would recognize: anxiety that outlives the crisis, a mood that has been flat for months, drinking that has crept up. Debt and depression end up in the same room that way, and the mood needs its own attention even when the balance won't move.

And it isn't something counselling can pay off. Nobody should pretend otherwise.

What actually drives it, scarcity and inequality

Two things, and they work differently.

The first is scarcity itself. Not being poor, exactly, but having no slack. Slack is what lets a broken washing machine be annoying rather than catastrophic. Take it away and every ordinary event becomes a decision with consequences, and the constant deciding is what wears people down. This is why someone can be careful, competent and still exhausted by money.

The second is the gap. Money stress isn't only about what your life costs. It's about the distance between your life and the lives visibly on display around you, at work, in your street, on a feed. Where that gap is wide, more of everyone's attention goes on status and on catching up, and the decisions that follow start to make sense: the purchase you can't justify, the long shot, the credit you knew was expensive. People compare themselves with the top of the range rather than the middle of it, and then take bigger risks trying to close a distance that keeps growing.

Add unpredictability and it's worse. Variable hours, a lease ending, a contract that renews or doesn't. Not knowing costs more than knowing something bad, because you can plan around a bad number and not around a question mark. Our page on intolerance of uncertainty is about that mechanism on its own.

Financial stress and mental health, what helps when the numbers will not change

Split the pile in two. One list is things that can be acted on: a call, a payment arrangement, a form, one conversation. The other is everything that can't be. Almost all the suffering lives in treating the second list as though it were the first.

Give the first list a slot. One bounded session a week, at a set time, with someone else in the room if that helps. Outside the slot it's booked, not solved, and that's allowed.

Use the free help before the paid help. Non-profit credit counselling agencies will go through a budget and negotiate with creditors. A Licensed Insolvency Trustee is the regulated route for debt that can't be serviced. Community legal clinics across Ontario help with tenancy, Ontario Works and ODSP problems at no charge. Dialling 2-1-1 will tell you what exists near you, including rent banks and utility arrears programs.

Bound the checking. Once a day, at a set time, not in bed.

Tell one person the real number. Not the softened version. The secrecy is doing more damage than the debt.

If you're a couple, give money a meeting. Twenty minutes, a written agenda, a timer, and a rule that nobody raises it outside the meeting. Most couples who fight about money are actually fighting about never being able to stop talking about money.

What counselling does here is narrower than people expect and more useful than it sounds. It can't pay a bill. It can stop the worry running your sleep, your temper and your marriage, and it can work on the shame that keeps you from asking for the practical help that exists. For couples, the work is about the conflict rather than the budget. Our pages on how to cope with anxiety and depression and your job cover neighbouring ground.

On cost, so you can decide without calling: an individual session costs $130 to $185 and runs 50 minutes, couples work is $170 to $195, and a one-time $50 setup fee sits outside what insurance will reimburse. A student therapist charges between $0 and $80, which exists for exactly this situation. Ontario Structured Psychotherapy is free and publicly funded for anxiety and depression, and adults can self-refer. If your employer has an assistance program, that's usually a few sessions at no charge. We send the bill to your insurer, starting takes an intake form and not a doctor's say-so, and our guides to therapy cost in Ontario and whether insurance covers therapy in Ontario lay out the rest.

If the cost of this is the reason you haven't called anyone, say that first in fifteen minutes that cost you nothing, and we'll point you to the cheapest honest route, including the ones that aren't us.