Depression and Self-Harm in Adolescents: A Guide for Parents

Q: Depression and Self-Harm in Adolescents: A Guide for Parents

Hello： It is a brave and challenging task to express complex and painful emotions, and I appreciate you reaching out. <br>Based on your description, my initial assessment suggests that you may be experiencing depression combined with hypothyroidism and anemia. <br>However, it is

Depression and self-harm?

Hello, doctor.
I am a 13-year-old student in the second year of junior high school.
Since the end of June this year, I have been experiencing emotional breakdowns and prolonged states of physical and mental exhaustion.
Every day, I feel extremely tired, and my mood has been consistently low.
I am unsure what is happening to me.
After a blood test, I learned that my low mood might be caused by hypothyroidism, but I didn't pay much attention to it.
After summer vacation, I continued to feel lost and believed that life had no meaning.
In early September, I began to experience more severe emotional lows, and it was during this time that my family discovered my self-harming behavior.
I was also diagnosed with iron deficiency anemia at that time.
From September to October, I started to experience irritability and anxiety.
Because of these issues, I have had to take one to two days off school almost every week.
Environments that I previously found tolerable now seem noisy and overwhelming.
In early October, I found myself wandering to the bathroom during class to zone out, and I suddenly began having thoughts of wanting to die or to end it all.
I have seen a psychiatrist twice and have been taking antidepressants (Escitalopram) for two weeks, but I still feel very distressed, even more so than before.
My insomnia seems to have worsened, and my self-harm has become more severe.

Bai Bai, 10~19 year old female. Ask Date: 2022/10/09

Dr. Li Guanying reply Psychiatry

Hello: It is a brave and challenging task to express complex and painful emotions, and I appreciate you reaching out.
Based on your description, my initial assessment suggests that you may be experiencing depression combined with hypothyroidism and anemia.
However, it is essential to further clarify the causal relationships, including your developmental history, family factors, psychological aspects, and interpersonal relationships.
Generally, antidepressants take at least 2-3 weeks to show effectiveness, and we also need to consider your recent physical condition, including your immune system, to make necessary adjustments.
I recommend that you seek consultation with a psychiatrist as soon as possible to clarify and adjust your treatment plan!

Reply Date: 2022/10/09

More Info

I'm truly sorry to hear about the challenges you're facing. It sounds like you're going through a very difficult time, and it's important to recognize that you're not alone in this struggle. Many adolescents experience emotional turmoil, and it can be exacerbated by various factors, including physical health issues like hypothyroidism and iron deficiency anemia, as you've mentioned.

Firstly, it's crucial to understand that depression and self-harm are serious issues that require attention and support. The feelings of exhaustion, hopelessness, and the desire to self-harm are often signs of underlying mental health conditions that can be addressed with the right help. It's commendable that you've already sought help from a psychiatrist and are taking medication. However, it's also important to remember that medication can take time to work, and sometimes it may need to be adjusted to find the right fit for you.

Your experience of feeling overwhelmed, irritable, and anxious, especially in environments that previously felt comfortable, is not uncommon in individuals dealing with depression. The fact that you're feeling more sensitive to noise and other stimuli can indicate heightened anxiety levels, which often accompany depressive episodes. It's essential to communicate these feelings to your healthcare provider, as they can help tailor your treatment plan to better address these symptoms.

Self-harm is a coping mechanism that some individuals resort to when they feel overwhelmed by emotional pain. It’s a way to express feelings that may be too difficult to articulate otherwise. However, it's crucial to find healthier coping strategies. Engaging in activities that promote emotional expression, such as journaling, art, or talking to someone you trust, can be beneficial. Additionally, practicing mindfulness and relaxation techniques, such as deep breathing exercises or meditation, can help manage anxiety and improve emotional regulation.

In terms of your physical health, addressing the hypothyroidism and iron deficiency is vital. Both conditions can significantly impact your mood and energy levels. Ensure that you're following up with your healthcare provider regarding these issues, as managing them effectively can lead to improvements in your overall well-being.

It's also important to have a support system in place. Whether it's friends, family, or a counselor, having people who understand what you're going through can make a significant difference. If you feel comfortable, consider discussing your feelings with your parents or a trusted adult. They may not fully understand what you're experiencing, but sharing your thoughts can help them support you better.

Lastly, if you ever feel that your self-harm is becoming more severe or if you have thoughts of wanting to end your life, it's crucial to seek immediate help. Contact a mental health professional, a trusted adult, or a crisis hotline in your area. Your safety and well-being are the top priority.

In summary, navigating through depression and self-harm is challenging, but with the right support and treatment, it is possible to find relief and regain a sense of purpose. Keep advocating for yourself, and don't hesitate to reach out for help when you need it. You're taking important steps by seeking help, and that is a strong and courageous move.

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