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Life can get overwhelming for our teen at times. When it does, some might consider self-harm or other extreme means to end their pain. Let’s learn to spot the warning signs of self-harm and suicide so that we can provide them with the support they need. Take any mention of suicide seriously and remember that help is always available.
If you or someone you care about needs a safe space and would like for someone to provide a listening ear, these helplines are available.
As parents, we always have our teen’s best interests at heart. We prepare them for adulthood by nurturing their social skills, helping them navigate the challenges of adolescence, and providing support for their emotional health and well-being.Emotional health is an important part of mental health. Having good emotional health does not mean one is always happy; emotionally healthy people experience a variety of emotions too. However, they are able to cope with life’s challenges, keep problems in perspective, feel good about themselves and have good relationships. Let’s read on to learn to identify the warning signs that our teen’s emotional health may be suffering and how we can help.
As our teen enters adolescence, many of them might experience some change in behaviour as they try to define their new identity. At this stage, their friends also become extremely important and have a great influence over them. As our teen focuses more on their peers, it might become common for them to spend less time with us. This might leave us feeling a little hurt but it doesn’t mean that they don’t need our support and love.However, if the changes are more unusual and extreme, it might be a tell-tale sign that our teen is struggling emotionally.
Teens might be tempted to experiment with new things…
Teens might be tempted to experiment with new things.Some examples may include:
Teens can be more rebellious at this stage and refuse to take...
Teens can be more rebellious at this stage and refuse to take instructions like they used to. Some defiance is normal as teens increasingly seek independence.Some examples may include:
Hormones and developmental changes during puberty often...
Hormones and developmental changes during puberty often mean that our teen might experience mood swings and display irritable behaviour from time to time.
Teens have the tendency to sleep later due to various factors...
Teens have the tendency to sleep later due to various factors, including changes to biological clock during puberty.
Most teens would have access to smartphones or electronic...
Most teens would have access to smartphones or electronic devices such as tablets, personal computers etc.It is common for teens to use social media or play online games to interact with their friends, and to learn more about their interests— these can have a positive impact on their well-being.
Most teens value privacy and are somewhat secretive about...
Most teens value privacy and are somewhat secretive about what they are doing.It is also normal for them to want to make their own day-to-day decisions without parental input, which may be why some teens choose to occasionally keep things from us.
Learn more about the early signs that our teen is struggling emotionally here.
If we notice any of these signs from our teen, it might mean that they need our support:
Self-harm means to cause harm to one’s body on purpose. It is a form of maladaptive coping behaviour (poor patterns of behaviour to cope with the situation) that may accidentally result in serious injury or even death. Some common examples of self-harm behaviour are:
Scratching or cutting one’s skin
Consuming toxic substances (e.g. bleach or detergent)
Swallowing sharp objects
Hitting parts of the body on hard surfaces or objects
Burning the skin
Consuming drugs or taking medicine in a manner or dosage more than what is prescribed
Pulling hair out
Having casual sex
Starving themselves or purging
Some reasons why a person could harm themself:
Distracting oneself from difficult situations, experiences, or emotions
A form of relief from intense and painful emotional or psychological distress
To seek a sense of belonging
A form of self-punishment due to feelings of guilt or shame from past traumatic experiences
A way of regaining some sense of control in their lives (e.g. being able to decide when, where and how to hurt oneself)
School pressures (e.g. heavy workload)
Relationship problems amongst family members/ friends/ romantic partners (e.g. conflict, bullying)
Social isolation (e.g. having no friends or not fitting in school)
Transitional changes (e.g. changing schools, entering the workforce)
Confusion and insecurity about self, such as one’s identity and role
Bereavement and grief (e.g. losing a loved one to death or breakup)
Mental health conditions (e.g. depression and anxiety)
Past traumatic experience
Alcohol or drug use
Left unchecked, constant self-harming can become a habit due to the sense of relief it may bring. However, this sense of relief is only temporary. It cannot help with the issues that make someone want to hurt themself in the first place.It is important to remember that self-harm is dangerous – a cut too deep or a bad reaction to a drug could put a person’s life at risk.While people who self-harm usually do not intend to end their lives, constant self-harm can increase the risk of suicidal tendencies.
Before the act of suicide, suicidal thoughts and behaviours may occur. They include having thoughts of ending one’s life, planning suicide, and enacting the plan. However, some suicidal behaviours may occur suddenly and impulsively.
Some factors that increase the risk of suicidal behaviour can include:
While these factors do not necessarily cause one to attempt suicide, they can increase the risk of suicidal tendencies. A combination of multiple “causes” may also heighten this risk.
Most teens who engage in self-harm tend to hide their actions or injuries to avoid confrontation or rejection. They may feel ashamed, confused or afraid about their actions. They might also worry that we may not understand their reason for self-harm, and as a result become angry about it or would reject them. This might make it difficult for us to know whether our teen is self-harming.These are some indications of the possibility of self-harm:
If we discover that our teen is displaying some signs that they may be engaging in self-harm, it is important to remain calm and not jump to conclusions or confront them immediately. Understandably, as parents, we are worried but our reactions may unintentionally add on to their stress or cause them to be even more withdrawn. We should give them a chance to open up voluntarily.
There are warning signs to suicide. Here are some examples of what someone considering suicide may say or do:
Try spotting the behaviours of concern using this quiz. There may be more than one correct response to the questions.
With hormonal changes and life challenges (e.g. exams), it is normal to feel worried, stressed or sad at times. However, if our teen is constantly emotional or frequently having anger outbursts, it is a sign that they might be struggling emotionally. This includes frequently crying, irritability, and low mood of feelings of worthlessness.We might want to check in with our teen to find out what is causing them to feel this way, and reach out for professional support if necessary.
At this stage, friends become extremely important and are a great influence. As teens focus more on their peers, they might spend less time with their family members. However, do take note if they suddenly withdraw socially, e.g. losing interest in hanging out with close friends and people they care about or in doing things that they enjoy.We might want to trust our instincts and check in with them to see if things are alright and if they would like a listening ear. Let them know that they are not alone.
It’s perfectly normal to experience ups and downs in school, but a pattern of negative change, deterioration in functioning and sharing of moody messages can be a sign that our teen needs help.
Take any mention of suicide seriously. If our teen mentions or talks about suicide, take it seriously and seek professional help. Do not leave them alone if they are suicidal. If they are in immediate danger, call 995 or 999.
For teens, it is usually important to them to look good, and they might control their diet in attempt to lose some weight.However, do look out for significant sleep or appetite changes, as they are signs that our teen might be stressed or struggling emotionally.If our teen is dieting too much, it may also be a cause of concern as there might be underlying body image issues.
Self-harm behaviour is usually a way to cope with difficult/distressing thoughts and feelings. It is a serious sign as it might accidentally result in serious injury or even death.Some teens may deliberately wear long sleeved clothing even on hot days, to hide self-inflicted cuts or scars.If we suspect or observe any self-harm behaviour, we should reach out to support them or consider seeking professional help for our teen.
As we grow with our teen, parents play an important role in showing them life skills, role-modelling and demonstrating to them coping, problem solving and help-seeking skills. Here are some tips that can help foster a stronger relationship with our teen.
Find opportunities to check in
Look for ways to check in with our teen and find the right time and moment to engage them.Ask them how their day has been and what they have been doing.We can also talk to them about their latest interests and hobbies. For example, we may want to invite them to join in a task, such as laying the table for dinner, so we can use the time to chat about their day.
Practise active listening
When our teen starts a conversation, we may wish to stop what we are doing to listen. Stay focused on the conversation and show genuine respect for what they are saying. This sends the message that we are genuinely interested in what’s going on in their life.
Observe for tell-tale signs if our teen is not keen to talk
If they prefer to keep to themselves, we may let them know that we are available for them whenever they need.In the meantime, we could observe for tell-tale signs that they may not be coping emotionally. If we are concerned, we could proactively check in with them.
Provide assurance and support
We could remind them that we are always here for them and that we are interested to know how they are feeling and what they are thinking.We can encourage them to reach out to us and let them know we are here to support them.
Respect their privacy and give them space
The desire for more privacy is a natural part of growing up as our teen is developing independence and new social interests. We could give our teen the appropriate time and space to be on their own. At the same time, we may want to balance this with ground rules such as curfews and that they should let us know whom they are going out with and where they will be.
Schedule time to spend with our teen
Take interest in what they enjoy doing and do it together. For example, we could go out for meals, or engage in sports with them. This not only shows we care about them but allows for opportunities for conversations to happen naturally.
Practising these tips on a regular basis can help us stay close, maintain open communication and a positive relationship with our teen, this way they are more likely to share with us when they are facing difficulties. It also makes it easier to notice warning signs when they are acting differently or struggling emotionally.
It is common for us to feel angry or at a loss when we see our teen struggling, especially if our teen has emotional outbursts or withdraws socially. Stay calm and think of a way to get our teen to share what is affecting them. These strategies might help our teen to start talking:
How to approach them
What can I do?
How to get them to share and open up
How to respond to them
We can also reach out using these tips and check out Hi #JustCheckingIn to help us navigate conversations with empathy and care.
When we observe our teen exhibiting the signs of distress more intensely, we could consider seeking professional support. Just like how we would see a doctor when physically unwell, it is equally important to seek help from mental health professionals when in distress. Help-seeking is not a sign of weakness, but a sign of resilience and courage.
If our teen feels consistently down for 2 weeks or more, and if their mood has significantly impacted their day-to-day functioning, we may want to bring them to a counsellor or General Practitioner. We may also choose to approach the School Counsellor if our teen is schooling. The School Counsellor is able to make referrals to mental health professionals at a subsidised rate. For more mental health resources and services, we can find the help we need via CHAT or Belle, the Beyond the Label helpbot.
If we notice that our teen has engaged in self-harm behaviour (e.g. cutting themself on any parts of the body) or has thoughts about suicide, it is important to take it seriously and seek professional help for our teen.
We should not leave our teen alone if they are suicidal. Reach out to any of these 24-hour helplines – Samaritans of Singapore (SOS) at 1-767 (1-SOS) or chat via SOS CareText for support. Alternatively, we can choose to call Institute of Mental Health (IMH) at 6389-2222. If our teen is in immediate danger, call 995 or 999.
Stopping self-harm can be challenging. Our teen may require some time to adopt effective coping techniques. Sometimes, they may relapse and go back to self-harming when they get overwhelmed with difficult or distressing thoughts and emotions. When a relapse occurs, this is what we can do:
If we notice that our teen has engaged in self-harm behaviour (e.g. cutting themself on any parts of the body) or has thoughts about suicide, seek support from a professional like a counsellor or psychologist. Take any mention of suicide seriously. Our teen might need us now more than ever, and intervention is important to stop someone who’s undergoing a crisis in harming themselves or taking their own lives. We could do the following to de-escalate the situation and keep them safe:
It might be very worrying to know that our teen is struggling, but as we care for our teen and juggle our own life demands, it is important that we also care for ourselves to avoid burnout. Visit here to learn tips on how we can better manage our emotions and care for ourselves. We can consider enlisting help from other adults or family members that our teen trusts, and work with our teen’s teachers and school counsellors to support them. If at any time we feel that we need emotional or psychological support and would like to speak to someone for further advice or information, please remember, it’s OKAY to reach out. Here are also some helplines that are available for us to reach out.
Signs that our teen may be struggling emotionally
If our teen refuses to comply with reasonable rules and boundaries and experiment in risky behaviours, this might be a behaviour of concern.Some examples of risky behaviour include:
Other signs to look out for include:
Defiance or rebellion
It may indicate a bigger issue if our teen exhibits more extreme rebellious behaviour such as:
These are behaviours that go beyond the norm of teen rebellion. Pay close attention and we might want to check in with their teacher on how they are doing in school.
Moodiness and irritability
If our teen’s moodiness is constantly escalating or if they don’t seem to be able to cope in normal day-to-day situations without landing in frequent anger outbursts, this could be a potentially concerning behaviour.Also, watch out for sudden changes in behaviour such as persistent sadness, anxiety, eating or sleep problems. If this persists over 2 or more weeks, it could indicate a possible mental health struggle.If our teen mentions or talks about suicide, we should take it seriously and seek professional help. We should never leave our teen alone if they are suicidal. If our teen is in immediate danger, call 995 or 999 for help.
If our teen is struggling to fall and stay asleep or routinely sleeping all day (e.g. more than 11 hours/day), repeatedly failing to get up for school, this might be a cause for concern.
Usage of electronics
Signs of cyber addiction in our teens could include the following:
If we find our teen gaming for extended periods, it could be a form of escapism or a coping mechanism where they are withdrawing into themself. Find out what is troubling them and see how we can help.
Omitting facts or lying
If our teen is consistently lying or lies to hide risky/dangerous behaviours, it could be a concerning behaviour.
Frequent emotional or anger outbursts
This includes frequent crying, feeling irritable, low mood or a sense of worthlessness.
E.g. loss of interest in doing things they used to enjoy, hanging out with close friends or with people they care about.
Deterioration in functioning
Significant sleep (either too much or too little) or appetite changes
Low mood and low energy
Signs of self-harm behaviour
E.g. burns, scratches or cuts on wrists or other body parts. Some teens may deliberately wear long-sleeved clothing even on hot days, to hide cuts or scars.
Provide a listening ear and support for our teen
What can I do or say?
Stay calm, listen and avoid judging, dismissing or jumping to assumptions about why the teen is engaging in self-harm.If we notice self-harm marks, we can try asking:
Help them to cope with their thoughts and emotions
Examine our teen’s thoughts and emotions together with them
If our teen is willing to work together, we can first help them to identify what is causing them to feel distressed or overwhelmed. The urge to self-harm can arise from triggers like:
Urges can include:
We might want to note down what was happening before our teen acts on the urge to self-harm. Help them to recognise the triggers and urges so they can manage these triggers and urges when they occur. If our teen has difficulties identifying their emotions, they can use the feelings tracker to identify how they are feeling and make sense of it using the emotions explorer.
Manage unhelpful thoughts
Sometimes, unhelpful thinking patterns might magnify the negativity of the situation. For example, our teen may overgeneralise and think, “I have failed once, I will fail for sure again”. We could encourage our teen to share their feelings and these thoughts with us. We could listen, empathise and validate their emotions. It may be useful if we can help our teen to reframe the negative thoughts into something positive or focus on good things around them.
Encourage our teen to seek support from a healthcare professional
We can encourage our teen to seek support from mental health professionals as they can provide professional advice such as safety plans and healthy coping methods. Assure them that healthcare professionals will keep their information confidential. We could try to accompany them to their appointments as much as possible. Some parts of treatment could be challenging. During treatment, they might be agitated, tired, anxious, and depressed. We could ask them what we can do to make things easier during this difficult time. They may feel that things will never get better, especially if they are finding treatment hard or if they experience triggers to engage in self-harm. We could offer hope by reminding them that most people do benefit from treatment.
Sharing resources or tips that might help
We can ask our teen whether they are willing to work together to manage their stress, emotions and self-harm tendencies. If they are willing, we can start by sharing with them that self-harm is a form of maladaptive coping behaviour (poor patterns of behaviour to cope with the situation), and we can work with them to find better ways to cope with difficulties. If they are not ready, we can ask if they prefer to reach out to self-help resources for support:
Be calm and do not scold or judge them
We may feel worried, upset or disappointed to learn that our teen has relapsed into self-harm. However, we can remind ourselves to remain calm and understand their action as a way to express their distress. Our teen may need the reassurance that we will still be there for them after their relapse.
We can encourage our teen to seek support from mental health professionals for confidential advice such as safety plans and healthy coping methods. We can also accompany them to their appointments.
Always prioritise safety first
Seek professional help
Work with our teen and professional to devise a safety plan
A safety plan prepares for the scenarios in which one may experience suicidal urges. An example of a safety plan consists of:
Help them create their safety plan here.
Be patient with our teen
Scolding or urging them to stop may not help. It could make them feel worse and might lead to a crisis situation. Our teen may also hide their struggles from us in the future.
Give them hope that things can get better
During these seemingly dark moments, our teen might feel that suicide is the only way out. Give them hope that they can manage to survive feelings such as self-loathing, hopelessness or isolation. We could let them know how we would still love them unconditionally, that they can take the time needed and that they are not alone. Help is always available and reaching out to someone can often help them address challenges and view things from a different perspective.
Go easy with expectations
One possible reason our teen may develop suicidal thoughts and/or urges could be high expectations. They may want to be the perfect version of themself all the time. However, these expectations could be unrealistic as no one is perfect. By constantly wanting to be perfect, our teen may end up being their harshest critic when things don’t go their way. We can remind them as well as ourselves, that everyone may make mistakes, feel frustrated, and experience misfortune in life. However, by managing one’s expectations and planning ahead, we can overcome future hurdles and challenges. We could work with our teen to review and break down what they set out to achieve into smaller, achievable steps. Let them know that we accept them for who they are regardless of their achievements.
Encourage them to be kind to themself
Being kind to oneself means showing compassion to oneself. Just as how one can give words and actions of comfort to others, one can extend the same things to oneself especially during difficult times.
Encourage them to practise gratitude
Practising gratitude is the act of being and feeling thankful for the people and things around oneself and the things they get to experience. This can be as simple as appreciating the cool weather or getting to enjoy their favourite meal.
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