Self-harm Awareness Month: How to Spot Self-Injury in Your Teen

March is Self-Harm Awareness Month. How to spot signs of self-injury in your teen.

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Trigger Warning: This post contains discussions of self-harm and suicide. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.

Self-Harm Awareness Month: How to Spot Self-Harm in Your Teen - CassandraStout.com

Self-injury or self-harm is practically the opposite of self-care.

People sometimes mirror emotional pain with physical pain. Sometimes, suffering people, especially teenagers, cut or burn themselves as a release valve. When they hurt themselves physically, the emotional pain often lessens. Other times, suffering people hurt themselves because they feel emotionally numb, and just want to feel something.

People who self-injure are heavily stigmatized. They are often labeled as attention seekers, especially girls, who are more likely to self-harm.

But self-harm is surprisingly common. Up to 15% of teenagers self-injure, as opposed to 4% of adults. An estimated 90% of self-harm starts around age 14, and continues into the late 20s. Self-harm crosses all boundaries: gender, social-economic, races, beliefs, and ages.

March is Self-harm Awareness Month in the U.S. The organizers have set aside March to combat self-injury stigma. For people who want to wear a ribbon to raise awareness of the issue, the color to wear to support people who self-harm is orange.

Signs of Self-Harm

Finding out that your teenager self-harms can be a shock. Most people who self-harm are able to hide their injuries successfully, or explain them away as accidental cuts and burns.

Be on the lookout for these common signs of self-injury:

  • Wearing long sleeves and heavy coats and sweaters even in the hot, summer months
  • Frequent, scabbed-over injuries on the arms or legs
  • Repeated excuses as to how or why the teen became injured
  • Isolation or withdrawal from normally pleasurable activities.

If you discover that your teen is self-injuring, you can help them address their self-harm. It’s not too late to seek help. Take them to a competent therapist who specializes in children and teenagers.

For a post on how to start seeing a therapist, click here. For a post on how to get a psychiatric evaluation, click here.

Suicide and Self-harm

Surprisingly, suicidal ideation is rarely a cause of self-harm. Most people who self-harm don’t want to die, they just want to release the pressure on themselves. Many people who self-injure do so to avoid suicide. However, those who have self-harmed are much more likely to attempt suicide or plan for it. The emotional distress that causes self-harm can cause suicidal ideation if not treated.

Final Thoughts

Self-injury Awareness Month is a time to set aside and combat stigma, especially gender-based stigma of girls as attention seekers. If it won’t put you in danger, try to be open about mental health and recovery. Too many people suffer in silence because they’re afraid of being judged.

If you or a loved one, especially your teens, engage in self-harm, it’s not too late to seek help. You can overcome this, together. Educate yourself about the disease of self-injury. Support your loved one, and, if you self-harm, try to perform self-care as a counter balance.

I wish you well in your journey.

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The Truth About Eating Disorders and Bipolar Disorder

People who suffer from bipolar disorder are more likely to develop eating disorders.

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Trigger Warning: This article discusses eating disorders in depth, and could be a trigger for anyone suffering from an eating disorder or related disorders.

This may come as a surprise to you, but the rate of eating disorders running concurrently with bipolar disorder is relatively high.

According to the University of Cincinnati College of Medicine, more than 14% of people who suffer from bipolar disorder also suffer from an eating disorder. To add insult to injury, these people tend to have worse symptoms of eating disorders. And people with bipolar disorder are more likely to develop eating disorders.

The Truth about Eating Disorders and Bipolar Disorder - CassandraStout.com

Sunday, February 22 through Sunday, February 29 is the international Eating Disorder Awareness week in 2020. T0he week is a time to counteract the myths and disinformation floating around about eating disorders, and to encourage people who suffer them to get help.

According to the National Institutes of Mental Health, just over 4% of the U.S. population suffers from eating disorders. Bipolar disorder affects 5.7 million adults in the U.S., or just over 3%.

Both eating disorders and bipolar disorder affect people of both genders from all socioeconomic and racial backgrounds, though eating disorders tend to affect women more frequently.

The Link Between Bipolar Disorder and Eating Disorders

The eating disorders most linked with bipolar disorder are:

  • Anorexia nervosa. People who suffer from anorexia tend to avoid eating in order to lose weight. When they do eat, they may obsessively count calories. They also often exercise in extreme amounts. Anorexia nervosa is not as closely linked to bipolar disorder, though some studies have associated the two.
  • Bulimia nervosa. As a contrast to people with anorexia, people with bulimia devour food and overeat, then immediately “purge” themselves by puking up the contents of their stomachs. They often also use laxatives to induce a purge. Bulimia is the eating disorder which is the most linked to bipolar disorder.
  • Binge-eating disorder. People with binge-eating disorder are often compelled to overeat, but unlike people with bulimia, binge-eaters don’t purge afterwards. They often feel guilty when they eat, and tend to eat very quickly, and often alone. Just under 10% of people with bipolar disorder binge eat. Some bipolar medications encourage binge-eating. Bipolar disorder also manifests differently in people who binge eat. People with bipolar disorder who binge eat are more likely to develop other mental health issues, including suicidal thoughts, psychosis, and substance abuse..

One study found that people who suffer worse symptoms of bipolar disorder are more likely to develop bulimia or bulimia combined with anorexia.

The Challenge in Treating Both Bipolar and Eating Disorders

Treating both bipolar disorder and an eating disorder can be tricky.

Antidepressants are often employed to treat eating disorders, but tend to encourage manic episodes in people with bipolar disorder. Prescribing mood stabilizers and anti-psychotics is also complicated, as these medications tend to trigger binge-eating episodes.

The best treatment available for people who suffer from an eating disorder concurrently with bipolar disorder is talk therapy. Cognitive behavioral therapy is known for treating anorexia, bulimia, and binge-eating.

Final Thoughts

If you suffer from bipolar disorder and an eating disorder, you are not alone. Developing an eating disorder while suffering from bipolar disorder is very common.

But there is hope. There is no shame in seeking help.

Talk to your psychiatrist about possibly adjusting your medications. It’s possible that with the right combination, your doctor can treat both disorders.

And talk to your therapist about targeted therapies to address your eating disorder and your bipolar disorder. (For a post on how to start seeing a therapist, click here.) You can develop coping skills and start the road to recovery from your eating disorder.

I wish you well in your journey.

The Truth about Eating Disorders and Bipolar Disorder - CassandraStout.com

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Common Pitfalls When Communicating With Your Kids About Your Bipolar Disorder, Part I

This is part one of a two-part post. [Part I | Part II]

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A picture of a little girl with black braids. Credit to flickr.com user Teresa Qin. Used with permission under a Creative Commons license.

Trigger warning: This post contains discussions of suicide. If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.

Communicating with your children about your bipolar disorder is one of the best ways to ensure that they can handle your ups and downs. You may have an instinct to hide uncomfortable situations from your kids, but kids are intuitive. They will know if someone in the family is suffering, even if they can’t put their fin0gers on why. If the problem isn’t explained to them, they can assume the worst, including but not limited to thinking that your mental illness is their fault. Preparing your kids properly is crucial to managing their relationship with you and your bipolar disorder.

Sometimes, things don’t go as well as you might expect. This happened to a friend of mine recently. Her son casually suggested that he wanted to die by suicide. “I wanted him to know I take that very seriously, and serious steps will be taken,” she said. “I wanted to scare him, just a little. But I scared the crap out of him.”

She explained to him that her 18-year-old cousin died by suicide, and then began to answer his questions. Her mistake was in answering too many of his questions, no matter how inappropriate for his age. “He was way too young for me to answer all those questions,” she said. “You have regrets in parenting… That’s on the list.”

When communicating with your kids about mental illness, having a plan or roadmap helps. Going astray from that plan is common, so here are some common pitfalls when talking with your kids about your mental illness, like bipolar disorder:

Your Children are Too Young

There is no “too young” for communication, but there are age-appropriate versions. My friend’s mistake was that her son was too young for the information and ideas that he received. He didn’t understand why casually suggesting that he wanted to die by suicide was so serious. So when she tried to explain that, she frightened him with knowledge beyond his ability to handle. Sometime our children are too young to understand issues surrounding mental illness. But even a two-year-old can understand that you need to take medication to stay healthy. Your toddler might not be able to quite get that your illness is in your head, but he or she can understand you saying, “Mom has an illness. Sometimes she needs to go see a doctor.”

With toddlers and the preschool set, keep your answers simple. Five to ten-year-olds require short, true answers, whereas preteens need more concrete, also true, information. Try to ask questions of your children to gauge what their maturity level is, so you know how much information to share.

Disrespecting Your Children’s Boundaries

Most parents don’t intentionally disrespect their children’s boundaries. But sometimes, we as parents can accidentally cross a line with our kids. We need to consider their comfort levels during conversations, especially ones about a parent’s mental illness. The topic is admittedly fraught with emotions, especially given how much our mental illnesses affect our kids. They are dependent on us for their physical and emotional health; thinking that their parent is fallible is scary.

The best way to avoid crossing boundaries with our kids is to ask questions, and check in with them regarding their comfort level. When discussing mental illness, try to be as pragmatic as possible. Offer explanations and reassurances in equal measure. Explain to your children that your moods are affected by your bipolar disorder, and that may affect them in turn. Tell them that you will always love them, regardless of how you’re feeling in the moment.

Try to gauge how uncomfortable your children are by reading their body language. If they turn away from you or fold their arms or generally look non-receptive, then back off and try the conversation again later, when they’re more ready.

Final Thoughts

Communicating with your children about your bipolar disorder is crucial for managing their relationship with you and your mental i0llness. You will make mistakes, like my friend. That’s okay. Just keep trying and do your best. Look for the last common pitfall and more tips to talk to your kids about your bipolar disorder in part II.

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How to Handle Intrusive Thoughts

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Credit to flickr.com user openDemocracy. Used with permission under a Creative Commons license.

Trigger Warning: Suicidal ideation.

“Intrusive thoughts are my best friends!” -My mother

Intrusive thoughts are part of the human condition. They are thoughts that everyone has that are inappropriate, bothersome, or downright dangerous, that feel out of your control. Surveys given to healthy college students revealed that they had all thought about harming people close to them or engaging in sexual violence. Suicidal thoughts are also common.

This does not mean that those college students wanted to hurt anyone, even themselves! Quite the opposite. These thoughts are not impulses, they’re just thoughts, and they’re usually easy to dismiss for most neurotypical people. But for people who suffer from mental illnesses, these thoughts can become an obsession.

These sorts of thoughts dramatically affect my day to day life. I often have–and dismiss–thoughts about driving into oncoming traffic, or what would happen if I fell down the stairs. Another thought I suffered a severe amount of anxiety from was due to the fact that I had to take a rectal temperature from my febrile infant. My intrusive fear was that the thermometer tip would break off inside of her. Dread clenched my belly and my heart turned to ice; I was unable to take the temperature in that manner.

I’d like to stress that these thoughts happen to everyone. Sometimes they can create a negative feedback loop in anxious individuals, by feeding into their fears and causing more.

There are a few ways to deal with intrusive thoughts:

  • Recognize that you are in control of your impulses
  • Know that these thoughts are automatic and ignorable
  • Accept the thought. Don’t try to push it away, as that only makes the obsession worse. These thoughts will go away on their own
  • Breathe deeply until your anxiety leaves

This can all be very difficult, but after a few weeks of trying, you can see improvement. I hope that these tips will help you conquer your intrusive thoughts the next time they strike!

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What is Bipolar Depression?

My apologies for setting the blog aside for so long without an announcement–and what a post to leave it on! I’ve been grappling with a severe depressive episode which has

Photo by Manarianz5. Used with permission under a Creative Commons license.
Photo by Manarianz5. Used with permission under a Creative Commons license.

escalated over the past year, leaving me not wanting to die, but just bereft of desire to participate in life.

Depression is often described as being miserable, down in the dumps, or–my favorite–trapped in a black, sucking hole of apathy. According to the Kübler-Ross model, also known as the five stages of grief, depression is one of the normal responses to a traumatic life event. Clinical or bipolar depression, however, rears its ugly head due to chemical imbalances in the brain, medication, or genes–meaning that it can strike at any time not connected to stress or winter blues. So what are depression’s signs and symptoms, and how are they treated?

Depression’s signs differ from person to person, but largely include a combination of these factors:

  • Persistent feelings of hopelessness
  • Poor concentration
  • Memory loss
  • Lack of energy
  • Isolation
  • Inability to sleep
  • Missed showers, meals
  • Suicidal tendencies

Over the past year I’ve isolated myself and my five-year-old, confining us both to the house due to both anxiety and depression. I’ve only just begun to emerge from the fugue, armed with new medications and new coping strategies, as well as an attempt to shuck off old habits.

Due to the advice of a dear friend, I found that doing things makes me want to do more things. It’s counter-intuitive, but making sure that I do the dishes and pick up the living room every day has worked as the best anti-depressant I’ve ever had. Staying in bed until I have to pick up my kid from kindergarten is a sure-fire way of destroying the rest of the day. Getting up and getting dressed is that first, difficult step, but I am better off when it’s done.

That said, I have to keep moving. How do you stay out of the sucking hole?

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