I feel fine, but I’m self-harming

[Terence]

I feel fine, or at least I should. There’s not really any significant issues going on maybe there’s a few smaller ones. I did break up with my gf and obviously I’m sad but I don’t think that’s the reason I’m self-harming. I’m also pretty tired after most days and feel like I’m forcing a happier mood. I have a feeling it might be cuz I’m lacking that deeper connection I might have felt when I had a gf? Like someone I can talk abt stuff I don’t tell my other friends, so maybe I’m hoping someone sees that I’m self harming and that opens that conversation up?

[KierC]

Hey Terence,

I’m so sorry to hear that you’re struggling, but I’m glad you’re here for support. Breakups can just be so crappy, and I hear you that it’s also tough to miss the deeper connection you had with your girlfriend. Do you want to talk more about how you’re feeling about the breakup? Or how you’re feeling in general? I hear you that you’ve been feeling tired at the end of the day, and I want to give you some space to talk about that, if you’d like.

I think having conversations with your friends about how you’re feeling could be a source of comfort going forward, but I know it can be difficult to start those conversations. To start, it could help to set aside time to talk and let your friends know that you want to talk about how you’re doing, being clear about what you’re seeking (For example, “Hey, I’m going through a rough spot right now and I want to be checked in with” or “I’m going through this specific thing, and I really need to just vent”). Would it help to have some more information and support around starting conversations with your friends that go a little deeper?

[Terence]

About the breakup we didn’t see each other very often so I wasn’t very sad, more like disappointed I think? Yeah I feel tired after the day, not exactly sure why. I feel like I am putting on a happier mood for other people though, so maybe that’s it.

I’m not really comfortable talking to most of my friends, maybe one or two of them, but I don’t like how awkward that will be. It would help though I guess.

I also wanted to add that I was self-harming before (not cutting) due to just general stuff like bad performances and low self-confidence stuff.

[Terence]

Since the replies can be disjointed cuz of different time zones I’m going to add another thought I had.

Cutting makes me feel guilty because it’s like I don’t have a valid reason to, like I’m just doing it to get that conversation. This is also why I’m terrified of my parents finding out because I don’t really have the explanation they’ll expect. Nothing bad is really going on, maybe I have stuff pretty often but not right now.

[Jacob]

Hey Terence!

I think a big thing to remind yourself of is that we do things because of feelings, just as much as, if not more than for objective reasons. And feelings are a more than good enough explanation.

Here's a metaphor: you might be trying to build a shelter because you're cold, but before then, you might also be shivering also because you're cold. If someone spends their time asking you to justify your decision to shiver, that's not super helpful; it's just a reaction to a feeling. But if they can help you build a shelter, or lend you a jacket, a thing that addresses that feeling, that's super helpful. Sometimes people's initial reaction to self-harm is to do the "Why do you shiver?" thing, and you are perfectly in your rights to say "That's not helpful, what I need help with is how cold I feel."

So I would bear in mind, if this does come up with your parents. They might also surprise you, by offering their help rather than pressuring you to explain it the way you're imagining.

Speaking of feelings, that tired and sad feeling, especially if its sticking around, and you're having to act happy when you're not, does sound a bit like depression. And that is a thing which can hit us any time, sometimes with no warning, or bad experiences, or "reasons" behind it at all.

It's totally true that talking to friends about your feelings can be awkward, especially if they're not particularly confident talking about their feelings either (this is pretty common for guys, but can be an issue for everyone). Sometimes encouraging your friendship group to be more open to talking about emotions can lay the groundwork for being able to have these kinds of conversations, and their reactions can show you which friend might be easier to turn to, but if they're not there yet either, it makes sense to look elsewhere first.

How would you feel about getting a doctor's appointment about your low-mood? That'd be someone who isn't a parent, or a friend, and might be someone who can refer you to treatments or services that could help with your mental health.

Feeling a lot of pressure to have "good performance" (do you mean in school?) and having low self-confidence and having self-critical thoughts about self-harming and having general low-mood anyway is actually a lot to deal with. Giving yourself permission to feel as bad as you've been feeling and asking for help could go a really long way.

[Terence]

That was a really good metaphor, thanks.

That would make sense about depression - I had (not diagnosed but there were symptoms) that before but it was a bit worse. It has actually been better (not fully but better). And I haven’t self harmed as much.

I would be open to going to a doctor but I don’t want to have to tell my parents, which I sorta need for it.

(The performance thing was anything really school games sport)

[Latha]

Hi Terence,

Do you think it would be possible to discuss visiting a doctor with your parents without telling them your actual reasons? You could say that your reasons are private, or you could tell a white lie.

[Terence]

It could be, yeah, but my parents are big on lying, and I don’t think they’d like either of the options. I don’t know if I want to go to the doctor either, like it’s not a massive urge to cut I feel like I’m just doing it cuz maybe I like the idea of having that secret to hide or smth

[Sam W]

Hi Terence,

Have you recently had just a general check-up with a healthcare provider? It may be different Australia, but here in the states it's common for students, especially students who are involved in athletics in some way, to have one once a year or so. That way, there'd be an obvious reason you'd be asking to schedule one.

If that's not the case, I still think asking for a general health check-up might be the way to go, since that would give you a chance to talk about the low mood without it being the sole focus of the appointment. How does that sound?

I'm seconding Jacob's comment to go to healthcare provider because, even though it feels like you've been struggling with low mood less lately, if there's an underlying diagnosis like depression, that means it's something that kind of ebb and flow in intensity. I say this as someone who went through a very similar period to the one you're describing at about the same age; when it stopped feeling as intense, I was like, "oh thank god, it's over, it won't be like that again."

Spoiler alert: I was wrong, and in retrospect I wish I'd used the time I wasn't in a more intense mental health crisis to get support. That would have made things easier when the low mood came back in a big way.

[Terence]

I don’t think I’ve had a general health checkup, but I’m sure another appointment will arise at some point. Only two things are that one of my parents will probably be there with me, and can I talk to any doctor about it? Won’t they tell my parents after anyway as well?

Ok, that’s something I’ll definitely keep in mind, thanks

Thanks for all the help

[Latha]

Hi Terence!

I imagine your parents will expect you to handle healthcare appointments on your own at some point. What if you asked them if you could meet with the doctor on your own, and framed it as practice? You could tell them that it would reassure you to have them nearby while you take this step.

Yes, you can talk about your mental health during a general health checkup. Primary care doctors can provide some types of mental health care, and they may also offer to refer you to a specialist, like a psychologist or psychiatrist.

They won't just tell your parents. From what I can tell, teens age 14 and older have the right to confidential medical treatment in Australia. Many doctors will ask if you want to have someone with you, or if you would like to speak to them on your own. They're here to help, and they know it can be tough to talk about certain topics in front of your parents.

Here is something to keep in mind: a doctor might choose to breach confidentiality if they have serious concerns for your safety. Self-harm doesn't necessarily mean that someone's life is in immediate danger, but keeping confidentiality in this situation will be up to your doctor's discretion. Before you discuss your concerns, you could ask them to tell you about their approach to patient privacy, and when they will decide to breach confidentiality. If it sounds like they won't keep information about self-harm private, you could omit that and still talk about your low mood.