Bipolar Disorder and Self Injury in Children and Adolescents


There is not much research about bipolar disorder and self injury in children and adolescents, but it is clear that this is a problem among my clients

What is the relationship between bipolar disorder and Cutting

Bipolar disorder and self injury types vary, but carving, cutting and scratching are most common among the clients that I see.

In life we learn how to deal with stress in small doses and we gradually develop the infrastructure to deal with larger stresses. If children are overwhelmed with stress that they don’t have the capacity to deal with, they often develop interesting ways to cope with it.

For example, children who are victims of sexual abuse, often learn to dissociate ( go somewhere else in their head) during the abuse. This becomes an unhealthy coping mechanism that they may continue to use as they get older to respond to stress. You can imagine that becomes pretty disruptive later on!

In this case, it’s important to realize that for this child, that coping skill allowed them to survive the unthinkable. The relationship between bipolar disorder and self injury is similar.

A child or teen that had an early onset of bipolar disorder often struggles with overwhelming stress, and is at a disadvantage because they have a deficit of normal healthy coping skills, academic skills, social skills, and problem solving skills. This disadvantage can be further exacerbated by long periods of instability, which many kids have had.

Kids with bipolar disorder use self injury as an attempt to cope with the overwhelming stress their illness has created for them. Bipolar disorder and self injury are related because in some way these kids and teens feel overwhelmed by anger, anxiety, and sadness and this somehow helps them to feel in control, helps them to communicate the immense pain they are in ,or releases some of their pain and tension.

For Kids with Bipolar Disorder Self Injury Provides a Sense of Control

In the past, research has demonstrated a relationship between self injury and sexual abuse, trauma, borderline personality disorder, mental retardation, autism, anxiety and depression. It peaks around mid adolescence but can begin as early as ten.

I am unaware of any research particular to bipolar disorder and self injury in children or teens. Many of the young bipolar clients I work with have experienced life as chaotic, out of control, and at times, intensely frightening. They feel their emotions more deeply than you or I could imagine. Often they cannot trust the accuracy of their perceptions. For those with bipolar disorder, self injury can provide a sense of control.

For Kids with Bipolar Disorder Self Injury Provides Relief from Unbearable Pain

When I think about unbearable pain I can only think about how I felt when I experienced the death of someone close to me. The children and adolescents I work with who have bipolar disorder really do feel “unbearable pain” all the time, every day. They want to live but also want to escape that pain.

Self injury is also a coping mechanism they use when they feel unbearable pain, anger, sadness, anxiety or other overwhelming, intense emotions. Unfortunately, along with the sense of relief, comes a great sense of shame and frustration. My clients indicate that the self injury is embarrassing and makes them feel weak, but the more they do it, the more they want to do it, because in some way it effectively relieves their pain.

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Self Mutilation Help. What Should You do to Help with a Child or Teen with Bipolar Disorder and Self Injury?

What little research that has been done has established that there are different motivations for self injury. In all cases regardless of the reason a child or teen with bipolar disorder is using self injury the ideas below should be helpful.

Treat the person with kindness and concern. Do not ever shame a child or teen who is self injuring. Remember how unbearable their pain is.

Do not punish a child or teen that is self injuring, the pain they are experiencing and the shame about being unable to stop is punishment enough.

Try to assist the person who is self injuring to communicate their emotions every day. Listen to what they have to say and assist them in expressing their feelings.

Problem solving skills are important for kids who are self injuring. Create a safe home environment where problems can be discussed and help your child generate and brainstorm different ways to solve those problems. After brainstorming weigh the pros and the cons of each choice.

Self mutilation is not the same as suicide, in fact often times it is used as a way to avoid suicide or suicidal thoughts.Remember that self mutilation is a coping skill that may be the most effective one the child or teenager has. Clearly there are better coping skills that can be learned, but also there are worse. An argument can be made, for example, that smoking is a worse coping skill.

Get your child into therapy. It may be that in the past you have had bad experiences with therapy, but it can be helpful to have a trained and supportive professional on your side. Your child will also have the opportunity to work on regulating their feelings and learning new coping skills in therapy.

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Decrease your child or teen’s sense of isolation. Involve them in things that they are good at. Involve them in activities with others who have similar interests. Contrary to the reports of the epidemics of cutting among teens, most of them choose to do it in isolation, and breaking that isolation can at times decrease the cutting.

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