Understanding Depression and Self-Harm in Children and Teens: A Guide for Parents

​Parenting is never easy, but it becomes especially challenging when your child is struggling with their mental health. For many parents, recognizing and understanding the signs of depression or self-harm can feel like an overwhelming task. To shed light on these issues and provide valuable guidance, Ekaterina Konovalova sat down with Wendy McSparren, a seasoned clinical social worker with over three decades of experience in mental health. Wendy is also the founder of Westmoreland Psychotherapy Associates, a practice that has grown significantly to meet the increasing need for mental health services, especially during the pandemic.

In this conversation, Wendy shared her expertise on recognizing signs of depression, the complexities surrounding self-harm in kids and adolescents, and how parents can support their children through these difficult times.
 
From Accounting to Psychology: Wendy’s Journey Into Mental Health

Wendy’s path to becoming a clinical social worker is rooted in her own experiences as a young adult. Originally an accounting major in college, she found herself unhappy in the field. After speaking with a psychologist who encouraged her to pursue a career that involved working with people, Wendy switched to psychology. She later pursued social work at the University of Pittsburgh, which she found deeply rewarding. Reflecting on her early struggles, Wendy emphasized how personal experiences shaped her passion for helping others. "I want to give hope to people that you can have struggles and difficulties in life, but there's hope and there's light at the other end of the tunnel," she shared.

Depression in Adolescents: More Than Just Feeling Sad

One of the most pressing issues facing parents today is understanding depression in their children, especially when they may not exhibit the "classic" symptoms. Wendy explained that it’s essential to differentiate between clinical depression and situational depression. While both can cause significant emotional distress, the causes and treatment options differ.
 
Situational depression often arises from life stressors such as a family issue, a personal loss, or school challenges. This form of depression is typically temporary, with emotional support and coping strategies helping the individual overcome it.
 
On the other hand, clinical depression has deeper biological roots and may require professional intervention, including medication. This can be especially tricky for parents when it comes to children and adolescents whose bodies are still developing. Wendy noted that many parents hesitate to consider medication for their kids due to concerns about its impact on growth and development.
 
Signs of Depression: More Than Just Sadness

While sadness and isolation are the hallmark symptoms of depression, Wendy pointed out that adolescents may also express their depression in less obvious ways, such as anger and irritability. This can be confusing for parents who may not immediately recognize these behaviors as signs of depression.
 
Furthermore, Wendy discussed the varying degrees of suicidal thoughts. "Most people have different degrees of thinking about what life would be like if I wasn’t here," she explained. These thoughts can range from fleeting moments of despair to more serious plans or attempts. In some cases, adolescents may engage in non-suicidal self-injury (NSSI) as a way to cope with intense emotions.
 
Understanding Self-Harm: The Emotional Release and Brain Chemistry

Self-harm, particularly cutting, is another area that many parents struggle to understand. Wendy elaborated on the emotional distress that often leads to self-injury. For some adolescents, self-harm provides an emotional release, almost like a "catharsis" for bottled-up feelings of anger, sadness, or loneliness.
 
Additionally, she explained how the brain’s protective mechanisms can sometimes reinforce self-harm. When the body is injured, the brain releases chemicals such as dopamine to numb the pain. For some individuals, this chemical rush can become reinforcing, leading them to repeat the behavior for emotional relief.
 
What Leads to the Build-Up of Emotional Distress?

According to Wendy, the build-up of emotional distress is often due to an inability to manage overwhelming emotions. For many adolescents, this distress comes from sources such as peer relationships, family dynamics, or societal pressures. Wendy pointed out that current events - including negative news and social media - can exacerbate these feelings, creating a sense of helplessness or anxiety.
 
The lack of distress tolerance - the ability to cope with difficult emotions - can make it even harder for young people to navigate their feelings, leading them to resort to harmful coping mechanisms such as self-harm.
 
Are Some Kids More At Risk Than Others?

A common concern among parents is whether certain children are more prone to depression or self-harm, particularly those with neurodiverse conditions such as Asperger’s Syndrome or other autism spectrum disorders. Wendy emphasized that all young people are at risk for these issues. However, children with depression are more likely to engage in self-injury. Additionally, some younger children with neurodiverse conditions may exhibit different forms of self-injury, such as headbanging or biting themselves, before resorting to cutting or other more severe forms.
  
What Can Parents Do?

One of the most important things a parent can do is stay calm and get curious. When you notice signs of distress or self-harm, the natural reaction might be panic or anger but responding with empathy is key. Instead of asking, “What’s wrong with you?” Wendy suggests asking, “What’s happening?”  This shift in language opens the door to conversation rather than defensiveness. If the child doesn’t want to talk right away, set a clear but gentle boundary: “We need to talk about this. Can we talk this afternoon?” Let them feel some control while making it clear that ignoring the issue isn’t an option.

Parent Phrase Cheat Sheet by Wendy McSparren, LCSW Founder & CEO of Westmoreland Psychotherapy Associates

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​When Trust Has Been Broken

For families experiencing high levels of conflict - perhaps due to divorce or past communication struggles - kids may not feel safe opening up. In these cases, Wendy suggests identifying a trusted adult for the child to speak to: a relative, therapist, school counselor, or coach. 

“It shouldn’t be a peer who’s also struggling,” Wendy warns. “It's like swimming out to a drowning person without a buoy, and you're trying to save them - and you both drown.”
 
Rebuilding Connection Through Community

Loneliness and social isolation are often at the heart of a child’s distress. Wendy highlights the importance of community and physical activity. Programs like Taekwondo, dance, or group sports can offer kids both emotional and physical outlets.

She also mentions emerging initiatives like DashStrom, a startup aimed at getting kids off screens and into real-world, active experiences that build emotional resilience and social connection.
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That said, every child is different. Some may thrive in group settings, while others might feel overwhelmed. “Kids don’t come with manuals,” Wendy reminds us. “You have to figure out the puzzle of your own child.”

Final Thoughts: Listen More, Fix Less

As children become teens, their peers often outweigh their parents in emotional influence. This doesn’t mean parents are powerless - it means they need to listen deeply, empathize genuinely, and seek support when needed. “There is hope,” Wendy says. “Struggles don’t have to define your child’s future. With the right tools, connection, and support, healing is possible.”