Twenty-year-old Amanda* from York, UK, took her first overdose when she was 16 years old. "There was a lot of pressure at home, my parents were splitting up and I was worried about my GCSE [exams]. I didn't feel like I could talk to my mom because our relationship wasn't very good, and I kept it from my friends."
Unable to talk about what was bothering her, Amanda took an entire packet of sleeping pills. "It was a conscious thing. I think I was quite naïve at the time, because I thought I'd just take them and I'd go to sleep and that would be it. But I know it doesn't work like that. So now, when I take them, it's in a different context." Since then, Amanda's been hospitalized for self-poisoning so many times, she's lost track.
"I went through a period where I'd take overdoses every couple of weeks. I'd be in hospital, be discharged and then a few weeks later I'd do it again." Although she isn't self-poisoning as frequently now, Amanda tells me she's still admitted to hospital every few months, in addition to other types of self-harm: "I probably cut myself three or four times a week."
Amanda is one of a growing number of teenage girls poisoning themselves with pills or alcohol as a way to self harm. While society has become much more aware of the phenomenon in recent years, persistent narratives exist about the ways in which people hurt themselves: the razor blades and nail scissors of popular myth.
A 2016 study from researchers from the University of Nottingham found that poisonings increased in the UK by 27 percent in the four years between 2007 and 2012 when compared to the same time frame between 1992 and 1996. The largest increases in intentional poisonings were found in females aged 16 to 17, with poor girls from deprived backgrounds overwhelmingly more likely to poison themselves than their more economically privileged peers.
"Our data covered a 20 year period, and partly we can infer that the sharp increase is due to more young people seeking help or improvements in how we record patient data," says Dr Edward Tyrrell, the lead researcher on the University of Nottingham study. "However, we don't think this fully explains the rise." He points to the testimony of frontline health workers in the UK who report increasing incidents of self-harm, as well as literature showing an increase in alcohol use among young girls.
Self-harming by poisoning doesn't need to involve sleeping pills or painkillers. Many young people find more prosaic ways of making themselves ill; namely, by intentionally abusing alcohol until they're sick. YoungMinds, a charity that specializes in adolescent mental health, confirmed that self-harming behavior takes many forms. Spokesperson Nick Harrop describes the "steep rise in self-poisoning [as] deeply concerning."
"We know that young people who are struggling with mental health problems are more likely to abuse alcohol, drugs, and prescription medication in an attempt to 'switch off' from distressing feelings," Harrop adds. According to figures from alcohol concern charity Drinkaware, 25 percent of those who report having low mental well-being drink at least once a week. John Larsen, a spokesperson from the organization, explains that they're most "concerned" by the types of teenagers who are becoming problem drinkers. "What we found was that young people who are socially deprived with low mental well-being are more likely to be drinking excessively."
Just as self-harming behaviours can take many forms—cutting, alcohol abuse, sexually risky behavior—so too is self-poisoning an umbrella term. Wedge, who prefers to withhold his last name for privacy reasons, runs LifeSIGNS, a user-led self-harm charity. Over email, he explains why young people and girls in particular might poison themselves. "[Some] people are concerned about leaving a mark, and about keeping their behavior and distress private. However, how a person finds or comes to rely on self-medicating and self-poisoning will be a unique story."
Self-poisoning behaviors are not uniform. "Many people self-medicate on a regular basis, by which I mean taking pills you don't need and that can harm you." While technically this counts as an overdose (and can be as harmful), Wedge differentiates this from what he terms acute overdosing. "Acute overdosing is just what you imagine it to be, and is incredibly dangerous and desperate. Actual self-poisoning—the act of drinking or eating something toxic—is thankfully rarer, but clearly devastatingly dangerous."
The girls I interviewed for this piece were all articulate, self-aware, and thoughtful about their struggles with mental health; while a number said they had attempted suicide previously, they viewed this as something separate from self-poisoning—a more extreme version of an already inherently dangerous activity. All had demonstrated self-harming tendencies from a young age, often stemming from normal teenage anxieties: problems at school or parents they perceived as inadequate.
Jessica*, an 18 year old from London, started self-harming at 13 and self-poisoning at 16. "It's all pretty complicated, but I was really isolated at school and I didn't have any friends, and my parents weren't great. That, combined with a brain that didn't really like me and my depression overall, meant that overdosing seemed to follow naturally. I'd been having impulses to overdose for years before I gave in."
When talking about self-poisoning, the word "control" recurs often. Lucy* from Peterborough first self-poisoned at the age of 17. She is now 20. "My main reason for self-harming with overdosing was that it was easy, no one could see what you had done because it was all internal, and I feel like I gained control from it somehow. My main cause for cutting was to get the instant gratification that self-poisoning didn't give me."
It made me feel relaxed instantly, but the feeling was always short-lived. It turned into a really bad addictive spiral.
Wedge from LifeSIGNS confirms that self-poisoning can become a dangerous way for young people to feel in control of emotions that can seem unbearably huge: "Self-injury becomes a reliable coping mechanism to help deal with past trauma and current distress."
In a society where teenage girls often feel like their bodies are in some way not their own, but a source of shame or embarrassment. Self-poisoning can be a paradoxical way of regaining ownership and control. "When I self-poison," Jessica says, "I feel out of control but I also feel in control in the sense that I can force a response from my own body." Self-poisoning also prompts an immediate reaction from those around them. "When I take an overdose, everyone kind of drops what they're doing and runs around panicking. So it can be a vindication of my feelings, like, 'I told you I was bad!'"
Although self-poisoning is a gendered phenomenon, men are in general overwhelmingly less likely to come forward and talk about mental health issues. "Some guys hit themselves or punch walls," Wedge explains, "and don't even consider it self-injury. Men are often excluded from the self-harm conversation, they don't come forward and they don't get counted in university or National Health Service figures." Nonetheless, girls are more likely to disclose they've self-poisoned. "The majority of our social media members are female," Wedge acknowledges, "and there's definitely more work needed to reach males, to reach people from diverse cultural backgrounds, and even to reach adults."
Like many forms of self-abuse, self-poisoning can rapidly escalate into addictive behaviour. "It made me feel relaxed instantly," Lucy says, "but the feeling was always short-lived. It turned into a really bad addictive spiral."
It wouldn't really bother me if anything serious [damage] were to happen. I'd just be like…that's that.
Amanda describes the feeling of overdosing as like a "timeout": "I guess part of it is that I don't have to worry now, I'm going to feel poorly for so long I won't have to think about anything else." Specific triggers can be major, or mundane. "Arguments with my mom. Or last year I took a massive overdose on [exam] results day, because I didn't want to think about the fact that all my friends were getting their results and finding out they were going to college and I wasn't."
The dangers of self-poisoning are huge, making such behaviour unfathomable to those with a limited understanding of mental illness. Over the counter painkillers—favoured because they are cheap and easily available—are one of the leading causes of liver damage in the UK. Overdose on depressants such as sleeping pills, and you run the risk of brain damage. Despite these risks, teen girls continue to self-poison. "I never really think about the consequences when I'm doing it," Amanda explains, "because I know that if I take too many I'll go to hospital and get treatment."
"The doctors say it's like Russian roulette, because you can't predict how your body will react to an overdose," she adds. "But it's like I can't accept that's real, because I've always felt so lucky until now. It wouldn't really bother me if anything serious [damage] were to happen. I'd just be like…that's that."
Unlike Amanda, Jessica does have one fear about self-poisoning: "I am scared of doing my liver permanent damage, and dying slowly from that. Because that's a real possibility, and I'm terrified of it."
Despite the struggles and the pain—both physical and emotional—all the girls I spoke to were hopeful that they might one day be able to break the cycle of self-poisoning. "I don't know if I can get away from it but I like to think I could," Amanda explains. "But stupid things worry me, like the fact I've got a gap on my CV. and my arms are so scarred. They'll always be there, as a reminder of what's happened.
"Maybe eventually I can have a job and a family and work with people who are in my position, and help them. Hopefully."