11/01/2026
Following on from my earlier post. I thought it might be good explore self-harm and eating difficulties in teenagers through a neurodivergence lens.
Many parents and school staff find self-harm and eating difficulties deeply worrying and hard to understand. The behaviours can feel confusing, frightening, and at times contradictory.
It can help to know that, for many young people, these behaviours are not about wanting to die or seeking attention. They are ways of coping when emotions, bodily sensations, or everyday demands feel overwhelming.
Adolescence is a period when emotions can feel intense and unpredictable. Shame, fear, anger, sadness, or a sense of not being good enough can arise quickly, and the brain is still developing the ability to regulate these experiences.
For some teenagers, particularly those who are neurodivergent whether diagnosed or not, the world can feel consistently more intense and exhausting. Sensory experiences such as noise, light, touch, hunger, fullness, or internal body sensations may be felt more strongly. Emotional responses can escalate rapidly and take longer to settle. Many neurodivergent young people spend large amounts of energy trying to fit in at school or socially by masking their differences, often without adults realising the effort involved. Over time, this sustained strain can lead to burnout, emotional shutdown, or a sense of being overwhelmed most of the time.
Within this context, self-harm and eating-related behaviours can develop as ways of regulating the nervous system rather than as expressions of defiance, attention seeking, or poor choices. For some young people, controlling food or harming the body creates a sense of predictability or control when everything else feels chaotic. Physical pain can feel more manageable than emotional or sensory pain. Certain behaviours can interrupt overload, reduce numbness, or bring a brief sense of relief.
When words are hard to find, behaviour often becomes the communication.
Shame is frequently central. Shame tells a young person that there is something wrong with them, that they do not fit, or that they are undeserving of care. For neurodivergent teenagers, shame often develops through repeated experiences of misunderstanding, correction, or being told directly or indirectly that their natural ways of responding are unacceptable. Self-harm or eating difficulties can temporarily reduce this shame or self-blame, even though over time they usually increase it.
When we talk about coping, it is important to distinguish between surviving and thriving. Many self-harm and eating-related behaviours are survival strategies. They develop when the nervous system believes there is threat, danger, or overwhelming emotional or sensory pain, and their purpose is to get the young person through the moment.
Survival strategies can work in the short term. They can reduce distress quickly, create a sense of control, or contain feelings that otherwise feel unbearable. However, survival narrows a young person’s world. Thriving allows flexibility, learning, connection, and growth.
Trauma specialist Janina Fisher writes in Transforming the Living Legacy of Trauma that shame often drives the nervous system to create more survival strategies. When a young person believes there is something fundamentally wrong with them, the system works harder to protect them, even if that protection looks harmful from the outside.
This is why trying to remove a survival strategy too quickly can increase risk. When shame or overwhelm increases, the nervous system often tightens its grip on the behaviour. This is particularly relevant for neurodivergent young people whose systems may already be operating close to overload.
From the outside, behaviours can appear confusing. A teenager may say they are fine and then self-harm later, promise to stop and then repeat the behaviour, or hide difficulties until emotions spill out during conflict. It is understandable that adults sometimes interpret this as manipulation or attention seeking.
Most of the time, it is neither.
These behaviours are usually driven by the nervous system rather than conscious planning. When emotional or sensory intensity rises, the thinking part of the brain goes offline and behaviour becomes the primary form of communication. For some young people, this shift can happen quickly and without obvious warning signs.
If a behaviour reduces distress, interrupts overload, or brings care or protection, the nervous system learns from that automatically. This learning is not deliberate. It is how survival systems operate.
A helpful shift for adults is moving away from asking why a young person is doing something and towards asking what the behaviour is doing for them in that moment. This change supports calmer, more compassionate responses and reduces blame. It also highlights the importance of helping young people develop alternative ways of coping rather than simply trying to stop behaviours without adequate support.
For neurodivergent teenagers, this often includes reducing sensory and environmental stress, allowing time for recovery, and supporting communication in ways that suit the young person rather than expecting them to adapt to adult systems.
EMDR therapy can be particularly helpful in this context. EMDR works by helping the brain process experiences that have left a young person feeling overwhelmed, unsafe, ashamed, or self-blaming. Rather than focusing on stopping behaviours first, EMDR reduces the emotional and physiological intensity that drives survival strategies.
For neurodivergent young people, EMDR can be adapted to sensory needs, pacing, and communication styles. As the nervous system begins to feel safer, reliance on self-harm or eating difficulties often reduces naturally.
The aim is not to remove coping before a young person is ready. It is to help them feel safe enough within their emotions and bodily sensations that survival strategies are no longer the only option.
Self-harm and eating difficulties are not signs of failure or bad behaviour. They are signals that a young person is trying to survive emotional, sensory, or nervous system overload with the tools they currently have.
When adults respond with curiosity, consistency, and compassion, and when appropriate therapeutic support is available, those tools can change. Young people can move from surviving to thriving.
If you would like any further information, please just ask.
