Also, the young person may not have the experience to recognise their feelings as depression. Common symptoms are low motivation, boredom, daytime sleepiness and increased eating. Sufferers may be aggressive and abusive. They may inflict harm upon themselves, and may be involved with drugs. These acts can stem from increasing self-hatred and depression, unresolved anger, aggression and powerlessness, causing tension and loss of control.
Mutilation relieves the tension and allows some control to be regained over the emotions.
Feelings of guilt and worthlessness follow, further lowering self-esteem. Working with these young people requires the establishment of trust, the recognition of feelings which are present, and the identification of alternative methods for coping with these feelings and thus achieving positive release. Intentional and unintentional overdose is common. Harm minimisation works through advice on safer drug and needle use, and needle exchange. Support and encourage, but be realistic.