"My daughter and I talk about everything. But I don't know what to say when she hurts herself."

Content warning: This story contains descriptions of mental health and self-harm, and may be distressing for some readers. If you need support, please contact Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.

I talk to my teenage daughter about sex, periods, condoms and smear tests.

Boys, bullying, smoking, alcohol and drugs. Exam stress, friendship bust-ups, social anxiety and unrequited love.

We talk about how to manage her time. How to study for tests. How to use a computer, an oven, a washing machine. How to apply foundation and mascara. How to shave her legs. How to put an outfit together and make her fine hair look like it has more volume.

I listen to her fears and try to ease her anxieties. That’s my job. Her father is the ‘best friend’. The ‘chill one’. I am not, and I’m not her best friend, even though I want to be.

I’m the one who runs the ship, keeps the schedule, remembers the appointments and writes the lists. I’m calm and steady, for her, because that’s who she needs me to be. I do all of these things for her because I’m her mother.

But I don’t know what to say when she self-harms.

You can watch this explainer on what anxiety feels like and how to help in the video below. Post continues after video.

I’ve told close friends and family my daughter has severe anxiety. It’s harder to tell them she’s been taking anti-depressants for almost a year now. I don’t have the words to say ‘my firstborn child hurts herself’, or that she spent Monday night in the emergency room getting stitches.

Mental illness runs in our family, so over the years, I’ve become accustomed to dark moods and up moods. Mental health plans and medications. Specialist appointment after specialist appointment.

If you’re like me and have never self-harmed, it’s difficult to understand why people do it. I’ve done hours of research and have spent the last year in and out of therapist and psychologist offices. Logically, I know my daughter is trying to ease her mental anguish through a physical act.

But I haven’t, and don’t think I ever will, get used to the idea of my perfect child deliberately hurting herself. I still can’t comprehend it. I can’t make the connection between the giggling, effervescent girl I know is inside her deep down, and the teen who feels so ashamed of herself, she cuts herself open.

There is nothing more isolating or lonely in this world than parenting a child with a mental illness.

I watch her school friends blossom as they discover their strengths and begin to figure out who they are. I see them join after school activities, excel at dance, easily make friends, and receive invites to all the social events. The daughters of my old school mum friends are like morning sunshine – bright and warm and full of new beginnings.

They don’t want to hear how things are bad with my daughter. That her attendance is dismal and her grades are slipping. That she spent most of last year in sick bay having panic attacks, or sitting alone.

Interactions that were once easy now feel awkward. They don’t know what to say. I don’t know what to say either. And when I’ve tried talking to other parents about my daughter self-harming, they act like it’s contagious. And as we learnt the hard way last year, they definitely don’t want their daughters to be friends with someone who struggles with mental health.

For more information about anxiety, how it affects both adults and children, and what you can do to help, listen to this interview with Dr Jodie Lowinger, the founder and Principal Clinical Psychologist of the Sydney Anxiety Clinic. Post continues after audio.

The hours alone leave me questioning everything. Why is my daughter so afraid and hard on herself? Was it something we did or didn’t do? Will we enable her self-harming behaviour by being compassionate? Or will taking a hard line make it worse? I’m scared to enforce rules or go too hard. Last time we did, she ended up in the emergency room and I found myself scrubbing blood from the kitchen sink at two in the morning.

There doesn’t seem to be a right answer, only relentless worry. A daily, hourly, minute-by-minute assessment of how she’s acting. Is she at risk? Is something going to happen?

Unless you’ve parented a child with mental illness, it’s hard to imagine what our life is like. It’s the most painful heartbreak you can imagine.

It’s phone calls from mental health services at random times of the day. It’s describing self-harming habits in the middle of a check-out aisle at the supermarket.

It’s hearing her voice, terrified and desperate, calling for me in the dark. “Mum! Mum! I’ve done something!”

It’s holding your 12-year-old son as he sobs, unable to sleep at 1am, curled in a ball in your bed because he’s afraid of what his sister will do next.

It’s fighting with your husband because the hospital discharge summary says “argument with mother” on it, and it feels like an accusation.

It’s finding it difficult to be near your own child because she has come to represent so much pain and fear, and then feeling like the worst mother alive for being distant.

It’s knowing you will look at that scar on her arm for the rest of your life and remember how it got there. It’s lying awake in the dead of night, asking yourself the questions you can’t permit yourself to think about during daylight hours.

Wondering how long her life will be and if we will get to see her grow into an adult. And if that time comes, will this all be a distant memory, or will she plagued by it once she enters the world on her own?

It’s wondering, who will hide the knives from her then?

If you or a young person you know is struggling with symptoms of mental illness and needs support, please contact Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800. You can also contact your local headspace centre here or chat to them online, here. If you are over the age of 25 and suffering from symptoms of mental illness, you can also contact your local GP for a Mental Health Assessment Plan. In the event of an emergency, call 000.

The author of this story is known to Mamamia but has chosen to remain anonymous for privacy reasons. The featured image used is a stock photo.