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Cutting: Understanding Self-Injury

We all feel sadness, anger, stress, and other emotions that are difficult to handle, and can feel overwhelming – or even unbearable – at times. People respond to such feelings in different ways, some healthy, and some not-so-healthy. Talking to a parent or counselor, for example, is a healthy way of coping, and can be the first step toward feeling better.

But if a person hasn’t learned positive ways to cope, he or she may seek relief from emotional pain in ways that are unhealthy or self-destructive. There are no easy answers as to why people self-injure. For some people, self-injury offers relief from emotional pain. For others who feel numb or empty, it offers a means of feeling something. Certain people may be at increased risk for self-injury, including adolescents, people who have been abused or neglected as children or have experienced severe trauma, and those with disorders such as borderline personality disorder, obsessive-compulsive disorder, depression, or eating disorders. Although self-injurious behaviors were once thought to be most likely to start around age 14, there has been an increase in self-injury among adolescents as young as 11 or 12.

People who self-injure harm their bodies through behaviors such as cutting themselves with a sharp object, burning or hitting themselves, or pulling out their hair. They may self-injure impulsively when they are extremely upset, or plan it ahead of time. It is common for people who self-injure to keep their behavior secret from their family and friends.

Because they often hide their behavior, it can be hard to tell whether someone is self-injuring. But there are certain warning signs that one might recognize, including:

  • cuts, scars, bruises, burn marks, or other marks
  • social withdrawal
  • keeping arms and legs covered during hot weather
  • carrying sharp objects
The most important thing to know is that people who self-injure can get professional help so they can stop. This is particularly important because self-injurious behavior can cause much more damage than a person intends---including permanent scarring, infection, blood loss, and even accidental suicide. Teens who self-injure often feel lonely or ashamed. They need to know they have the care and support of those who love them. If they can, they should confide in an adult they trust who can refer them to a mental health professional for treatment.

      Treatment might involve medication therapy for underlying problems such as depression or anxiety as well as different types of talking therapy. Dialectical behavior therapy (DBT) may be used to teach the patient safe ways to manage stress and other problems instead of self-injuring. Treatment helps teens to deal with the problems at the root of the self-injuries and build healthy coping skills so they can stop the painful cycle.

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      All content has been reviewed by a psychiatrist specializing in child and adolescent care.