Stress and Scars

Suicide is an attempt to end one’s life, while cutting, and other forms of self-mutilation, is an attempt to cope with one’s life. The difference between the two gives us insight into a painful and growing habit among today’s teen population.

Between 2 and 3 million people — or about 1 percent of the population — in the United States exhibit self-abusive behavior. And the number is on the rise due to increased stress and life complexity. While self-abusive behavior can range from burning or biting to head banging or hair pulling, studies reveal cutting is the most popular.

Why are teens cutting?

Sixty percent of self-mutilating teens choose cutting as their primary form of injury. Cutting causes a chemical reaction created within the wounded human body, which then causes the brain to rapidly release endorphins. These hormones provide an immediate, but short-lived, relief from the true problem: underlying stress and emotional pain.

Most teens who cut lack healthy stress management and coping skills. Many have experienced hard things in life, like post-traumatic stress, sexual or physical abuse, or have overwhelming feelings of being out of control. The average cutter is female, and the habit starts in the early teens. It can increase in severity if left unchecked, but as coping skills develop, the incidence of self-injury declines. Cutting, however, can occur in people of any gender, age and race, and can result in very dangerous deep or infected wounds that can potentially be fatal.

Because teens know the behavior is unacceptable, most who cut keep their habit hidden. That means parents need to be aware and on the lookout for these warning signs:

• Isolation for hours on end, whether in their bedroom or bathroom.
• Sharp objects, like razors, missing or in strange locations.
• A teen who never wears short-sleeve shirts or shorts.
• Friends who self-mutilate.
• Mental health or mood disorders, eating disorders or a history of trauma or abuse.

When I suspect a patient to be involved in cutting, I make sure to ask the patient about it when others aren’t around, and in a tactful, caring and direct dialog. I suggest the same approach for parents and loved ones who suspect self-mutilating behaviors.

If a teen admits to cutting, help him or her get professional help right away. Do not react with disgust. Teens involved in self-injury feel fragile and have a low self-esteem already. Negative reactions will only magnify the problem. Recognize that your teen is crying out for help. Provide that help by contacting your family physician for a referral to a psychotherapist that can aid in getting your teen professional attention.

Parents often wonder how to prevent tweens and teens from forming self-injury habits. Developing the following positive habits at a young age will make things easier as stress and life experiences become more turbulent:

• Give a child one-on-one attention. Enjoy quality time with your child.
• Teach positive ways to deal with stress. Introduce yoga, exercise, journaling and other forms of healthy stress-management techniques. Skill-building camps, church opportunities and athletics also teach coping methods.
• Keep lines of communication open. Listen to a child’s concerns and refrain from passing judgment as he or she matures.
• Allow a child to make appropriate choices in life.
• Make sure the family schedule represents true priorities. There are plenty of good extracurricular activities available, but over-packed schedules can add stress and feelings of being out of control. Be selective and wise in what, and how much, a child is signed up to do.

Reacting to a Cutting Habit

Although you may feel shocked and disappointed to find out about cutting, do not begin to blame yourself for your child’s behavior. Studies show that parental self-blame does not help the situation. Overall, today’s troubled teens need to learn positive coping skills, as well as some need professional help developing the skill set. As new and healthier stress management strategies flourish, the emotional and physical scars from cutting can fade.

Dr. Benjamin Missick is a family practice physician at Blakeney Family Physicians.