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Youth Engaging in Serious Self-Injury
by James P. Perry, Ph.D.

Parents need to be aware that a growing trend is occurring in our nation’s young people. While sometimes called self-injury, it is also known as self-mutilation, self-harm or self-abuse. It is most prevalent in teens and young adults.

Self-injury can include cutting, scratching, picking scabs or interfering with wound healing, burning, punching self or objects, infecting oneself, inserting objects into body openings, bruising or breaking bones, and some forms of hair-pulling.

Many who self-harm use multiple methods. Cutting arms or legs is the most common practice.

These behaviors, which pose serious risks, may be a symptom of a deeper mental health problem ranging from Borderline Personality Disorder and Major Depression to Bipolar Disorder or even Schizophrenia.

Loved ones need to know the warning signs that someone may be injuring themselves. These signs include: unexplained/frequent injury (such as cuts and burns); wearing long pants and sleeves in warm weather; low self-esteem; difficulty handling feelings; relationship problems; and poor functioning at work, school or home.

Approximately 1% of the population are habitual self-injurers, with a higher proportion of females than males taking part in the practice.

The typical onset of self-harming acts is at puberty, with the behaviors often lasting five-to-ten years. However, it can persist much longer if appropriate treatment is not obtained.

Typically, but not always, those seeking treatment are usually from a middle- to upper-class background, of average-to-high intelligence, and have low self-esteem.

Nearly 50% report physical and/or sexual abuse during childhood. Many report they were discouraged from expressing emotions, particularly anger and sadness.

Self-injurers commonly report they are feeling empty inside, unable to express their feelings, lonely, not understood by others, and fearful of emotionally intimate relationships and adult responsibilities.

Those who harm themselves feel desperate about their lack of self-control and the addictive-like nature of their acts. Self-injury is their way to cope with or relieve those painful, hard-to-express feelings, and is generally not a suicide attempt.

But cutting to experience feeling is often a temporary fix that leads to further frustration when the pain or desperation continues. Without proper treatment, this growing “dis-ease” becomes a self-destructive cycle that can escalate to include suicide attempts.

Unfortunately, self-injury behaviors sometimes cause more harm than intended. While not necessarily a real suicide attempt, medical complications can ensue. As well, eating disorders and alcohol or substance abuse intensify the threats to overall health and quality of life.

Diagnosis for someone who self-injures can and should only be determined by a licensed psychiatric professional. Treatment options vary in accordance with the diagnosis and the individual.

Most often, a combination of medication and therapy is effective. Medication is useful in the management of depression, anxiety, obsessive-compulsive behaviors , and the racing thoughts that may accompany self-injury. Therapy helps individuals understand and manage their destructive thoughts and behaviors.

While parents can be stunned, confused, angry, distressed and/or frightened to discover a son or daughter self-injures, it is important to not let those feelings interfere with the seeking of treatment. When self-injury is addressed by professionals, recovery is a reality.