“My daughter has been taking handfuls of over-the-counter painkillers and has been cutting herself,” my friend blurted out to me as she and I were in the middle of our ski trip.
I instantly felt a rush of sadness, empathy, and concern. I immediately went right into my “doctor mode ” & began asking questions about her childhood. How frequently she cuts herself, her past and current relationships, her hobbies, and whether these intentional overdoses are linked to suicidal ideations.
“She never takes enough pills to have her stomach pumped; but she knows just how much Ibuprofen she needs to elicit a trip to the emergency room. Her therapist believes she is acting out because she felt that she was abandoned as a child. There has also been mention of borderline personality disorder. “
I had a roommate in college who engaged in cutting, and I have seen this a lot in my adolescent patient population. But for whatever reason, cutting and other self-injury behaviors are not commonly discussed within the media, on college campuses, or in high school classrooms. Parents are shocked when they discover their son or daughter is engaging in these behaviors.
Approximately 14 percent of adolescents are estimated to engage in self-harm behaviors. Clinically referred to as non-suicidal self-injury; self-harm is the act of physically inflicting pain on oneself without the intention of dying. Cutting is the form of self-injury that is portrayed most often in the media .
Individuals will use sharp objects to carve into their skin (most commonly in the legs, arms, and stomach) to elicit feelings of physical pain as an unhealthy coping mechanism to relieve feelings of guilt, internal pain, shame, anxiety, and worthlessness. This physical pain induces a sense of calmness and relief and, for some, even a rush of euphoria. This instant gratification and sense of relief are quickly replaced by feelings of guilt and shame, perpetuating the vicious cycle of the urge to self-harm once again. In a sense, self-harm is similar to addiction.
This behavior can be fueled in part by drugs and alcohol ; which are also unhealthy coping mechanisms to numb internal pain. As a result, a substance use disorder can go hand-in-hand with self-harm behavior.
As a parent, watching your child engage in self-harm behavior can be one of the most gut-wrenching and frustrating experiences. Most parents do not understand why their child is drawn to this behavior. They worry that their child can be severely harmed from their physical injuries or, even worse, take their own lives.
Although self-harm behaviors can indeed result in complications such as nerve damage and wound infections, they do not always coincide with suicidal ideation. However, research shows that individuals who engage in self-harm behavior have an increased risk of suicidal ideations and suicidal attempts in the future.
According to an article in the journal PLOS ONE, “among those with a history of NSSI, 70% have attempted suicide at least once and 55% several times. The risk of death by suicide is highest during the first six months after an NSSI episode and tends to fall later on.”
Because of the increased risk for suicide attempts within this six-month window, individuals must seek professional treatment immediately to prevent suicidal ideations. Unfortunately, most individuals who engage in self-harm behaviors are teenagers and adolescents, and access to care for these age groups is quite difficult (50% do not seek help at all, and only 20% ask for medical treatment).
Other times, I look at my scars and see something else. A girl who was trying to cope with something horrible that she should never have had to live through . My scars show pain and suffering, but they also show my will to survive. They’re part of my history that’ll always be there.
Blog article reproduced after appropriate permissions from original author. Link to original article https://www.psychologytoday.com/us/blog/happiness-is-state-mind/202002/the-secret-world-self-injury
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