In March 2021, the independent nonprofit organization, FAIR Health, released a report about the staggering mental health challenges children and teens have experienced during the COVID-19 pandemic. Depression, anxiety, adjustment disorder, drug overdoses, obsessive compulsive disorder (OCD), and eating disorders have all been on the rise. The report also found a 334% increase in the rate of intentional self-harm for 13- to 18-year-olds in one section of the U.S.
The term self-harm refers to the intentional act of causing physical harm to oneself through a destructive means, but without the goal of suicide. In some cases, it can be an extreme measure such as crashing a car, but more often, self-harm involves burning, head-banging, hitting, severe scratching, skin picking, and hair-pulling, as well as cutting or carving the skin with a sharp object such as a razor blade, knife, or even a paperclip.
Cutting is the most common form of intentional self-harm and represents up to 80% of cases. In the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V), it falls under the category of non-suicidal self-injury (NSSI). Even in a “normal” year, approximately 15% of teens engage in cutting, with a greater percentage found in college students, although some adults and children also cut. Females tend to self-injure somewhat more than males, and the highest rates appear to be in those who are bisexual, but the reasons for this are still not completely understood.
The Motivation for Cutting
While there are many reasons a young person might intentionally cut themselves, this behavior is largely a maladaptive coping mechanism for kids and teens who are not able—or don’t know how—to express their emotions in a safe and healthy way. Those who cut are often seeking a type of symbolic relief from bad feelings they have or that are difficult for them to manage.
Cutting is a maladaptive coping mechanism for people, especially kids and teens, who aren’t able—or don’t know how—to express their emotions in a safe and healthy way. Share on XFor example, someone who dissociates or feels emotionally numb may cut to “feel alive,” while depressed teens may cut to “release” some of their sadness. Among other causes, cutting may also come from feelings related to:
- Anxiety or stress
- Loneliness and isolation
- Being bullied or rejected
- Past trauma
- Social pressure or interpersonal problems
- A sense of emptiness inside
- Drug or alcohol addiction
Who’s at Risk?
Self-injury is usually linked to underlying mental health conditions. In particular, it is strongly associated with a history of childhood abuse, especially sexual abuse. Self-injury is also seen in those with posttraumatic stress disorder (PTSD), anxiety, OCD, depression, bipolar disorder, schizophrenia, eating disorders, and addictions, as well as in borderline personality disorder (BPD)—a condition for which emotional regulation is very difficult. Research from the medical journal Encephale indicates that 50-80% of those with BPD engage in some form of self-mutilation, including cutting.
Cutting Can Become Addictive
Because cutting provides a temporary sense of relief to the person doing it, it can become a form of self-medication. The actual pain from the cut induces a release of endorphins—the body’s natural pain killers—which can boost mood or feelings of calmness. However, by repeatedly engaging the brain’s opioid system in this way, tolerance to the pain can build up, thus leading to increased cutting to get the same level of relief from the endorphin response.
Clues to Look For
While cutting can be done anywhere on the body, the most frequently targeted areas are the thighs, wrists, hands, and stomach. It is likely that a young person will try to hide the evidence of this behavior, so if you are concerned about your child or teen cutting, be aware of these clues:
- Having frequent unexplained cuts and scars
- Patterns or repetitious marks cut closely together in the skin
- Wearing long sleeves or pants when it’s hot outside
- Concealing areas of injured skin with bandages or Band-Aids
- Having sharp objects in their room, backpack, or purse for unspecified reasons
Mental Health Treatment for Cutting
If you discover that your child has been cutting, it can be shocking—even frightening, but it’s important to understand that this behavior is treatable. Letting your child know that you care and want to help her or him find healthier ways to cope with their feelings is a great first step.
In addition to possible medication for certain patients, some of the treatment modalities include:
- Dialectical Behavior Therapy (DBT): This type of therapy helps improve coping skills and incorporates mindfulness strategies for managing stress and emotions.
- Cognitive Behavioral Therapy (CBT): Based on the premise that our thoughts control our emotions, CBT is used to identify and change the unhealthy thinking patterns that lead to distress.
- Art Therapy: This modality uses various forms of art, such as painting or drawing, to help clients express feelings they may otherwise have difficulty articulating.
- Self-Harm Support Groups: The connections made with others in a group who are healing from the same problem can help fortify the progress made through other types of therapy and prevent a relapse of cutting.
Whether it’s in an outpatient or inpatient setting, finding a mental health practitioner who is experienced with treatment for self-harming clients and their underlying mental health issues can pave the way for a healthier future for the young person in your life.
Self-harm and other mental health problems can’t wait. During these uncertain times, your mental well-being—and that of your loved ones— is more important than ever. Waiting until life gets back to “normal” is likely to worsen symptoms over time.
At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
Cutting was not a known about or widespread behavior in the 1960-70s. When it became discussed in the 80s, more and more young people started imitating the behavior. Copycat cutting has now mushroomed exponentially. I realize that, as parents, we need to be aware of the behavior , but children have also certainly been hurt by all the talk about it because it has given many a new, dangerous way to self-harm. What is the answer to that dilemma?
Comment by Mom — March 24, 2021 @ 3:52 AM
Thank you for this information
Comment by Denise Caruselle — March 24, 2021 @ 8:07 AM
I remember once upon a time. Two of my friends and I got drunk. They got razor blades from the bathroom and started cutting their arms. I did not understand. We were 12 and 13, junior high age.
Now older, I know the real story. These two girls were raped and or being sexually abused at the time. I did not know that then but this article clarifies what was really happening. I am now 60, this was a long time ago. Both of the “abusers” were men and are now dead. My two friends have suffered their entire lives with drug and alcohol addiction, plus mental health issues. I knew a lot of girls who had the same happening to them. Nothing was ever done to help them. It was always a secret.
Comment by Lisa Mullikin — March 24, 2021 @ 9:41 AM
My 11 yr.old granddaughter mentions self , harm says she would never do it, but should I be alarmed?
Comment by Bonnie Durante — March 24, 2021 @ 10:18 AM
Please figure out a way to make mental health care affordable. Those who need it the most are the least able to access it.
Comment by Farmers — March 25, 2021 @ 12:40 AM
Our 19 year old son is really struggling. He may be doing self harm, as well as drugs. We have MHN insurance, and I literally cannot find anyone who first off is taking new patients, but also anyone my son considers relatable. At times I really fear for his life and well being. Can you please let me know how much a brain scan costs at Amen clinics?
Comment by Virginia Wong — March 25, 2021 @ 5:32 AM
Hi Virginia. Amen Clinics offers consultations and different types of evaluations based on the needs of the patient. For information regarding pricing, insurance, and financing options, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.
Comment by Amen Clinics — March 25, 2021 @ 9:07 AM
Oh gosh. It’s so important to give children the opportunity to express and learn how to manage their emotions. Having worked with children that self-harm, giving them the opportunity to let go and heal from the trauma that is causing them emotional pain without having to talk about it, such as through Havening Techniques, is so vital. Many children can’t even talk about their pain (and often might not be able to). When we equip our children with the right tools, we empower them to help themselves unchain their pain and help them see hope and possibility for their future.
Comment by Dr Ruth Mary Allan (Certified Brain Health Professional and Havening Techniques Practitioner) — March 25, 2021 @ 3:04 PM
I wonder how much social media is at play here too…children and teens are socializing each other online, I am sure there is more imitation happening due to that. Dr. Gabor Mate has some interesting work around healing from trauma, parenting children and teens so they are still influenced by parents (rather than losing attachment to parents and attaching to other teens). There are also body-brain methodologies like HANDLE and reflex integration that can reorganize the lower level brain systems, tactile integration, etc. I’ve seen significant improvements in adults and children with autism using Dr. Masgutova’s Tactile Integration program as well as HANDLE. The only thing to be mindful of is if a person has experienced sexual abuse the Tactile Integration program will need to be implemented with that in mind.
Comment by April DeAngelis — April 6, 2021 @ 3:14 PM
I just happened to be cleaning up my computer hard drive and stumbled across this article. I am so glad I had saved it, as we’ve a student now that’s cutting herself weekly, if not every other day. She said she (and her brother) have been bullied all their life. A teenager now, we’re at wits end on how to best help her. Getting feedback from her parents has been slim to none.
Comment by Willie Smith — February 20, 2022 @ 4:05 PM