Cutting: The Secret Epidemic

Back in February, I wrote an article about cutting for ModernMom.com. At the time, it was something I was just starting to see in my office. Since then, I’ve started to see multiple teens every day who are cutting. The behavior is exploding. It’s a true epidemic. It seems that teens hear about it and then decide to try it out. Don’t assume your teen is immune (I’ve seen straight A, “good kids” doing it as well as teens who are struggling). It affects everybody, so become educated. Much of the information below is from my article in ModernMom, but because the behavior seems to affect so many teens these days, I’m recovering the topic here as well, with a few updates, etc.

What is cutting?

If you’re not familiar with it, “cutting” is exactly what it sounds like. It is a form of self-harm (SH) or self-injury (SI). It is the act of actually cutting the skin with some object (usually razor blades, knives, pins). It is most commonly done on the arms or thighs, but can be other places, like the belly. The cuts are usually very linear, small, and superficial (deep enough to bleed, but rarely needing sutures). To be clear, it is not a suicide attempt. Kids who cut are not trying to kill themselves.

Why teens cut?

This is the million dollar question. Generally, psychiatrists teach that cutting is done to blunt emotional pain. It can also be highly addictive, as the act of cutting can release endorphins to create a feel-good feeling. People who cut often have other underlying psychiatric disorders (e.g., depression, bipolar, anxiety, eating disorders), but not always. I saw a “straight A” student this week who heard about it on social media and decided to try it.  The reasons kids cut are complex. I always ask “Why do you cut?” when I see a kid in clinic who is cutting, and I usually get an answer akin to: “So I can feel something.” That phrase tells me that there is more involved than just blunting emotional pain. There seems to be a component of control playing into the pain (both when and how).

Everyone’s doing it?

Ask any teen or preteen if they know someone who cuts and the answer seems to be, “yes.” In my patients, 100% of the kids who cut have friends or know people who cut. One of my patients claims he only started doing it because his friends did. Is that a peer pressure thing or a curiosity thing? While social dynamics are involved, most kids cut when they are by themselves. Because it is an act that kids are often doing by themselves, they hear about it or discuss it on social media.

How did I not know?

All of my patient’s parents were horrified when they found out that their kids cut. Most kids had been doing it for months before parents found out. Kids lie about it, and hide it. “The cat scratched me,” is a common, believable excuse. It’s easy to wear long sleeves and pants to cover it up. Pay attention if your kid is wearing long sleeves in 100 degree weather. Many of my savvy patients cut on their upper thighs so parents won’t see the lines. I’m not suggesting that you make your kids stand in their underwear while you inspect their bodies (your kid won’t appreciate the violation of privacy), but be aware. Know what you’re looking for (multiple fine linear marks/scars often in various stages of healing and usually more numerous on the opposite side than your child’s handedness). And here’s yet another reason to be aware of your kid’s media: many of my parents discovered kids’ actions via media means (e.g., Facebook postings, texts).

What do I do?

Your kid needs help, long-term help. Involve your doctor. Are there underlying psychiatric issues or bigger problems that need to be addressed? I had one patient who was brought in for cutting and discovered the patient was being sexually abused. That case required I call DCFS (the Department of Child and Family Services) and law enforcement. Your child may need psychotherapy. Goals of therapy include improving self-esteem, gaining self-respect, and learning healthy coping mechanisms. Your child will definitely need lots of support and love. Don’t think that cutting is just a phase. Kids that cut (who have underlying issues) and don’t get help, turn into adults who have issues. With some help, intervention, and especially love, kids can gain the tools they need to overcome this, and future problems thrown their way.