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Adolescent self-injury can be cured

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WASHINGTON, Sep 01, 2003 (United Press International via COMTEX) -- Adolescent self-injury, most commonly in the form of cutting the skin, is becoming more common in the United States.

"It's a huge problem," said David Rosen, a University of Michigan adolescent medical specialist. "Millions of people in this country are doing some sort of self-harm, and cutting is most predominant form," he told United Press International in a phone interview. "The teenage years are when we see it the most. The average age when we start to see it is 14. It happens in girls more often than boys."

But it can occur at any age, in either sex, or among people from any socioeconomic background, said Rosen, who is on the faculty of the University of Michigan Medical School.

Self-injury can also include burning, sticking oneself with sharp objects, or hitting and bruising oneself.

"The common thread that we see in people who self-harm is that they feel bad, and they're looking for something to help them feel better," Rosen told UPI.

"People describe what they do in different ways. Some people say they're hurting on the inside, and they need some way of making their pain more tangible and more real - and they cut to do that.

"Other people say they have a hard time expressing their feelings, and this substitutes what it is they're feeling - which is real bad."

Rosen said a sense of being alone is common, as well as feelings of emptiness, anxiety, being out of control, or sometimes guilt.

Anger, depression and low self-esteem seem linked to cutting, but are not necessarily causal.

"Certainly you could make the case that lots of people who cut are angry, and the majority of people who cut probably do have some degree of depression," said Rosen. "But most people who are depressed don't cut, and some people who cut aren't depressed."

Rosen said he often hears cutters explain that they feel numb, or they don't feel anything, or they're not even sure they're there anymore.

"The cutting is a way of shocking their system. I've heard people say, 'It wakes me up to do this.'

"I don't think there is a common precipitate or that it always happens in the same setting," Rosen told UPI.

Rosen elaborated in a public education videotape the University of Michigan produced for the media. Parents are often the first to recognize their child has a problem with emotions or behavior, he said. Warning signs are changes in school performance, depression, anger and aggression. Parents need to be alert to unexplained scratches or gashes, wearing long sleeves in hot weather, or not wanting to put on a bathing suit.

Doctors are prepared to take the patient's history, examine the extent of the cutting, and check for the presence of other medical problems. Subsequent evaluation by a mental health professional is almost always required to identify and treat the underlying cause of self-injury.

Upon diagnosis, a treatment plan is proposed. At the University of Michigan, experts take a multidisciplinary approach. Patients are taught how to make the present moment more tolerable, how to identify their emotions, and how to control their impulses. Medication, including anti-depressants, might be prescribed.

"People who cut themselves do get better," Rosen says on the videotape. "If we provide people with great support and treatment and sometimes medicine, we see people improve. Families should be optimistic that with proper treatment, their son or daughter can stop this behavior completely."

Copyright 2003 by United Press International.

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