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When Scab-Picking, Cutting Becomes Addictive

Many adolescents practice self-harm in an attempt to cope with pressure or emotions.

Who Cuts?

Self-harm can occur with other disorders such as depression, obsessive-compulsive disorder, addictions, and eating disorders. It usually starts around puberty and can get worse if not treated.

And "anybody could be doing it," Rosen says. "It's more girls than boys, and more people start when they are 13 or 14, and self-harm is associated with depression, low self-esteem, anxiety, and a history of trauma or abuse," Rosen says.

Women who are abused physically or verbally by their partner are 75 times more likely to harm themselves, according to a study in the Emergency Medical Journal. And men who harm themselves were more than twice as likely to report partner abuse than their non-self-harming counterparts, report researchers from Addenbrooke's Hospital in Cambridge, England.

However, they are not sure if it's the chicken or the egg. Either domestic abuse could lead to self-harm, or self-harm could be associated with personality traits that make a person more likely to choose to be or stay in an abusive relationship.

"There seems to be a high percentage of people who report physical, sexual, or emotional abuse, but that doesn't have to always be the red flag," SAFE's Conterio says. "Divorce can be a trigger, or sometimes there is an ill child in the family where the healthy child is neglected and may feel guilty, as in 'why I am I healthy? Why is my sibling sick?' So they self-harm," she says.

You can tell by "unexplained injuries or injuries such as 'my cat scratched me' or hiding of arms or legs in warmer weather. I think if a parent does suspect their child is self-harming, they should ask, 'Are you hurting yourself?" she says. If they say yes, then get some evaluation to see how serious it is, she recommends.

"Noticing a cutter in summer is easy as pie if they are wearing short sleeves -- its 'gotcha,'" says Levenkron.

Parents and peers need to recognize the signs of distress linked to cutting such as being increasingly anxious, depressed, unable to handle feelings or emotions, and panicky.

"We try to help people understand why they do this and develop strategies to manage the anxiety, [and] there is some sense that medication can be helpful," Rosen says.

Cutting is often associated with other psychiatric illness, so addressing other disorders can help stop the self-harm, he says.

SAFE offers a 30-day inpatient program for adolescents, and for adults there is an inpatient/outpatient program.

With a combination of medications and therapy, Levenkron says that 90% of self-mutilators in his practice give up the self-harming behaviors within one year of treatment. This is followed by much longer period of time in therapy to heal the underlying causes of these behaviors.

For more information, call SAFE at (800) DONT CUT or visit


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