“I cut my wrists so bad I had to get stitches. At the time, I told the doctor that I cut myself on a light bulb, which was true –I just didn’t mention that I’d done it on purpose.” -Cecil, 23.

“My parents have noticed my cuts, but only the ones that aren’t so bad and look like scrapes… Sometimes they’ll see one they don’t recognize, so I make up an excuse… I don’t want them to know.”-Kris, 13.

“I had been a self-injurer since I was 11. I knew of God’s high regard for the human body, but even this did not deter me.”-Jenny, 20.

You might be familiar with someone like Cecil, Kris, or Jenny. It could be a schoolmate. It could be a sibling. It could be you. In the United States alone, it is estimated that millions of people –many of them youths –deliberately hurt themselves by various means such as cutting, burning, bruising, or scraping their skin.

Deliberately hurting themselves? In the past many would link such behavior with some bizarre fad or cult. In recent years, however, knowledge about self-injury –which includes cutting or self-mutilation –has grown dramatically. Evidently, so has the number of those coming forward with the problem. “Every clinician says it’s increasing,” states Michael Hollander, director of a treatment center in the United States.

Self-injury is rarely fatal, but it is dangerous. Consider Beth, for example. “When I injure myself, I use a razor,” she says. “I’ve been hospitalized twice. Once I had to go to the emergency room because of a deep cut.” Like many sufferers, Beth has carried the practice of self-injury into adulthood. “I have been doing it since I was 15 years old, and now I’m 30,” she says.

Have you or someone you know fallen prey to self-injury? If so, do not despair. Help is available.

                                                                A DIVERSE PROFILE

It is difficult to put self-injury –or cutters, as they are sometimes called –into a single category. Some come from troubled families; others from stable, happy homes. A number are failing at school, but many are excelling as students.

Often, self-injurers give little if any indication that they have a problem, for a person who is beset with adversity does not always show it on the outside.

Then, too, the severity of self-injury differs from one person to the next. One study, for example, found that some individuals cut themselves only once a year, while others average twice a day. Interestingly, more males are injuring themselves than was once thought. Still, the problem is found mostly among adolescent girls.

Even with such a diverse profile, some self-injurers seem to share certain traits. One encyclopedia on youths observes: “Adolescents who self-injure often feel powerless, have difficulty trusting others with emotions, feel isolated or alienated, feel afraid, and have low self-esteem.”

Of course, some may say that this description could fit almost any young person who is facing the fears and insecurities of growing up. For the self-injurer, though, the struggle is particularly intense. The inability to put troubled feelings into words and to express these to a confidant can make pressure from school, demands of work, or conflicts at home appear overwhelming.

She sees no solution and feels she has no one to talk to. The tension feels unbearable. Finally, she discovers something: By hurting herself physically, she seems to find some relief from the emotional anguish, and she feels she can carry on with her life –at least for the moment.

Why does the cutter resort to physical pain in an effort to relieve emotional anguish? To illustrate, consider what happened when you are in a doctor’s office about to get a shot. As the process begins, have you ever found yourself pinching your skin or perhaps putting pressure on it with your fingernail, just to distract yourself from the sting of the needle?

What the self-injurer does is similar, although on a more serious level. To the self-injurer, cutting provides a form distraction and a sense of relief from the sting of emotional anguish. And the anguish is so great that by comparison physical pain is preferable. Perhaps that is why one self-injurer describes cutting as “medicine for my fear.”

                                                       A MECHANISM TO COPE WITH STRESS

To those who are not acquainted with the disorder self-injury may appear to be an attempt at suicide. But this is not usually the case. “Generally speaking, these people are trying to end just their pain, not their lives,” writes Sabrina Solin Weill, executive editor of a magazine for teens. Hence, one preference work refers to self-injury as “a ‘life preserver’ rather than an exit strategy.” It also calls the practice “a mechanism to cope with stress.”

                                                                  What kind of stress?

It has been found that many self-injurers have suffered some type of trauma, such as childhood abuse or neglect. For others, family conflict or the alcoholism of a parent is the factor. For some, a mental disorder is involved.

There could be other problems as well. Sara, for example, was in the throes of what she calls self-abusive perfectionism. While she had made serious mistakes and had received help from other persons.

                                        HOW DOES IT FEEL TO BE DEPRESSED

I woke up one morning when I was 12 years old, remembers James sat on the edge of my bed, and wondered, is today the day I die. James was in the grip of major depression. Every day of my life, says James 30 years later. I have fought this emotional and mental illness. James felt so worthless when he was young that he tore up his childhood photographs. I didn’t even think I was worth remembering, he recalls.

More than just a spell of melancholy blues, clinical depression is a grave disturbance that often hinders a person from carrying out daily activities
Because we all contend with feelings of sadness occasionally, we could conclude that we understand what depression is all about. But how, does it feel to have clinical depression.

Although depression sometimes has an obvious trigger, it often intrudes on a person’s life without warning. Your life is suddenly darkened by a cloud of sadness for no apparent reason. Nobody you know has died, and nothing distressing has occurred. Yet, you feel dejected and listless. And nothing will make the cloud go away. You are overwhelmed by feelings of despair, and you don’t know why.

Depression is nothing to be ashamed of. Yet, Jon in Brazil felt ashamed to be diagnosed with depression. In fact, eight years later I still feel ashamed of myself, she admits. In particular, she finds it difficult to deal with her emotional anguish. The suffering is sometimes so intense, that I feel physical pain.

 All the muscles in my body hurt. At such times it is impossible to get out of bed. And then there are the times when Jon cannot stop crying. I sob with such intensity and become so exhausted, she says, that it feels as though my blood has stopped circulating.

There are a number of treatments for depression, varying according to the symptoms and the severity of the illness. Many people may be helped by their family physician, but some need more specialized treatment. The doctor might prescribe antidepressant medication or recommend some other form of assistance. Some people have experienced good results with herbal medications, dietary adjustments, or a controlled exercise program.

                                                           COMMON ISSUES

[1] Well-meaning friends with little or no medical training might try to tell you which method of treatment to accept and which to reject. They might also have strong opinions about whether you should take herbal medicine, prescribed medication, or nothing at all.

CONSIDER: Make sure that any advice you accept comes from a reliable source. In the end, you are the one who must make an informed choice.

[2] Discouragement may make patients discontinue their choice of treatment because they do not seem to be getting better or because of unpleasant side effects.

CONSIDER: There is a frustrating of plans where there is no confidential talk, but in the multitude of counselors there is accomplishment. A program of medical therapy is more likely to succeed if there is good communication between doctor and patient.

Frankly explain your concerns or describe your symptoms to your doctor, and ask whether you need to adjust the treatment or simply to persevere before you will begin to experience benefits.

[3] Overconfidence can make patients stop their medical remedy abruptly after a few weeks because they feel better. They may forget how debilitating their symptoms were before they started their medication.

CONSIDER: Suddenly terminating medical treatment without consulting a doctor can have serious and even life-threatening consequences.

                                          WHAT KIND OF DEPRESSION?

 The effectiveness of any particular medical approach depends on what type of depression a patient has.
MAJOR DEPRESSION has symptoms that are severe enough to last six months or longer if untreated and that impact on most aspects of a sufferer’s life.

BIPOLAR DISORDER is also known as maniac depression. Sufferers may experience emotional extremes that careen between prolonged episodes of intense hyperactivity [maniac] and devastating lows [depression].

DYSTHYMIA although not as disabling as major depression, has depressive symptoms that make it difficult for the patient to function normally. Some may also experience intermittent periods of major depression.

POSTPARTUM DEPRESSION is a debilitating emotional condition that affects many mothers after they give birth.

SEASONAL EFFECTIVE DISORDER likely occurs as a result of a lack of sunlight during autumn and winter. It usually clears up during spring and summer.