After sharing a deeply intimate night together, Lauren’s boyfriend, Bryan, broke up with her. She was angry, sad, devastated, and felt used. Hoping to cheer her up, Lauren’s friends talked her into dinner. When she arrived, Bryan’s car was outside. When Lauren saw Bryan and Jenny there together, he smiled and pulled Jenny close. Lauren could feel her heart in her throat; it felt as though everything was spinning around her. She turned and ran out the door to her car. The pain in Lauren’s chest was agonizing. She felt sick to her stomach and could not stop crying as she drove home. Her friends told her to calm down, that it was no big deal. Lauren felt like no one was actually listening; no one understood. The pain was too much and it had to end.

When she got home, Lauren found a pair of scissors on her mother’s sewing table. In the quiet of her bathroom, she carved small cuts into her arm. Lauren was careful not to cut too deep as to leave visible scars. She placed them carefully as to be easily concealed. With each cut, she felt a sense of calm rush over her. Exhausted from such an emotional evening, she cleaned the scissors, placed them back on the table and went to bed. Lauren felt empty inside, but the pain of the cuts helped her remember she was in control of her pain.

Cutting became a source of release for Lauren. It cleared her mind and caused her emotional pain to subside. Lauren found control in cutting. She could decide where and how deeply to cut. It helped her to relieve anxiety and stress. It was a secret she kept to herself. Rather than relying on the support of friends or family, Lauren would cut when the world became too much, until the night that even cutting couldn’t ease her pain.

When teens are faced with new levels of stress, whether it is over grades, or relationships or how they will perform during a game, they must find a way to relieve the stress knotted up inside their body. Some teens turn to positive coping mechanisms such as moderate exercise, meditation, journaling or listening to music. Others find ways that alter the way they feel through alcohol use and self-medication, self-injury (such as cutting) or participating in risky behavior. Much like alcohol and drugs, self-injury can lead to an immediate feeling of relief but each time it requires more and more to have the same effect.

“When working with a child who self-injures, the first important thing to understand is ‘why’ they self-injure. What pain are they trying to mask,” said Caitlin Mudd, Program Director for Canopy CARES Center. “Your brain releases chemical endorphins as a self-preservation mechanism when your body experiences physical injury. For many of our kids who have experienced a lot of trauma, it is actually easier for them to experience physical pain than emotional pain, so self-injury helps them replace what’s going on inside with something they can manage through the body’s natural response. We work with them to understand their pain and find a healthier way to address it.”

Each year, one in five girls and one in seven boys engage in self-injurious behavior. Approximately 90 percent of individuals who engage in self-harm, do so during their teen and pre-teen years. If often starts by the age of 14 and can carry on into their 20s without the right help. Self-injury can occur for many reasons including an individual’s attempt to relieve emotional numbness or pain, inflict punishment on themselves, reenact abuse, establish what is “real,” or regain a sense of control over one’s self. Self-injuring behaviors may start from introduction from a peer, something the youth has seen on the internet or television, or it may happen merely out of impulse or by accident. Self-injury can, but does not always, accompany the presence of a mental health challenge such as anxiety, depression, or eating disorder.

Self-harm is identified by a number of behaviors. The most common include:

• Cutting
• Burning
• Interfering with wound healing (picking or reopening wounds)
• Punching or hitting oneself or other objects
• Inserting objects into the skin
• Purposely bruising or breaking one’s bones
• Pulling out eyelashes, brows or scalp hair (not for grooming)

Self-injurious behavior is often concealed. Do not confuse this as a ploy for attention as individuals often don’t broadcast self-injury wounds, making these behaviors sometimes difficult to spot. If you notice someone wearing unusual clothing for the time of year, i.e. long sleeves during hot summer months, they could be concealing self-injury wounds. A person may also refuse to participate in activities they once enjoyed that would reveal such wounds, i.e. going swimming or visiting the beach. A sign can also be if a person has consistently fresh wounds but also has a seemingly logical story, i.e. cat scratches, or getting in a fight no one saw to explain a broken hand. You may also notice items that they use to self-injure in peculiar places such as razor blades in their backpack or pocket.

If you suspect someone is self-injuring, approach them and tell them you want to help. When you broach the topic, remain calm and don’t be demeaning. Tell them what you’ve noticed that concerns you. Ask them about things that are going on in their lives and how it makes them feel. Be particularly mindful of feelings of emptiness. Encourage a teen to be open with their parents or trusted adult who can connect them with a mental health professional. Finding adequate support can help to end or ease the frequency of self-injury.

If you or someone you know is self-injuring, confide in someone who can help find a better way to cope. This can be a counselor, therapist, teacher, coach, parent, youth minister, pediatrician or other trusted adult. Don’t just assume symptoms will go away on their own. Getting professional help is important for long-term safety. Ignoring the problem can push a child toward more dangerous and risky behaviors.

Canopy Children’s Solutions is a Mississippi-based non-profit with Behavioral Health Clinics in Jackson, Hattiesburg and Gulfport working specifically with children and adolescents ages 5-20. For more information on Canopy outpatient clinics, contact a Care Coordinator at 800.388.6247. You can also click here.