Cutting and other forms of self-harm are types of medical illnesses. These occur when patients hurt themselves to help deal with deep-set emotions or distress. The prevalence of intentional self-injury is increasing.
Understanding the disease can help you or your loved one recognize the signs and get help. Proper and swift treatment is the best way to prevent self-harm from becoming fatal.
Why Cutting?
The motives behind cutting are often counterintuitive since a person who cuts does it to feel better. Often, cutting is the only way she knows how to deal with negative emotions like depression, rage, guilt, emptiness, and self-hatred.1 Most people who inflict self-harm are looking for relief from pent-up emotions. Like addiction, people struggling with self-harm are not in full control of their actions. Cutters see their actions as positive because it allows them to express feelings and remain in control.
Cutters also see self-harm as:
- A distraction from difficult life events
- A relief from guilt when used as a form of self-punishment
- A way to feel more alive
Once you know the reasons behind the cutting, you can help you loved one find treatment. Treatment helps cutters see what they are doing as harmful, while encouraging positive behaviors that provide the same benefits.
Cutting Risk Factors
Cutting is dangerous. While each person cuts for different reasons, there are some common characteristics of the behavior. Certain risk factors may increase a person’s risk for cutting, but they do not always lead to the behavior.
Some of these include:
- Life Issues
Many people who cut themselves were abused in some way as a child. Whether the abuse was sexual, physical or emotional, or a case of neglect.
- Teenagers
Teenagers are more likely to cut themselves. Self-harm often begins in the early teen years due to emotional ups and downs, peer pressure, loneliness and conflicts with authority figures.
- Mental Health Issues
People who are self-critical and have many negative emotions are at increased risk of cutting. Cutters tend to be more impulsive and have poor cognitive skills.
- Mental Disorders
Those who struggle with borderline personality disorder, depression, anxiety disorder, post-traumatic stress disorder and eating disorders are at a higher risk of cutting.
- Substance Abuse
Cutting often occurs when a person is under the influence of drugs or alcohol.
- Having Friends Who Cut
Having a friend who self-injures increases an individual’s risk of cutting.
How to Tell if a Loved One Is Cutting
Clothing and a calm demeanor can easily disguise cutting and other forms of self-injury. Your loved one may be experiencing inner turmoil but none of the pain is evident on her face. There are warning signs that can help you identify the disease. If you recognize any of the following signs in your loved one, it’s time to get help:
- Multiple unexplained cuts or abrasions. These wounds are usually found on the wrists, arms, chest or thighs – places where your loved one can easily reach.
- Bloodstains on clothing, bedding or towels. You may also find a lot of blood-soaked tissues. Often, the cutter will try to hide these soiled fabrics. If discovered, they will deny that they own the clothing or that it was an old injury.
- Covering up. A person who cuts often wears shirts with long sleeves or long pants even if the weather is hot.
- Owning cutting instruments. Cutters will often own razors, knives, glass shards or sharp bottle caps. You may be able to see bloodstains on these instruments.
- Frequent accidents. People who cut themselves often say they were in an accident in order to explain their self-inflicted injuries. They may also say they are very clumsy or that they were working with tools.
- Isolation and irritability. Individuals who cut themselves often isolate themselves and are irritable in public. They are prickly because they are in extreme emotional distress and unable to cut themselves while in public.2
Gauging the Severity of Cutting
Once the diagnosis has been established, physicians attempt to gauge the severity of the cutting disorder.
A series of interviews with some of the following questions can help identify the severity of the illness and the effectiveness of treatment.
- When did the cutting begin?
- How often does it occur?
- What triggers the cutting episodes?
- Are there any underlying issues?
- Are their thoughts of suicide?
Therapist and counselors also ask if there is any personal or family history of mental illness, the types of treatment the patient received, the patient’s future plans and his or her social relationships. These questions help mental health professionals determine the form of treatment that is best.3 In mild cases, the patient will be advised to enroll in a support group that can help them deal with their emotional stresses.More severe cases require intense behavioral therapy and psychological evaluation, including hospitalization and the use of medications.
Side Effects of Cutting
Although a person may think cutting will help, according to the Mayo Clinic, the practice actually aggravates the person’s feelings of shame or low self-esteem.2 Cutting only temporarily resolves the negative emotions and does nothing to change longstanding emotional issues.
Cutting also increases the risk of developing infection, either from the self-inflicted wounds or from sharing cutting tools.
Most cutters do not practice proper hygiene and can contract infectious diseases from contaminated cutting implements. There are some reports of cutters dying after contracting an infection due to their cutting habits.
If a major artery or vein is cut, the individual is at risk of bleeding to death. Frequent bloodletting also leads to anemia, which can damage other organs within the body. The risk of suicide (whether accidental or deliberate) is increased in people who cause self-harm. In cases of accidental suicide, the patient unintentionally cuts a major blood vessel. To make matters worse, these patients often cut themselves while under the influence of alcohol or other drugs, increasing the risk of suicide.
Permanent scars or horrible disfigurement are also possible complications of cutting. In rare cases, the cutter will destroy a vital tendon or nerve and thus lose the ability to control their hands or legs. And sometimes the paralysis is permanent. In long-term cases of cutting, the behavior becomes a compulsion. Cutters will seek out times and areas where they can cut themselves. Even if they don’t want to, they have become addicted to the cutting behavior.
Finding Help for Cutting
Mental healthcare professionals are always ready to help treat cutting disorders, but it may be difficult to convince your loved one to seek treatment. People who mutilate themselves are very secretive and do not want to share their actions with anyone. Staging an intervention is one of the most effective ways to approach someone suffering from a self-harming disorder.
Intervention provides a setting where proper dialogue can begin between the team members and their loved one. During an intervention, personal feelings and emotions can be expressed without worrying about damaging a relationship. Everyone participating knows the main goal is to help the cutter get the care she needs.
If you or a loved one struggle with cutting, we are here for you. Call our helpline, 706-914-2327, 24 hours a day to speak to an admissions coordinator about available treatment options.
Sources
1 “Cutting.” Edited by D’Arcy Lyness, KidsHealth, The Nemours Foundation, July 2015.
1 “Self-Injury/Cutting.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Aug. 2017.
1 “Self Harm.” National Alliance on Mental Health, NAMI, 25 May 2018.