Cutting away the pain

Where only first names appear, names have been changed to protect the identities of the sources.

Anthony, a junior, stares silently, intensely fixated on the flame before him. Without any hesitation, he lifts the lighter closer to his hand, this time so that it touches his flesh. He waits and clenches his fist as the flame engulfs his knuckle. Five, 10, then 30 seconds go by until he finally drops the lighter. He is left with nothing but an empty mind and a scar to remind him of his pain.

Anthony's act of self-harm late last year was not accidental, but it was by no means an attempt at suicide. Since his introduction to self-harm during his sophomore year, he has become one of a significant number of teenagers who regularly channels his depression, anger and anxiety through self-mutilation.

The term self-mutilation, used interchangeably with self-injury and self-harm, is defined as the act of inflicting injury or pain on one's own body. Many researchers argue that this deliberate alteration and destruction of body tissue is done without a conscious suicide attempt. But new research indicates that it can lead to an increased risk of suicide, according to psychiatrist Tim Zwerdling.

According to the National Mental Health Association (NMHA), there are a reported two million cases of self-harm in the U.S. alone, and it is estimated that one out of every 200 girls ages 13 to 19 regularly practices self-abuse behavior. Other forms of mutilation include cutting, burning, self-hitting and wound interference. For some, the urge to cut, burn and even break bones can be suppressed with the help of medication and therapy. But for Blazers battling the urges of self-mutilation, it can become a helpless addiction.

The first taste

Sitting leisurely in a classroom, Karen, a freshman, begins to run her hands along the length of her forearm. Her fingers move slowly as they touch her raised scars, 14 in all. In the middle of seventh grade, Karen became overwhelmed with her constant depression, and she decided to cut herself with a pair of scissors. "It was random, almost [instinctive]," explains Karen. "There were things inside me, and I couldn't get rid of them."

According to the NMHA, the most common form of self-mutilation is cutting, which makes up 72 percent of reported cases.

Last November, senior Walker Davis struggled to cope with his intense emotions and became another statistic: part of the 78 percent of reported cases to use more than one method of self-abuse.

It began when Davis had a long and emotional conversation with a good friend, after which he "got bummed out and depressed" and took it out on himself. "It was seven years of ignoring and internalizing. It opened everything that was bottled up," he explains.

For the next couple weeks, Davis engaged in what he would call intense "workout sessions," where he would sprint more than half of his usual running route and do "too many reps too fast," he says. His mind wasn't on protecting his body; it was on ridding it of his anxiety and anger.

Zwerdling, who works with many teenage self-abusers, explains that Davis's rationale is a common reason for self-mutilation. Teenagers are often in a state of strong emotion, says Zwerdling, and "they find that by cutting themselves or doing other forms of [self-mutilation], it relieves that state of intense bad feelings."

Number the scars

For the past two years, cutting provided an emotional release for Karen. Even after seeing a psychiatrist and taking anti-depressants, Karen's habit has progressively worsened - at times leaving her with over 30 cuts on her arm.

She explains that her cutting, especially recently, is no longer about experiencing pain for the mere sensation but rather to maintain the illusion of control over her life. "It's not the pain that feels good but being able to see that I have self-discipline and I can take control of things," says Karen. However, in spite of her lack of concern, self-mutilation, especially cutting, can cause significant physical dangers. Excessive bleeding is not at all uncommon and can potentially lead to death.

Teenagers often mislead themselves into thinking they have control, Zwerdling explains, when in reality self-mutilation can become close to an addiction. "Any kind of behavior has the potential to be a little harmful - things escalate, and you up the ante," says Zwerdling. "Cutting can escalate to cutting deeper and in more serious places, gaining the potential to being truly dangerous to their well-being and lives," he says.

Despite the risks and warnings, cutting still remains an attractive method of coping with her feelings, says Karen. "I don't think it's healthy or a good release of emotion," she admits. "But I enjoy being my own self-medication."

Testing the limits

Anthony explains he was victim of a continuous "cycle of depression" and needed a release. For this reason, he resorted to cutting his shoulder and stomach with a razor.

Like for many self-abusers, cutting proved to be much like a gateway drug, introducing him to other, more painful and dangerous acts of self-mutilation. While in the shower, Anthony put shampoo on his wounds, causing a powerful stinging and burning sensation without the risk of creating big scars. He explains that his self-harm stems from a need to find his breaking point. "I'm testing my limits," says Anthony. "I wanted to see how [far] I could go."

A couple months later, Anthony confided in his brother, who encouraged him to seek help. Despite seeing a psychiatrist, a psychologist and even receiving depression medication, Anthony soon fell back into his old patterns. "I stopped for a while, but things kept building up, so I started burning myself. It was more practical - there was less blood," he explains. He has since burned his stomach and knuckles, both of which left permanent scars.

Anthony's relapse into burning hardly went unnoticed, and he was soon confronted by a concerned friend. The friend's call to the suicide hotline forced Anthony to check into the hospital for having suicidal tendencies. His 24-hour hospital experience was enough to put a temporary but significant halt on all attempts of self-abuse.

No end in sight

Oftentimes, self-abuse behavior can cause more harm than intended, which can result in medical complications or death. "The biggest issue beyond immediate treatment is taking care of the psychiatric issue and finding the base of what is initiating the behavior. That is the most difficult part to treat," says Dr. Elise Riley, a physician at Holy Cross Hospital. Regardless, Riley is firm in her belief that there are remedies that work, the most effective being getting appropriate counseling. "The idea is that we do have treatments," says Riley. "I've seen patients successfully treated."

Zwerdling suggests teenagers do anything to change their state of mind, from going running to listening to music. However, for people like Anthony and Karen, both who have tried these techniques, Zwerdling offers a unique piece of advice: "Get a plastic bag of ice and put it on your arm where you would ordinarily cut. That really intense cold feeling can accomplish just about the same thing without causing harm," he says.

Recently, Anthony has been relying on his fear of further confrontation to stop from cutting or burning himself, neither of which he has done in the past month. "Last time I tried, my lighter broke and then the fear of the hospital stopped me," he says.

Similarly, Karen hasn't cut herself in about a month and admits that she wishes she had never began. "There are times when I'm like, 'It would be easier to not be living like this,' but I'm not going to act on that. I don't want to die."

Places to go for help:

Self-Abuse Finally Ends: 1-800-DONT-CUT or http://www.selfinjury.com

Montgomery Crisis Center: 24 hours a day, 7 days a week at (240)-777-4000.