Today’s teenagers are under a great deal pressure. In fact, according to the CDC, 1 out of every teenager has a diagnosable mental health issue. In addition, depression, anxiety, drug overdoses and suicide are currently at epidemic rates for teenagers. In fact, suicide was the third leading cause of death for teenagers and now it is the second leading cause of death (CDC). Furthermore, cutting or self-harming behaviors are also at epidemic rates for teenagers (CDC). Self-harming behaviors include teenagers cutting themselves with knives or scissors in addition to scratching themselves severely and sometimes teenagers may even use erasers to erase their skin and cause sores. These are only a few examples.
Let’s look at the pressure teenagers are facing today. One major stressor is social media. They look at the accounts of other teens who post everything is going great in their lives and they have a lot of friends. This is not the reality, but most teenagers are not aware of this fact and they start to wonder what is wrong with them. Why don’t they have the same wonderful lives full of friends and good grades?
Another stressor for teenagers is the Coronavirus. Over 700,000 Americans have died from Covid and 1200 Americans are still dying daily (CDC). Therefore, many teenagers are grieving the loss of family members and friends and the grief is especially difficult during the Holidays. Additionally, we do not have a firm grip on the Coronavirus and information is changing daily. Therefore, teenagers are still dealing with restrictions at school and are not able to see their friends on a regular basis. Furthermore, they don’t know if their lives are ever going to return to pre-pandemic routines or have their lives and childhood been permanently changed.
Finally, teenagers today are dealing with school shootings which continue on a regular basis. The school shootings impact more teenagers than we think are impacted by them. When there is a school shooting every student at that school, in that community and in our Country is effected. They are traumatized again and again begin to worry, will I be killed today at school. This is why the shooter in Oxford was charged with terrorism. Every student, teacher, parent and first responders were terrified about would they be killed, would someone they know be killed, how are they going to cope with what they find at the school and students, parents are teachers all over the Country worried about could this happen at our school? As a result, many teenagers do not want to go to school because they don’t feel safe and parents worry when their child leaves that day for school, could it be the last time they see their child alive. All of these factors are a lot to expect a 13 year old to cope with on a daily basis, year after year.
Ten years ago as part of my initial evaluation of a teenager I would ask, if they were cutting or had ever cut, once in a while I would get an answer of yes. Today when you ask teenagers about cutting most teenagers answer yes. They say they have used cutting to cope with the stress of life or they have thought about it. In fact, it’s no longer just teenagers. Children as young as 8 or 10 years old often respond yes to this question. This is alarming, but it is evidence of the amount of emotional pressure these kids have to deal with today. They apologize for trying it or thinking about it, but they explain life was so stressful they didn’t know how to cope with the emotions they were feeling. Again these teenagers are facing stress because they are admitting that life has become too stressful. They are afraid that I will be upset with them or that their parents may be upset that they cannot handle everything that is going on in their lives.
When you ask a teenager about cutting behavior, they usually respond it was easier to deal with the physical pain than the emotional turmoil they were dealing with inside. Others will say the cutting takes their mind off of the emotional situation and others even say it makes them feel human. So as you can see there are numerous reasons, but teenagers are also very embarrassed and ashamed about the cutting behavior, as I stated above. If I am treating a teen who is engaging in cutting I must be very sensitive and non-judgmental about the behavior if I’m going to help. In addition, the family needs to be non-judgmental as well. Teenagers do not cut for the attention and as I stated above they are embarrassed about their behavior. If they sense that someone is viewing them in a negative way, they will not talk about it. Additionally, teenagers who are engaged in cutting hide their cuts so no one will know about their behavior.
Therefore, when treating or dealing with a teenager who is cutting you need to be patient and non-judgmental. Remember they are resorting to this behavior because it is the only way they are able to deal with the emotions they are feeling and the situations they are facing. Life today can be very overwhelming and often teenagers are not prepared for what they have to face in life and they are embarrassed to ask for help too. Often they are embarrassed because our society looks down on people dealing with mental health issues. I recently had a 13 year old ask me, “why don’t we place more emphasis on mental health so people can get the help when they need it?” A very good question to ask. Our society has a very strong negative stereotype regarding mental health and therapy. As a result, it is very difficult for teenagers to ask for and receive the mental health care they need.
After being treated for cutting, many teenagers are still embarrassed and feel awkward about their past behavior. Many times teenagers are left with scars on their bodies from cutting. Most families cannot afford plastic surgery and insurance will not cover it, even though it is a mental health need and in my opinion should be covered. The point is many teenagers continue to feel embarrassed and ashamed of the scars years after they have stopped cutting. Below is a blog from a teenager who discusses how they feel about their scars and people’s reactions. It also may help give you some insight to what teenagers are going through these days and how many of them are feeling overwhelmed by life. Instead of ignoring their cries for help we need to figure out how we can help them without making them feel embarrassed or crazy.
A teenager’s blog about cutting. My self-harm scars are “hideous.” I’m covered in them. Head to toe. No amount of time, no amount of fading will make them unnoticeable. That doesn’t mean I hate them. It doesn’t mean I’m embarrassed by them. I am aware that they make other people uncomfortable and there are times, when out of respect for others, I will cover them. There are other times when I won’t cover them. Whether I choose to cover them or not, I don’t feel that I should have to explain my choice. If I choose to cover them, it doesn’t mean I’m ashamed or feel forced to cover them. If I choose not to cover them, it doesn’t mean I want attention.
I regularly see people comment on social media saying, “If you make a public post people have the right to say whatever they want.” Apparently this entitles people to be nasty and judgmental. It excuses them from filtering what they say and think. It exempts them from extending basic decency and courtesy to others.
I’ve heard the same said about people who walk around with self-harm scars exposed. No. Just because you can see my scars doesn’t give you a free pass to say what you want. You don’t get to say, “You’re too pretty for that.” You don’t get to say, “You’re too smart for that.” It doesn’t matter whether you know me or not. They are my scars from my battles. Even if you know me, I can guarantee you won’t know all about my battles. You won’t know my darkest moments or thoughts. If you’re a stranger? What could you possibly think you know about my life? You don’t get a say on what my scars look like. You don’t get a say on whether or not I’m too pretty, too smart or too strong for that. You don’t get a say on whether or not I cover them.
Yes, you can see them. Yes, they are “hideous.” Look away. Walk away. Think about it by all means. Talk to someone else about it. If you’re game, educate yourself on it. Take responsibility for what you are doing. Take responsibility for what you are saying. Yes, you can see my scars but that doesn’t make me responsible for your reaction.
This is how one teenager tries to explain cutting to adults and how it makes them feel years after they have stopped cutting. Really read and think about what this teenager is saying. Should any teenager have to feel this way because they are feeling overwhelmed by life? Overwhelmed by circumstances which are not their fault and they cannot control? Is it fair they should suffer this way, when they are asking for help, but insurance companies deny to help them? What responsibility do we have to help these teenagers who are begging for help?
Dr. Michael Rubino is a psychotherapist with over 24 years experience treating children and teenagers. In addition, he specializes in treating victims of trauma and first responders. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.