Cutting and suicide: What you should know

One of the most stunning things the 13 Lewiston Middle School students revealed during a frank discussion about their lives was how prevalent cutting is in middle school.

Contacted days later, Roslyn Gerwin, director of pediatric psychiatry consultation service at Maine Medical Center in Portland, wasn’t so surprised.

In her experience, cutting — or burning or other forms of self-harm — has been edging down from older teenagers to younger ones in recent years.

“It certainly doesn’t shock me now for middle school,” she said. “I would definitely say it’s on the table for middle school.”

People often cut themselves as a way to cope with stress, trauma or emotional pain. Some kids cut because they feel numb. Or they cut because they feel too much. Or they cut because they think they deserve to be punished.

“Most will tell me it’s a little bit of all of those reasons,” Gerwin said.

Although parents may see cutting as a suicide attempt, Gerwin said most kids who cut aren’t actively trying to kill themselves in the moment. But the fact that they’re cutting can be a worrisome sign for their future.

“You can make the leap that if that pain exists, it’s putting them at higher risk for it evolving into more lethal action. That’s not a healthy coping skill,” she said. “So you worry.”

She called cutting “sort of the beginning of the Pandora’s box.”

“What else is going on with this child? Because it could mean a lot of different things. And we don’t know how far the horse is out of the barn, so to speak,” Gerwin said.

Some kids hide it when they hurt themselves, cutting their stomach or inner thigh, for example, where it’s not likely to show. Other kids want people to see.

In that way, cutting is similar to suicide. For some kids, there are warning signs before suicide. For other kids, there aren’t.

“I always tell families that sometimes it’s challenging to see it coming,” Gerwin said.

Her advice to parents:

• Watch for signs of depression, like slipping grades, withdrawing, not sleeping, not eating, not doing things they used to enjoy.

• Talk to your child about how they’re feeling. Is there bullying at their school? How do they handle it when things get hard? Do they feel supported by their peers?

• Ask point-blank questions about your child’s state of mind. “You don’t even necessarily have to use the word suicide. You could ask a kid, ‘Is there ever a time where I need to be worried about your safety? You know, because I really care about you and I want to make sure that we’re in a safe place. You seem down, you seem like you aren’t really yourself anymore,'” Gerwin said.

If parents are concerned that their child is cutting themselves, she suggests talking with them first — open, neutral, caring without “freaking out.” Then she recommends seeking help, possibly through the local mental health agency or with assistance from the child’s doctor.

If parents are concerned about suicide, she suggests talking, seeking help and, if parents are worried about their child’s immediate safety, going to the local emergency room or calling the crisis hotline.

“If your child has said to you recently, ‘I have had thoughts that maybe suicide is an answer,’ to me that is an emergency,” she said. “The worst that you’re going to lose is time, and who cares? Safety first.”

For kids who are worried about a friend — maybe they talked about killing themselves or posted photos online cutting themselves — Gerwin urges them to tell a trusted adult.

“Kids, I think, feel like sometimes they have to be psychic and say, ‘What does this mean?’ and make these very heavy decisions about, ‘Oh, that person really was just kidding.’

“(But) it’s not really a joke. And I think about the trauma of what it would be like if they guessed wrong, if they interpreted wrong, and the next day they find their friend dead,” she said. “I always share with a kid, ‘I would rather your friend be alive to be angry with you than for you to live with the burden of being responsible for something. You don’t want that.'”

ltice@sunjournal.com