I am a regular morning news show watcher and have been following the story about Demi Lovato entering a treatment center to deal with her “emotional and physical health issues”.   Recently, I had a chance to read Ms. Lovato's story in People magazine. She sets the record straight: she's been dealing with an eating disorder and has a history of cutting herself. I commend her for facing the fact that she has problems that require professional treatment, and for getting help sooner than later.

I have seen many adolescents who have a history of cutting. When I first saw these young girls, I was totally baffled as to what in the world was going on with their behavior.  I often would find telltale signs of cutting during a physical exam, as most of these adolescents try to hide their cutting.

But as I continued to practice and talked to these adolescent girls I began to realize that their cutting themselves was a form of self-mutilation.  Many of these girls stated that they “used physical pain as a coping mechanism for emotional pain”.  Other girls have told me that they “felt numb” and that the pain of cutting allowed them to feel real emotions.

In either case the cutting behavior causes a release of chemicals and endorphins in the body that provide a sense of well being or euphoria for a short time after the cutting has occurred. But as one doctor stated, “cutting is a SICK way of coping”.

Studies show that somewhere between 14-17% of high school and college students have admitted to cutting themselves, and it is much more prevalent among adolescent girls than boys.

There is also data to support the belief that those who self mutilate often have a past history of trauma or abuse, which may include a history of being bullied.   There has been speculation as to whether bullying played a role in Demi Lovato’s issues.  As we know bullying has become more and more prevalent and is now also a concern on the internet where bullying has become an epidemic.

Cutting like many other emotional based behaviors also seems to have an addictive quality, and many of the adolescents that I see have concomitant issues such as an eating disorder, with either anorexia or bulimia.   The deep emotional issues surrounding these disorders are quite confusing and seem counter-intuitive to most of us.

Some adolescents have stated to me that their own life is so “out of control” that they can only assume some control of their lives by restricting what they eat, or by controlling what they “feel” through cutting.  These are both self destructive behaviors that need to be dealt with by well trained professionals. These are difficult disorders to treat and usually take a team of professionals.

With Demi Lovato being the latest child/teen star to acknowledge that she has issues that she needs to deal with, one can hope that there will be other teen fans who may have been self-mutilating and will now come forward to seek help from their own parents and physicians.

Being a child/teen movie star may not be as glamorous as we onlookers think, but having the good sense to get help makes her even a bigger star to me!

That's your daily dose for today.  We'll chat again tomorrow.

Send your question or comment to Dr. Sue.