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Depression Cutting In

Dear Dr. Ryan,
I’ve never been happy. There have been times in my life when things were good, but there was that feeling of insecurity that something would soon go wrong, and I would become depressed once again. I started cutting myself when I was fourteen because it was the way I felt control over things. After some permanent scarring I finally stopped after a year. I’m now eighteen and a college freshman and I’ve been feeling urges of cutting again. I know it’s probably the newness of school and transition, but i’m worried I’m going to fall back into that dark place. Please help.
-Depression Cutting In

Dear Cutting In,
I’m sorry to hear about the struggles you’ve been having. It sounds like depression and low mood have been with you for a while and they have really caused some problems for you. Although self-injury became a primary way that you sought relief, the costs became too much for you. You committed to making changes and you were able to remain self-injury free for several years. You should be proud of the progress that you have made and remind yourself of this success as you face this challenge again.

You may find it helpful to know that for many people who struggle with self-injury, it often started in adolescence. Self-injury occurs in only about 4% of the general population, while it can occur in up to 20% of those experiencing mental health struggles. Self-injury can have several functions, with the most common reasons including to distract from painful emotions, as a form of self punishment, and to feel in control. You mentioned these in your question including feelings of insecurity and a desire to exert control. These will be priorities to better understand and process as you move forward into being safe and self-injury free.

I’m not sure what you did in the past to help you out of that dark place whether it was psychotherapy, medication, or other means, but I would strongly consider them again. If you took this on by yourself in the past, I think it is time to reach out for additional support. Know that engaging in therapy may feel as though you are losing control at first but will ultimately increase your feelings of control and self-efficacy in the long run.

Your college may have an on-campus counseling center or you could seek help outside the university. Since self-injury has served as a way to exert control in your life, it will be important for you to find new ways to manage painful feelings when they show up. Mindfulness can be a powerful tool to help you manage these feelings. In addition, Dialectical Behavior Therapy (DBT) skill workbooks could be helpful in your journey.
-Dr. Ryan

This was originally posted on DearHoopers.com

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