From a teen in Malaysia: I was 13 when my friend talked me into cutting. At first, I thought it was harmless and it was genuinely just for “fun” (I know,sick). But after doing it for a few more times, I started channeling my normal sadness into self harm. And honestly, I liked the pain. At that time, I was occasionally sad but I was never “depressed”.

Fast forward to when I was 16. I was homeschooled. I had a lot of friends but I talked to them via the internet. I don’t know why but I’ve always loved physical affection or physical touch. So at that time,I was lonely and I was desperate for physical affections (my mum hugs me but that was not enough for me). I channeled my “pain” and sadness and loneliness into self harm and that was when I was addicted to it.

I’m not promoting self harm in any way, is but it felt nice. Not trying to be poetic, but it felt like the pain would flow out of my system, even if it was just for a few minutes. I loved it.

I used to self diagnose myself (I know it’s wrong and I truly understand that now). I told myself that I have depression. I did that because I wanted to just put a label to my sadness. To me, it was an easy way to solve “why are you feeling this way?” It was an easy way to answer other people’s questions too. Why are you always crying? Why are you so sad? Easy. “I have depression”. Now that I’ve learnt more about depression, I constantly doubt myself. Do I really have depression?

I’m 19 now and the last time I’ve self harmed was a few months ago. I constantly have the urge to self harm to deal with my emotions, but now I’m trying my best to refrain from doing so.

I’m actually a very cheerful person, people might even call me the life of the party! But I have constant “episodes” of these sadness. They get triggered by small things or even nothing at all. And when they come, I feel totally worthless, I’ve even thought of dying but I told myself it was stupid and I’d never have the courage. Do I have depression, or am I just an attention seeker? Is this an “act” I put on since 13 and never got to end it?

A: Thank you for such a thoughtful letter. I can’t tell if you have depression on the basis of a letter. I can tell you that what you report is reason for concern. Self-harm is a serious matter. Feeling so sad that your only way to channel it is by hurting yourself is a terrible way to live.

It’s notable that you are known for being generally cheerful but then you have these, out of the blue, bouts of depression. If we were talking, I’d first be checking for these two things:

1) Are you getting enough regular sleep? A sleep disorder sometimes is a factor in descriptions like yours.

2) I would then evaluate you for either depression or bipolar disorder. People with mood disorders experience mood shifts that can be unexpected and can vary enormously in intensity.

I strongly encourage you to seek out a mental health professionals to do a thorough evaluation. You’ve been dealing with this for at least 6 years. Although you’ve done a remarkable job restraining yourself from self-harm, the impulse is still there. You need the help and support of a professional to get to the root cause of your feelings and to help you decide on a treatment plan for managing them.

Please take yourself seriously. Love yourself enough to get the information you need to live a more carefree life.

I wish you well.
Dr. Marie