I bought blades in bulk

I bought blades in bulk


Runny (above) made sure her cuts were as close as possible "to save space". -- ST PHOTO: LIM SIN THAI
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Runny's parents first found out that she was cutting herself when they stumbled on her trying to wash the bloodstains from her clothes.

She was 15 then. Runny (not her real name) would cut herself three to five times a week while hiding in public washrooms, or in the bathroom at home.

For the past nine years, Runny, now 24 and married, has been cutting herself intermittently. She is candid about her condition.

'When I cut, I try to cut as close as possible, like kueh lapis, to save space.'

'I also buy penknife blades in bulk', she added.

Although the frequency of her cutting has decreased since her last hospitalisation in October last year, her left arm is still a battlefield, roped with scars that are a testament to her fight against depression with psychotic features, borderline personality disorder and dissociative identity disorder.

'It started off as a response to stress and after cutting myself I felt more mellow,' said Runny.

'However, it later became so ingrained that it was almost like a default response.'

One factor that may have contributed to Runny's cutting was her non-assertiveness when bullied in school.

'It was subtle. I would be purposely excluded from activities and it got worse after I started cutting myself. Some people would look and me and say 'she's freaky', or 'here she comes again'.'

Her negative experience in school was compounded by the lack of support from her family.

'Although we live together physically, we're separated emotionally. My family preferred to leave things to the health-care professionals, and they would say things like 'hang on, your next appointment at IMH is on Friday',' said Runny.

She first visited a psychiatrist at age 15, when her secondary school referred her to the Institute of Mental Health's (IMH) Child Guidance Clinic.

At 16, she began taking five types of medication for her condition: anti-psychotic drugs, anti-depressants, tranquillisers, sleeping pills and mood stabilisers.

At 17, she was warded against her will in IMH, following a regular check-up.

She has also undergone six cycles of electroconvulsive therapy (ECT), which she said helped her.

For ECT, a patient is anaesthetised and electrodes (electric conductors) placed at each temple. Electricity is then passed through the head to induce a seizure for therapeutic effect.

Today, she is still on medication and sees two different therapists once a week: one for psychotherapy and one for medication.

However, life has not been without its bright spots.

'Someone once researched mental health with me and used the information to show me that there is hope and that this can be treated,' said Runny. That 'someone' is now her husband, Kevin, 33. They have been married for seven months.

Dr Daniel Fung, chief of the department of child and adolescent psychiatry at IMH, said that with people who self-mutilate, the intention is more important than the action. 'They may not be trying to commit suicide, it may just be a maladaptive way of dealing with emotional pain,' he said.

He also cautioned against teenagers experimenting with such methods of release.

'Cutting may start off as an experiment, but turn into an addiction.'

Other growing pains

Coping with taunts...

When Joshua Lim, 23, was younger, his friends and relatives would make fun of him for being too skinny.

'I had nicknames like 'Scrawny Josh', and 'Teck Ko (Hokkien for bamboo pole) Lim',' said the student.

When he was in Secondary 1, Joshua was 165cm tall and weighed 45kg.

His skinny frame stuck with him all through Secondary School.

Joshua said that he was the butt of numerous jokes. 'It was mostly harmless teasing, about my frame... even the bigger girls could beat me at arm wrestling,' he said.

Although the teasing may not have been malicious, it left its mark on him.

'When you hit puberty, you get very concerned about the way you look,' he said. It took two years in National Service for Joshua to learn to be happy with the way he looked.

Aside from the fact that he put on some weight during his NS stint, he also found out that big did not mean better.

'I learnt that the biggest guys weren't always the ones who could run the furthest or the fastest or carry the most weight.'

While Joshua still wants to put on more weight, he is no longer as bothered as before about being small.

Dr Daniel Fung, chief of the department of child and adolescent psychiatry at the Institute of Mental Health, said that it is common for teenagers who do not fit in to feel awkward.

'Anyone who looks different will get teased. The most imporant thing is for the teenager to still feel comfortable with himself and to feel loved and cared for.'

Dr Fung also said that the impact of teasing or low self-esteem can be blunted by having a good support network.

... and crushes

Michelle (not her real name), 19, fell in love with her Literature teacher in her first year of junior college. And she still harbours romantic feelings towards him even though she has finished school.

She can pinpoint the exact incident that made her realise she was attracted to him.

'At first I just thought that he was a really cool teacher because of his unconventional views,' she said.

'I'm quite a low profile student and normally teachers don't notice me. But once he singled out my work and praised it in class and I was really touched. It was then that I realised that his opinion meant a lot to me.'

While this is the first time that Michelle has ever had a crush on a teacher, she does not think that it is too unusual or alarming.

'I don't think that this is normal, but then again there are many different types of love,' she said.

She thinks that her teacher is an ideal life partner.

'I need security and affection and someone who appreciates me for who I am. I feel that he's this person.'

While she was still in junior college, each day was an emotional roller-coaster.

'I would look out for him on a daily basis. When I caught a glimpse of him I'd smile to myself. Sometimes I felt like crying when he treated me nicely.'

She was so infatuated with her teacher that she could not leave school without making her feelings known to him.

' I approached him in person and talked to him. I bought him a gift that cost almost $50 and I wrote him a message describing my feelings for him,' she said.

'But after that I felt a bit sad, because I knew that the situation was hopeless and that it wouldn't go anywhere.'

For now, the flame that she carries in her heart for her teacher has yet to die out. Dr Clarice Hong, consultant psychiatrist and psychotherapist at Raffles Hospital, said that while the feeling may be intense, 'it's probably just an infatuation'. 'I would say the 19-year-old is still maturing. She sees in her teacher admirable qualities or achievements which younger men have not accomplished yet.'

Dr Daniel Fung, chief of the department of child and adolescent psychiatry at the Institute of Mental Health, said that infatuations are extremely common, but that taken one step further, they could become an obsession.

Pain relief

Pain relief


-- POSED PHOTO: DESMOND WEE
The words 'angst', 'cutting' and 'emo' are part of today's mainstream teenage lexicon. And that should be a warning.

'It's not just a Singaporean thing,' says Dr Brian Yeo, consultant psychiatrist at Mount Elizabeth Medical Centre.

'All over the world, this phenomenon is getting more airplay. It is highlighted in the media, in American Idol, Singapore Idol.'

Youth face a host of pressures ranging from intense academic competition to relationship commitments.

Often, they feel suffocated by demands that they are unable to fulfil, whether self-imposed or not.

The result is often a feeling of anxiety, frustration, disillusionment and insecurity - a phenomenon commonly known as angst.

Even if teenagers are able to outrun external sources of stress, angst may still catch up with them.

Growing pains can also be manifested as angst, hitting teenagers hard as they struggle to find their footing in a fast-paced world.

The unavoidable acne, first crushes, a sudden obsession with looks - all these serve only to exacerbate an already pressing problem.

Angst may also be the result of a teen subculture.

In recent years, there has been a proliferation of 'emokids' - teens who stereotypically wear black, embrace the melancholic side of life and have mantras like 'I hate the world, no one understands me'.

'They are more in touch with their feelings and they are more emotional. Some of them even engage in self-harm,' says Dr Yeo.

Attention-seeking behaviour can also be a cause of angst, as can long-term mental health issues such as paranoia or depression.

The point is that there are countless sources of angst and teenagers are relentlessly buffeted by them. It is little wonder that they are constantly seeking avenues to release their pent up feelings.

While some teenagers may choose to play sports or write music, others may turn to more detrimental means to unwind.

Cutting oneself is one of these methods.

'When someone cuts himself, the pain will trigger the release of endorphins. These hormones will numb the pain and give the person something like a 'high'. The effect of endorphins can be similar to certain hard drugs like heroin, which makes cutting so addictive,' says Dr Daniel Fung, chief of the department of child and adolescent psychiatry at the Institute of Mental Health.

In this case, razors, penknives, nail clippers or anything with a sharp or pointed edge become potential sources of relief, as teenagers find a physical outlet for emotional pain through self-mutilation.

Substance abuse is another. Cough syrup, glue sniffing and even alcohol provide a key to an escapist fantasy-land, even if only for a while.

'The incidence of glue sniffing is also on the rise', says

Dr Yeo.

'Also, there are many clubs opening in Singapore and teenagers go to many parties where drinks are easily available.'

Promiscuity is also on the list. A lack of self-love, parental love or support from friends often leads to teenagers looking for affection in all the wrong places.

'In the past, it was accepted that boys and girls were respectful of their chastity, but such people are now exceptional,' says Dr Yeo.

'While we can advise and cajole them, their thinking has already changed.'

Self-isolation, unprovoked aggression and violence are also examples of such behaviour.

Unfortunately, the use of such methods of stress relief seems to have increased in recent years.

Dr Fung also warns of the contagion effect - a teenager who is exposed to it more often is more likely to begin to explore such methods.

But there's help. Over the past few decades, the number of mental health-care avenues available to youths has burgeoned.

More hotlines are being set up, and there are counsellors stationed in many schools to provide support and professional guidance.

But many youths still don't seek help, maybe because they do not see their destructive behaviour as a problem.

They accept cutting their wrists or other parts of their body as a legitimate method of stress relief.

And many parents are oblivious to their children's circumstances.

'Many children have two working parents. They may have more disposable incomes and greater access to IT, but the time spent together is very little,' says Dr Yeo.

Teenagers are at a critical juncture in their lives and they not only need parental support, but they also need parents to catch them before they slip into the habit of self-harm.

Teenagers may also turn their feelings in upon themselves because of the unavailability of appropriate professional help.

While the school counsellor is easily accessible, there is an immense amount of stigma - such as being labelled 'crazy' by classmates - attached to seeking psychological help in school say the doctors interviewed.

But private psychiatrists are not as easily available and it can cost over $100 an hour to seek private professional help, excluding the cost of medication such as antidepressants.

While it is commonplace now for teenagers to 'horrify' adults with their hobbies, fashion, music and language, these passions usually take the form of harmless whims that they outgrow.

Unfortunately for some, like those we feature, their behaviour can be self-destructive.

lting@sph.com.sg

Razors, penknives, nail clippers become a potential source of relief, as teenagers find a physical outlet for emotional pain through self-mutilation.

But many youths still don't seek help, maybe because they do not see their destructive behaviour as a problem.