Self-harm, a growing trend among youth
Maryam* was a beautiful girl, had a good academic record, shone in
sports and came from a middle-class family. Loved by her friends and
teachers, she was the star at school having won several accolades. But
everyday, there were cuts on her arms and wounds that were visible even
on her legs. Nobody knew what was going on but it was evident that she
was cutting herself but she was hiding her problems without talking to
Self-injury is not a new trend in Sri Lanka and it still affects a
considerable proportion of the population, at some point in their lives.
While some get over it, there are many who suffer in silence and still
continue to mutilate themselves.
In Sri Lanka, the condition of “teenage cutting”, self-mutilation,
self-harm or self-injury is not properly understood. While a doctor
might treat a teenager for a wound or an injury, there are signs that
show if a wound has been accidental or intentional.
Many people have been successful in hiding their injuries so they cut
themselves in places where it is not visible but what they should know
is physical wounds might heal but mental scars will never fade. They
also say it is accidental and do not know that there are ways of
determining how a cut is made when it is self-made.
More often than not, a doctor might ask the teenager if they have
depression or any other ailments, but since teenagers often consult a
doctor with their parents, the injury will be treated and not followed
up. Also, parents tend to influence doctors saying that teenagers have
no problems but do not realise (or do not accept) that there might be
issues beyond just the self-inflicted wound.
At present, Sri Lanka does not have the statistics with which to
determine the number of self-injury cases. Even though we have
specialised units dealing with abuse and teenage pregnancy, there is no
such hospital dealing with self-injury especially pertaining to the
However, an international expert, Dr. Marcel de Roos, a psychologist
with a PhD from Holland has been doing research and treating such cases.
Practising in Sri Lanka for three years now, Dr. Roos said, “I have
successfully treated about 15 cases of teenage self-injury by not just
giving them anti-depressant drugs but talking and counselling them.”
The doctor said that self-harm or self-mutilation can consist of any
form of trying to hurt oneself. “I have seen cuts not only on the arms
and wrists but also side cuts on the neck and thighs. There have been
one or two cases on the belly as well,” he said.
According to him, there are no exact figures of the prevalence of
self-harm, but he sees it as a growing condition which is turning into a
“In Sri Lanka, the culture is such that nobody talks about it in the
open and problems at home are supposed to be kept at home and not
divulged to anybody.
If outsiders know about it, they don't interfere or because they
don't want to get into trouble,” said the doctor. He said that sorting
out problems at home is good but more often than not, there have been
cases of abuse, violence or pressure from family members which drives
teenagers to turn to self-harm as a mode of escapism. There are
teenagers with problems who turn to alternative forms of self-harm such
as drinking alcohol and smoking because they use such habits to escape
Such experiences could have been associated with neglect, humiliation
or the loss of loved ones and a lack of self-esteem is formed and it
becomes difficult to express their feelings, especially with others.
Besides abuse, low self-esteem is also a problem which stems from
past issues and gives the teenager equal amount of pain when they can't
deal with the problem. Dr. Roos said that there are teenagers who lead a
good life at home with loving parents but if they are bullied in school
or are in love with someone they cannot have, they might cut themselves
because they think there is nobody to talk to or nobody will listen.
Often they even hide their problems from their friends unless someone
comes up to them and tries to talk to them.
“For the teenager, when the emotional pain is too much to handle,
they cut themselves because physical pain is easier to deal with than
mental agony. They feel helpless or depressed which drives them to cut
themselves,” said Dr.Roos. According to experts, there is distribution
among the genders of teenagers who injure themselves. It is known that
men often engage in different forms of self-harm (predominantly hitting
themselves) than women (predominantly cutting themselves). Loneliness is
also another reason why teenagers would cut themselves.
“During adolescence, teenagers will want to shut themselves out from
the rest of the world, talk less to their parents and try to be close to
their friends. They think their friends are right and if led astray, it
can have deadly consequences,” he said.
The problem in Sri Lanka is that parents are not aware of this
condition to determine what is going on. There are different levels of
society where people have to be educated and find what is wrong and what
is right. Often they are concerned about the well-being of their
children, but they might not see the warning signs.
“In helping their children, parents should talk and listen to their
child. Parents might have a certain perception but for teenagers it
might be something entirely different,” he said. Dr. Roos said that
children should have trust in their parents and shouldn't treat their
family members as the enemy but should be friends. He said, “When your
child trusts you enough, she will open up and tell her story. If
necessary, parents should look for psychological help.”
Dr. Roos said that if counselling is needed, go to the right people
because doctors might only tell the teenager to take pills to stop
depression but this doesn't solve the problem. So it is best to tackle
it from the root cause and tell the teenager that they can always talk
about anything that is bothering them.
He said, “Try to be there for your teenager and don't judge them if
they come out with some startling revelations. Just take your child
seriously and look for a way to help deal with the problem together.”
In Sri Lanka, the pressure from parents as the teenager to perform
academically is a big issue and also, during consultations, the parents
sit in with the child.
“I usually talk to the parents and with their permission, sit with
the teenager and ask them personally what is going on and then the truth
comes out,” he said.
The teenager needs reassurance and this is more than just keeping
blades, knives and scissors away from them. Adolescence is the most
important time in a teenager's life and there will be obstacles so
dealing with it, getting help and knowing.
Before practising in Sri Lanka, Dr.Roos said he saw the same problem
among models when he was in Holland. “It is a difficult thing to see,
beautiful girls with everything they could wish for, falling prey to
self-injury because they aren't happy with themselves,” he said.
Dr. Roos said, “When in therapy the whole personality should be taken
into account and not only just the physical signs of cutting.”
He said that therapy and recovery process can take a long time in a
teenager to heal but finding alternative methods of coping with the
feelings of anxiety or stress or “numbness” is often a good start.
“Dabbling in other hobbies and stimulating the mind to do other
things instead of wasting time on such negative emotions is good for the
Also channelling the energies into a sport such as tennis or going to
the gym will help the teenager deal with the pain better instead of
looking at hurting themselves. Dr. Roos said, “However, the real change
has to come from within, which means that the teenager understands that
she has every reason to feel angry and hurt.
That she starts to understand why she feels guilty, ashamed or
powerless. That she can cry and feel her hurt and that the feeling of
hurt will slowly ebb away.
That she has the right to exist and be herself.”If you're a teenager,
take heed and ensure that if you or a friend has a problem, deal with it
the proper way.
We should be happy and love ourselves because we have been given a
beautiful body and a lovely life so we should not waste or ruin it.
*Names changed to protect identities
[The types of self harm]
Self-mutilation was a non-fatal expression of an attenuated death
wish and thus coined the term partial suicide. In 1938, Karl Menninger
refined his conceptual definitions of self-mutilation. His study on
self-destructiveness differentiated between suicidal behaviours and
self-mutilation. These are classified as follows:
* Neurotic - nail-biters, pickers, extreme hair removal and
unnecessary cosmetic surgery.
* Religious - self-flagellants and others.
* Puberty rites - hymen removal, circumcision or clitoral alteration.
* Psychotic - eye or ear removal, genital self-mutilation and extreme
amputation organic brain diseases – which allow repetitive head-banging,
hand-biting, finger-fracturing or eye removal.
* Conventional - nail-clipping, trimming of hair and shaving beards.
Detecting streptococcal infection in newborns
A more accurate, faster diagnostic test for Group B Streptococcal
infection in babies has been reported in the *Journal of Medical
Microbiology*. The new test could allow better treatment and management
of the disease and reduce the risk of mortality among newborns. Group B
streptococcus (GBS) infections, caused by the bacterium Streptococcus
agalactiae, are the most common cause of meningitis, septicaemia and
pneumoniain newborns. In 2010 there were 506 cases of GBS infections in
infants across England, Wales and Northern Ireland.
Health researchers have developed a novel test that accurately
detects whether the GBS bacterium is present in samples of blood or
spinal fluid in less than two hours. It detects the presence of the cylB
gene in S. agalactiae, which is an important disease-causing factor. GBS
bacteria live harmlessly in the female genital tract of women and are
carried by 20-30 p.c. of pregnant women.
The bacteria can also form part of normal skin and gut flora. GBS can
be transmitted from mothers to newborns during delivery.
1-3 p.c. of infants who become colonized with the bacterium go on to
develop blood infections within their first week of life, which can be
fatal. Lead Author, Dr Aruni de Zoysa, Senior Scientist at the
Streptococcus reference Unit who developed the new diagnostic test
believes that this test should have a positive impact on management of
GBS infections in babies.
“If we can allow clinicians to diagnose GBS infection quickly and
accurately, this will mean antibiotic treatment can start sooner. Better
management of the disease in this way should reduce the risk of
mortality,” she said.
Dr de Zoysa explained that the new test has a number of advantages
over traditional methods for detecting GBS infection. “Currently, GBS
infection is only able to be diagnosed by taking blood samples and
waiting for the bacteria to grow in the laboratory, which is
time-consuming and can sometimes be unreliable,” she said.
“Our new test, although still in the early stages of development, is
an invaluable tool that is based on detecting DNA, which makes diagnosis
far more accurate and allows us to get results much faster.” The assay
also uses very small sample volumes, which is an advantage particularly
“As there is no vaccine at present for GBS, rapid and accurate
detection of GBS bacterium is crucial to reduce the risk of infant
deaths from GBS infection,” stressed Dr de Zoysa
Neuronal stress linked to Alzheimer's disease
A link has been found between brain insulin resistance (diabetes) and
two other key mediators of neuronal injury that help Alzheimer's disease
(AD) to propagate. The research found that once AD is established,
therapeutic efforts must also work to reduce toxin production in the
Alzheimer's disease is one of the most common degenerative dementias,
and more than 115 million new cases are projected worldwide in the next
40 years. There is clinical and experimental evidence that treatment
with insulin or insulin sensitiser agents can enhance cognitive function
and in some circumstances help slow the rate of cognitive decline in AD.
Alzheimer's and other neurodegenerative diseases destroy the brain
until the patients finally succumb. To effectively halt the process of
neurodegeneration, the forces that advance and perpetuate the disease,
particularly with regard to the progressive worsening of brain
insulin/IGF resistance, must be understood. “Brain insulin resistance
(diabetes) is very much like regular diabetes,” de la Monte said. “Since
the underlying problems continue to be just about the same, we believe
that the development of new therapies would be applicable for all types
of diabetes, including Alzheimer's disease, which we refer to as Type
She said, “This study points out that once AD is established,
therapeutic efforts should target several different pathways - not just
one. The reason is that a positive feedback loop gets going, making AD
progress. We have to break the vicious cycle. Restoring insulin
responsiveness and insulin depletion will help, but we need to reduce
brain stress and repair the metabolic problems that cause the brain to
produce toxins.” Ultimately, these findings will help to expand ways to
both detect and treat AD.
Growing evidence supports the concept that AD is fundamentally a
metabolic syndrome that leads to abnormalities linked to brain insulin
and insulin-like growth factor (IGF) resistance. In AD, brain insulin
and IGF resistance and deficiencies begin early and worsen with severity
of the disease. The rationale behind the progression of the disease is
that insulin-resistance dysregulates lipid metabolism and promotes
ceramide accumulation, thereby increasing inflammation and lipid
metabolism, causing toxic ceramides to accumulate in the brain. The end
result is increased stress that threatens the survival and function of
neurons in the brain. - MNT
Public ignorance about impact of lung disease
New data released by the Forum of International Respiratory Societies
(FIRS) to coincide with World Spirometry Day has revealed a worrying
lack of understanding and concern among the public about the world's
biggest killer - lung disease, which now claims the lives of almost four
million people a year.
Despite the high incidence of lung disease, research done across four
continents revealed that people are far more worried about cancer, heart
disease and stroke.
This lack of concern is even more striking as data shows that while
the other major diseases have been decreasing as a cause of death in the
last three decades, death due to COPD has doubled in the same period.
As well as underestimating the impact of lung disease, the public
poll reveals a lack of understanding about how to manage it.
Despite the fact that simple lung tests like spirometry can help
detect conditions such as COPD and asthma before the onset of
debilitating symptoms, the survey revealed that the majority, 57 p.c.,
of respondents have never had their lungs tested.
The research also revealed that 70 p.c.thought that those with lung
disease were unable to undertake even moderate exercise like swimming or
going to the gym.
However, in reality, physical activity can help to manage and improve
the symptoms of lung disease such as breathlessness, even in the most
As the world gears up to the Olympics, FIRS is using the new data to
urge people to get their lungs tested and to get active to improve their
What's more, with only 41 p.c. of those already suffering from a lung
disease claiming to have discussed the importance of physical activity
with a healthcare professional, FIRS is encouraging current patients to
approach healthcare practitioners to talk about the benefits of
exercise. On World Spirometry Day, and throughout the build up to the
Olympics, healthcare professionals will be taking to the streets across
the globe to run public lung testing events to raise awareness of
The test, which usually takes less than 10 minutes , is the most
effective way of testing lung health.
The Chair of FIRS and President of the European Respiratory Society
(ERS),Klaus Rabe, said:“Chronic lung disease is a major health issue but
- as the FIRS poll shows - its burden continues to be underestimated.
There is widespread ignorance not only around the seriousness of lung
disease but about what can be done to prevent it. As countries celebrate
the achievements of the world's best athletes - we feel the time is
right to focus on how we can all improve our lung health.
“Respiratory physicians understand more and more about the importance
of exercise but our research confirms ignorance is still out there. Even
gentle walking for those with severe disease can help in improving lung
capacity and general well being and we must get this message through to
Monica Fletcher, Chair of the European Lung Foundation, who has
co-ordinated the global initiative of WSD said: “World Spirometry Day
provides a point in time for people to understand the importance of
getting their lungs tested.
Early diagnosis for lung conditions can lead to more effective
interventions which, in turn can help alleviate symptoms and slow the
progression of the disease.”
A number of high-profile athletes are supporting the campaign, to
highlight what can be achieved by those suffering from lung diseases and
encourage more people to take up exercise. Some 448 competitors in the
2004 Olympics in Athens had chronic lung conditions.
Supporters include Norwegian Olympic rower, Olaf Tufte, who has won
two gold and one silver medal, despite suffering from severe allergic
asthma.Talking about his own experiences of lung disease, Olaf said:
“I am determined not to let my asthma limit me or restrict my
ambitions. Instead, I see it as one challenge among many that I need to
master in order to come top in my sport. People with lung conditions can
lead healthy, active lives - if they take steps to ensure their
condition is identified early enough and treated well.”