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Dr. Drew

What Is Bipolar?

Aired April 14, 2011 - 21:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. DREW PINSKY, HOST: Catherine Zeta-Jones is getting treatment for bipolar II disorder. I`m going to help you understand what it is and how to know if you have it, what to do if someone around you is suffering.

Then teens who cut. This is clearly becoming a real problem. Parents, I`ve got something to say about it, so listen up.

And keep your questions coming. I will be answering more tonight. So let`s get started.

Tonight we are talking about bipolar disorder. It`s on our radar this week because a celebrity confronted her own situation. Catherine Zeta- Jones checked into a psychiatric hospital.

(BEGIN VIDEO CLIP)

CATHERINE ZETA-JONES, ACTRESS: We just battle through.

(END VIDEO CLIP)

PINSKY: The battle against Michael`s cancer, that is. Then there was the lawsuit from his ex-wife, and his son being sent to prison. All of that plus two young children. What a year. The intense stress took its toll on Catherine Zeta-Jones, aggravating her bipolar II disorder.

Six million Americans have it. Countless families feel the effects. You are not alone. Get rid of the ridiculous stigma. Bottom line, this is a medical issue. I`m going to help you understand it, the warning signs and what you should do. It`s time to get the facts and get down to the business of understanding bipolar disorder.

All right, that is what I want to do here. I want to examine this in ways that`s not done elsewhere on the media. So before we go further, let me tell you what this thing is we call bipolar disorder. It used to be called manic depression or manic-depressive disorder. It is a brain disorder. The hallmark is intense mood swings. It is a mood disturbance. Manic, or what`s called hypomanic highs -- people are inflated, they don`t need to sleep very much, they are hypersexual, they have inflated ideas about themselves and depressing rock bottoms, lows. It usually develops in teen or young adulthood.

Joining us to talk about this condition is Oscar-winning actress and mental health advocate Patty Duke. Patty was diagnosed with bipolar disorder at age 35. And Maurice Benard is here. The "General Hospital" actor has publicly battled bipolar disorder, as well. Thank you guys for being here.

Patty, I wanted to start with you. You knew at a young age that something wasn`t right. What did you first feel? What did you first see? And how did this come to light?

PATTY DUKE, OSCAR-WINNING ACTRESS, SUFFERS FROM BIPOLAR DISORDER: I must tell you that part of the cover for my illness -- to the public -- was the roles I played. Having played Helen Keller, where I beat up a grown- up, that was very therapeutic for me. But it was not the absolute answer.

I went -- at my, oh, early 20s, the manifestations started with the depression. Didn`t get out of bed for months at a time except to go to the bathroom or attempt suicide. Then the surge upward would happen. And then I spent all of my money, and anybody else`s that I could, and did things that were really kind of scary, such as marrying someone I did not know, which was annulled 13 days later.

But these should have been to me examples of something very wrong, and that was a medical condition. It wasn`t until I had the good fortune at 35 to be going to a psychiatrist at the time and kicked into an up time, and the doctor was able to diagnose because he had seen me in the down time. And that wasn`t until I was 35. So I wasted a lot of years by not going for help sooner.

PINSKY: I want to point out to people it`s very common for bipolar patients to be treated as what`s called unipolar depression, and sometimes antidepressant medicines can kick somebody into a manic episode. That`s how the doctor then makes the diagnosis. But treatment for bipolar -- medical condition with a medical solution -- is different than the treatment for unipolar or the kind of depression that people think about characteristically.

Now, Maurice, you play a character on "General Hospital" who apparently suffers from bipolar disorder. It`s like art imitating reality, reality imitating art. Let`s check this out.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Can you tell me how old you were when you realized you acted different from other people? I mean, I know you weren`t diagnosed until you were an adult, but can you ever remember getting angry for no reason even when you were my age?

MAURICE BENARD, "GENERAL HOSPITAL": Are you really doing a school project, or for whatever reason, you think you might be bipolar?

(END VIDEO CLIP)

PINSKY: What do you think when you see that? Were they creating that storyline because they knew you were struggling or...

BENARD: Well, yes. When I first started the show, you know, I was making choices like the character was at that point, manic-depressive. And they started talking to me, the writers started talking to me about my own life and they started incorporating it into the role. And they even did a story line where Sonny, the character, has a breakdown and goes to a psychiatrist to get help.

PINSKY: Did Maurice go get help? Did anybody suggest that? It`s great they`re creating a story around the character, but did somebody look after you?

BENARD: Well, you know, the reality is I`d been taking my -- I`ve been taking my medication now for 20 years straight.

PINSKY: Oh.

BENARD: So I was cool. But I got be honest with you. At the end of the story line, my wife had to call them and say, Let`s stop this, because at the end of it, I had an anxiety attack.

PINSKY: It was too close to home.

BENARD: Yes, it got too -- it went on too long and I couldn`t -- I couldn`t kind of shake it, you know?

PINSKY: We actually have a viewer call. This is Jamie. She is in West Virginia. Jamie, what`s your question for the panel here?

UNIDENTIFIED FEMALE: Hi, Dr. Drew.

PINSKY: Hi, Jamie.

UNIDENTIFIED FEMALE: My concern is, I suffer from bipolar type 2, rapid cycling, myself. And there`s also a family history of mental illness.

PINSKY: Of course.

UNIDENTIFIED FEMALE: And I`m wondering how genetically predisposed are my children to this disease?

PINSKY: Two interesting questions here, and one thing we need to clarify. We`ve not yet really clarified what bipolar II is, which is what Catherine Zeta-Jones has announced she had, which is a -- let`s say it`s a milder form of bipolar where there`s at least one episode of hypomania but not true mania. Mania is people can disconnect from reality sometimes. Hypomania, they`re inflated, but they still are not psychotic. They`re not disconnected from reality.

Patty, do you have an answer to that, the genetic predispositions?

DUKE: I do. I believe that it is -- that the theory that it`s a genetic illness is true. My mother may have been unipolar, but she may have been bipolar because her behavior wasn`t examined when she was in her up and angry state.

I have children. I have grandchildren. I feel good that we know enough about this now that if symptoms begin to show, we can help that person go for help. So far, we haven`t had it yet, but I`m not counting -- I`m not counting us out.

PINSKY: Well, right. It`s a medical condition like any other medical condition that can emerge during our life. And treating it early actually reduces the severity of the illness.

Maurice, are you worried that your kids might have it? Do you feel...

DUKE: Precisely.

PINSKY: Do you feel guilt or -- I mean, I imagine it`s a very concerning thing for you.

BENARD: I don`t worry about it, but I know that if I saw the symptoms, I could catch it early because of my own experience. But you know, there are times that my wife and I talk about it, and we think, you know, What if? But I think, you know, with treatment, you can live a great life.

PINSKY: Maurice, I think we`re going to say farewell to you. Do you have any messages to my listeners or my viewers that might have -- be struggling with this?

BENARD: You know, basically, the message is, if you feel you have any kind of symptoms, seek help. Get treatment. And stay on your medication.

PINSKY: Yes. Stay on the medication is a big one.

(LAUGHTER)

PINSKY: I think you learned that one the hard way. But that`s a very common challenge for those of us, as physicians, to get people to do that. We`re going to talk about that.

When we come back, we actually have a young woman with bipolar disorder who wants our help. We`re going to talk about why she hid this problem from family and friends.

(COMMERCIAL BREAK)

PINSKY: We are back talking with Patty Duke about bipolar disorder. And I really want to be sure this is sort of accessible material for people. People are hearing about it a lot now with Catherine Zeta-Jones and her story. It`s an easy thing to get your head around. I hope this is the place you`ll get your information about it. And we`re going to ask questions of Diane...

DUKE: Doctor?

PINSKY: Yes, ma`am? Patty`s interrupting me. Go right ahead, please.

DUKE: I`m so sorry. I can`t help but interrupt you because I hope that you recognize the public service that this show is. The way you`re dealing with it, the way you are explaining it to us in detail doesn`t happen other places. So thank you.

PINSKY: Well, thank you, Patty. I appreciate that. And I know that, and as a doctor, I know how common this thing is and I know how important it is to get the word out. There are people out there with it that don`t know they have it. There are people out there that know they have it who are resisting treatment which is exactly why I asked Diane Guilmette to come in here. She was diagnosed two years ago and she hid her problem from family and friends. Got to figure out why that. And again, we`re trying to address the stigma, as well as helping people understand what this thing is. And Carrie Bearden. She is an expert when it comes to bipolar disorder. She does research.

First, before we go to our new panelists, I want to go to a FaceBook question. This is from Michelle S. She reached out to us and she wants to know, "Do you have to stay on your meds for the rest of your life if you suffer from bipolar disorder?"

Patty, you kind of tipped your hat to me on this one a little bit when I brought it up during the commercial break.

DUKE: I do.

PINSKY: I know you have some strong feelings about compliance, so let`s get to it.

DUKE: I do. OK, first of all, the word "compliance" could be one of the off-putting things about it. Yes, as a patient of almost 30 years, I have taken my medicine every day. I do not miss it. You get to feel well, and so you think, Oh, I don`t need this junk anymore. That`s not right. And it`s a kind of a silly thing to worry about. For all of our problems, that`s pretty much the least.

The other thing is, I wanted to let you know that recently, I started to feel kind of wonky. I wasn`t sure what it was. Maybe it was depression, maybe -- I mean, there are a lot of things in the world to be depressed about. But this was above and beyond that. So I swallowed my pride and went to the doctor, and my medication has now been tweaked. That means a different medication has been added. And I must tell you, in the last 35 days, I feel so much better. And I`m grateful for the people who have encouraged me to keep up my meds.

PINSKY: And Diane, that`s really one of the points here, which is that it is a condition that goes across the lifespan, and it can be something that people aren`t too happy about speaking up about. That was your story, yes?

DIANE GUILMETTE, SUFFERS FROM BIPOLAR DISORDER: Right. Very much so. It`s the stigma that`s attached to it. You don`t want to be categorized in this group of "Now I have to take medication every day. Now I"...

PINSKY: Did you even know what they were talking about when they said you had bipolar disorder?

GUILMETTE: I had suspected for many years because I would have very low points and very high points. You know, as my mom has described, when I`m on, I`m great. But when I`m down, I mean, I -- there are times when I won`t get out of bed. I won`t eat. I won`t shower. I won`t change. There`s just nothing that I feel motivated to do.

PINSKY: Do you still feel the stigma, even though you understand how biological and medical this condition is?

GUILMETTE: I know -- my mind wants to tell me that this is -- it`s just a medical illness and -- but still, you -- I haven`t been very open with most of my friends or family. And it`s still the -- I have to take medication for this. I have been in the hospital for this. And if you had diabetes, you wouldn`t be ashamed to tell anyone. You wouldn`t be ashamed to carry insulin around with you. But yet when people see my medications in my purse, you feel like you want to tell them, Oh, that`s just for my blood pressure. It`s just something else.

PINSKY: Carrie...

GUILMETTE: And there`s still this shame.

(CROSSTALK)

PINSKY: ... why that is? Oh, wait. To Patty.

DUKE: (INAUDIBLE) traveler?

PINSKY: Please?

DUKE: As a fellow traveler, I had a very, very, very brief time of, Oh, God, somebody`s going to find out.

GUILMETTE: Yes.

DUKE: I then recognized that I was in a position -- my celebrity would be helpful in getting the word out. And that became my passion. It doesn`t have to be everybody`s passion.

GUILMETTE: No.

PINSKY: It`s your business. But I wish that you would take the stigma away from your medicine.

GUILMETTE: Well, that`s why I`m so grateful...

DUKE: There`s nothing to be...

GUILMETTE: ... for you -- for you making it public...

(CROSSTALK)

GUILMETTE: ... and making it well known, and people like yourself and for Catherine Zeta-Jones for making this a public thing so that people do become more aware of it and that it becomes something that is not something to be shameful to speak of.

PINSKY: Carrie, let me go to you next because I`ve got a million questions about...

DUKE: Precisely.

PINSKY: ... how common this thing is, how many people get treatment, how many people stay on treatment. Why don`t we stay there?

CARRIE BEARDEN, ASSOC. PROF. OF PSYCHIATRY, UCLA: I think it`s a great question. So about 1 in 100 people have bipolar I disorder, which is the most severe form of the illness. But there`s probably another 2 percent or 3 percent of people that have a spectrum of illnesses, and there may be even more that have milder forms of the illness, psychothymia, which is basically mood swings that don`t meet the full level of severity for a bipolar diagnosis.

PINSKY: How many of those come to treatment?

BEARDEN: How many of those come to treatment -- the 1 in 100 figure that I`m citing are really people that have come to treatment that have gotten the diagnosis. There may be many more people out there. I think it is an underdiagnosed condition.

PINSKY: And how many stay on treatment? This is what Patty`s talking about. She loves the word "compliance," so I`m going to use it...

(LAUGHTER)

PINSKY: ... because it`s -- I`m a doctor. I get to use disgusting words.

DUKE: Oh, you devil!

(LAUGHTER)

PINSKY: So what -- what percentage stay with it? Because this is the problem as a physician, again, getting people to stay with their meds. For the very reason they -- they don`t want to believe they have it, or I don`t know what it is. It`s very funny.

BEARDEN: It is really -- this is one of the most confounding things about treating this disorder is, really, that more than 70 percent of people will discontinue their medication at some point during their course of illness. And there`s -- I think there are a lot of factors, and I think one of them is just not having good communication with your doctor.

PINSKY: Well, God knows our health care system functions so well and so smoothly, I can`t understand why the doctor...

(CROSSTALK)

PINSKY: ... the patient relationship is being broken down.

Let`s go to a phone call. This is Nancy. She is from Florida. Nancy, what`s up?

UNIDENTIFIED FEMALE: Hey, you know, this is an awesome, awesome thing you`re doing, only for your true sincerity on this. So thank you. And you know, when you come -- when this all comes about and you share it with the ones closest to you, your family, the problem is, it`s like, all of a sudden, it`s like you`re crazy, or, you know -- and no matter what you do, you still have that stigmatism attached to you. And they make you -- and somehow, the family members, some of them, they just make you feel shamed, and you`re not really -- they treat you differently. And I don`t really understand that because...

DUKE: I take a vacation from those family members!

PINSKY: What`s that, Patty?

DUKE: I said I take a little vacation from those family members.

PINSKY: Yes. Well, you know, that`s very much to the point. I mean, that sounds more like a family systems problem than a problem with bipolar. If somebody is going to shame you and use your medical condition against you, that`s coercive and that`s sad.

But I got to say, Nancy, it`s a good question because I noticed that Diane actually responded to it. She`s saying, Oh, my gosh, that`s what`s going to happen to me if I admit it to my friends. They`re going to hold it against me. They`re going to use it against me.

GUILMETTE: When is Diane going to go crazy?

PINSKY: Oh, Diane`s a crazy person.

(CROSSTALK)

PINSKY: How do -- how do the people deal with that, Carrie?

GUILMETTE: Oh, careful, she`s going to get depressed!

PINSKY: And let`s be fair that some people with bipolar are brittle. They`re very fragile. And that`s -- but that`s not the most common thing, is it, Carrie.

BEARDEN: Well, it`s a challenging issue because a lot of people, the family members will report that they feel like they`re walking on eggshells all the time, that they are going to trigger something. And so I think that there`s some truth to that for some people.

But I think one of the biggest things about the treatment is really getting the whole family involved in treatment. And family-focused therapy is really effective for -- not just for people with bipolar disorder but also for children of parents with bipolar disorder and really helping understand what their parents re going through, so...

PINSKY: And it`s like addiction, disconnecting the person from the disorder and helping them understand they don`t need to walk on eggshells, and if they are walking on eggshells, it`s probably because the disorder is not completely treated yet.

BEARDEN: Is not completely treated.

PINSKY: Not thoroughly under control. if somebody`s irritable and tense and aggressive or excessively depressed and has trouble functioning, that`s inadequate treatment. If you`re still having symptoms, that means that the disorder is not completely and thoroughly treated yet. You`ve got to keep going back and get the treatment. You can expect complete remission.

I want to thank our panel. Diane, thank you for being so courageous. I know -- if you have any repercussions, let me know...

GUILMETTE: Will do.

PINSKY: ... because people now are going to know about this.

GUILMETTE: Thank you. Yes.

PINSKY: Carrie, thank you for joining us. I really appreciate it.

BEARDEN: My pleasure.

PINSKY: And Patty, God bless you. Thank you so much for doing us.

DUKE: He does.

(CROSSTALK)

DUKE: Thank you, Doctor.

BEARDEN: ... from someone in the mental health field...

DUKE: You`re who we need out there.

BEARDEN: ... I think it`s so important.

PINSKY: Thank you, Patty. I think we will all agree, I want to thank Catherine Zeta-Jones for coming forward with this so we can talk about this. She has done something important for millions of people.

When we come back, what about if you`re taking meds for bipolar disorder and you have an addiction? That`s something I can answer. And more of your questions after this.

(COMMERCIAL BREAK)

PINSKY: Welcome back. And thanks to each and every one of you who has contacted us. It`s time for your questions. And we are first up going to go off into FaceBook. I like that because it helps me use my new toys here. There`s our FaceBook question.

It is from Michael P. And he asks, "What is the worst thing a bipolar person can experience?" And let`s be clear. The worst outcome from bipolar is death. Suicide is very common in bipolar patients. And what I think is counterintuitive and needs to be pointed out is that a bipolar patient actually statistically is more likely to kill themselves, suicide, when they`re manic. The misery of mania is actually what triggers more suicides than the depression, which is what we more commonly think about as something that`s going to cause a suicidal thought. So bipolar disorder must be thoroughly treated.

We have James. He is from Indiana. He`s on the phone. What is up there, James?

UNIDENTIFIED MALE: Hey, Dr. Drew. How`re you doing?

PINSKY: Hey, buddy. What`s going on?

UNIDENTIFIED MALE: I was diagnosed with type 2 bipolar disorder. And there`s occasions where I go on and off my meds. Is there going to be any adverse effects of that?

PINSKY: Right. I think you`re asking whether or not there are any medical consequences of going on and off, are you going to hurt other organs, other than your brain? And not really. That`s not the big issue.

The big issue, my friend, is that you have a dangerous condition that you are determining how to treat, not taking direction from a doctor. So you can expect the worst possible outcomes in terms of your bipolar disorder. Please, if you go on and off, just do it with the supervision of a physician or psychologist who can really watch the -- what are really pernicious and subtle symptoms that can come on when you`re off your meds.

We had Maurice here earlier in the show. Every time he went off, he had a major, major breakdown. It`s a serious thing, going on and off. But no, you`re not going to cause other organ damage or other medical conditions. But you certainly aren`t being managed properly.

We`ve got also Shannon. She is on the line. She is from Washington. Shannon, what have you got for me?

UNIDENTIFIED FEMALE: Hi, Dr. Drew. My question is about addiction and bipolar disorder.

PINSKY: Go ahead.

UNIDENTIFIED FEMALE: I`ve had addiction problems in the past. I`ve been sober for a couple years now. And I`ve had problems finding a provider who can deal with both.

PINSKY: Yes.

UNIDENTIFIED FEMALE: I`ve had a psychiatrist who doesn`t want to even see me in her office when I was using, and then my addiction counselor, who doesn`t want to address the bipolar because it`s not her area.

PINSKY: Right. I totally, completely understand. This is a very common thing. People with addiction are actually more likely to have bipolar disorder, either caused by the addiction by messing with their brain chemistry, or people with bipolar disorder are actually also a little more likely to have addiction than the average population. So it`s a real serious issue.

I`m not sure I can answer it in way that`s going to be that satisfying for you except to say benzodiazapine medicines are very common and effective for bipolar patients, but they, in my opinion, are a no-no for bipolar with addiction. So be careful about that.

Secondly, there are psychiatrists and internists out there and family practitioners that are trained to handle both. You want to look for somebody that`s board-certified in addiction medicine. And just make sure -- I think just make sure you`re going to your 12-step meetings, have a sponsor and keeping the basics while you see an expert in mental health, like the psychiatrist, who really should -- excuse me -- should really manage the bipolar disorder separately. It really is two separate things that need to be managed separately.

If you have a question, you can contact me at CNN.com/drdrew.

When we come back, teen cutters. Why do kids self-mutilate? We`re going to get at that.

(COMMERCIAL BREAK)

PINSKY: I hope all of you remember our guest from last week. She made quite an impression on all of us and so did her YouTube video. Take a look.

(BEGIN VIDEO CLIP)

(END VIDEO CLIP)

PINSKY: All right. So, we, tonight, are going to address teen cutting. Kay Mowery-Seufer`s 18-year-old son, Hayden, is a self-mutilator, and he`s recently tried to overdose on pills. We welcome Hayden to the show and his mom. Hayden, I`m going to start with you. How old were you when you started cutting?

HAYDEN MOWERY-SEUFER, CUTS SELF: I was in sixth grade.

PINSKY: How did you even think of it?

HAYDEN MOWERY-SEUFER: Someone on my bus that cut.

PINSKY: So, you heard other kids talking about it.

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: And it sounded like a good idea? What went through your mind?

HAYDEN MOWERY-SEUFER: I don`t really remember why I did it. I just remember I was angry the first time I did do it.

PINSKY: And can you take us through -- see, I think people that are hearing about this topic or don`t understand it wonder what you`re trying to accomplish when you cut.

HAYDEN MOWERY-SEUFER: I get this adrenaline rush and then it kind of numbs.

PINSKY: So, it`s a numbing -- it`s a numbing effect?

HAYDEN MOWERY-SEUFER: It`s first adrenaline rush then numbing.

PINSKY: OK. It`s almost a little bit of a high?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: OK. I`ve heard many patients describe that. Mom, how does it feel when you hear your son talking about it that way?

KAY MOWERY-SEUFER, SON CUTS SELF: It`s -- you don`t feel -- you feel very helpless. You know, because it`s something very counterintuitive to what most people would feel, what they would do, and it`s -- it`s just a feeling of helplessness.

PINSKY: How did you find out about it?

KAY MOWERY-SEUFER: Through school, actually. I got a phone call. He had taken a pencil sharpener apart. He was frustrated in math. And he cut himself in the stomach, and I got a phone call at work to come and get him and, you know, take him to the emergency room.

PINSKY: And what did you think was happening? Did you think he was trying to harm himself?

KAY MOWERY-SEUFER: I think -- I think he was -- it was a cry for help. He was not -- he was doing very poorly in math. He had a teacher that didn`t speak very good English, which was a problem. And it was -- he was frustrated.

PINSKY: But when you first heard that he had self-harmed, had he done any self-harm before?

KAY MOWERY-SEUFER: He had cut himself with glass, like in elementary school, and, you know, he has seen counselors weekly since he was in elementary school.

PINSKY: Hayden, do you feel any ambivalent feelings when you cut? That is to say you get a numbing effect, but then, you also feel guilt or shame for having done it?

HAYDEN MOWERY-SEUFER: Not all the time, but sometimes.

PINSKY: Sometimes you do. My understanding is you recently had a suicide attempt also.

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Is depression a big part of your condition?

HAYDEN MOWERY-SEUFER: I`d say so.

PINSKY: And did you really want to harm yourself with the pills?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: You intended to kill yourself?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: That`s how bad your depression got?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: And yet, the cutting is something altogether separate from that?

HAYDEN MOWERY-SEUFER: Yes. Definitely.

PINSKY: This is what I don`t think people understand. For those of you at home are trying to make sense of all this, cutting is not an attempt to harm yourself so much, is it?

HAYDEN MOWERY-SEUFER: No. I would say it`s to harm yourself but not in, like, end your life.

PINSKY: Not end your life.

HAYDEN MOWERY-SEUFER: More -- I do it for a, as a coping skill for when I have a peak emotion, like, I`m really angry or I`m really sad. Even sometimes when I`m happy, I`ll cut myself.

PINSKY: So, any emotion intensity triggers this?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Do you know other kids that do it?

HAYDEN MOWERY-SEUFER: Yes. People -- I was in a program that was just for people who self-harmed.

PINSKY: For cutting.

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Tell me about that program.

HAYDEN MOWERY-SEUFER: It was safe alternatives. It was in St. Louis. And it was a bunch of therapy sessions and kind of talked about trauma and why you cut, people cut.

PINSKY: What did you learn about that?

HAYDEN MOWERY-SEUFER: I learned that it`s a survival technique, in a way, because if you get so overwhelmed, that`s the only way you know how to deal with it.

PINSKY: Mom, does that make sense to you?

KAY MOWERY-SEUFER: It does.

PINSKY: How would you describe it to people at home, other parents out there, who may have a kid that has cut, how do you help them make sense of this?

KAY MOWERY-SEUFER: Well, I think the biggest hurdle is trying to find the right counselor, therapist, that can help as far -- because there aren`t support groups.

PINSKY: For cutting.

KAY MOWERY-SEUFER: For cutting.

PINSKY: Yes.

KAY MOWERY-SEUFER: And especially not for adolescent.

PINSKY: But these days, cutting, in my experience, has been so common, increasingly common. We`re going to keep talking about how common it has become with experts, and it`s often associated with trauma, as you said, but also with addictions and eating disorders. And sort of there`s nowhere for cutters specifically to go very often, as you`re saying. What is the connection, Hayden, between the trauma and the cutting? Did they make that connection for you at the treatment program?

HAYDEN MOWERY-SEUFER: I don`t know how to answer that.

PINSKY: Maybe a better way to ask the question is, trauma leaves you with some emotional liabilities, right?

HAYDEN MOWERY-SEUFER: Yes, just, I guess not knowing how to cope with it.

PINSKY: Right. That`s kind of what I was going for is the trauma leaves -- trauma, do you want to define for people what we mean by trauma?

HAYDEN MOWERY-SEUFER: Like, something that happened in your life that was negatively impacted you. And --

PINSKY: Let me, hey, let me help you out with this. And for people at home, let me say, the way we think about trauma, we`re talking about childhood trauma, and the extraordinary thing about human -- mom, you jump in and interrupt me at any point here if I get off track, but the extraordinary thing about the human is that things that happen early in life have a disproportionate effect on everything else that is to follow.

You guys agree with that? And trauma, we`re talking about childhood trauma where something shattering happens, something that exceeds the child`s ability to manage emotionally, and it leaves an effect on your brain and that effect is what you`re talking about, Hayden, where things feel overwhelming and you use the word cope. I would use the word regulate. You can`t manage your emotions. Mom, you say yes.

KAY MOWERY-SEUFER: Yes.

PINSKY: How would a parent identify a child with that sort of issue?

KAY MOWERY-SEUFER: Well, I think that for Hayden, anyway, it`s any kind of change. Change in schools, change in routine, anything. He has trouble adapting to it. So, because of that, I mean, I think this was just an outlet, another way for him to try and manage the chaos that he felt inside, even though --

PINSKY: Emotionally.

KAY MOWERY-SEUFER: Right, emotionally, even though, you know, and I guess maybe some family chaos also that you are internalizing.

PINSKY: There was a divorce around that time.

KAY MOWERY-SEUFER: Right.

PINSKY: Do you blame yourself for some of this?

KAY MOWERY-SEUFER: I`m -- well, actually, since he`s gone into the latest treatment program, you know, I do blame myself for doing maybe too much, doing everything to try and make his life as calm as possible, you know? You know, I`ve pretty much done everything, taken him step-by-step to get through his day.

PINSKY: But you don`t blame yourself for causing an unstable environment because of the divorce?

KAY MOWERY-SEUFER: It would have been more unstable --

PINSKY: Without the divorce.

KAY MOWERY-SEUFER: Right.

PINSKY: OK.

KAY MOWERY-SEUFER: So, you know, you do the best that you can with what you have to work with.

PINSKY: Go ahead.

HAYDEN MOWERY-SEUFER: I would say it was more my dad, not my mom.

PINSKY: OK. Your dad had some -- can you tell me a little bit about that?

HAYDEN MOWERY-SEUFER: My dad currently is a recovering alcoholic, but he was a bad alcoholic up until a year ago, and he would call our house when we moved to Kansas and cuss mom out and he would just -- when you get drunk, nothing good happens from it.

PINSKY: It became terrorizing.

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Terror is a very unhealthy experience for young people. That is trauma. And I would remind anyone out there who has alcoholism or addiction, if you think your kids aren`t affected by it, they are, and there is a solution. So, please take advantage of that. I`m glad your dad is in recovery. That`s a good thing. Well, thank you, mom. We`re going to keep Hayden out here, and we`re going to keep talking about the warning signs about cutting or for cutting throughout the show. Parents, teachers, friends, you have to be vigilant.

As we go to break, let`s look at this statistic. According to the AMA, almost 50 percent of cutters or self-injuring individuals have been reported to have been sexually abused. We will be back in just a minute.

(COMMERCIAL BREAK)

PINSKY: We are talking today about teens who self-mutilate, specifically, by cutting which is such a common thing these days. Hayden Mowery has done it, so has Lauren Waight. She is 19 years of age. Lauren`s mother, Audrey, is here as well, and we are joined by Dr. Wendy later. She is an expert in the field. I want to go first, though, to our new young person on the panel. Lauren, how did this happen to you? Why did you start? When did you start?

LAUREN WAIGHT, CUTS SELF: I started my freshman year in high school. For me, it was a way to gain control of what I felt was a very out of control life. It was kind of like a defense mechanism in the sense that if I was in control of everything around me, then there`s no possible way for me to get hurt. There`s no possible way for me to be vulnerable in a situation. So, no one else can hurt me. Only I can hurt myself.

PINSKY: Was there a particular feeling that triggered this?

LAUREN WAIGHT: Well, I was having issues with my relationship with my dad, and I`ve always struggled with perfectionism. And, for me, I felt that I wasn`t good enough.

PINSKY: Was there an eating disorder here, too?

LAUREN WAIGHT: Yes.

PINSKY: That those words trigger my thinking about eating disorders, and they do go hand-in-hand very frequently, don`t they, cutting and eating disorders?

WENDY LADER, PH.D., PRESIDENT, S.A.F.E. ALTERNATIVES: It`s the most concomitant disorders. Eating disorders and self-injury often go together.

PINSKY: Why do you think in today, I mean, it seems like it`s increasingly severe symptom. And let`s be clear, cutting is a symptom, it`s not a disorder, a condition, but it`s a symptom that we`re hearing about more and more, thus, we`re doing this show. Why today? Why is this happening?

LADER: You know, we have a lot of theories. We don`t have great research on this. We`re not even absolutely sure about the increase because this used to be diagnosed as suicide years ago. And so, we don`t have great statistics from early on. But anyone in the field -- and teachers will all tell you that this is a growing phenomenon. We suspect that about actually the research at Cornell States that about one in five kids has attempted to self-injure at least once, and 75 percent of those have done it more than once.

Why is this increasing? Why are kids doing it? I would look towards a sense of alienation and a sense of fragmentation. That our world is changing very rapidly. The internet is certainly a place where kids are going to for mentoring, but it`s also -- it`s the blind leading the blind often.

PINSKY: Dr. Lader, is it our families? It`s the disruption in our family systems?

LADER: We have -- I mean, I look towards when I was a kid, and that was a long time ago, but, in the history --

PINSKY: How dare you, first of all. I don`t feel like it was that long ago.

(LAUGHTER)

PINSKY: It must have been longer for me. I`m being traumatized today.

(LAUGHTER)

LADER: But in the history of things, it`s a relatively short time. And divorce was very uncommon back then. And I`m not making a comment about divorce except that lots of things come with divorce. There`s fighting in the family. Kids have to live in two different households. Sometimes, they have to deal with their parents dating other people.

PINSKY: When you said fragmentation, and to me, that`s what kids that I deal with complain about when they come from a broken family. They feel broken and fragmented. Lauren, I want to go back to you. Do you think that YouTube has had an impact on the awareness of cutting, at least, had an impact on you?

LAUREN WAIGHT: It definitely did. For me, the YouTube videos, I`ve started looking them up just because I felt so alone. And looking them up and you see them, you know, you`re trying to commend people for at least trying to get awareness out, but they show such graphic images that it was almost adding fuel to the fire.

PINSKY: We`re watching video of Alye right now who is giving an impassioned plea about nearly cutting which is different than the kind of YouTube videos you`re talking about. You`re actually -- there are some sort of how-to videos out there, aren`t there?

LAUREN WAIGHT: Yes.

PINSKY: That`s sort of stunning to me. And kids know about them and know where to go.

LAUREN WAIGHT: Yes.

PINSKY: Hayden, did you ever go to YouTube videos?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: That had an impact on you, too?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Dr. Lader, is that something we see out there?

LADER: Yes, unfortunately, there`s new research out of a couple of universities in Canada on YouTube, and we`re finding that it`s very common that there are lots, and they`re very graphic, and they`re very rarely any kind of warning of what kids are going to be seeing. So, for kids who are self-injurers, it can be extremely triggering. And very few of them actually say not to do this or that this is unhealthy coping strategy.

PINSKY: And although, cutting is the one that sort of became popular, should I use that word? Let`s remind people that self-injury includes hitting your head, burning with cigarettes, hitting -- the burning and the hitting the boys are more likely to do. The girls are more likely to cut. Is that correct?

LADER: That`s correct, but we also should know that self-injurers often injure in multiple ways. They don`t always just choose one way to injure.

PINSKY: Now, Audrey, you didn`t think I was going to let you off the hook, did you? I`m going to talk about moms. How did you find out about Lauren`s behavior?

AUDREY WAIGHT, DAUGHTER CUTS SELF: It took about two years before I realized what Lauren was doing, because I trusted Lauren and --

PINSKY: Can I stop you?

AUDREY WAIGHT: Sure.

PINSKY: You`re a trustworthy girl, right? Is it about trust, Dr. Lader?

LADER: It`s really not about trust. This is an attempt to cope with life.

PINSKY: OK. I just want to qualify -- she didn`t really violate mom`s trust so much. You just trusted that she was well, I guess.

AUDREY WAIGHT: Yes. Yes. I trusted that she was well.

PINSKY: I`m going to interrupt you. And she would come to you if she were in distress?

AUDREY WAIGHT: Yes.

PINSKY: I got to give a message to -- how old were you when this started again?

LAUREN WAIGHT: Fourteen.

PINSKY: I`ve not met a 15-year-old yet that consistently goes to parents when they`re in distress or with absolute abject truth about what they`re experiencing. That 15-year-old does not exist. So, parents, take note. I`m sorry, I have to interrupt you.

AUDREY WAIGHT: Yes. I always felt like Lauren and I had an open door policy. That she can come to me if there was anything that she was struggling with. The clues were there. I just would question Lauren and she would say, no, I`m fine.

PINSKY: What did you see?

AUDREY WAIGHT: He clues were, in the summertime, Lauren would wear long sleeves. Lauren, why are you wearing long sleeves? She would say, well, it`s chilly, but it was in the middle of summer, and I would let it go. Another thing is I would find a razor or two in her sister`s room which was adjoining hers, and I thought it was kind of strange. I questioned her because her sister went away to school.

Where did these razors come from? And she would insist that they belonged to her sister. So, I believed that. I would find blood smears from where she turned the light switch on and off. Question that. Oh, just a little something, I cut myself by accident.

PINSKY: So, you used razor blades. Did you, Hayden, use razor blades as well?

HAYDEN MOWERY-SEUFER: Yes.

PINSKY: Razor blades. Most common, razor blades?

LAUREN WAIGHT: Yes.

PINSKY: And when you discovered that this was cutting, what did you think? What did you do?

AUDREY WAIGHT: Actually I found out when I cleaned her room one day because her room was just out of control. So, I went in to clean her room, and while cleaning her room, I stumbled across her diary and I read it. And in her diary, she had written about what she was doing. And I waited for her to come home from school and I spoke to her about it, and she was very upset with me, said that, I didn`t trust her for reading the diary.

And, you know, we talked about her getting help. She had a lot of rage at that time. She just didn`t want to talk to anyone. Anything that we tried to speak to her about was just, she just wanted to argue.

PINSKY: All right. So, what we`re going to do next after this break is we`re going to talk about the solutions. How you got her to go to treatment? What treatment is about? And I want you to consider this, that almost 50 percent of self-abusers begin at the age of 14 and continue into their 20s. We`ll be back after this.

JOY BEHAR, HOST: Hi, Drew. Tonight, I`ll talk to a woman who got divorced, got plastic surgery, and then, got a hot young boyfriend. I guess, revenge is sweet, huh? You don`t want to miss this one.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

PINSKY (voice-over): If someone you know is cutting, there is help at S.A.F.E. Alternatives. You can reach them at 1-800-366-8288 or go to selfinjury.com.

(END VIDEO CLIP)

PINSKY (on-camera): We are back with our guests, Hayden and Lauren and Lauren`s mother, Audrey, and Dr. Wendy Lader. I want to go first to Audrey to talk very briefly about how you got through the resistance and denial.

AUDREY WAIGHT: Well, Lauren made two attempts on her life, and she came to the realization, herself. She researched. She came to me, and she said, mom, I need help, and she found the program she wanted to be part of which was the S.A.F.E. program. She made contact, and she checked herself in.

PINSKY: OK. So, Dr. Lader, this is the point which is that cutting creates headlines and the public never gets a real discussion on what this symptom is. It`s in a bigger psychiatric context. Briefly tell us about that so people can understand how this co-exists with other disorders.

LADER: Right. Absolutely. Self-injury is a coping strategy, and that`s hard for people to understand. I think Kay earlier said that it`s counterintuitive, but bottom line is four people in emotional trauma, it works, which means that they feel better almost immediately.

PINSKY: So, to treat it?

LADER: The problem is the feeling better isn`t the issue. They need to actually get better. And treating it means getting to the underlying issues and that means identifying feelings, identifying the precipitant to those feelings, and then learning to not get rid of feelings, not medicate them away or numb them away, but actually, to learn to tolerate those feelings.

PINSKY: And so, this includes family therapies --

LADER: Yes.

PINSKY: Trauma therapies, because we`ve discussed so many of the kids are trauma survivors.

LADER: Absolutely.

PINSKY: And other psychiatric interventions that might be necessary, sometimes medication.

LADER: Yes. Our program is very intensive. We have groups so that their peers can also help to challenge them on those levels. And we have group therapies for -- we have art therapy, we have music therapy, we get to it at different ways.

PINSKY: OK. So, I think I would remind people to call that phone number if you want help. Help is available. And young people here, Lauren, Hayden, thank you for joining us. Very courageous. I know you can be help to other young people out there. It is so important that young people have a relatable source like you, guys, to go, oh my gosh, if she can do that, if he can do it, I can get better, too. You look sad. You shouldn`t be.

(LAUGHTER)

PINSKY: You should be proud of yourself. You should be really proud of yourself, Lauren, really. You OK?

LAUREN WAIGHT: Yes.

PINSKY: OK. All right. Now, listen, I want to get on to a topic that HLN has been covering today. Police in Ipswich, Massachusetts are looking into teen cyber bullying. I almost choke on this story. Someone hacked into a high school`s Facebook page, sent e-mails with the names of 22 girls that do not have a prom date. This very e-mail then ranked the size and looks and characteristics of these young girls.

Another e-mail, apparently, detailed the girls` sexual experience. Here is some of what was said about the girls. They gave one star for never having been kissed. Two stars for someone who had a couple of relationships. Three stars for students who wore yoga pants and had a belly ring or wore low-cut shirts. I don`t even know -- I can`t -- I choke on this. I don`t know what to say.

I don`t -- here we are doing a thing about young people in emotional distress they`re under and the internet now has created an environment -- Audrey said during the break, I don`t know if the internet is a good place or not because young people are bullying each other and acting out there. Can we cut it out? Can we cut it out? And will parents, please, be responsible for this as well? It makes me sick.

It makes me sick that young people treat each other like this, and they think that is OK, that this is a model for behavior in our country and that it goes by. Do we have to have laws? Do we have to have big brother going in there and stepping in and helping our behavior? Can we just get our self together on our own? I think we can. Stop.

Thank you for watching DR. DREW. I`ll see you next time.

END