From a teen in the U.S.: I’m only 13, and when I think about the stuff I’m about to write, I feel like I’m just like all the other kids who want attention so they exaggerate their problems. Well, I am only going to tell the truth because I genuinely want to know if I should seek help or change anything about my life.

I get the urge to tear the skin off of my wrists, knuckles, and arms with my teeth. The most harm I’ve done to myself because of this is just biting my wrists and knuckles. Another thing I think about that’s similar to this is cutting into my leg a bit and peeling the skin off of it like a banana. These could just be intrusive thoughts, but they’re very common for me.

Things that might be related to OCD: I have to wash my face every few hours or I feel extremely uncomfortable. I collect tiny worthless objects and keep them in a box. I can’t sleep with my hair touching my face. I won’t breathe near other people and avoid their breath. I do everything I can to avoid going into public places or talking to people. I can’t stand being complimented.

There are a few things that are a bit more concerning to me: I cover the cameras on my phone in fear of people being able to watch me through them. When I’m home alone, I use my phone light to check for cameras in vents or cracks in my house. I talk to household appliances and objects as if they are alive and have feelings even though I know that’s strange. I worry about using objects in fear that the object can feel pain or doesn’t want to be used. I try hard not to think certain things when around people because I’m afraid that they can hear my thoughts and will judge me for them.

I daydream about eating and skinning people. These daydreams are not intrusive thoughts because I welcome them and create them consciously. I don’t have the urge to act on these thoughts but I figure they aren’t normal and I was hoping that someone might have an idea of why I’m having them. Specifically, why do I think about human cannibalism so much?
I believe all of these things, but what if I’m lying to myself for self-pity?

This all must be very, very hard to live with. I’m going to take you at your word that you are not just looking for attention. The thoughts and behaviors you are describing are serious and need to be taken seriously.

An important piece of information you didn’t include is when all this started. Has it been with you your whole life or did it begin within the last couple of years? It makes a difference.

Either way: The place to start is with your doctor. Sometimes disturbing thoughts are a result of an undiagnosed medical problem. The culprits are usually either hormonal at your age or neurological. Before we send you off to a mental health professional, you should have a complete physical.

You should keep a sleep diary for a few weeks before your appointment because sleep disorders can also provoke disordered thinking. A sleep diary includes the time you go to bed, times you wake up in the night (if you do) and what you are thinking about at the time, times you get back to sleep and time you have to get up and function in the morning. You should be getting 8 – 9 hours of quality sleep at  your age for your brain and body to be ready for the next day.

You might find it helpful to look at this article.

If your doctor sees nothing wrong and your sleep is okay ( or if it hasn’t been okay but you fix it) and you still have the thoughts you described, please get an appointment with a licensed therapist who specializes in working with teens. Your doctor or your school counselor can probably give you the names of someone locally who can evaluate what’s going on with you. The therapist will then talk to you about what you can do to get relief.

You asked me to take you seriously. Now I want you to do the same for yourself. You made an important first step by writing to us here at PsychCentral. Now follow up. Make those appointments right away. You deserve to get some relief from such disturbing thoughts and feelings.

I wish you well,

Dr. Marie