Is cutting a sign of a true suicide attempt or just a gesture?

Depends: Although the majority of self-cutting is not intended to be fatal, I have had patients to deliberately try to open an artery with the intent of dying. One concern with wrist-cutting is that teens may not be aware how many tendons are just under the skin that can be severed if they cut cross-wise. Usually, though, wrist cutting is quite superficial and, as dr. Brown indicated, a cry for help.

It Varies: Some people who cut do so with the desire or wish to die. More often, they are not really trying to kill themselves, but are looking for a way to cope with and express overwhelming feelings of distress and turmoil.

Cutting: It depends on the person, the seriousness of the cutting, how long it's been going on, what emotional issues the person is facing, and a myriad of related issues. There is no one answer. I always open up the discussion with asking them what cutting means to them? I tell them: "Look, you're doing this for a reason, obviously, and I'm just wondering what the reason is?"