Understanding Teen Self-Harm: Signs, and Intervention

Teen self-harm refers to deliberate acts of physical harm, such as cutting or burning, that some adolescents engage in as a coping mechanism to manage overwhelming emotional pain or distress, often as a way to regain a sense of control or as a temporary release.

Signs of teen self-harm may include unexplained cuts, bruises, or burns on their body, wearing concealing clothing even in warm weather, and withdrawing from social activities or relationships.

Interventions for teen self-harm can include therapy (such as cognitive-behavioral therapy or dialectical behavior therapy), support groups, and creating a supportive and safe environment at home and school.

What Does Self Harm Mean?

Self-harm, also known as self-injury or self-mutilation, refers to deliberate, non-suicidal acts of physical harm that individuals inflict upon themselves as a way to cope with emotional pain, distress, or overwhelming feelings.

Self-harm can take various forms, including cutting, scratching, burning, hitting, hair pulling, or biting oneself. These acts are typically carried out in private and are often hidden from others. Individuals who engage in self-harm may experience a sense of temporary relief or release from emotional pain, a distraction from emotional turmoil, or a way to regain a sense of control over their emotions or their bodies.

It is crucial to understand that self-harm is not a solution or a healthy coping mechanism. It is a manifestation of deeper emotional struggles and should be taken seriously.

What Can Make Teens Indulge in Self-Harm?

Teenagers may engage in self-harm as a way to cope with intense emotional pain or distress. Several factors can contribute to why some teens turn to self-harm:

  • Emotional Distress: Teens facing overwhelming emotions such as sadness, loneliness, anger, anxiety, or frustration may resort to self-harm as a way to release or distract themselves from these intense feelings.
  • Difficulty Expressing Emotions: Some teens may struggle with expressing their emotions verbally or have limited coping skills to manage their emotions effectively, leading them to turn to self-harm as an outlet for emotional release.
  • Seeking Control or Relief: Engaging in self-harm can provide a temporary sense of control or relief from emotional pain. It may serve as a way for teens to regain a sense of control over their bodies or emotions when they feel overwhelmed or powerless.
  • Peer Influence: Peer pressure or influence can play a role, as some teens may engage in self-harm if they observe their peers doing so or if it becomes normalized within their social circles.
  • Coping with Trauma or Abuse: Teens who have experienced trauma or abuse may resort to self-harm as a maladaptive coping mechanism to deal with the lingering effects of their traumatic experiences.
  • Mental Health Conditions: Underlying mental health conditions, such as depression, anxiety, borderline personality disorder, or eating disorders, can increase the likelihood of self-harm as individuals may use it as a way to manage their symptoms or emotional distress.

It is essential to approach self-harm with empathy and understanding, recognizing that it is a sign of deeper emotional struggles.

What are the Self-Harming Signs to Look Out For?

When it comes to identifying potential signs of self-harm, it’s important to remember that they can vary from person to person. However, here are some common signs to look out for:

  • Unexplained injuries: Frequent and unexplained cuts, burns, bruises, or scratches, often found on the arms, legs, or other areas that can be easily hidden.
  • Wearing concealing clothing: Consistently wearing long sleeves or pants, even in warm weather, to hide potential self-harm marks or scars.
  • Secretive behavior: Engaging in secretive or isolating behavior, such as spending excessive time alone, avoiding social activities or events, or spending long periods in the bathroom or locked rooms.
  • Presence of sharp objects: Discovering sharp objects like razors, knives, or broken glass in their personal belongings or living space.
  • Emotional and behavioral changes: Noticeable shifts in mood, increased irritability, expressions of hopelessness or worthlessness, frequent self-criticism, sudden withdrawal from hobbies or activities they previously enjoyed, or changes in eating or sleeping patterns.
  • Unusual fascination with self-harm: Expressing an unusual interest in self-harm, such as discussing it frequently, writing about it, or creating artwork related to self-harm.
  • Cover-up stories: Providing inconsistent or unconvincing explanations for injuries, using excuses like “accidents” or blaming it on falls or bumps.
  • Signs of depression or anxiety: Exhibiting symptoms of depression, such as persistent sadness, loss of interest, changes in appetite or sleep patterns, or symptoms of anxiety, including restlessness, excessive worry, or panic attacks.

Teenagers who self-harm may not be open to revealing why they do it, which is why it is crucial to approach them with caution and love and not with judgment.

Is Self-Harm a Precursor to Suicide?

Self-harm is not a direct precursor to suicide, but it can be an indicator of increased risk. While self-harm may serve as a coping mechanism and a way to communicate distress, it is crucial to take it seriously as a sign of underlying emotional struggles. 

Shared risk factors between self-harm and suicide, such as mental health conditions, trauma history, and social isolation, highlight the importance of seeking professional help. Prompt intervention by mental health professionals can provide appropriate support, assess the level of risk, and develop a safety plan to address the individual’s emotional well-being and reduce the potential for suicidal thoughts or behaviors.

What Interventions Can Help Self-Harming Teenagers?

Several interventions can help self-harming teenagers. Here are some commonly used approaches:

1. Therapy

Various therapeutic modalities, such as Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or psychodynamic therapy, can be effective in addressing self-harm. These therapies aim to explore underlying emotional issues, develop healthier coping skills, and enhance emotional regulation and distress tolerance.

2. Safety planning

Creating a safety plan involves working with mental health professionals to develop strategies to manage and cope with distressing emotions or urges to self-harm. This may include identifying supportive individuals, developing alternative coping mechanisms, and establishing steps to follow during a crisis.

3. Support groups

Participating in support groups or group therapy sessions with peers who have similar experiences can provide a sense of validation, understanding, and support. It can also offer an opportunity to learn from others who have successfully navigated their self-harm struggles.

4. Medication

In some cases, medication may be prescribed to address underlying mental health conditions that contribute to self-harm, such as depression, anxiety, or borderline personality disorder. Medication should always be prescribed and monitored by a qualified healthcare professional.

5. Family involvement

Involving the family in the treatment process can be beneficial. This may include family therapy sessions to improve communication, understanding, and support within the family system.

6. School support

Collaboration with school counselors or mental health professionals can help create a supportive environment for the teenager. This may involve implementing accommodations, such as a safety plan at school, providing a trusted staff member for support, or fostering a positive and inclusive school climate.

Remember, each individual is unique, and interventions should be tailored to their specific needs.

What is the Difference Between Self Harm and Suicidal Behavior?

Self-harm is a deliberate act of causing physical harm to oneself as a way to cope with emotional pain, distress, or overwhelming feelings. It is typically non-suicidal and is not intended to result in death. 

Suicidal behavior refers to thoughts, intentions, or actions that involve an individual wanting to end their own life. It encompasses a range of behaviors, including suicidal ideation (having thoughts of suicide), suicide attempts, or completed suicide. Suicidal behavior is driven by a desire to escape unbearable emotional pain, a perception of hopelessness, or a belief that death is the only solution to their distress.

Key Differences:

  • Intent: Self-harm is typically an expression of emotional distress or an attempt to cope with overwhelming feelings, while suicidal behavior involves a desire to end one’s life.
  • Severity: Self-harm is often seen as a way to manage emotional pain without intending to cause lethal harm, whereas suicidal behavior carries a significant risk of resulting in death.
  • Long-term outcome: Self-harm, although concerning and requiring intervention, does not necessarily indicate a direct intention to die. Suicidal behavior, on the other hand, has a primary focus on ending one’s life.

Despite these differences, it’s important to note that self-harm can indicate an increased risk for suicidal thoughts or behaviors. Any signs or concerns about self-harm or suicidal behavior should be taken seriously, and immediate professional help should be sought. 

What Can I Do As a Parent if My Child is Self-Harming?

If you discover or suspect that your child is self-harming, it is crucial to respond with understanding, support, and appropriate intervention. Here are some steps you can take as a parent:

1. Stay Calm and Maintain Open Communication

Approach the situation with calmness and empathy. Create a safe and non-judgmental space where your child feels comfortable talking about their emotions and struggles. Listen actively, validate their feelings, and assure them of your support.

2. Seek Professional Help

Consult with a mental health professional experienced in working with self-harming adolescents. They can assess the severity of the situation, provide guidance, and develop a comprehensive treatment plan tailored to your child’s needs.

3. Avoid Blaming or Punishing

It’s important to understand that self-harm is not a choice or a deliberate attempt to cause trouble. Avoid blaming or punishing your child for their self-harming behavior, as it may further exacerbate their distress. Instead, focus on understanding their emotions and providing appropriate support.

4. Encourage Therapy

Encourage your child to engage in therapy or counseling with a qualified mental health professional. Therapeutic approaches such as Cognitive-Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT) can help them develop healthier coping strategies, and emotional regulation skills, and address underlying issues.

5. Create a Supportive Environment

Foster a supportive and understanding environment at home. Be available to listen, offer emotional support, and encourage healthy communication. Ensure that your child knows they can come to you for help and that seeking support is a sign of strength, not weakness.

6. Remove or Secure Harmful Objects

Make an effort to remove or secure any objects that may be used for self-harm, such as sharp items or medications. This can help reduce the immediate risk while your child receives appropriate treatment.

7. Educate Yourself

Take the initiative to learn more about self-harm, its underlying causes, and available resources. Educating yourself will help you better understand your child’s struggles and provide informed support.

Will My Child Outgrow Self-Harming Behaviors?

The outcome of self-harming behaviors varies for each individual. While some individuals may outgrow self-harm, it is not guaranteed. Factors such as the underlying causes, presence of mental health conditions, access to support, and commitment to recovery influence the outcome. 

Early intervention and professional help are crucial for addressing the underlying issues and developing healthier coping strategies. Creating a supportive environment, encouraging therapy, and fostering open communication can increase the likelihood of long-term recovery. It is important to take self-harm seriously and seek appropriate professional guidance for your child’s well-being.

How can teenagers cope with triggers or urges to self-harm?

Teenagers can learn healthy coping strategies to manage triggers or urges to self-harm, such as practicing relaxation techniques like deep breathing or mindfulness, engaging in creative outlets like art or music, exercising regularly, seeking support from trusted friends or family members, and distracting themselves with enjoyable activities or hobbies.

What should someone do if they suspect a friend or classmate is self-harming?

If someone suspects that a friend or classmate is self-harming, it’s essential to approach the situation with sensitivity and empathy. They can express concern for their friend’s well-being, offer support and encouragement to talk about their feelings, and encourage them to seek help from a trusted adult or mental health professional. It’s crucial not to judge or criticize their behavior but instead offer understanding and support.

Can self-harm lead to more severe forms of harm or suicide attempts?

While not all teenagers who engage in self-harm will go on to attempt suicide, self-harm is considered a risk factor for suicide. It’s essential to take any self-harm behaviors seriously and seek professional help promptly to prevent escalation and ensure the safety and well-being of the teenager.

How can schools address self-harm among students?

Schools can play a crucial role in identifying and addressing self-harm among students by providing education and training for teachers and staff on recognizing warning signs, implementing school-wide prevention programs, fostering a supportive and inclusive school environment, and offering access to counseling and mental health resources.

How does self-harm behavior differ between teenagers with and without underlying mental health conditions?

Self-harm behavior can manifest differently between teenagers with and without underlying mental health conditions. In adolescents with mental health conditions such as depression, anxiety, or trauma, self-harm may serve as a maladaptive coping mechanism to alleviate emotional distress or numb overwhelming feelings. These individuals may engage in self-harm as a way to regulate their emotions or regain a sense of control over their lives. On the other hand, teenagers without underlying mental health conditions may still engage in self-harm, but it may be more impulsive or experimental in nature, often in response to situational stressors or peer influences rather than as a coping strategy for deeper emotional issues.

Author: Shantel Sullivan Ed.D., LCSW
Dr. Shantel Sullivan, Ed.D., LCSW, serves as the CEO of Bright Path with a rich background in residential adolescent treatment, adult outpatient services, and academia, leveraging over a decade of licensed social work experience in New York and North Carolina. Her academic credentials include a BA in Sociology, an MSW and a graduate certificate in addictions counseling from the University of New England, culminating in a doctoral degree in Educational Leadership focused on transformational leadership. Beyond her clinical expertise, Dr. Sullivan contributes to the field as a national speaker, educator, and editor of the Bright Path Teen Mental Health Blog, committed to enhancing access to evidence-based mental health care for adolescents and their families.
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