Warning Signs That a Teen is Self-Harming

Self-harm in teens, also known as self-injurious behavior (SIB), refers to when adolescents knowingly hurt themselves physically, usually as a response to intense emotional distress. Common forms of self-injury include cutting, burning, scratching, inserting objects under the skin, hitting, hair pulling, or reopening wounds. Self-harming in teens is distinct from a suicide attempt, but it is a strong predictor of suicide risk, and both behaviors can overlap (learn more about suicide here).

Some types of self-injury include:

• Cutting the skin with a sharp object
• Burning oneself with matches, cigarettes, or other hot objects
• Scratching or breaking the skin
• Inserting objects just under the skin
• Self-hitting or punching
• Pulling hair
• Open existing wounds
• Banging one’s head or breaking

Approximately 1 in 10 young people report having engaged in self-harm. Self-injurious behavior is the strongest clinical predictor of later death by suicide, and it causes significant concern among family members, teachers, and clinicians (Moran, 2015). A 2018 study found that up to 14.8% of teenage boys and up to 30.8% of teenage girls reported self-harming in the previous year, though rates vary by region.

Some adolescents who engage in non-suicidal self-injury (NSSI) experience over two times the odds of depression, anxiety, and problematic cannabis use at age 18. Adolescents who engage in suicidal self-harm have a five-fold increase in depression/anxiety and are over six times more likely to misuse cannabis—and both groups are more than twice as likely to develop harmful patterns of alcohol use (Hawton et al., 2006).

Is your teen hurting? Our providers can help.

With so many teens impacted by SIB, you may wonder: what causes teens who self-harm to resort to these behaviors? The main function of self-harming in teens is usually to cope with overwhelming emotions or psychological pain. While it can temporarily provide a sense of relief or calm, the effect is short-lived and often replaced by shame or guilt.

Research shows that non-suicidal self-injurious behavior (NSSI) can arise when adolescents have not developed healthy coping skills for expressing strong feelings (Hawton et al., 2006). Contributing factors for self-harm in teens often include:

• Punishing themselves for perceived flaws
• Seeking to express or release powerful emotions
• Distracting from intense emotional pain
• Regaining a sense of control or feeling something when dissociating
• Attempting to manage symptoms of anxiety, depression, or trauma

It’s important to note that SIB does not always have an obvious cause. Sometimes teens self-harm impulsively after a triggering event, even if adults do not perceive it as serious. Factors like breakups, bullying, parental divorce, identity struggles, or trauma can all be triggers.

Also Read: There’s a Mental Health Crisis in LGBTQ+ Youth, and Adults Need to Help

Teens who engage in self-injurious behavior often hide evidence of harm due to shame or fear of intervention. Still, certain signs can raise red flags for parents, teachers, or caregivers:

• Unexplained cuts, burns, or bruises, especially those that are similar in size and at different stages of healing
• Wearing long sleeves or pants even in warm weather to conceal injuries
• Withdrawal from friends and family, increased isolation
• Heightened emotional distress or strong negative emotional outbursts
• New or worsening symptoms of depression, anxiety, or mood disorders

It’s especially important to look for these signs after known stressors, such as a breakup, family conflict, bullying, or trauma. Self-harming in teens is associated with increased risk for future substance misuse and mental health disorders (Hawton et al., 2006).

Also Read: Signs Your Teen Is Considering Suicide

Learning that your teen is self harming can be overwhelming. Remember, this is not your fault. Take a deep breath and focus on supporting your child with compassion and empathy. Some responses include:

• Start a gentle conversation using “I” statements like, “I care about your safety” or “I’ve noticed some changes and want to support you.” Avoid accusations or shaming.
• Reassure them of your love and willingness to help, no matter what.
• Encourage your teen to consider therapy, where a professional can help them develop healthier coping skills. See our guide on how to support your teen through therapy.
• Recognize that non-suicidal self-injurious behavior (NSSI) is a mental health concern, not a “phase” or attention-seeking behavior.
• If you are unsure how to help, speak to a mental health provider for guidance and resources.

If you need immediate help or your teen is in crisis, contact emergency services or use the resources listed at the beginning of this article.

Is your teen hurting? Our providers can help.